Culture Sensitive Resource Oriented Peer-Groups

In Austria, in 2004, 24,676 persons applied for political asylum, with people from Chechnya being one of the most prominent ethnic groups among them. Approximately 50% of them suffer from severe posttraumatic stress, but very few can be offered psychotherapy for financial reasons. Additionally, the Western concept of PTSD has been shown to be of little relevance to non-Western people. Avoidance only rarely occurs and psychological symptoms of traumatization are frequently replaced by somatic ones. Belonging to a Moslemic, group-oriented culture, Chechnyans are not used to reveal their problems to Western experts and therefore are reluctant to use conventional medical and psychological interventions. There is growing evidence, however, that people from non- Western cultures benefit from culture sensitive, community based offers which emphasize indigenous coping techniques, thus promoting the participants` empowerment and self-help skills. Although these preliminary data are encouraging, such interventions have not been tested with respect to their effectiveness on the basis of controlled studies. This is the aim of the present research. We intend to install Culture-Sensitive Resource Oriented Peer (CROP)-Groups for Chechnyan asylum seekers and refugees in Austria, separately for men and women; like guided self-help groups, these groups should be facilitated by indigenous, same-sex paraprofessionals who will be trained for their task beforehand (N = 10 each group). The CROP groups will meet 15 times, i. e., over approximately four months, once a week. We intend to form waiting list control groups as well as Cognitive Behavior Therapy (CBT) control groups, one for men and one for women respectively, with N = 10 each. Another control group (N = 15) will receive Eye-Movement-Desensitization and Reprocessing (EMDR) on a one-to-one basis (total N = 75). We hypothesize (1) that the outcome of the CROP-Groups will be significantly superior to the waiting list control groups, (2) that the outcome of the CROP-Groups will not differ significantly from the well established CBT and EMDR treatments or be significantly superior to them, and (3) that the CROP-Groups will yield an effect size of at least 1.00 in terms of a comparison between the CROP and the waiting list control groups. These hypotheses will be tested (a) for trauma specific symptoms by items 1 to 16 of the Harvard Trauma Questionnaire (HTQ), (b) for general psychopathology by the Hopkins Symptom Checklist-25 (HSCL-25), and (c) for "Posttraumatic Growth" by the Posttraumatic Growth Inventory (PGI). These instruments will be applied prior to and immediately after the interventions and at a three months and a six months follow-up occasion. In addition, focus groups will be employed as qualitative methods to assess the participants` judgments of the interventions as well as post-traumatic growth, enhanced self-management abilities and other positive or negative changes in the course of the interventions. If the CROP-Groups could be shown to be efficient, they could be realized worldwide on a large scale and with participants from other cultures. Besides the immediate humanitarian implications, consequences for a culturally more sensitive view in clinical psychology may be expected.

In Austria, in 2004, 24,676 persons applied for political asylum, with people from Chechnya being one of the most prominent ethnic groups among them. Approximately 50% of them suffer from severe posttraumatic stress, but very few can be offered psychotherapy for financial reasons. Additionally, the Western concept of PTSD has been shown to be of little relevance to non-Western people. Avoidance only rarely occurs and psychological symptoms of traumatization are frequently replaced by somatic ones. Belonging to a Moslemic, group-oriented culture, Chechnyans are not used to reveal their problems to Western experts and therefore are reluctant to use conventional medical and psychological interventions. There is growing evidence, however, that people from non- Western cultures benefit from culture sensitive, community based offers which emphasize indigenous coping techniques, thus promoting the participants` empowerment and self-help skills. Although these preliminary data are encouraging, such interventions have not been tested with respect to their effectiveness on the basis of controlled studies. This is the aim of the present research. We intend to install Culture-Sensitive Resource Oriented Peer (CROP)-Groups for Chechnyan asylum seekers and refugees in Austria, separately for men and women; like guided self-help groups, these groups should be facilitated by indigenous, same-sex paraprofessionals who will be trained for their task beforehand (N = 10 each group). The CROP groups will meet 15 times, i. e., over approximately four months, once a week. We intend to form waiting list control groups as well as Cognitive Behavior Therapy (CBT) control groups, one for men and one for women respectively, with N = 10 each. Another control group (N = 15) will receive Eye-Movement-Desensitization and Reprocessing (EMDR) on a one-to-one basis (total N = 75). We hypothesize (1) that the outcome of the CROP-Groups will be significantly superior to the waiting list control groups, (2) that the outcome of the CROP-Groups will not differ significantly from the well established CBT and EMDR treatments or be significantly superior to them, and (3) that the CROP-Groups will yield an effect size of at least 1.00 in terms of a comparison between the CROP and the waiting list control groups. These hypotheses will be tested (a) for trauma specific symptoms by items 1 to 16 of the Harvard Trauma Questionnaire (HTQ), (b) for general psychopathology by the Hopkins Symptom Checklist-25 (HSCL-25), and (c) for "Posttraumatic Growth" by the Posttraumatic Growth Inventory (PGI). These instruments will be applied prior to and immediately after the interventions and at a three months and a six months follow-up occasion. In addition, focus groups will be employed as qualitative methods to assess the participants` judgments of the interventions as well as post-traumatic growth, enhanced self-management abilities and other positive or negative changes in the course of the interventions. If the CROP-Groups could be shown to be efficient, they could be realized worldwide on a large scale and with participants from other cultures. Besides the immediate humanitarian implications, consequences for a culturally more sensitive view in clinical psychology may be expected.