Introduction: Cognitive behavioural
therapy (CBT) with trauma focus is the most
evidence supported psychotherapeutic
treatment of PTSD, but few CBT treatments
for traumatized refugees have been described
in detail.
Purpose: To describe and evaluate a
manualized cognitive behavioral therapy for
traumatized refugees incorporating exposure
therapy, mindfulness and acceptance and
commitment therapy.
Material and methods: 85 patients received
six months’ treatment at a Copenhagen
Trauma Clinic for Refugees and completed
self-ratings before and after treatment. The
treatment administered to each patient was
monitored in detail. The changes in mental
state and the treatment components associated
with change in state were analyzed statistically.
Results: Despite the low level of functioning
and high co-morbidity of patients, 42%
received highly structured CBT, which was
positively associated with all treatment
outcomes. The more methods used and the
more time each method was used, the better
the outcome. The majority of patients were
able to make homework assignments and this
was associated with better treatment
outcome. Correlation analysis showed no
association between severity of symptoms at
baseline and the observed change.
Conclusion: The study suggests that CBT
treatment incorporating mindfulness and
acceptance and commitment therapy is
promising for traumatized refugees and
punctures the myth that this group of
patients are unable to participate fully in
structured CBT. However, treatment
methods must be adapted to the special
needs of refugees and trauma exposure
should be further investigated.