المؤلفون: Felicity L. Brown, Frederik Steen, Karine Taha, Gabriela V. Koppenol-Gonzalez, May Aoun, Richard Bryant, Mark J D. Jordans

المصدر: International Journal of Mental Health Systems, Vol 18, Iss 1, Pp 1-10 (2024)

مصطلحات موضوعية: Child psychosocial distress screener, Pediatric symptom checklist, Psychosocial screening, Lebanon, Validation, Adolescence, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571

الوصف: Abstract Background In humanitarian settings, brief screening instruments for child psychological distress have potential to assist in assessing prevalence, monitoring outcomes, and identifying children and adolescents in most need of scarce resources, given few mental health professionals for diagnostic services. Yet, there are few validated screening tools available, particularly in Arabic. Methods We translated and adapted the Child Psychosocial Distress Screener (CPDS) and the Pediatric Symptom Checklist (PSC) and conducted a validation study with 85 adolescents (aged 10–15) in Lebanon. We assessed internal consistency; test-retest reliability; convergent validity between adolescent- and caregiver-report and between the two measures; ability to distinguish between clinical and non-clinical samples; and concurrent validity against psychiatrist interview using the Kiddie Schedule for Affective Disorders and Schizophrenia. Results The translated and adapted child-reported PSC-17 and PSC-35, and caregiver-reported PSC-35 all showed adequate internal consistency and test-retest reliability and high concurrent validity with psychiatrist interview and were able to distinguish between clinical and non-clinical samples. However, the caregiver-reported PSC-17 did not demonstrate adequate performance in this setting. Child-reported versions of the PSC outperformed caregiver-reported versions and the 35-item PSC scales showed stronger performance than 17-item scales. The CPDS showed adequate convergent validity with the PSC, ability to distinguish between clinical and non-clinical samples, and concurrent validity with psychiatrist interview. Internal consistency was low for the CPDS, likely due to the nature of the brief risk-screening tool. There were discrepancies between caregiver and child-reports, worthy of future investigation. For indication of any diagnosis requiring treatment, we recommend cut-offs of 5 for CPDS, 12 for child-reported PSC-17, 21 for child-reported PSC-35, and 26 for caregiver-reported PSC-35. Conclusions The Arabic PSC and CPDS are reliable and valid instruments for use as primary screening tools in Lebanon. Further research is needed to understand discrepancies between adolescent and caregiver reports, and optimal methods of using multiple informants.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1752-4458Test

الوصول الحر: https://doaj.org/article/a9fd06e2dae64ed594384e271aef2149Test

المؤلفون: Abdelrhman Elnasseh, Varun S. Mehta, Gergana Manolova, Gloria A. Pedersen, Shannon Golden, Liyam Eloul, Frezgi Gebrekristos, Pamela Y. Collins, Teresia Mutavi, Anne W. Mbwayo, Muthoni Mathai, Tessa Concepcion, Rozane El Masri, Frederik Steen, Jerome T. Galea, Carmen Contreras, Josephine Akellot, Rosco Kasujja, Samuel Wasereka, Byamah Brian Mutamba, Wietse A. Tol, Mansurat Raji, Sacha Moufarrej, Alison Schafer, Brandon A. Kohrt

المصدر: BJPsych Open, Vol 10 (2024)

مصطلحات موضوعية: Education and training, transcultural psychiatry, qualitative research, psychosocial interventions, low- and middle-income countries, Psychiatry, RC435-571

الوصف: Background The use of feedback to address gaps and reinforce skills is a key component of successful competency-based mental health and psychosocial support intervention training approaches. Competency-based feedback during training and supervision for personnel delivering psychological interventions is vital for safe and effective care. Aims For non-specialists trained in low-resource settings, there is a lack of standardised feedback systems. This study explores perspectives on competency-based feedback, using structured role-plays that are featured on the Ensuring Quality in Psychosocial and Mental Health Care (EQUIP) platform developed by the World Health Organization and United Nations Children’s Fund. Method Qualitative data were collected from supervisors, trainers and trainees from multiple EQUIP training sites (Ethiopia, Kenya, Lebanon, Peru and Uganda), from 18 key informant interviews and five focus group discussions (N = 41 participants). Qualitative analysis was conducted in Dedoose, using a codebook with deductively and inductively developed themes. Results Four main themes demonstrated how a competency-based structure enhanced the feedback process: (a) competency-based feedback was personalised and goal-specific, (b) competency-based feedback supported a feedback loop, (c) competency-based feedback supported a comfortable and objective feedback environment, and (d) competency-based feedback created greater opportunities for flexibility in training and supervision. Conclusions A better understanding of the role of feedback supports the implementation of competency-based training that is systematic and effective for trainers and supervisors, which ultimately benefits the learning process for trainees.

