Trauma Treatment Trial; 'Triple T'

There are two active arms to this trial; Arm 1: Neurofeedback integrated with trauma counselling (NFT) Arm 2: A ‘lifestyle enhancement intervention’ (LEI) involving trauma counselling, nutrition and exercise therapy Both treatment arms will participate in 30 x 1 hour sessions, scheduled at two per week for 15 weeks. For NFT, each of the 30 sessions will include approximately 20mins of neurofeedback training integrated with 40 mins of counselling. LEI will involve a one hour session week in counselling (15 sessions) and one in a lifestyle enhancement session. Both interventions will be delivered individually and face-to-face, onsite at STARTTS’s neurofeedback/counselling rooms. Adherence will be measured as number of sessions attended. Attendance, intervention and session length are recorded by the clinician as part of routine care. NEUROFEEDBACK TRAINING is a non-invasive method of modifying brainwave patterns using principles of behavioural learning. Brain activity is measured using an electroencephalograph (EEG) and is shown to the trainee via a simple signal (visual or auditory) to indicate to them when their brain is producing the desired activity. Over sessions new patterns are strengthened, increasing mental flexibility for processing situations in a more self-serving way. Training protocols are chosen based on a decision tree for symptoms, and informed by quantitative EEG. The default protocol will target the most prevalent presentation seen in PTSD of hyperarousal and involve reinforcement of alpha (8-10Hz) and right parietal and temporal regions. Neurofeedback therapy will be delivered by psychologists who have experience and training with neurofeedback and trauma counselling with this population. LIFESTYLE ENHANCEMENT INTERVENTION was developed at STARTTS as a complement to standard counselling. They focus on improvement of lifestyle habits in diet, sleep and physical activity, through education, monitoring support and coaching, in order to improve physical health and psychological wellbeing. TRAUMA FOCUSED COUNSELLING (part of both NFT and LEI arms) Counselling delivered at STARTTS tailored for the special needs of refugees and draws on current research and clinical experience. A variety of therapy modalities will be used according to the presentation of the client and the background of the clinician. Methods include case management, psychoeducation, mindfulness, acceptance and commitment therapy, grief counselling and cognitive therapy.