Subproject SP2 focuses on the cultural and contextual adaptation of a treatment program addressing the needs of emotionally burdened refugees in Germany, both online and in a face-to-face therapy setting. By this means a significant gap in the German health care system is to be closed. As a first step, the so-called „Common Elements Treatment Approach“ (CETA) is linguistically and culturally adapted to the target group of Arabic-speaking refugees. As a transdiagnostic treatment method, CETA is not limited to a specific disorder, but addresses a number of psychological problems that are widespread in refugees. Next, an Internet-based equivalent of the culturally adapted CETA intervention will be developed: the „ALMAMAR“-app. Through regular cooperation with refugees, therapists and other relevant stakeholders, cultural and other barriers are identified and resolved during development, resulting in a successive improvement of the App’s usability and acceptance.  

In another subproject of the I-Reach consortium the effectiveness and acceptance of the Internet-based program will be compared with the face-to-face variant of CETA (SP3). Moreover, the suitability of the ALMAMAR-app as a supplementary treatment for refugees in an inpatient setting (i.e. blended care) will be investigated (SP4).

Study procedures

The following timeline illustrates the steps of cultural adaptation and subsequent app development. By regularly involving representatives of the target group (Expert Panels), ideas and change requests may directly be incorporated. 

Formative Research
Literature review, Interviews and Focus groups with refugees/ healthcare professionals addressing needs and barriers
Adaptation of the CETA treatment manual
Based on results of formative research
A first version of the online intervention is developed
Next: Feedback on the first version by Expert Panel (Refugees, Healthcare Professionals)
A second version of the online intervention is developed
Next: Feedback on the second version by Expert Panel
The final version of the online intervention is developed
Next: Feasibility, Usability and Acceptance is tested
Efficacy study in subproject SP3
Online vs. face-to-face treatment with CETA

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FU Berlin

Study results

The ALMAMAR app can be downloaded by study participants of the SP3 subproject to their smartphones or computers. Further information on the efficacy study or study participation can be found under the following link (link to SP3). The entire software infrastructure will also be made available open source for use by other research institutions.


Prof. Dr. Christine Knaevelsrud, Freie Universität Berlin, Abteilung für Klinisch-Psychologische Interventionsforschung

Dr. Nadine Stammel, Zentrum Überleben gGmbH, Berlin