وصف الملف: electronic resource

العلاقة: https://www.cambridge.org/core/product/identifier/S2056472424000371/type/journal_articleTest; https://doaj.org/toc/2056-4724Test

الوصول الحر: https://doaj.org/article/40ff7c988b1149dcb278140811c6b3bbTest

المؤلفون: Mark J.D. Jordans, Felicity L. Brown, Jeremy Kane, Karine Taha, Frederik Steen, Rayane Ali, Joseph Elias, Bassel Meksassi, May Aoun, Claire M. Greene, Aiysha Malik, Aemal Akhtar, Mark van Ommeren, Marit Sijbrandij, Richard Bryant

المصدر: Comprehensive Psychiatry, Vol 127, Iss , Pp 152424- (2023)

مصطلحات موضوعية: Randomized controlled trial, Psychological intervention, Refugee mental health, Adolescents, Lebanon, Psychiatry, RC435-571

الوصف: Background: There is a need for scalable evidence-based psychological interventions for young adolescents experiencing high levels of psychological distress in humanitarian settings and low- and middle-income countries. Poor mental health during adolescence presents a serious public health concern as it is a known predictor of persistent mental disorders in adulthood. This study evaluates the effectiveness of a new group-based intervention developed by the World Health Organization (Early Adolescent Skills for Emotions; EASE), implemented by non-specialists, to reduce young adolescents' psychological distress among mostly Syrian refugees in Lebanon. Methods: We conducted a two-arm, single-blind, individually randomized group treatment trial. Adolescents aged 10 to 14 years who screened positive for psychological distress using the Pediatric Symptom Checklist (PSC) were randomly allocated to EASE or enhanced treatment as usual (ETAU) (1:1.6). ETAU consisted of a single scripted psycho-education home-visit session with the adolescent and their caregivers. EASE consists of seven group sessions with adolescents and three sessions with caregivers. The primary outcome was adolescent-reported psychological distress as measured with the PSC (internalizing, externalizing, and attentional symptoms). Secondary outcomes included depression, posttraumatic stress, well-being, functioning, and caregivers' parenting and distress. All outcomes were assessed at baseline, endline, and 3 months (primary time point) and 12 months follow-up. Results: Due to the COVID-19 pandemic and other adversities in Lebanon at the time of this research, the study was prematurely terminated, resulting in an under-powered trial sample (n = 198 enrolled compared to n = 445 targeted). We screened 604 children for eligibility. The 198 enrolled adolescents were assigned to EASE (n = 80) and ETAU (n = 118), with retention rates between 76.1 and 88.4% across all timepoints. Intent-to-treat analyses demonstrated no between-group differences on any of the outcome measures between the EASE and ETAU. We did observe a significant improvement on the primary outcome equally in the EASE and ETAU groups (−0.90, 95% CI: −3.6, 1.8; p = .52), − a trend that was sustained at three months follow-up. Sub-group analyses, for those with higher depression symptoms at baseline, showed ETAU outperformed EASE on reducing depression symptoms (difference in mean change = 2.7, 95% CI: 0.1, 5.3; p = .04; d = 0.59) and internalizing problems (difference in mean change 1.0, 95% CI: 0.08, 1.9; p = .03; d = 0.56) . Conclusion: No conclusions can be drawn about the comparative effectiveness of the intervention given that the sample was underpowered as a result of early termination. Both EASE and single session psycho-education home visits resulted in meaningful improvements in reducing psychological distress. We did not identify any indications in the data suggesting that EASE was more effective than a single session family intervention in the context of the COVID-19 pandemic and other crises in Lebanon. Fully powered research is needed to evaluate the effectiveness of EASE.

