Viabilidad y aceptabilidad del programa Enfrentando Problemas Plus con Procesamiento Emocional (EP+PE) para jóvenes refugiados que viven en los Países Bajos: Protocolo de investigación

Translated title of the contribution: Feasibility and acceptability of Problem Management Plus with Emotional Processing (PM+EP) for refugee youth living in the Netherlands: study protocol

Cansu Alozkan Sever*, Pim Cuijpers, Ellenor Mittendorfer-Rutz, Richard A. Bryant, Katie S. Dawson, Emily A. Holmes, Trudy Mooren, Marie Louise Norredam, Marit Sijbrandij

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review


Background: Refugee youth experience hardships associated with exposure to trauma in their homelands and during and after displacement, which results in higher rates of common mental disorders. The World Health Organization (WHO) developed Problem Management Plus (PM+), a non-specialist-delivered brief psychological intervention, for individuals who have faced adversity. PM+ comprises problem-solving, stress management, behavioural activation and strengthening social support. However, it does not include an emotional processing component, which is indicated in trauma-exposed populations. Objective: This pilot randomized controlled trial (RCT) aims to evaluate the feasibility and acceptability of PM+, adapted to Syrian, Eritrean and Iraqi refugee youth residing in the Netherlands, with and without a newly developed Emotional Processing (EP) Module. Methods: Refugee youth (N = 90) between 16 and 25 years of age will be randomized into PM+ with care-as-usual (CAU), (n = 30), PM+ with Emotional Processing (PM+EP) with CAU (n = 30) or CAU only (n = 30). Inclusion criteria are self-reported psychological distress (Kessler Psychological Distress Scale; K10 > 15) and impaired daily functioning (WHO Disability Assessment Schedule; WHODAS 2.0 > 16). Participants will be assessed at baseline, one-week post-intervention and three-month follow-up. The main outcome is the feasibility and acceptability of the adapted PM+ and PM+EP. The secondary outcomes are self-reported psychological distress, functional impairment, post-traumatic stress disorder (PTSD) symptom severity and diagnosis, social support, and self-identified problems. The pilot RCT will be succeeded by a process evaluation including trial participants, participants’ significant others, helpers, and mental health professionals (n = 20) to evaluate their experiences with the PM+ and PM+EP programmes. Results and Conclusion: This is the first study that evaluates the feasibility of PM+ for this age range with an emotional processing module integrated. The results may inform larger RCTs and implementation of PM+ interventions among refugee youth. Trial Registration: Registered to Dutch Trial Registry, NL8750, on 3 July 2020. Medical Ethical Committee of the Amsterdam University Medical Centre, location Vrije Universiteit Medical Centre, Protocol ID: 2020.224, 1 July 2020.

Translated title of the contributionFeasibility and acceptability of Problem Management Plus with Emotional Processing (PM+EP) for refugee youth living in the Netherlands: study protocol
Original languageSpanish
Article number1947003
Pages (from-to)1-11
Number of pages11
JournalEuropean Journal of Psychotraumatology
Issue number1
Early online date5 Aug 2021
Publication statusPublished - 2021

Bibliographical note

Funding Information:
This study is funded by Swedish Research Council (Grant No: 2018-05783).

Publisher Copyright:
© 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

Copyright 2021 Elsevier B.V., All rights reserved.


  • anxiety
  • common mental health problems
  • depression
  • post-traumatic stress disorder
  • Refugee youth
  • scalable interventions


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