STRENGTHS Project - Resources

Links to Publications, background information and documents

• Publications from the STRENGTHS project

  Scientific publications

  The first scientific article of the STRENGTHS project was published in the European Journal of Psychotraumatology. The paper was written by Marit Sijbrandij, Full Professor at VU Amsterdam and coordinator of the consortium, and her colleagues. It describes why the project is needed and what the consortium intends to do:

  Strengthening mental health care systems for Syrian refugees in Europe and the Middle East: integrating scalable psychological interventions in eight countries

  Since then, various scientific articles about the project have been published.

  2023

  Brown, F. L., Taha, K., Steen, F., Kane, J., Gillman, A., Aoun, M., … & Jordans, M. J. (2023). Feasibility randomised controlled trial of the Early Adolescent Skills for Emotions psychological intervention with young adolescents in Lebanon. BMC psychiatry, 23(1), 1-18. https://doi.org/10.1186/s12888-023-04571-9

  de Graaff, A. M., Cuijpers, P., Twisk, J. W. R., Kieft, B., Hunaidy, S., Elsawy, M., … & Sijbrandij, M. on behalf of the STRENGTHS consortium. (2023). Peer-provided psychological intervention for Syrian refugees: results of a randomised controlled trial on the effectiveness of Problem Management Plus. BMJ Mental Health, 26, 1-10. http://dx.doi.org/10.1136/bmjment-2022-300637

  Spaaij, J., Fuhr, D. C., Akhtar, A., Casanova, L., Klein, T., Schick, M., … & Morina, N. (2023). Scaling-up problem management plus for refugees in Switzerland-a qualitative study. BMC Health Services Research, 23(1), 488. https://doi.org/10.1186/s12913-023-09491-8

  Woodward, A., Fuhr, D., Barry, A.S, Balabanova, D., Sondorp, E., Dieleman, M.A., Pratley, P., Schoenberger, S., McKee, M., B., Sijbrandij, M., Cuijpers, P., Roberts, B. (2023). Health system responsiveness to the mental health needs of Syrian refugees: mixed-methods rapid appraisals in eight host countries in Europe and the Middle East [version 1; peer review: awaiting peer review]. Open Research Europe, 3, 14. https://doi.org/10.12688/openreseurope.15293.1

  Woodward, A., Burchert, S., Barry, A. S., Broerse, J. E., Sondorp, E., Bold, A., … & Dieleman, M. A. (2023). Scalability of digital psychological innovations for refugees: A comparative analysis in Egypt, Germany, and Sweden. SSM-Mental Health, 100231. https://doi.org/10.1016/j.ssmmh.2023.100231

  Woodward, A., Sondorp, E., Barry, A.S, Dieleman, M.A., Fuhr, D., Broerse, J.E.W, Akhtar, A. Awwad, M., Bawaneh, A., Bryant, R., Sijbrandij, M., Cuijpers, P., Roberts, B. (2023). Scaling up task-sharing psychological interventions for refugees in Jordan: a qualitative study on the potential barriers and facilitators, Health Policy and Planning, czad003. https://doi.org/10.1093/heapol/czad003

  2022

  Acarturk, C., Uygun, E., Ilkkursun, Z., Yurtbakan, T., Kurt, G., Adam-Troian, J., … & Fuhr, D. C.(2022). Group problem management plus (PM+) to decrease psychological distress among Syrian refugees in Turkey: a pilot randomised controlled trial. BMC psychiatry, 22(1), 1-11. https://doi.org/10.1186/s12888-021-03645-w

  Akhtar, A., Koyiet, P., Rahman, A., Schafer, A., Hamdani, S. U., Cuijpers, P., Sijbrandij, M., & Bryant, R. A. (2022). Residual posttraumatic stress disorder symptoms after provision of brief behavioral intervention in low- and middle-income countries: An individual-patient data meta-analysis. Depress Anxiety, 39(1), 71-82. https://doi.org/10.1002/da.23221

  Bryant, R., Bawaneh, A., Awwad, M., Al-Hayek, H., Giardinelli, L., Whitney, C., . . . Akhtar, A. (2022). Twelve-month follow-up of a randomised clinical trial of a brief group psychological intervention for common mental disorders in Syrian refugees in Jordan. Epidemiology and Psychiatric Sciences, 31, E81. https://doi.org/10.1016/j.ssmmh.2022.100171

