An online intervention designed to reduce self-stigma and increase help-seeking in Arabic-speaking refugees with posttraumatic stress symptoms: A randomized controlled trial

Abstract

Despite elevated rates of psychopathology, refugees underutilize mental health services. Mental health self-stigma is a prominent barrier to accessing psychological support; however, there is limited research on intervention approaches to reduce self-stigma among refugees. The present study aimed to provide further support for the Tell Your Story (TYS) intervention in reducing self-stigma and increasing help-seeking among Arabic-speaking male and female refugees. In this randomized controlled trial (RCT), 67 Arabic-speaking refugees with self-stigma and at least subthreshold posttraumatic stress symptoms (PTSS) were randomly allocated to the TYS group or waitlist control group. At baseline, postintervention, and 3-month follow-up, participants completed assessment measures indexing measures of self-stigma (related to symptoms and help-seeking) and help-seeking (intentions and behavior). Poisson regression analyses revealed that participants in the TYS group demonstrated more help-seeking behavior at 3-month follow-up than those in the waitlist control group, Hedges’ g = 0.67. However, linear mixed models showed that the waitlist control group demonstrated larger decreases in PTSD-related self-stigma across time, T2: g = 0.07, T3: g = 0.04, whereas no significant group differences were observed for self-stigma related to help-seeking. Although the findings were mixed and suggest a need for further investigation in a larger RCT with a sample of refugee men and women, the results provide support for the intervention's utility in expanding one's help-seeking network in a population with low treatment uptake.