Joop de Jong

Character strengths are positive traits and qualities that are an integral part of an individual’s personality. These strengths can function as protective factors against mental disorders by providing traumatized refugees with resources and tools to cope with stressors and daily challenges. The purpose of the current study was to explore the role of character strengths of refugees in the Netherlands in their problem-focused and/or emotional-focused coping strategies to deal with daily challenges. We interviewed 26 refugees who attained a temporary asylum residence permit and who lived in an asylum seeker center (AZC) or a municipality in the Netherlands. Qualitative data analyses yielded five key character strengths, namely self-regulation, perseverance, gratitude, love of learning, and hope. Patience and adaptability were two additional strengths that function as specific self-regulation techniques. Our findings also suggest a shift from emotion-focused coping strategies during the stay at an asylum seeker center towards problem-focused coping when living in a municipality. Depending on the migration phase in which refugees find themselves, they apply different character strengths in relation to emotion-focused or problem-focused coping strategies. Interventions that aim to increase the well-being of refugees and contribute to successful integration into society should consider relevant contextual factors, in addition to cultural factors.

We aimed to understand how risk (trauma history, health problems, financial problems, family problems) and protective (friend support, family support) factors influenced daily functioning (e.g., self-care, mobility, social participation) among Tunisian adults during the COVID-19 pandemic, directly and through their impact on depression, with a focus on gender differences. We recruited a representative sample of 2014 participants (1024 males, 990 females) using random digit dialing of mobile phone numbers across all 24 governorates in Tunisia. Females reported higher depression, greater impaired functioning, and a higher likelihood of having had COVID-19. Path analysis showed a good fit to the model when paths for males and females were allowed to vary, providing evidence for gender differences. Associations between trauma exposure and depression and depression and age with functioning were stronger among females. Social support from friends was a protective factor for males only. For males, all study variables were associated with functioning indirectly through their association with depression, except for support from friends. For females, family responsibilities and health problems had both direct and indirect effects, whereas other study variables were only linked with functioning through depression. Findings provide insights into factors that can be targeted in interventions aimed at reducing depression and improving daily functioning for males and females.

This protocol investigates the efficacy of a mental health and psychosocial support (MHPSS) program named BAMBOO. The goal of this program is to increase resilience and mental well-being among refugees. In recent years, there has been an increasing number of refugees fleeing to Europe and applying for permanent residence. In the Netherlands, a wide variety of programs that focus on increasing mental well-being among refugees is available. BAMBOO is a strengths-based intervention, which consists of five weekly two-hour group-based sessions. It is based on the theoretical framework of positive psychology and adapted according to the guidelines for the implementation of culturally sensitive cognitive behavioral therapy among refugees. The program does not focus on the treatment of trauma, mental disorders, or underlying problems, but aims to increase factors such as personal strengths, positive emotions, positive relations, and self-esteem. The first version of the program (BAMBOO 1.0) has been conducted at over 50 asylum centers in the Netherlands since January 2020. In the time period from September 2020 to September 2022, qualitative and quantitative data were collected among BAMBOO trainers and participants and the program was adapted, leading to a revised version (BAMBOO 2.0). A single-blinded parallel pilot randomized controlled trial, with an intervention group and awaiting list control group, with 34 participants per group will be used to test the program’s efficacy. Outcomes include resilience, satisfaction with life, positive and negative affect, and self-esteem. The study will be conducted among adult Arabic speaking refugees, residing at an asylum center in the Netherlands and/ or in a Dutch municipality, Baseline, post-intervention, and five-week follow-up assessments will be conducted. This paper describes the protocol for the evaluation of a novel and culturally adapted program. The study will shed light on the efficacy of a culturally sensitive strengths-based intervention as a preventive approach to increase refugee well-being. ERB Tilburg University, TSB RP623.

The ongoing wars in many regions—such as the conflict between Israel and Hamas—as well as the effects of war on communities, social services, and mental health are covered in this special editorial. This article emphasizes the need for international efforts to promote peace, offer humanitarian aid, and address the mental health challenges faced by individuals and communities affected by war and violence.