  Bryant, R. A., Bawaneh, A., Awwad, M., Al-Hayek, H., Giardinelli, L., Whitney, C., … & STRENGTHS Consortium. (2022). Effectiveness of a brief group behavioral intervention for common mental disorders in Syrian refugees in Jordan: A randomized controlled trial. Plos Medicine, 19(3), e1003949. https://doi.org/10.1371/journal.pmed.1003949

  de Graaff, A. M., Cuijpers, P., Acarturk, C., Akhtar, A., Alkneme, M. S., Aoun, M., … & Sijbrandij, M. (2022). Scalable psychological interventions for Syrian refugees in Europe and the Middle East: STRENGTHS study protocol for a prospective individual participant data meta-analysis. BMJ Open, 12(4), e058101. https://doi.org/10.1136/bmjopen-2021-058101

  Spaaij, J., Kiselev, N., Berger, C., Bryant, R. A., Cuijpers, P., De Graaff, A. M., … & Morina, N. (2022). Feasibility and acceptability of Problem Management Plus (PM+) among Syrian refugees and asylum seekers in Switzerland: a mixed-method pilot randomized controlled trial. European Journal of Psychotraumatology, 13(1), 2002027. https://doi.org/10.1080/20008198.2021.2002027

  Woodward, A., de Graaff, A. M., Dieleman, M. A., Roberts, B., Fuhr, D. C., Broerse, J. E., … & Sondorp, E. (2022). Scalability of a task-sharing psychological intervention for refugees: A qualitative study in the Netherlands. SSM-Mental Health, 100171. https://doi.org/10.1016/j.ssmmh.2022.100171

  2021

  Drescher, A., Kiselev, N., Akhtar, A., Acarturk, C., Bryant, R. A., Ilkkursun, Z., … & Morina, N. (2021). Problems after flight: understanding and comparing Syrians’ perspectives in the Middle East and Europe. BMC Public Health, 21(1), 1-12. https://doi.org/10.1186/s12889-021-10498-1

  Akhtar, A., Bawaneh, A., Awwad, M., Al-Hayek, H., Sijbrandij, M., Cuijpers, P., & Bryant, R. A. (2021). A longitudinal study of mental health before and during the COVID-19 pandemic in Syrian refugees. European Journal of Psychotraumatology, 12(1), 1991651. https://doi.org/10.1080/20008198.2021.1991651

  Akhtar, A., Engels, M. H., Bawaneh, A., Bird, M., Bryant, R., Cuijpers, P., … & STRENGTHS Consortium. (2021). Cultural Adaptation of a Low-Intensity Group Psychological Intervention for Syrian Refugees. Intervention, 19(1), 48-57. DOI: https://doi.org/10.4103/INTV.INTV_38_20

  Akhtar, A., Cuijpers, P., Morina, N., Sijbrandij, M., & Bryant, R. (2021). Exploratory and confirmatory factor analysis of the 12-item Arabic World Health Organization Disability Assessment Schedule (WHODAS 2.0) as a screening tool for Syrian refugees. BJPsych Open, 7(6), e190. https://doi.org/doi:10.1192/bjo.2021.1017

  Akhtar, A., Giardinelli, L., Bawaneh, A., Awwad, M., Al-Hayek, H., Whitney, C., … & Bryant, R. (2021). Feasibility trial of a scalable transdiagnostic group psychological intervention for Syrians residing in a refugee camp. European Journal of Psychotraumatology, 12(1), 1932295. https://doi.org/10.1080/20008198.2021.1932295
  

  de Graaff, A. M., Cuijpers, P., Leeflang, M., Sferra, I., Uppendahl, J. R., de Vries, R., & Sijbrandij, M. (2021). A systematic review and meta-analysis of diagnostic test accuracy studies of self-report screening instruments for common mental disorders in Arabic-speaking adults. Global Mental Health, 8, 1-18. https://doi.org/10.1017/gmh.2021.39

  Woodward, A., Dieleman, M. A., Sondorp, E., Roberts, B., Fuhr, D. C., Ventevogel, P., … & Broerse, J. E. (2021). A System Innovation Perspective on the Potential for Scaling Up New Psychological Interventions for Refugees. Intervention, 19(1), 23-26. https://doi.org/10.4103/INTV.INTV_29_20

  2020

  Acarturk, C., McGrath, M., Roberts, B., Ilkkursun, Z., Cuijpers, P., Sijbrandij, M., … & Fuhr, D. C. (2020). Prevalence and predictors of common mental disorders among Syrian refugees in Istanbul, Turkey: a cross-sectional study. Social Psychiatry and Psychiatric Epidemiology, 56, 475-484. https://doi.org/10.1007/s00127-020-01941-6

