Abstract
Young refugees face numerous challenges before, during, and after their journey, leading to higher rates of mental health issues such as depression, anxiety, and posttraumatic stress disorder. These problems often remain untreated due to barriers like limited services, stigma, and varied distress expressions. One effective scalable intervention that bridges this treatment gap is problem management plus (PM+), a transdiagnostic program delivered by trained nonspecialists. However, PM+ lacks a module directly targeting posttraumatic stress, which is a common problem in young refugees. This study presents the cultural and contextual adaptation process of PM+ for young refugees in the Netherlands that includes a newly developed emotional processing module. Qualitative data collection included free list interviews with youngsters (n = 33), key informant interviews with professionals (n = 9), policymakers (n = 5), key people from communities (n = 10), focus group discussions (n = 11) and one focused interview. A new module targeting distressing memories was developed and reviewed by experts (n = 14). Results supported protocol adaptations, including culturally and age-appropriate language, examples, illustrations and length. This research aims to develop feasible, culturally sensitive mental health interventions tailored to the unique needs of young refugees. Impact statement This qualitative study aims to shed light on the experiences, daily problems and challenges young refugees, particularly ones from Syria, Eritrea and Afghanistan face while living in the Netherlands, with the view of developing a suitable adaptation of Problem Management Plus (PM+) to address posttraumatic stress. Young refugees may be at risk for common mental disorders such as depression and posttraumatic stress disorder (PTSD). However, they experience several barriers and challenges reaching mentalhealth services available inthe Netherlands. By adapting aneffective scalable intervention PM+ for young refugees from Syria, Eritrea and Afghanistan in the Netherlands, this study aimed to develop a potentially acceptable and safe treatment strategy, contextually adapted for use in youth refugee care. This study also contributes significantly by introducing a newly developed, brief module that can be delivered through task-sharing and designed to address the processing of emotions associated with memories of negative or traumatic past experiences and reduce symptoms of PTSD. This module can be used in future randomized controlled trials among refugee youth exposed to traumatic experiences. Given the prevalence rates of PTSD among young refugees, integrating a module specifically targeting traumatic experiences into a scalable intervention like PM+ holds substantial promise. PM+ with the emotional processing module, adapted for use among young refugees, has the potentialtoyield improved outcomes interms of reducing PTSD symptoms and related mental health problems among young