Providing Refugees with Accessible Resources About the Biological and Psychological Effects of Forced Migration
Subsequent Statement of Responsibility
D'Andrea, Wendy
.PUBLICATION, DISTRIBUTION, ETC
Name of Publisher, Distributor, etc.
The New School
Date of Publication, Distribution, etc.
2020
PHYSICAL DESCRIPTION
Specific Material Designation and Extent of Item
146
DISSERTATION (THESIS) NOTE
Dissertation or thesis details and type of degree
Ph.D.
Body granting the degree
The New School
Text preceding or following the note
2020
SUMMARY OR ABSTRACT
Text of Note
The influx of displaced persons to refugee camps within the Middle East presents a challenge to mental health professionals due to the elevated mental health symptom burden and substantial mental-health stigma within these communities. Individual-level interventions using "gold-standard" treatments may be efficacious in reducing symptoms, but they are not scalable due to the shortage of mental health professionals in refugee settings. Instead, recent efforts have focused on the need for self-guided interventions involving minimal clinician support. Self-guided intervention must directly address stigma as a barrier to engaging with mental healthcare in order to succeed. The present study comprises a randomized controlled trial (RCT) of a psychoeducational intervention called The Field Guide for Barefoot Psychologists, with 160 adult Syrian refugees residing in the Zaatari Refugee Camp, Jordan. The Field Guide is novel in that it incorporates stories from Syrian refugees and grounds the psychological effects of forced migration in accessible neurobiological language throughout the text in order to reduce mental health stigma and promote engagement with a menu of self-care exercises. The RCT is itself novel in that it includes psychophysiological measures, complementing self-reporting measures of Complex Posttraumatic Stress Disorder (CPTSD), distress, emotion regulation and awareness, and mental health stigma pre, post- and three-months following interventions. Fifty refugees diverse with respect to symptom burden were randomized to receive the intervention in group format from trained facilitators, a further 50 received the materials to read at home, while 60 were initially on a waitlist and then received the group intervention eight weeks after study onset. Mixed linear models indicated improvements in stigma, CPTSD, emotional awareness and resilience in the first group, with improvements also seen for some measures in the reading at home group; heart rate variability metrics did not significantly change for any group. Overall, findings highlight the importance of including an optimistic tone, personal narratives, and both psychosocial (e.g. forced migration) and neurobiological explanations when developing interventions to improve refugee mental health and reducing stigma. Follow-up studies are needed, particularly those integrating a wider range of physiological metrics, and deploying components of The Field Guide in other post-conflict settings.