Grief Disorder, Prolonged Clinical Trial
Official title:
Beyond Quake: A Human-Centered SH+ Randomized Controlled Trial for Earthquake Survivors
The central aim of this research is to execute a randomized controlled trial aimed at assessing the impact and effectiveness of the group-based SH+ intervention among earthquake survivors in Türkiye. The principal focus lies in investigating the potential benefits of the intervention. The key parameter of interest will be the extent of psychological distress encountered by the participants. In addition, various secondary outcomes will also be evaluated, encompassing depression, anxiety, post-traumatic stress disorder (PTSD) symptoms, psychosocial well-being, and grief levels. The evaluation of the intervention's effectiveness on the sample of interest will hinge on the comparison of scores obtained during the pretest and posttest measurement phases. It is hypothesized that scores will exhibit a decline following the participants' engagement with the SH+ program over the span of five weeks. Specifically, the hypothesis being tested posits that there will be a notable reduction in depression, anxiety, post-traumatic stress, psychological distress, psychosocial impairment, and grief scores during the post-assessment stage in contrast to the pre-assessment stage. It is expected that the experimental group and the control group will demonstrate significant differences in depression, anxiety, post-traumatic stress, psychosocial impairment, and grief scores. The primary outcome measure of psychological distress will show a statistically significant difference between the experimental and control groups at both the immediate posttest assessment and the 3-month follow-up assessment.
On February 6 2023, Türkiye experienced two consecutive major earthquakes measuring 7.6 and 7.8 on the Richter scale, resulting in extensive devastation across 11 provinces. According to data provided by the World Health Organization, the earthquakes resulted in a death toll of 51,000 and affected 9.1 million people, causing the displacement of 3 million individuals and the provision of accommodation for over 3 million people. The region experienced numerous subsequent aftershocks. The aftermath saw the collapse or severe damage of no fewer than 298,000 buildings. Earthquakes represent a well-explored phenomenon. The devastating impact of these seismic events goes beyond mere physical destruction and loss of life; it extends to people's aspirations and future plans, causing disruptions to the natural trajectory of their lives. While the anguish experienced by those who've lost loved ones cannot be alleviated, and the reality of the disaster cannot be undone, there may be measures we can adopt to alleviate its repercussions. A fundamental protective element, psychological flexibility, emerges as a means to mitigate the adverse aftermath of earthquakes. This trait empowers individuals to embrace psychological liberation by acknowledging their present circumstances and openly investigating the facets that are within and beyond their control. Natural calamities possess the capacity to reshape our perspective on the world. Our outlook on the future, our self-perception, and our perception of others undergo transformation compared to our pre-earthquake mindset. The seismic event disrupts the innate cognitive flow, triggering introspection about personal safety, one's role in the world, and the significance underlying social connections. The once-steadfast sense of security is replaced by a belief that danger looms, with vulnerability a constant companion. Traditional cognitive-behavioral therapy (CBT) methods challenge such notions, insisting on factual validation, whereas Acceptance and Commitment Therapy (ACT) charts an alternate course. It's noteworthy that as psychological flexibility heightens, the intensity of posttraumatic stress symptoms follows suit. Self-Help Plus (SH+), an intervention developed by the World Health Organization (WHO), is designed as a group-oriented stress management program tailored for adults. Rooted in Acceptance and Commitment Therapy (ACT) principles, SH+ comprises five sessions dedicated to fostering five essential skills: grounding, disengaging from unhelpful thoughts, aligning actions with personal values, practicing kindness, and creating emotional space. Functioning as a facilitated intervention, SH+ seeks to equip participants with the tools to effectively navigate their own distress through a cost-effective and concise approach. In the context of earthquake-affected communities, the imperative lies in implementing interventions that are both scalable and grounded in evidence. Within this framework, SH+ emerges as a structured vehicle to nurture the development of these five core skills among earthquake survivors. The program follows a group format and spans five weeks. Group-based interventions provide a platform for individuals to exchange their experiences, garner social support, normalize their emotional responses, and cultivate coping mechanisms, all of which collectively contribute to an enhanced state of psychological well-being. It is the shared exchange of mutual experiences within a supportive environment that catalyzes the healing process. In this light, SH+ holds the potential to fulfill this role effectively. ;