Case Series for Traumatized Refugees With Khat Dependence

Study Overview
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Brief Summary
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The research project will offer psychotherapeutic treatment to Somali refugees with PTSD and comorbid khat dependence. In this case series, evidence-based techniques will be applied and adapted to the cultural background of Somali refugees in Kenya.

Detailed Description
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More than 500.000 Somali refugees live in Kenya. This group is especially burdened by high rates of exposure to traumatic events, high prevalence of PTSD and a high comorbidity with substance use disorders, mainly related to khat (catha edulis). There's a shortage of literature on psychotherapeutic methods that are applicable in this group. The aim of this case series is to develop modifications of standard therapeutic techniques to the Somali culture and to the needs of this group. Twenty successive cases will be recruited from a community clinic where refugees often seek for treatment because of psychiatric problems. Senior level psychotherapists will apply and adapt techniques and approaches like Community Reinforcement Approach (CRA), Relapse Prevention (RP), and Narrative Exposure Therapy (NET); all sessions will be video recorded. Regular supervision with external experts and group discussions will be held to evaluate and adapt the single procedures and techniques. The aim of this study is the development of a standardized approach that can be used in a Randomized Controlled Trial which will be conduced in the future.

Official Title
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Sustainable and Adapted Treatment Strategies to Restore Psychological Functioning and Mental Health Among Displaced Somalis: Preparation of a Multicenter Treatment Study (P114/02/2014): Pilot Study 3.

Conditions
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Posttraumatic Stress Disorder, Khat Use Disorder

Intervention / Treatment
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* Behavioral: Integrated Psychotherapeutic Intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: PTSD (DSM-IV) Khat Dependence (DSM-IV) Exclusion Criteria: Severe Psychotic Disorder Suicidality Mental Disability

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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Male

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Integrated Psychotherapeutic Intervention<br>Integrated treatment of khat use disorder and PTSD | Behavioral: Integrated Psychotherapeutic Intervention<br>* Evidence-based standard tools for the treatment of PTSD and comorbid khat dependence: Community Reinforcement Approach, Relapse Prevention, Narrative Exposure Therapy<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Posttraumatic Stress Diagnostic Scale (PDS) | Pre-post change of self-reported PTSD-symptom severity | 3 months | 
| Time-Line Follow Back(TLFB) | Pre-post change of self-reported days with khat use | 3 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Hopkins Symptom Checklist (HSCL) | Pre-post change of self-reported depressive symptoms | 3 months |