Cognitive Behavioral Group Therapy To Treat the Psychological Distress of Migrant Returnees from Saudi Arabia: The Case of Entoto and Bole-Michale Refugee Center

Abstract

The devastating negative effects of migration on returned migrants' mental health, as well as the scarcity of research findings in the therapeutic field , prompt research into the treatment aspect of the problem.This study examined the use of group cognitive behavioral therapy (CBT) in addressing the psychological distress of Ethiopian returned migrants. It was conducted by involving returned migrants who have been staying at Entoto and Bole-Michale refugee center, receiving bio-psycho social support from EPHI in Addis Ababa. The study was a quasi-experimental nonequivalent group pretest-posttest design of a mixed research method both quantitative and qualitative approaches.Purposely selected forty-four participants were assigned to the treatment and control groups, each with 22 participants. To assess the psychological distress level of the research participants, the Kessler Psychological Distress Scale (K10) was used on two occasions: pretest and posttest. Participants in the treatment group received eight group CBT sessions for two hours each, two times a week. After the intervention, a focus group discussion (FGD) was held with members of the treatment group to pinpoint the opportunities and major challenges in the group CBT.Paired samples t-test indicated that there was a statistically significant decrease in psychological distress from baseline (M = 39.15, SD = 7.67) to posttest assessment (M = 29.68, SD = 2.67, t (15) = 4.324, p 0.05 in the experimental group. The mean decrease in psychological distress was 9.46, with a 95% confidence interval ranging from 4.80 to 14.13. On the other hand, the paired sample t-test result of the control group showed no statistically significant difference in psychological distress scores from baseline (M = 38.33, SD = 6.72) to posttest assessment (M = 39.05, SD = 5.16, t (16) = -315, p =.757). The mean difference in psychological distress was -720, with a 95% confidence interval ranging from -5.572 to 4.131. In addition, an independent samples t-test indicated a significant difference in psychological distress scores between the treatment group (M = 29.68, SD = 2.67) and control group (M = 39.05, SD = 5.16; t (24), p =.000). The majority of participants in the experimental group showed very high (81.25%) and high (18.75%) psychological distress before treatment. Similarly, in the control group, it was found that (17.7%) high and (82.4%) very high psychological distress during the pre-test. After the group CBT, the treatment group showed a statistically significant reduction in the level of psychological distress from pretest to posttest mean of psychological distress. However, there was no statistically significant difference in psychological distress scores from pretest to posttest mean in the control group. Moreover, there was a significant difference in mean psychological distress between the treatment and control groups after group CBT intervention. According to the FGD results, group CBT has the potential to help participants identify common dysfunctional or negative thoughts deeply embedded in their traumatic migration life experience. It also fosters hope, encourages sharing of personal experiences, and acts as a catalyst for cognitive and behavioral change. A significant challenge to providing group CBT was recognized as staying too long in the refugee camp, being cut off from family, failing to attend therapy sessions because of a sudden illness, being referred to the hospital, and leaving the camp illegally. Based on the findings of the study, it was suggested that group CBT will have paramount importance in addressing the psychological distress of returned migrants, but it needs further comprehensive studies in the area.