Culturally adapted Metacognitive Training for Depression (CA-D-MCT) for Arabic- and Farsi-speaking refugees: a feasibility trial

Abstract

Background: A significant number of people with a refugee background suffer from depression and may benefit from psychological interventions. Culturally adapted Metacognitive Training for Depression (CA-D-MCT) is a low-threshold and resource-saving group intervention that has not yet been evaluated among refugees with depression. Objective: This study aimed to assess the feasibility, patient acceptance, and initial treatment effects on depression and other secondary outcomes of CA-D-MCT for refugees with depression, potentially presenting with comorbid post-traumatic stress disorder (PTSD). Method: In an uncontrolled feasibility trial, 50 adult refugees with a diagnosis of depression, who spoke Arabic or Farsi, received interpreter-assisted CA-D-MCT. Patients completed module evaluations to assess acceptability. Depressive symptoms were assessed with the Patient Health Questionnaire (PHQ-9) at baseline (t0), post-treatment (t1) and at three-month follow-up (t2). Secondary outcomes included quality of life, subjective integration and PTSD symptoms. Results: Descriptive analysis showed a high level of acceptability of the intervention. A repeated-measure ANOVA revealed a large effect size associated with improvements in depressive symptoms (η² =.175, p =.010), suggesting a positive treatment effect. Medium effect sizes were observed for subjective integration, quality of life and PTSD symptoms, but differential values were not statistically significant. Conclusions: CA-D-MCT seems to be feasible and well accepted. The findings provide preliminary evidence for a treatment effect of CA-D-MCT. A randomized controlled trial is warranted to further investigate its efficacy.