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S0010440X23000615Test; https://doaj.org/toc/0010-440XTest

الوصول الحر: https://doaj.org/article/ae524afa69d84c1c8261adfb193012d3Test

المؤلفون: Felicity L. Brown, Karine Taha, Frederik Steen, Jeremy Kane, Aviva Gillman, May Aoun, Aiysha Malik, Richard Bryant, Marit Sijbrandij, Rabih El Chammay, Chiara Servili, Mark van Ommeren, Aemal Akhtar, Edwina Zoghbi, EASE Intervention Development, Training Team, Mark J. D. Jordans, on behalf of the STRENGTHS Consortium

المصدر: BMC Psychiatry, Vol 23, Iss 1, Pp 1-18 (2023)

مصطلحات موضوعية: Feasibility trial, Psychological intervention, Refugee mental health, Young adolescents, Psychiatry, RC435-571

الوصف: Abstract Background Globally, there is a vast mental health treatment gap, whereby the majority of adolescents living in low- and middle-income countries requiring mental health services, do not have access to adequate care. To improve access, the World Health Organization (WHO) developed a range of interventions, designed to be low-cost and delivered by non-specialists. We conducted a two-arm, individually randomised group treatment feasibility trial of a new WHO group intervention for young adolescents with emotional distress (‘Early Adolescent Skills for Emotions’; EASE) in Lebanon. Method The aim of this study was to determine the feasibility of the intervention and study procedures. Adolescents aged 10 to 14 years were eligible to take part if they scored above a validated cut-off on the Child Psychosocial Distress Screener. Participants were randomized to EASE or enhanced treatment as usual (ETAU) control using a 1:1 ratio. EASE consisted of seven group sessions with adolescents and three sessions with caregivers. ETAU consisted of a single brief psychoeducation home visit. Child and caregiver outcomes were measured by blind assessors at baseline, endline (8 weeks post-randomisation), and three month follow-up (20 weeks post-randomisation), with the primary outcome measure being child psychological symptoms on the Pediatric Symptom Checklist. Qualitative interviews were conducted with adolescents (n = 13), caregivers (n = 17), facilitators (n = 6), trainers (n = 3), and outreach staff (n = 1) at endline to assess barriers and facilitators related to the feasibility and delivery of EASE and study procedures. Results Of 154 adolescents screened, 67 (43%) were eligible, completed baseline, and were randomized. Sixty adolescents (90%) completed endline assessments (31 EASE, 29 ETAU), and fifty-nine (88%) completed three-month assessments (29 EASE, 30 ETAU). Qualitatively, participants provided overall positive feedback about the intervention. Several challenges and suggestions for improvement were raised around logistics, intervention content, and acceptability of assessment measures. Implementation data highlighted challenges with intervention uptake and attendance. Outcome measures generally had strong psychometric properties (range: α = 0.77 to α = 87), however did not demonstrate change over time in either group. Conclusions The EASE intervention and study procedures are acceptable and feasible for implementation with vulnerable adolescents in Lebanon, however several improvements are necessary prior to full-scale evaluation. Trial registration #ISRCTN60799626, retrospectively registered on 04/10/2022.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1471-244XTest

الوصول الحر: https://doaj.org/article/0d78e310624542fcbc03ac2ecdfc347cTest

المؤلفون: Rozane El Masri, Frederik Steen, April R Coetzee, May Aoun, Brandon A Kohrt, Alison Schafer, Gloria A Pedersen, Rabih El Chammay, Mark J.D Jordans, Gabriela V Koppenol-Gonzalez

المصدر: Intervention, Vol 21, Iss 1, Pp 47-57 (2023)

مصطلحات موضوعية: actors, competency assessments, competency raters, competency tools, mhpss training, non-specialists, roleplays, supervision, training, Psychology, BF1-990, Mental healing, RZ400-408

