“I’ve been waiting for 10 years to start living again” – Self-perceived problems of Afghan asylum seekers and refugees and their experiences with a short psychological intervention

Background: This study examined Afghan asylum seekers and refugees’ experiences treated with an adapted version of the brief psychological intervention Problem Management Plus (aPM+) and explored which problems trouble them most, and how these problems influence their daily functioning. It further examined how various standardized outcome measures correlate with these subjectively perceived problems. Method: This study is part of a larger research project (PIAAS study) and uses a multi-method approach consisting of two parts. First, it investigated the participants’ self-identified problems and subjective functional impairment with quantitative and an qualitative assessments within the treatment and control group (n=88). Second, we conducted qualitative in-depth interviews to gain a deeper understanding of personal experiences with aPM+ as well as suggestions for improvement with a subsample of the treatment group (n=24). Spearman correlations were applied for quantitative data and for qualitative data deductive and inductive approaches of thematic analysis were used. Results: We identified six main themes of self-perceived problems (post migration living difficulties, general mental problems, interpersonal stressors, mental problems specifically associated with stress, and somatic problems) and their consequences as well as subjective functional impairment. Standardized measures of general mental health, posttraumatic psychopathology, and quality of life did not correlate with the perceived intensity of the self-perceived problems. aPM+ was perceived mostly positively and few participants had recommendations for its improvement. Conclusion: The study aimed at giving a voice to Afghan trauma survivors to inform service providers and policy makers about their needs. Further, it includes their expertise to tailored interventions for their actual needs and its practical use. APM+ shows to be a positively perceived intervention that reduces subjective symptom burden and facilitate daily functioning. Thus, culture-sensitive treatments should be facilitated within (mental) health services to increase service use and (mental) health in a long run.