  Akhtar, A., Giardinelli, L., Bawaneh, A., Awwad, M., Naser, H., Whitney, C., … & Bryant, R. A. (2020). Group problem management plus (gPM+) in the treatment of common mental disorders in Syrian refugees in a Jordanian camp: study protocol for a randomized controlled trial. BMC Public Health, 20(1), 1-8. https://doi.org/10.1186/s12889-020-08463-5

  Brown, F. L., Aoun, M., Taha, K., Steen, F., Hansen, P., Bird, M., … & Jordans, M. J. (2020). The cultural and contextual adaptation process of an intervention to reduce psychological distress in young adolescents living in Lebanon. Frontiers in Psychiatry, 11, 212. https://doi.org/10.3389/fpsyt.2020.00212

  de Graaff, A. M., Cuijpers, P., Acarturk, C., Bryant, R., Burchert, S., Fuhr, D. C., … & Sijbrandij, M. (2020). Effectiveness of a peer-refugee delivered psychological intervention to reduce psychological distress among adult Syrian refugees in the Netherlands: study protocol. European Journal of Psychotraumatology, 11(1), 1694347. https://doi.org/10.1080/20008198.2019.1694347

  de Graaff, A. M., Cuijpers, P., McDaid, D., Park, A., Woodward, A., Bryant, R. A., … & Sijbrandij, M. (2020). Peer-provided Problem Management Plus (PM+) for adult Syrian refugees: a pilot randomised controlled trial on effectiveness and cost-effectiveness. Epidemiology and Psychiatric Sciences, 29, E162. https://doi.org/10.1017/S2045796020000724

  Drescher, A., Kiselev, N., Akhtar, A., Acarturk, C., Bryant, R., Ilkkursun, Z., … & Morina, N. (2020). Problems After Flight: Understanding and Comparing Syrians’ Perspectives in the Middle East and Europe. BMC Public Health, 21(1), 1-12. https://doi.org/10.1186/s12889-021-10498-1

  Fuhr, D. C., Acarturk, C., McGrath, M., Ilkkursun, Z., Sondorp, E., Sijbrandij, M., … & Roberts, B. (2020). Treatment gap and mental health service use among Syrian refugees in Sultanbeyli, Istanbul: a cross-sectional survey. Epidemiology and Psychiatric Sciences, 29, E70. https://doi.org/10.1017/S2045796019000660

  Fuhr, D. C., Acarturk, C., Sijbrandij, M., Brown, F. L., Jordans, M. J., Woodward, A., … & Roberts, B. (2020). Planning the scale up of brief psychological interventions using theory of change. BMC Health Services Research, 20, 801. https://doi.org/10.1186/s12913-020-05677-6

  Fuhr, D. C., Acarturk, C., Uygun, E., McGrath, M., Ilkkursun, Z., Kaykha, S., … & Roberts, B. (2020). Pathways towards scaling up problem management plus in Turkey: a theory of change workshop. Conflict and Health, 14(1), 1-9. https://doi.org/10.1186/s13031-020-00278-w

  Fuhr, D. C., Roberts, B., Woodward, A., Sondorp, E., Sijbrandij, M., De Graaff, A., & Balabanova, D. (2020). Health System Responsiveness to the Mental Health Needs of Forcibly Displaced Persons. In Health Policy and Systems Responses to Forced Migration (pp. 213-234). Springer International Publishing AG. https://doi.org/10.1007/978-3-030-33812-1_12

  Kiselev, N., Morina, N., Schick, M., Watzke, B., Schnyder, U., & Pfaltz, M. C. (2020). Barriers to access to outpatient mental health care for refugees and asylum seekers in Switzerland: the therapist’s view. BMC psychiatry, 20, 378. https://doi.org/10.1186/s12888-020-02783-x

  Kiselev, N., Pfaltz, M., Haas, F., Schick, M., Kappen, M., Sijbrandij, M., … & Morina, N. (2020). Structural and socio-cultural barriers to accessing mental healthcare among Syrian refugees and asylum seekers in Switzerland. European Journal of Psychotraumatology, 11(1), 1717825. https://doi.org/10.1080/20008198.2020.1717825

  Kiselev, N., Pfaltz, M., Schick, M., Bird, M., Pernille, H., Sijbrandij, M., … & Morina, N. (2020). Problems faced by Syrian refugees and asylum seekers in Switzerland. Swiss Medical Weekly, 150:w20381. https://doi.org/10.4414/smw.2020.20381

  Morina, N., Drescher, A., Akhtar, A., Spaaij, J., & Kiselev, N. (2020). Understanding and comparison of self-reported problems of Syrian refugees in three countries. European Journal of Public Health, 30(Supplement_5), ckaa165-624. https://doi.org/10.1093/eurpub/ckaa165.624