الوصف: There is an increasing need to improve the competency and quality of non-specialists delivering psychological interventions. As part of the Ensuring Quality in Psychological Support (EQUIP) initiative, this study evaluates the process of roleplay-based competency assessments using three tools to assess the competencies of facilitators delivering a psychological intervention for children in Lebanon. With a group of five competency raters, five facilitators and four actors, this study uses a mixed methods approach, comprising competency assessment data, qualitative interviews and focus group discussions. Data were collected during a two-phase process. Findings of the study showed inter-rater agreement was generally acceptable after additional training of raters. Eventually, it is feasible to prepare actors, facilitators and raters on roleplays for effective implementation of competency-driven training. As for the non-specialists, it was found that overall the experience of taking part in competency assessments was useful to understand their points of improvement. Pre- to post-training improvements in competencies showed that despite reported feelings of anxiety, the facilitators benefited from the feedback given on their competencies. We concluded that using roleplay-based competency assessments and preparing for competency-based training is feasible and useful to ensure quality control in mental health and psychosocial support (MHPSS) service provision.

وصف الملف: electronic resource

العلاقة: http://www.interventionjournal.org/article.asp?issn=1571-8883;year=2023;volume=21;issue=1;spage=47;epage=57;aulast=ElTest; https://doaj.org/toc/1571-8883Test; https://doaj.org/toc/1872-1001Test

الوصول الحر: https://doaj.org/article/0ff489197c814b3e8b4132ef49a0308fTest

المؤلفون: Pim Cuijpers, Jos W R Twisk, Ceren Acarturk, Martha Bird, Zeynep Ilkkursun, Marit Sijbrandij, Bayard Roberts, Richard Bryant, Egbert Sondorp, David McDaid, Christine Knaevelsrud, Mark Jordans, A-La Park, Aemal Akhtar, Theo K Bouman, Ulrich Schnyder, Hanspeter Moergeli, Sebastian Burchert, Trudy Mooren, Daniela Fuhr, Peter Ventevogel, Anne M de Graaff, Annelieke Drogendijk, Daniela C Fuhr, Pernille Hansen, Mahmoud Hemmo, Nikolai Kiselev, Gülsah Kurt, Saara Martinmäki, Naser Morina, Matthis Schick, Julia Spaaij, Frederik Steen, Karine Taha, Claire Whitney, Martine van den Dool, Cansu Mirzanlı, Nana Wiedemann, Aniek Woodward, Barbara Kieft, Sam Hunaidy, Mariam Elsawy, Noer Gorgis, Miriam J J Lommen, Katie S Dawson, Akinçi Ahmad Bawaneh, Felicity Brown, Anne de Graaff, Jonas Maria Hessling, Monique Pfaltz

المصدر: BMJ Mental Health, Vol 26, Iss 1 (2023)

مصطلحات موضوعية: Psychiatry, RC435-571

الوصف: Background The mental health burden among refugees in high-income countries (HICs) is high, whereas access to mental healthcare can be limited.Objective To examine the effectiveness of a peer-provided psychological intervention (Problem Management Plus; PM+) in reducing symptoms of common mental disorders (CMDs) among Syrian refugees in the Netherlands.Methods We conducted a single-blind, randomised controlled trial among adult Syrian refugees recruited in March 2019–December 2021 (No. NTR7552). Individuals with psychological distress (Kessler Psychological Distress Scale (K10) >15) and functional impairment (WHO Disability Assessment Schedule (WHODAS 2.0) >16) were allocated to PM+ in addition to care as usual (PM+/CAU) or CAU only. Participants were reassessed at 1-week and 3-month follow-up. Primary outcome was depression/anxiety combined (Hopkins Symptom Checklist; HSCL-25) at 3-month follow-up. Secondary outcomes included depression (HSCL-25), anxiety (HSCL-25), post-traumatic stress disorder (PTSD) symptoms (PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition; PCL-5), impairment (WHODAS 2.0) and self-identified problems (PSYCHLOPS; Psychological Outcomes Profiles). Primary analysis was intention-to-treat.Findings Participants (n=206; mean age=37 years, 62% men) were randomised into PM+/CAU (n=103) or CAU (n=103). At 3-month follow-up, PM+/CAU had greater reductions on depression/anxiety relative to CAU (mean difference −0.25; 95% CI −0.385 to −0.122; p=0.0001, Cohen’s d=0.41). PM+/CAU also showed greater reductions on depression (p=0.0002, Cohen’s d=0.42), anxiety (p=0.001, Cohen’s d=0.27), PTSD symptoms (p=0.0005, Cohen’s d=0.39) and self-identified problems (p=0.03, Cohen’s d=0.26), but not on impairment (p=0.084, Cohen’s d=0.21).Conclusions PM+ effectively reduces symptoms of CMDs among Syrian refugees. A strength was high retention at follow-up. Generalisability is limited by predominantly including refugees with a resident permit.Clinical implications Peer-provided psychological interventions should be considered for scale-up in HICs.

