ArticleTrials2020
Improving mental health care for unaccompanied young refugees through a stepped-care approach versus usual care+: study protocol of a cluster randomized controlled hybrid effectiveness implementation trial.
Article in Trials, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.
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Who cites it
24 citing papers in PubMed, 2 syntheses or guidelines pooled it, 37 citations in OpenAlex.
- Interventions for prevention and treatment of substance use in youth with traumatic childhood experiences: a systematic review and synthesis of the literature.European child & adolescent psychiatry · 2024Pooled it
- Community-based interventions for improving mental health in refugee children and adolescents in high-income countries.The Cochrane database of systematic reviews · 2022Pooled it
- Prevalence and risk factors of suicidal ideation amongst unaccompanied young refugees: a machine learning approach.European child & adolescent psychiatry · 2026Article
- Evaluation of a training programme for interpreters in the field of trauma-focused cognitive behavioural therapy - one year follow-up.European journal of psychotraumatology · 2025Article
- Professional quality of life of child welfare workers and psychotherapists working with traumatized young unaccompanied refugees in Germany: a cross-sectional study.Child and adolescent psychiatry and mental health · 2025Article
- Quality of life in unaccompanied young refugees: the role of traumatic events, post-migration stressors and mental distress.BMC psychiatry · 2025Article
- Challenges and facilitators in treating unaccompanied young refugees with posttraumatic stress disorder in a dissemination trial: a qualitative study with psychotherapists.Child and adolescent psychiatry and mental health · 2025Article
- Trajectories of mental health problems in unaccompanied young refugees in Germany and the impact of post-migration factors - a longitudinal study.European child & adolescent psychiatry · 2025Article
- Investigating factors influencing utilization of trauma-focused cognitive behavioral therapy among unaccompanied young refugees: an exploratory analysis.Child and adolescent psychiatry and mental health · 2025Article
- The dissemination and implementation of trauma-focused cognitive behavioural therapy for children and adolescents in seven European countries.BMC health services research · 2024Article
- Agreement for posttraumatic stress symptoms among unaccompanied young refugees and professional caregivers.European journal of psychotraumatology · 2024Article
- Psychotherapeutic and Psychosocial Interventions with Unaccompanied Minors: A Scoping Review.Healthcare (Basel, Switzerland) · 2023Article
- Potential traumatic events and symptoms of post-traumatic stress in unaccompanied refugee minors-a comparison with youth in foster care.European child & adolescent psychiatry · 2023Article
- Mental health problems in unaccompanied young refugees and the impact of post-flight factors on PTSS, depression and anxiety-A secondary analysis of the Better Care study.Frontiers in psychology · 2023Article
- Development and evaluation of a training program for interpreters in the field of trauma-focused cognitive behavioral therapy.Frontiers in psychology · 2023Article
- Associations between social factors and school belonging among newcomer and non-newcomer youth in Sweden.PloS one · 2023Article
- Factors affecting the acculturation strategies of unaccompanied refugee minors in Germany.Frontiers in psychology · 2023Article
- Trauma-focused treatment for traumatic stress symptoms in unaccompanied refugee minors: a multiple baseline case series.Frontiers in psychology · 2023Article
- Effectiveness and cost-effectiveness for the treatment of depressive symptoms in refugees and asylum seekers: A multi-centred randomized controlled trial.The Lancet regional health. Europe · 2022Article
- Feasibility of a randomised trial of Teaching Recovery Techniques (TRT) with refugee youth: results from a pilot of the Swedish UnaccomPanied yOuth Refugee Trial (SUPpORT).Pilot and feasibility studies · 2022Article
Corrections and comments
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Authors and funding
12 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundMore than half of the unaccompanied young refugees (UYRs) resettled in Europe report elevated levels of posttraumatic stress symptoms (PTSS) and comorbid symptoms. Earlier studies have highlighted the effectiveness of the trauma-focused preventive group intervention "Mein Weg" (English "My Way"), and the feasibility of trauma-focused cognitive behavioral therapy (TF-CBT) for UYRs. Both interventions are deemed to be empirically supported treatments (ESTs). However, UYRs seldom receive ESTs or, in fact, any treatment at all. In view of the high need and the limited treatment resources available, a stepped-care approach is indicated but has not been evaluated so far. The purpose of this trial is to compare the stepped-care approach BETTER CARE with usual care enhanced with screening and indication (usual care+).
methodsIn a cluster randomized controlled trial involving N = 540 UYRs living in up to N = 54 child and youth welfare service (CYWS) facilities, BETTER CARE will be compared with usual care+. We will randomize clusters comprising a CYWS facility with at least one eligible psychotherapist. BETTER CARE consists of step (1) screening and indication and either step (2) preventive trauma-focused group intervention "Mein Weg" delivered by trained CYWS staff or step (3) TF-CBT delivered by trained community therapists and supported by trained translators if necessary. Participants will be assessed 6 and 12 months after randomization. The primary outcome is the severity of PTSS after 12 months. Secondary outcomes are depressive and anxiety symptoms, quality of life, and proxy reported PTSS. Furthermore, drug use, health costs, benefits, and long-term effects on integration/acculturation will be assessed. DISCUSSION: The trial will directly integrate a stepped-care approach into existing structures of the German child welfare and (mental) health system. It could, therefore, serve as a blueprint for how to implement ESTs for UYRs. If successful, screening, prevention, and intervention will be sustainably implemented in CYWS in southern Germany.
trial registrationGerman Clinical Trials Register DRKS00017453 . Registered on 11 December 2019.
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