The effect of integrating cross-sectoral collaboration in psychosocial treatment of trauma-affected
refugees; a randomised controlled trial.
2. Project period
4. Supervisors and collaborative partners
Jessica Carlsson and Lene Eplov.
Postmigration conditions in resettlement countries may moderate or exacerbate mental health outcomes
in refugees (1). Ongoing stresses related to social problems may lead to difficulties focusing on the content
and process of treatment for trauma-related mental health problems (2). This could reduce treatment
outcomes. Cross-sectoral collaboration and coordination of municipal social interventions and regional
psychiatric treatment are currently limited (3).
The aim of this study is to investigate the effect of integrating cross-sectoral collaboration with the
municipality in psychosocial treatment of trauma-affected refugees.
7.1 Number of participants (N)
Included in the study are refugees with post-traumatic stress disorder, who are unemployed and
attending a municipal job centre or sickness-benefit unit in one of the five collaborating municipalities;
Frederikssund, Gladsaxe, Hillerød, København, or Lyngby-Taarbæk.
7.3 Description of data and data collection
The randomised controlled trial is comparing treatment as usual comprising 10 sessions with a medical
doctor (pharmacological treatment and psycho-education) and 16 sessions with a psychologist
(cognitive behavioural therapy) with add-on of the cross-sectoral social intervention. The core of the
intervention consists of three meetings between the patient, the municipal case counsellor and
clinicians from CTP. The meetings are held at the beginning, half-way and end of an 8-10 months
multidisciplinary treatment course. The patient’s self-perceived social stressors are addressed and a
comprehensive action plan for handling the patient’s challenges is made. In-between the meetings the
involved parties will be in ongoing contact.
In addition, qualitative data will be collected for approximately 15 participants throughout the
treatment period and 6 months after treatment has ended. The qualitative data collection will focus on
how the participants have experienced the cross-sectoral collaboration, psychiatric recovery and
treatment outcome, social recovery and whether the participants are left with a better plan and overview of life situation and circumstances. It will primarily consist of interviews and observations of
7.4 Application/acceptance from the Danish Data Protection Agency, the National Committee on
Health Research Ethics
Application has not yet been submitted.
The primary outcome is WHODAS 2.0 together with a variety of secondary outcomes measuring
psychiatric symptoms, quality of life and social factors (HTQ, HSCL-25, WHO-5, EQ6D, CHAI, HAM17-
D+A, GAF-F+S). Different qualitative analysis will be carried out in accordance with the nature of the
8. Expected results
We expect the integrated cross-sectoral intervention to enhance outcomes of treatment.
9. Dissemination of results
PhD thesis and 4-6 scientific publications.
1. Porter M, Haslam N. Predisplacement and postdisplacement of refugees and internally displaced
persons: A meta-analysis. J Am Med Assoc. 2005;
2. Bruhn M, Rees S, Mohsin M, Silove D, Carlsson J. The range and impact of postmigration stressors
during treatment of trauma-affected refugees. J Nerv Ment Dis. 2018;206(1):61–8.
3. Rigsrevisionen. Forløbet for flygtninge med traumer. 2018.