The objective of the research project described here was to test CETA, developed for the treatment of co-morbid presentations of depression, anxiety, and trauma symptoms among survivors of imprisonment, torture, and related traumas in Burmese refugees in Thailand. CETA is based on existing trans-diagnostic manuals and is designed specifically for delivery by non-professional providers in low-resource settings4.CETA is an inexpensive and widely accessible approach that can reduce the burden of disability due to common mental health problems. In Thailand, CETA was delivered by lay workers to Burmese refugees. Eligible participants reported trauma exposure and met severity criteria for depression and/or posttraumatic stress symptoms (PTSS).
- Psychoeducation (introduction)
- Anxiety management (relaxation)
- Behavioral activation (getting active)
- Cognitive coping/restructuring (thinking in a different way)
- Imaginal gradual exposure (talking about difficult memories)
- In vivo exposure (live exposure)
- Safety (suicide/homicide/danger assessment and planning)
- Other elements (Skills building, talking about difficult memories, problem-solving)
This was a single-site, two-arm (1:1 allocation), single-blinded, wait-list RCT. Outcomes were assessed by interview using locally adapted and validated instruments. Interviews were conducted at recruitment (baseline) and approximately 4 months later (the maximum duration of treatment plus 1 mo to allow for delays) for both intervention and control groups.
The results showed that CETA provided by lay counsellors was highly effective across disorders among trauma survivors when compared to waitlist controls. These results support the further development and testing of this and similar trans-diagnostic approaches as possible treatment options alongside existing EBTs.