وصف الملف: electronic resource

العلاقة: https://ebmh.bmj.com/content/26/1/e300637.fullTest; https://doaj.org/toc/2755-9734Test

الوصول الحر: https://doaj.org/article/333fc419cf294455b57b22248f6d80faTest

المؤلفون: Pim Cuijpers, Kenneth Carswell, Ceren Acarturk, Martha Bird, Zeynep Ilkkursun, Marit Sijbrandij, Ersin Uygun, Bayard Roberts, Richard Bryant, Egbert Sondorp, David McDaid, Christine Knaevelsrud, Mark J D Jordans, A-La Park, Aemal Akhtar, Ulrich Schnyder, Sebastian Burchert, Trudy Mooren, Anke B Witteveen, Peter Ventevogel, Anne M de Graaff, Mhd Salem Alkneme, May Aoun, Manar Awwad, Ahmad Y Bawaneh, Felicity L Brown, Annelieke Drogendijk, Michelle Engels, Daniela C Fuhr, Pernille Hansen, Edith van 't Hof, Luana Giardinelli, Mahmoud Hemmo, Jonas M Hessling, Nikolai Kiselev, Gülsah Kurt, Saara Martinmäki, Naser Morina, Hadeel Naser, Monique C Pfaltz, Matthis Schick, Julia Spaaij, Frederik Steen, Karine Taha, Claire Whitney, Martine van den Dool, Cansu Mirzanlı, Nana Wiedemann, Aniek Woodward

المصدر: BMJ Open, Vol 12, Iss 4 (2022)

مصطلحات موضوعية: Medicine

وصف الملف: electronic resource

العلاقة: https://bmjopen.bmj.com/content/12/4/e058101.fullTest; https://doaj.org/toc/2044-6055Test

الوصول الحر: https://doaj.org/article/b062c01514574935ab7e7a35a9146798Test

المؤلفون: Kenneth E Miller, Gabriela V Koppenol-Gonzalez, Ali Jawad, Frederik Steen, Myriam Sassine, Mark J.D Jordans

المصدر: Intervention, Vol 18, Iss 2, Pp 119-128 (2020)

مصطلحات موضوعية: adolescence, life skills, psychosocial, refugees, resilience, syrian, Psychology, BF1-990, Mental healing, RZ400-408

الوصف: Armed conflict and displacement pose threats to children’s mental health and psychosocial wellbeing. We report on the findings of an evaluation of I-Deal, a life skills intervention aimed at fostering resilience among early adolescent refugees. We used a parallel group randomised controlled trial to compare I-Deal to a structured recreational activity group (SRA). 325 adolescents in Akkar, Lebanon, 74% of them Syrian, were randomised to I-Deal or SRA. The primary outcome was psychosocial wellbeing; secondary outcomes included psychological distress, prosocial behaviour, hope, self-esteem and social connectedness. Assessments were conducted at baseline, endline and 3-month follow-up. Due to low reliabilities, only wellbeing, distress and hope were included in the analyses. These outcomes showed similar results: no statistically significant changes over time, no significant differences between groups and no significant interaction between group and time. Our findings do not support the effectiveness of I-Deal. Several factors are considered that may help explain the lack of effect, including the aspects of the intervention design, possible measurement error suggested by low reliabilities on several instruments and a ceiling effect on our primary outcome. A replication using rigorously piloted instruments, the selection of outcomes more specifically tailored to the intervention and a nonactive control condition could help provide definitive evidence regarding the effectiveness of the I-Deal intervention. Key implications for practice This study contributes to the growing literature on the effectiveness of life skills interventions for refugee adolescents. The lack of any intervention effects in this study raises important questions about the appropriate focus and role of preventive and promotive interventions with refugee adolescents. Methodological issues in the study underscore the vital importance of using validated and well piloted measures of appropriately selected intervention outcomes.

