Türkiye was struck by two large earthquakes with moment magnitudes 7.7. and 7.6, on the 6th
of February 2023. The disaster resulted in more than 50 thousand people losing their lives,
more than 107 thousand people getting injured and more than 84 thousand buildings being
demolished, severely damaged or slated for demolition. After the earthquakes, various mental
health issues can emerge among the survivors such as depression, anxiety disorders,
posttraumatic stress disorder, sleep problems, prolonged grief disorder, decrease in quality
of life, increase in suicidality and substance use, and their effects can be prolonged if not
treated.
An effective treatment method for the mental health issues that the earthquake survivors may
experience is cognitive behavioral therapy (CBT) which is effective both in individual and
group formats. Moreover, culturally adapted versions of CBT demonstrated higher
effectiveness. One such adaptation, developed as a transdiagnostic intervention by Devon
Hinton, is known as Culturally Adapted CBT (CA-CBT), which has shown effectiveness across
various cultures and countries. It has been successfully applied to depressed and traumatized
women in Türkiye, reducing depressive symptoms and PTSD. CA-CBT incorporates emotion
regulation techniques, mindfulness and stretching exercises as well as cognitive-behavioral
approach principles. Some advantages of the CA-CBT are: (1) as a transdiagnostic
intervention, it can be applied to treat various psychopathologies (2) as a group
intervention, it can be applied to multiple individuals simultaneously, (3) as an 8-session
intervention, it can improve mental health in the short term.
CA-CBT has not been tested with a population specifically consisting of individuals affected
by earthquakes before. This pilot randomized control trial (RCT) aims to assess the potential
effectiveness and feasibility of CA-CBT, specifically tailored for the earthquake survivors,
and their mental health issues following the disaster. The main research questions of the
study are whether the group CA-CBT is effective in decreasing psychological distress and
depressive symptoms and increasing well-being among earthquake survivors one month after
post-assessment.
The study is planned to be conducted with the collaboration with non-governmental
organizations giving services to earthquake survivors. After the baseline assessment,
eligible 60 participants will be randomized to two arms according to the 1:1 principle with
automatized randomization software. 30 randomly allocated participants will receive CA-CBT
and 30 randomly allocated participants will receive Enhanced Care as Usual (E-CAU) as the
control group. One week after the completion of the sessions, all participants including
control group participants will have post-assessments consisting of the same questionnaires
as baseline assessment. One month after the post-assessment, all participants including
control group participants will have follow-up assessments consisting of the same
questionnaires as baseline and post-assessments.
If CA-CBT proves effective for individuals affected by earthquakes, it can be disseminated
among mental health care professionals. Consequently, more earthquake survivors can access
this high-quality evidence-based intervention adapted to their culture.