Push the Button: A study protocol of the development and evaluation of personalized trauma-focused psychotherapy for refugees with Complex PTSD

Background: The coronavirus has exposed millions of people to a new threat, potentially causing more people to seek international protection. Due to having experienced multiple traumatic events, refugees are at risk of developing Complex PTSD (CPTSD). At present, there is no evidence-based treatment available. To address the natural symptom fluctuation of the disorder, a personalized approach to therapy is needed. Ecological momentary assessment (EMA) allows continuous collection of an observed experience. An EMA-based self-tracking instrument was created to collect the subjective experience of CPTSD-related symptoms at the moment they occur. Building on EMA data, clinicians can personalize evidence-based interventions to the triggers as they occur during the patient’s daily life. Objective: In the current study we develop the treatment format of a novel personalized trauma-focused psychotherapy for refugees with CPTSD integrating the use of a self-tracking instrument, and test its effectiveness. At present, no psychotherapeutic treatment has integrated the use of a self-tracking instrument in therapy making this study the first of its kind. Method: Using a multiple baseline case series design, 40 refugees diagnosed with CPTSD using the International Trauma Questionnaire (ITQ) will be included and will receive 20 weekly sessions (duration of 60-90 minutes). The primary outcome is ITQ (monthly assessed). Secondary outcomes are PTSD symptoms, well-being, depression, emotion regulation, and social functioning. Semi-structured interviews exploring patients’ and clinicians’ experiences with the integration of a self-tracking instrument into psychotherapy will be conducted. Results: None. Conclusions: By offering refugees with CPTSD a personalized treatment, we seek to improve treatment outcome through better-targeted interventions.