Delivering therapy over telephone in a humanitarian setting: a pilot randomized controlled trial of common elements treatment approach (CETA) with Syrian refugee children in Lebanon

Many displaced individuals living in low and middle income countries (LMICs) meet the criteria for mental health issues. However, the vast majority never receive treatment due to multiple reasons, including a shortage of mental health professionals in LMICs, transportation challenges in accessing clinics, and clinic hours conflicting with family commitments.

This pilot randomised controlled trial with 20 refugee children investigated whether individual psychotherapy delivered by trained lay counsellors over telephone (t-CETA) is effective and overcomes barriers to treatment access.

The study found a significant session-by-session decrease in self-reported mental health symptoms over the course of treatment. Independent assessments showed that t-CETA resulted in a greater reduction of symptoms than standard in-person treatment as usual. There was no difference between groups for impairment. Importantly, the majority of children allocated to t-CETA completed treatment whilst no children in the treatment as usual condition were able to do so.

The results show the potential for use of t-CETA to reduce mental health symptoms in humanitarian settings, although findings remain to be replicated in larger trials.