2 - (OP15) A Cbt-based Brief Intensive Group Emotion Schema Therapy Intervention for PTSD in Older Female North Korean Defectors

North Korean defectors are frequently exposed to severe and repeated traumatic experiences during defection, including starvation, violence, human trafficking, bereavement, torture, and detention. In these contexts, emotional suppression and reduced emotional awareness may develop as survival strategies and persist after resettlement, contributing to emotion regulation difficulties and chronic posttraumatic stress disorder (PTSD). Accordingly, affirming CBT-based interventions that contextualize trauma responses within survival experiences are needed. Emotion Schema Therapy (EST), a CBT-based approach targeting beliefs and interpretations about emotions, may be particularly suitable. This study examined the effects and feasibility of an EST-based brief intensive group intervention for older female North Korean defectors with PTSD.
Participants were 25 female North Korean defectors aged ≥50 years. The intervention was delivered in small groups (4–6 participants per group) over two consecutive days (eight 90-minute sessions) and designed as an equity-oriented format to reduce barriers related to time, mobility, and emotional burden. Core components included breathing-based mindfulness, psychological stabilization, emotion-focused brainstorming and psychoeducation, and emotion-focused memory work addressing common emotion schemas (e.g., emotional suppression, excessive guilt), ending with strategies to expand emotional space and emphasize the non-permanence of emotions.
Outcomes were assessed at pre-, post-, and follow-up using the PCL-K-5 (PTSD), ITQ-K (CPTSD), K-DERS and LESS-II (emotion regulation/emotion schemas), and LSIS (social isolation/loneliness). Effect sizes were calculated using Hedge’s g.
Results indicated meaningful reductions in PTSD symptom severity. The proportion meeting PTSD screening criteria decreased from 100% (n = 25) at baseline to 60% (n = 15) post-intervention and 72% (n = 18) at follow-up; CPTSD screening rates decreased from 32% (n = 8) to 16% (n = 4). Improvements were also observed in emotional awareness/clarity, emotional nonacceptance, and maladaptive emotion schemas, as well as loneliness and social isolation (high-risk loneliness: 64% [n = 16] to 44% [n = 11]; high-risk isolation: 44% [n = 11] to 24% [n = 6]).
In conclusion, this EST-based two-day brief intensive group program showed promising effects for older female North Korean defectors with PTSD by integrating an affirming CBT-based perspective with an equitable intervention model, supporting the feasibility of a sustainable CBT approach for trauma-exposed underserved populations.