وصف الملف: electronic resource

العلاقة: http://www.interventionjournal.org/article.asp?issn=1571-8883;year=2020;volume=18;issue=2;spage=119;epage=128;aulast=MillerTest; https://doaj.org/toc/1571-8883Test; https://doaj.org/toc/1872-1001Test

الوصول الحر: https://doaj.org/article/ab312f9cc1bd4d358adce9c7483dea09Test

المؤلفون: Felicity L. Brown, Frederik Steen, Karine Taha, May Aoun, Richard A. Bryant, Mark J. D. Jordans, Aiysha Malik, Mark van Ommeren, Adnan Abualhaija, Ibrahim Said Aqel, Maha Ghatasheh, Rand Habashneh, Marit Sijbrandij, Rabih El Chammay, Sarah Watts, Aemal Akhtar, on behalf of the STRENGTHS-consortium

المصدر: Trials, Vol 20, Iss 1, Pp 1-11 (2019)

مصطلحات موضوعية: Psychological intervention, Randomised controlled trial, Study protocol, Low and middle income countries, Humanitarian emergencies, Armed conflict, Medicine (General), R5-920

الوصف: Abstract Background There are significant barriers to providing accessible, quality mental health care for young adolescents affected by adversity. In an attempt to overcome this, the World Health Organization (WHO) has developed the Early Adolescent Skills for Emotions (EASE) psychological intervention for young adolescents with internalising problems. EASE is group-based (seven sessions for adolescents, three sessions for their caregivers) and can be delivered by non-specialist providers. This paper outlines the study protocols for two trials of EASE in the Middle East - one in Lebanon and one in Jordan. Methods We will conduct two, single-blind, two-arm, individually randomised group treatment trials in Lebanon and Jordan, with at least 445 young adolescents per trial. Adolescents will be screened eligible for the trial if they demonstrate levels of psychological distress indicative of internalizing problems requiring treatment. Participants will be randomly assigned to receive the EASE intervention, or enhanced usual care (one home-visit psychoeducation session). The primary outcome is reduction in overall child-reported psychological distress over time, with 3 months post-treatment as the primary end point. Secondary child-reported outcomes include post-traumatic stress symptoms, depression symptoms, daily functioning, and wellbeing. Secondary caregiver-reported outcomes include parenting style, overall child distress, and caregiver psychological distress. Coping strategy use will be explored as a mediator of treatment effects in Lebanon, and relevant moderators of treatment effects will be explored. Discussion These trials will provide the first assessments of the effectiveness of the EASE intervention for use in the Middle East, with important implications for the use of low-intensity, non-specialist interventions for this age range. Trial registration Lebanon: ISRCTN75375136. Registered on 11 March 2019. Jordan: Australia New Zealand Clinical Trials Registry, ACTRN12619000341123. Registered on 5 March 2019 (https://www.anzctr.org.auTest/)

وصف الملف: electronic resource

العلاقة: http://link.springer.com/article/10.1186/s13063-019-3654-3Test; https://doaj.org/toc/1745-6215Test

الوصول الحر: https://doaj.org/article/c1d77988e9734d3cbd4877a5a8554bc4Test

المؤلفون: Felicity L. Brown, Frederik Steen, Karine Taha, May Aoun, Richard A. Bryant, Mark J. D. Jordans, Aiysha Malik, Mark van Ommeren, Adnan Abualhaija, Ibrahim Said Aqel, Maha Ghatasheh, Rand Habashneh, Marit Sijbrandij, Rabih El Chammay, Sarah Watts, Aemal Akhtar, on behalf of the STRENGTHS-consortium

المصدر: Trials, Vol 20, Iss 1, Pp 1-3 (2019)

مصطلحات موضوعية: Medicine (General), R5-920

الوصف: Following publication of the original article [1], we have been notified that Figure 1 was published with the track changes. In this Correction the incorrect and correct Fig. 1 are shown.

وصف الملف: electronic resource

العلاقة: http://link.springer.com/article/10.1186/s13063-019-3717-5Test; https://doaj.org/toc/1745-6215Test

الوصول الحر: https://doaj.org/article/f680b13ea75e441bbf530885fe39f8cbTest