  Uygun, E., Ilkkursun, Z., Sijbrandij, M., Aker, A. T., Bryant, R., Cuijpers, P., … & Acarturk, C. (2020). Protocol for a randomized controlled trial: peer-to-peer Group Problem Management Plus (PM+) for adult Syrian refugees in Turkey. Trials, 21(1), 1-9. https://doi.org/10.1186/s13063-020-4166-x

  Wen, K., McGrath, M., Acarturk, C., Ilkkursun, Z., Fuhr, D. C., Sondorp, E., … & Roberts, B. (2020). Post-traumatic growth and its predictors among Syrian refugees in Istanbul: a mental health population survey. Journal of Migration and Health, 1, 100010. https://doi.org/10.1016/j.jmh.2020.100010

  2019
  
  Brown, F. L., Steen, F., Taha, K., Aoun, M., Bryant, R. A. , Jordans, M. J. D., Malik, A., van Ommeren, M., Abualhaija, A., Aqel, I. S., Ghatasheh, M., Habashneh, R., Sijbrandij, M., El Chammay, R., Watts, S., Akhtar, A.; STRENGTHS-consortium (2019). Early Adolescent Skills for Emotions (EASE) intervention for the treatment of psychological distress in adolescents: study protocol for randomised controlled trials in Lebanon and Jordan. Trials, 2;20(1):545. https://doi.org/10.1186/s13063-019-3654-3

  Burchert, S., Alkneme, M. S., Bird, M., Carswell, K., Cuijpers, P., Hansen, P., … & Knaevelsrud, C. (2019). Usercentered app adaptation of a low-intensity e-mental health intervention for Syrian refugees. Frontiers in Psychiatry, 9, 663. https://doi.org/10.3389/fpsyt.2018.00663

  Dawson, K. S., Watts, S., Carswell, K., Harper Shehadeh, M., Jordans, M. J. D., Bryant, R., Miller, K. E., Malik, A., Brown, F. L., Servili, C., van Ommeren, M. (2019). Improving access to effective psychological interventions for young adolescents: Early Adolescent Skills for Emotions (EASE). World Psychiatry, 18, 105-107. https://doi.org/10.1002/wps.20594

  Fuhr, D. C., Acarturk, C., McGrath, M., Ilkkursun, Z., Sondorp, E., Sijbrandij, M., Ventevogel, P., Cuijpers, P., McKee, M., & Roberts, B. (2019). Treatment gap and mental health service use among Syrian refugees in Sultanbeyli, Istanbul: a cross-sectional survey. Epidemiology and Psychiatric Sciences, 29:e70. https://doi.org/10.1017/S2045796019000660.

  Kiselev, N., Morina, N., Schick, M., Watzke, B., Schnyder, U., & Pfaltz, M. (2019). Current Situation and Admission Barriers in Outpatient Mental Health Care for Refugees and Asylum Seekers in Switzerland: The Therapists’ View, European Journal of Psychotraumatology (Vol. 10). https://doi.org/https://doi.org/10.1186/s12888-020-02783-x

• Background articles about scalable interventions and other useful resources

  Several STRENGTHS collaborators were involved in publications that are relevant for the project:

  • Le, L., Morina, N., Schnyder, U., Schick, M., Bryant, R. A., & Nickerson, A. (2018). The effects of perceived torture controllability on symptom severity of posttraumatic stress, depression and anger in refugees and asylum seekers: A path analysis. Psychiatry research, 264, 143-150.

  Scalable psychological intervention in Lebanon:

  • Carswell, K., Harper-Shehadeh, M., Watts, S., van’t Hof, E., Abi Ramia, J., Heim, E., . . . van Ommeren, M. (2018). Step-by-Step: a new WHO digital mental health intervention for depression. mHealth, 4(8). 

  Scalable psychological intervention with refugees:

  • Tol, W. A. A., J., Carswell, K., Leku, M.R., Adaku, A., Brown, F.L., Garcia-Moreno, C., Ventevogel, P., White, R., Kogan, C.S., Bryant, R., van Ommeren, M. (2018). Feasibility of a guided self-help intervention to reduce psychological distress in South Sudanese refugee women in Uganda. World Psychiatry, 17(2)
  • Tol, W. A., Augustinavicius, J., Carswell, K., Brown, F. L., Adaku, A., Leku, M. R., Ventevogel, P. , White R.G. & Van Ommeren, M. (2018). Translation, adaptation, and pilot of a guided self-help intervention to reduce psychological distress in South Sudanese refugees in Uganda. Global Mental Health, 5

  PM+ in Kenya:

  • van’t Hof, E., Dawson, K. S., Schafer, A., Chiumento, A., Shehadeh, M. H., Sijbrandij, M., … & Ulate, J. (2018). A qualitative evaluation of a brief multicomponent intervention provided by lay health workers for women affected by adversity in urban Kenya. Global Mental Health, 5.