Background: Syrian refugees face multiple hardships and adversities which put them at risk for the development of mental health problems. However, access to adequate mental health care in host countries is limited. The WHO has developed Problem Management Plus (PM+), a brief, scalable psychological intervention, delivered by non-specialist helpers, that addresses common mental disorders in people affected by adversity. This study is part of the STRENGTHS project, that aims to evaluate peer-refugee delivered psychological interventions for Syrian refugees in Europe and the Middle East. Objective: To evaluate the effectiveness and cost-effectiveness of the peer-refugee delivered PM+ intervention among Syrian refugees with elevated levels of psychological distress in the Netherlands. Methods: PM+ will be tested in a randomized controlled trial (RCT) among Arabic-speaking Syrian refugees in the Netherlands aged 18 years and above with self-reported psychological distress (Kessler Psychological Distress Scale; K10 >15) and impaired daily functioning (WHO Disability Assessment Schedule; WHODAS 2.0 >16). Participants (N = 380) will be randomized into care as usual with PM+ (CAU/PM+, n = 190) or CAU only (CAU, n = 190). Baseline, 1-week post-intervention, and 3-month and 12-month follow-up assessments will be conducted. Primary outcomes are symptoms of depression and anxiety. Secondary outcomes are functional impairment, posttraumatic stress disorder symptoms, self-identified problems, anger, health and productivity costs, and hair cortisol concentrations. A process evaluation will be carried out to evaluate treatment dose, protocol fidelity and stakeholder views on barriers and facilitators to implementing PM+. Results and Conclusions: PM+ has proved effectiveness in other populations and settings. After positive evaluation, the adapted manual and training materials for individual PM+ will be made available through the WHO to encourage further replication and scaling up. Trial registration: Trial registration Dutch Trial Registry, NL7552, registered prospectively on March 1, 2019. Medical Ethics Review Committee VU Medical Center Protocol ID 2017.320, 7 September 2017.

Psychological first aid (PFA) is a world-wide implemented approach to helping people affected by an emergency, disaster, or other adverse event. Controlled evaluations of PFA’s training effects are lacking. We evaluated the effectiveness of a one-day PFA training on the acquisition and retention of knowledge of appropriate responses and skills in the acute aftermath of adversity in Peripheral Health Units (PHUs) in post-Ebola Sierra Leone. Secondary outcomes were professional quality of life, confidence in supporting a distressed person, and professional attitude. PHUs in Sierra Leone (n = 129) were cluster-randomized across PFA (206 participants) and control (202 participants) in March 2017. Knowledge and understanding of psychosocial support principles and skills were measured with a questionnaire and two patient scenarios to which participants described helpful responses. Professional attitude, confidence, and professional quality of life were assessed using self-report instruments. Assessments took place at baseline and at three- and six-months post-baseline. The PFA group had a stronger increase in PFA knowledge and understanding at the post-PFA training assessment (d = 0.50; p < 0.001) and at follow-up (d = 0.43; p = 0.001). In addition, the PFA group showed better responses to the scenarios at six-months follow-up (d = 0.38; p = 0.0002) but not at the post-assessment (d = 0.04; p = 0.26). No overall significant differences were found for professional attitude, confidence, and professional quality of life. In conclusion, PFA training improved acquisition and retention of knowledge and understanding of appropriate psychosocial responses and skills in providing support to individuals exposed to acute adversity. Our data support the use of PFA trainings to strengthen capacity for psychosocial support in contexts of disaster and humanitarian crisis. Future studies should examine the effects of PFA on psychosocial outcomes for people affected by crises.

The objective of this study is to evaluate the effects of a culturally adapted multi-component positive psychology intervention (MPPI) on resilience. We conducted a randomized controlled trial among 158 employees of multi-ethnic origin in Paramaribo, Suriname. The participants were assigned to a 6-session intervention program or a wait-list control group. Data were collected at baseline, post-intervention, and at 3-months follow-up. Strict guidelines were followed to minimize risk of bias and to assure a high methodological quality. Analysis of covariance revealed large significant improvements on resilience, mental well-being, and negative affect, moderate improvements on depression and positive affect, and small improvements on anxiety compared to control. The intervention was not more beneficial on stress, financial distress, and psychological flexibility than control. In conclusion, a culturally adapted MPPI may be a promising intervention to increase resilience and well-being among healthy adults with a multi-ethnic background in the Caribbean.