START adolescents: study protocol of a randomised controlled trial to investigate the efficacy of a low-threshold group treatment programme in traumatised adolescent refugees
Florian Hammerle,
Michael Huss,
Esther Sobanski,
Andrea Dixius,
Eva Möhler,
Susanne Koudela-Hamila,
Ulrich Ebner-Priemer,
Christian J Merz,
Tina In-Albon,
Brigitte Pollitt,
Hanna Christiansen,
David Kolar,
Susanne Ocker,
Nicole Fischer,
Ina Burghaus
Affiliations
Florian Hammerle
Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Centre of the Johannes Gutenberg University Mainz, Mainz, Germany
Michael Huss
Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Centre of the Johannes Gutenberg University Mainz, Mainz, Germany
Esther Sobanski
Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Centre of the Johannes Gutenberg University Mainz, Mainz, Germany
Andrea Dixius
Department of Child and Adolescent Psychiatry, SHG Saarland Hospital Group, Idar-Oberstein, Germany
Eva Möhler
Department of Child and Adolescent Psychiatry, SHG Saarland Hospital Group, Klein-Blittersdorf, Germany
Susanne Koudela-Hamila
Department of Applied Psychology, Mental mHealth Lab, Karlsruhe Institute of Technology, Karlsruhe, Germany
Ulrich Ebner-Priemer
Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University Heidelberg, Mannheim, Germany
Christian J Merz
Department of Cognitive Psychology, Institute of Cognitive Neuroscience, Ruhr University Bochum, Bochum, Germany
Tina In-Albon
Department of Child and Adolescent Psychology and Psychotherapy, University of Koblenz Landau - Campus Landau, Landau, Germany
Brigitte Pollitt
Department of Child and Adolescent Psychiatry and Psychotherapy, Johanniter Clinics, Neuwied, Germany
Hanna Christiansen
Department of Psychology, Clinical Child and Adolescent Psychology, University of Marburg, Marburg, Germany
David Kolar
Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Centre of the Johannes Gutenberg University Mainz, Mainz, Germany
Susanne Ocker
Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Centre of the Johannes Gutenberg University Mainz, Mainz, Germany
Nicole Fischer
Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Centre of the Johannes Gutenberg University Mainz, Mainz, Germany
Ina Burghaus
Coordination Centre for Clinical Trials, University of Heidelberg, Heidelberg, Germany
Introduction No evaluated therapeutic approaches, that can efficiently be established in routine mental healthcare, are currently available for traumatised adolescent refugees in Germany. This study evaluates the efficacy of the Stress-Traumasymptoms-Arousal-Regulation-Treatment (START) programme to reduce trauma-related symptoms and psychological distress in traumatised adolescent refugees based in Germany.Methods and analysis This randomised, waiting-list-controlled, multicentre trial with a 12-week follow-up will include 174 refugee minors with partial or full post-traumatic stress disorder who are fluent in either Arabic, Dari, English, German or Somali. Eligible refugee minors will be randomised to the START or waiting-list control groups. The manualised 8-week START programme is based on techniques of dialectical behaviour therapy (DBT), fosters adaptive coping with emotional distress and traumatic symptoms and comprises eight therapy modules and a booster session. Study assessments are planned at baseline, post-treatment (ie, after programme participation or waiting time), booster session at week 12 or 12-week waiting time, and at the 12-week follow-up. Primary and coprimary outcomes are changes in psychological distress and traumatic symptoms at post-treatment and will be analysed as response variables in linear mixed regression models. Secondary outcomes are changes in further trauma-related and other psychopathological symptoms, emotion regulation and intermediate effects of the programme at follow-up. We will also assess effects of the programme with ecological momentary assessments and on neuroendocrine stress parameters using hair cortisol.Ethics and dissemination This study has been approved by the lead ethics committee of Rhineland-Palatinate and the ethics committees of participating sites. The study results will be disseminated through peer-reviewed publications and scientific conferences.Trial registration number DRKS00020771.