  PM+ in Nepal:

  • Sangraula M, van’t Hof E, Luitel NP, Turner EL, Marahatta K, Nakao JH, van Ommeren M, Jordans MJ, Kohrt BA. (2018. Protocol for a feasibility study of group-based focused psychosocial support to improve the psychosocial well-being and functioning of adults affected by humanitarian crises in Nepal: Group Problem Management Plus (PM+). Pilot and Feasibility Studies 4(1):126.

  Mental health issues of refugees in the Netherlands:

  • Slobodin O, Ghane S, De Jong JT. Developing a culturally sensitive mental health intervention for asylum seekers in the Netherlands: A pilot study. Intervention [serial online] 2018 [cited 2018 Aug 17];16:86-94.

   

  Further reading

  The STRENGTHS project adapted Problem Management Plus (PM+) a ‘scalable psychological intervention’ for use amongst Syrian refugees. The PM+ intervention had not been tested in this group before. Part of our work was to collect and review the available literature. Some interesting articles providing background to Problem Management Plus are:

  General information about PM+:

  • Problem Management Plus (PM+): a WHO transdiagnostic psychological intervention for common mental health problems

  Results of randomised controlled trials:

  • Effectiveness of a brief behavioural intervention on psychological distress among women with a history of gender-based violence in urban Kenya: A randomised clinical trial
  • Effect of a Multicomponent Behavioral Intervention in Adults Impaired by Psychological Distress in a Conflict-Affected Area of Pakistan: A Randomized Clinical Trial

  Research protocols:

  • Problem Management Plus (PM+) in the management of common mental disorders in a specialized mental healthcare facility in Pakistan; study protocol for a randomized controlled trial
  • Problem Management Plus (PM+) for common mental disorders in a humanitarian setting in Pakistan; study protocol for a randomised controlled trial (RCT)
  • Evaluating effectiveness and cost-effectiveness of a group psychological intervention using cognitive behavioural strategies for women with common mental disorders in conflict-affected rural Pakistan: study protocol for a randomised controlled trial
  • Evaluating feasibility and acceptability of a group WHO trans-diagnostic intervention for women with common mental disorders in rural Pakistan: a cluster randomised controlled feasibility trial
  • Problem Management Plus (PM+) in the treatment of common mental disorders in women affected by gender-based violence and urban adversity in Kenya; study protocol for a randomized controlled trial
  • Feasibility trial of a scalable psychological intervention for women affected by urban adversity and gender-based violence in Nairobi

• Documents

  Various project-related public documents, as well as resource documents such as policy advice and implementation support packages.

  Public documents:

  • End report on process and outcomes of PM+ implementation in Jordan (December 2022)
  • End report on process and outcome evaluation of EASE implementation in Lebanon (children) (December 2022)
  • End report on process and outcomes of PM+ implementation in the Netherlands (December 2022)
  • End report on process and outcomes of gPM+ implementation in Türkiye (December 2022)
  • End report on process and outcomes of PM+ implementation in Switzerland (December 2022)
  • End report on process and outcomes of Step-by-Step implementation in Egypt, Germany, and Sweden (December 2022)
  • Economic evaluation of implementation (December 2022)
  • Economic modelling of scaling up implementation (December 2022)
  • Integrated framework (December 2022)
  • Rapid appraisal report for mental health systems (December 2021)

  Resource documents:

  • Policy brief (December 2022)
  • Dissemination packages (December 2022)

  Modelling tool:

  Below is an Excel tool which provides models for each of the iPM+, gPM+, and SbS and EASE interventions in each of their different country contexts. It is based on preliminary results from STRENGTHS.

  A welcome page provides some brief background on the tool. Two options are then possible: clicking on a link to download a brief version of a manual with instructions on how to use the tool or alternatively clicking on the link to ‘proceed to the interventions menu’. Most of the cells of the tool are protected, but interventions examined, countries of implementation, and many specific parameters can be varied for each of the four models in the tool.

  Please note that the tool is still being developed and will be updated as more data becomes available. At this stage, it is not to be used for informing policy decisions.

  Please click on the following link to access the document: STRENGTHS modelling tool.