title: Cognitive behavioral psychotherapeutic treatment at a psychiatric trauma clinic for refugees: description and evaluation.
abstract: BACKGROUND
  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.
  
  
  OBJECTIVE
  To describe and evaluate a manualized cognitive behavioral therapy for traumatized refugees incorporating exposure therapy, mindfulness and acceptance and commitment therapy.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Competence Center for Transcultural Psychiatry (CTP), Psychiatric Center Ballerup, the Mental Health Services of the Capital Region of Denmark. Correspondence to: caecilie.boeck.buhmann@regionh.dk.
authors.forename: Cæcilie
authors.initials: C
authors.lastname: Buhmann
authors.forename: Ida
authors.initials: I
authors.lastname: Andersen
authors.forename: Erik Lykke
authors.initials: EL
authors.lastname: Mortensen
authors.forename: Jasmina
authors.initials: J
authors.lastname: Ryberg
authors.forename: Merete
authors.initials: M
authors.lastname: Nordentoft
authors.forename: Morten
authors.initials: M
authors.lastname: Ekstrøm
mesh_terms: D000328:Adult; D003071:Cognition; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003718:Denmark / Q000453:epidemiology; D005006:Ethnicity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012036:Refugees / Q000523:psychology*; D012189:Retrospective Studies; D013313:Stress Disorders, Post-Traumatic / Q000208:ethnology / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult