Lay Therapist Effectiveness With Displaced Persons Kurdish Iraq

Lay Therapist Effectiveness With Displaced Persons Kurdish Iraq: Promising Exploratory Results for Global Mental Health Access

Negative mental health effects of war exposure and displacement are pervasive, but many displaced persons and refugees in low-and-middle income countries lack access to evidence-based treatments. Community lay-therapists are a promising solution for the global mental health field. However, in spite of results from randomized-control trials, no research to-date has examined the external validity of community-led lay-therapist effectiveness. In this exploratory study, longitudinal data at three time points were collected from 28 Arabic-speaking displaced persons (nineteen women and nine men, ages 18-57) seeking mental health services from the Jiyan Foundation: a non-profit founded and based in Kurdish Iraq. Lay therapists trained in evidence-based treatments upon being hired operated largely independently of supervision from foreign clinicians. Participants in weekly psychotherapy completed the Posttraumatic Stress Checklist (PCL-5) and the Psychological Health Questionnaire (PHQ-9) at baseline, one month, and three months, as well as a modified measure assessing traumatic exposure, purpose-in-life, and a modified Afghan Daily Stressors Scale at baseline to assess for moderators of change over time.

Study Overview

• Status: Completed
• Conditions: Mental Health; Therapeutics
• Intervention / Treatment: Behavioral: Community Lay Therapist-Administered EBT

• Study Type: Observational
• Enrollment (Actual): 28

Contacts and Locations

Study Locations

• Iraq
  • Erbil, Iraq
    • Jiyan Foundation for Human Rights

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Participants were 18-years-or-older Arabic speakers displaced from their homes in either Central/Southern Iraq or Syria and now residing in Kurdish Iraq and seeking treatment for mental health difficulties.

Description

Inclusion Criteria:

• Must speak Arabic fluently; must be seeking mental health services at the Jiyan Foundation

Exclusion Criteria:

• No Arabic proficiency; under 18 years

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Treatment Group; Participants seeking treatment completed longitudinal data	Behavioral: Community Lay Therapist-Administered EBT; Community Therapists Used CBT and EMDR Interventions

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
PTSD Symptoms	Measured by the PCL-5	3 months
Depression Symptoms	Measured by the PHQ-9	3 months

Collaborators and Investigators

• Sponsor: University of New Mexico

Study record dates

Study Major Dates

• Study Start (Actual): October 1, 2017
• Primary Completion (Actual): January 31, 2018
• Study Completion (Actual): January 31, 2018

Study Registration Dates

• First Submitted: December 21, 2020
• First Submitted That Met QC Criteria: December 21, 2020
• First Posted (Actual): December 28, 2020

Study Record Updates

• Last Update Posted (Actual): November 8, 2021
• Last Update Submitted That Met QC Criteria: October 31, 2021
• Last Verified: October 1, 2021

More Information

Terms related to this study

• Keywords: refugee; evidence-based treatments; global mental health; lay therapists
• Other Study ID Numbers: Jiyan01

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: Dataset is available with participant answers, but original forms are not to be shared as some personal information was written in notes (i.e. names)
• IPD Sharing Time Frame: Data will be available for two years after reporting and by request following.
• IPD Sharing Access Criteria: Data is publicly available at OSF for download, or can be requested by contacting blackwell@unm.edu
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; ICF; ANALYTIC_CODE

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No