ARC Journal of Psychiatry Volume 2, Issue 2, 2017, PP 7-14 www.arcjournals.org ARC Journal of Psychiatry Page | 7 A Pilot Evaluation Study of an Intercultural Treatment Program for Stabilization and Arousal Modulation for Intensely Stressed Children and Adolescents and Minor Refugees, Called START (Stress-Traumasymptoms-Arousal-Regulation-Treatment) Andrea Dixius*, Adrian Stevens, Eva Moehler SHG Klinik für Kinder und Jugendpsychiatrie, Psychotherapie, Psychosmatik, Waldstr. 40, Kleinblittersdorf, Germany 1. BACKGROUND Prevalence of psychiatric disease in unaccompanied refugeed minors is described to be about 80% [1]. In Germany about 60000 unaccompanied refugeed minors were recorded by the Government in 2016 [2]. Varying numbers of psychiatric abnormalities in this population ranging from 20% - 81,5% [3]. Among others, refugeed minors are identified as a highly vulerable risk group, with the lack of psychosocial support increasing the risk for mental health problems in this population [4-7] The short therapeutic program START was developed in clearing contexts for refugeed minors [8, 9]. Originally conceived for the work with refugeed minors only, an attraction and potential clinical use for domestic adolescents in stressful situations was discovered [10]. The program consists of very playful elements for self- perception of inner tension. In the second step adolescents try out skills to reduce their tension in an equally playful way, requiring very little speech. The last step is the construction of an indivdual skills box and *Corresponding Author: Andrea Dixius, SHG Klinik für Kinder und Jugendpsychiatrie, Psychotherapie, Psychosmatik, Waldstr. 40, Kleinblittersdorf, Germany, Email: a.dixius@io.shg-kliniken.de Abstract Background: During or after periods of intense stress, such as traumatic migration or other experiences children and adolescents are in danger of developing psychiatric or physical symptoms. In these cases frequent barriers to treatment have recenty been described for refugeed minors, including language or cultural impediment. Therefore a short, very low threshold, playful program for emotion regulation and self soothing was developed, the Stress-Traumasymptoms-Arousal-Regulation-Treatment, START. Methods: Adolescents in acute crisis at the age of 13 – 18 years participated in the START program for 5 weeks in multinational group settings, with two sessions per week. Compounds of START are derived from elements of dialectic behavioral therapy and trauma-focused cognitive behavioral therapy for children. After informed consent, the first 22 adolescents completing the program twere assessed for trauma (CATS, CPTCI), emotion regulation (FEEL-KJ), general mental and physical Health (RHS), experienced self-control (SCS) and perceived stress (PSS) immediately before and after treatment. Results: Traumasepcific symptom load (CATS; CPTCI) was very high in the first 22 adolescents. A positive effect of START on emotion regulation (specifically the scale adaptive stratagies), and self-control can be found as well as a negative effect (reduction) of perceived stress (PSS-10). Also, on a visual analogue scale adolescents scored better for general subjective well being in the refugee health screener after completing the START program. Conclusion: The results are promising first data supporting the applicability and helpfulness of START in young refugeed minors and other highly stressed adolescents underlining intercutural use with an additional advantage of integration and strengthening of relilience in several at rsik populations. Small sample size is a limitation, as well as the lack of a treatment- as -usual control group. Future studies are warranted. Keywords: Traumasymptoms, Intensely stressed adolescents, minor refugees, Early-intervention, Prevention, Stress-resilience-training