Collaborative development of a self-tracking assisted psychotherapy treatment concept for refugees with complex PTSD: Participatory Action Research (Preprint)
Authors: Riisager Lisa G. , Larsen Jakob E. , Huniche Lotte , Christiansen Thomas B. , Moeller Stine B. 
Published: October 2024

BACKGROUND

Refugees often face severe mental health challenges from traumas like war, torture, genocide, and childhood abuse. These complex traumas can lead to Complex Posttraumatic Stress Disorder (CPTSD). Traditional therapies such as Cognitive Behavioral Therapy and Eye Movement Desensitization and Reprocessing are often limited in addressing the complex, culturally specific needs of refugees. Additionally, adherence to therapeutic homework is a significant barrier. Self-tracking technology has shown promise in offering a personalized approach to mental health management in the patient’s daily life, though its active use in psychotherapy remains underexplored.

OBJECTIVE

This study aims to collaboratively develop a psychotherapeutic treatment concept for refugees with CPTSD that integrates a research prototype wearable, self-tracking instrument for personalized self-tracking, the One Button Tracker (OBT) to support the therapeutic process. Designed for personalized self-tracking, the OBT allows patients to track subjective experiences in the moment, bridging the gap between therapy sessions and daily life.

METHODS

The study was conducted at the Clinic for Trauma and Torture Survivors in Denmark, specializing in treating refugees and veterans with PTSD and CPTSD. A Participatory Action Research design was employed from November 2022 to April 2024, involving therapists, patients, clinical psychology researchers, and Human-Computer Interaction researchers. Qualitative data from interviews, peer supervision, and logbooks, as well as self-tracking data from the OBT, informed the development of the treatment concept.

RESULTS

Over a period of 17 months, 40 peer supervision sessions, two workshops, and 25 patient interviews were conducted with nine patients whose treatment durations varied from eight to 24 sessions. The use of self-tracking varied, ranging from 22 to 366 days, with patients tracking between 1 and 14 different target phenomena. Results suggest that the OBT enhanced patient engagement by facilitating active participation in symptom management. Despite some technical issues affecting data collection, therapists reported that the OBT provided valuable insights into patients' daily experiences, facilitating more personalized interventions. The flexible use of the OBT allowed patients to shift focus from distressing phenomena to alternative coping strategies, reinforcing therapeutic interventions outside sessions. Additionally, the integration of self-tracking data strengthened the therapeutic alliance by improving communication and collaboration between patients and therapists.

CONCLUSIONS

This study, alongside the pilot study, is the first to use PAR methodology for collaborative development of a treatment concept integrating self-tracking technology into psychotherapy for refugees with CPTSD. The self-tracking technology shows promise in fostering patient engagement, improving adherence to therapeutic homework, and strengthening the therapeutic alliance. The broad applicability of this treatment concept suggests a transtheoretical and transdiagnostic potential, offering a personalized and flexible approach to psychotherapy. Future research should focus on refining the treatment model and exploring its applicability across diverse populations.

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