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Narrative Therapy for Anxiety and Depression in Palestinian Refugee Adolescents

NCT07691021 · Status: COMPLETED · Phase: NA · Type: INTERVENTIONAL · Enrollment: 120

Last updated 2026-07-08

No results posted yet for this study

Summary

This study evaluated whether a culturally adapted 10-week narrative therapy program could reduce anxiety and depression symptoms among middle school students living in refugee camps in Northern Palestine. Adolescents aged 12-15 years from UNRWA-operated schools with moderate-to-severe anxiety and depression symptoms participated. The study used a quasi-experimental design with 120 students assigned to either the narrative therapy program (n=60) or standard school services (n=60). The 10-week program included weekly 60-minute group sessions that incorporated Palestinian cultural metaphors such as sumud (steadfastness) and olive tree symbolism. Participants completed the Revised Children's Anxiety and Depression Scale (RCADS) at three time points: before the program, immediately after the 10-week intervention, and three months later. The study measured changes in anxiety and depression symptoms, clinical improvement, and feasibility outcomes including retention, fidelity, and acceptability. Results showed that participants in the narrative therapy program experienced greater reductions in anxiety and depression symptoms compared to those receiving standard school services. The effects were maintained at the three-month follow-up. Seventy-two percent of intervention participants achieved clinically significant improvement compared to 21% of controls. The program demonstrated high retention (95%), good implementation fidelity (87.3%), and strong acceptability (85% of participants found the cultural metaphors helpful). The findings suggest that culturally adapted school-based narrative therapy may be a feasible and promising approach for addressing mental health needs among refugee adolescents in humanitarian settings. However, because this was not a randomized controlled trial, the results should be interpreted as associations rather than definitive causal effects.

Conditions

  • Anxiety
  • Depression - Major Depressive Disorder

Interventions

BEHAVIORAL

Culturally Adapted Narrative Therapy

A 10-week manualized narrative therapy program delivered in weekly 60-minute group sessions. The program integrates Palestinian cultural metaphors including sumud (steadfastness) and olive tree symbolism. Key components include problem externalization (using shadow and cloud metaphors), agency restoration (identifying personal strengths and resilience stories), collective resilience (community narratives), mindfulness practices, and future-oriented narrative reconstruction. Each session follows a structured format including check-in, main activity, discussion, and closing reflection. The program was delivered by trained school counselors and psychologists in UNRWA-operated middle schools.

Sponsors & Collaborators

  • Nablus University for Vocational and Technical Education

    lead OTHER

Study Design

Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Model
PARALLEL

Eligibility

Min Age
12 Years
Max Age
15 Years
Sex
ALL
Healthy Volunteers
No

Timeline & Regulatory

Start
2024-06-16
Primary Completion
2024-09-14
Completion
2024-12-14

Countries

  • Palestinian Territories

Study Locations

More Related Trials

Entities

Diseases

Read the full study record

This page highlights key information. For complete eligibility criteria, study locations, investigator contacts, and the full protocol, visit the original record on ClinicalTrials.gov.

View NCT07691021 on ClinicalTrials.gov