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.
