A Randomized Controlled Pilot Study using Mind–Body Interventions among Refugees in Sweden

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Kevin M. Cloninger
Alexandre Granjard
Nigel Lester
Erik Lindskär
Patricia Rosenberg
C. Robert Cloninger
Danilo Garcia


Background: Migration is one of the major challenges of the 21st century with many refugees being victims of torture and experiencing war and the collapse of their society. Sweden, for example, received about 169,520 refugees during 2015 and 20–30% of them were estimated to suffer from mental illness. Nevertheless, research shows that about 66.40% of refugees never reveal their traumatic experiences to a doctor and a majority refuse psychiatric help. Hence, we need innovative methods to promote the physical, mental, and social health of refugees.
Objective: We examined the effects of Anthropedia’s Well-Being Coaching (i.e., a biopsychosocial approach to coaching) and Well-Being Spa (i.e., modern version of age-old Spa interventions) on the personality and health of a sample of refugees living in Sweden.
Methodology: Participants were recruited as part of a health and employment project in Blekinge, Sweden. A total of 70 Syrian refugees were randomly assigned to a six-month intervention comprising either Well-Being Coaching, or Well-Being Spa, or both (i.e., Mind–Body). The participants reported personality (temperament and character), well-being (positive and negative affect, life satisfaction, and harmony in life), and ill-being (defeat and entrapment, and anxiety and depression) at the beginning and at the end of the six-month intervention period.
Results: Participants assigned to the Well-Being Coaching intervention showed increases in self-directedness (Cohen’s d = 0.84), cooperativeness (Cohen’s d = 0.36), positive affect (Cohen’s d = 0.43), and life satisfaction (Cohen’s d = 0.56), and decreases in both negative affect (Cohen’s d = 0.38) and defeat (Cohen’s d = 0.89). Participants assigned to the Well-Being Spa intervention showed decreases in harm avoidance (Cohen’s d = 0.55), reward dependence (Cohen’s d = 0.69), negative affect (Cohen’s d = 0.82), anxiety (Cohen’s d = 0.53), defeat (Cohen’s d = 0.34), and external entrapment (Cohen’s d = 0.42). Participants assigned to the Mind–Body intervention showed significant decreases in harm avoidance (Cohen’s d = 0.47), anxiety (Cohen’s d = 0.61), depression (Cohen’s d = 0.34), defeat (Cohen’s d = 0.56), external entrapment (Cohen’s d = 0.44), and internal entrapment (Cohen’s d = 0.79) and increases in persistence (Cohen’s d = 0.27), self-directedness (Cohen’s d = 0.28), cooperativeness (Cohen’s d = 0.43), self-transcendence (Cohen’s d = 0.51), positive affect (Cohen’s d = 0.42), and harmony in life (Cohen’s d = 0.36).
Conclusions: The results of the present study suggest that Well-Being Coaching strengthens refugees’ character, while the Well-Being Spa treatments reduced participants’ tendency to worry and anxiety. Finally, the combination of these two interventions seems to promote the development of health-related traits, reduce ill-health, and stress, and increase well-being in a wider biopsychosocial perspective.

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