The effectiveness of therapeutic interventions on psychological distress in refugee children: A systematic review

Abstract

Objective To systematically review existing research exploring the effectiveness of psychological interventions in reducing symptoms of distress amongst refugee and asylum‐seeker children. Method Six databases were searched to identify English studies presenting original empirical quantitative data (published before September 2022) testing the efficacy of psychological interventions for children from refugee and asylum‐seeking backgrounds. Quality of studies were assessed through the Appraisal Tool for Cross‐Sectional Studies as well as the Cochrane Risk of Bias Tool. Relevant data were extracted to facilitate a narrative synthesis. Results Seventy‐one eligible articles were identified (n > 10,000). A number of cognitive‐behavioral, psychosocial, and trauma‐focused interventions that catered specifically to children and their families were identified. A synthesis of these results suggest that interventions may assist in the reduction of various psychopathologies, although the effects were mixed across intervention types. Conclusions While the review yielded promising findings, most findings were derived from small pilot and empirical studies, leading to difficulties with drawing conclusions. There remains a need for studies using more rigorous research methodologies to expand and ratify this valuable knowledge base. Clinical significance: Forced displacement is at an all‐time high. Many children are being forced to seek asylum and refuge, and they become vulnerable to the development of poor mental health, with limited understanding surrounding how to appropriately intervene. This review aims to equip clinicians with increased knowledge and confidence in working therapeutically alongside clients from refugee or asylum‐seeking background, with the goal of fostering positive mental health and wellbeing.

Psychotherapeutic and Psychosocial Interventions with Unaccompanied Minors: A Scoping Review

“…The increase in RCTs and controlled studies is indicative of that. Thus, as Cowling and Anderson [ 21 ] also pointed out, the findings are very promising; nevertheless, it is still difficult to draw conclusions in terms of effectiveness.…”

“…We opted to include papers included in previous reviews within our own review rather than move on from them because of differences in the inclusion criteria adopted by different reviews. The systematic review of Cowling and Anderson [ 21 ] was not scanned for the literature, as it was published while this paper was being written.…”

“…Various reviews on therapeutic and supportive interventions have been published. We found one practitioner [ 19 ] and two systematic reviews [ 20 , 21 ] (one of them including a meta-analysis [ 20 ]) that examined psychotherapy for refugee children with war-related trauma and/or mental distress, as well as a systematic [ 22 ] and a scoping review [ 23 ] examining psychotherapy specifically with UAMs. Several therapeutic approaches were reported, including cognitive behavioural therapy (CBT); trauma-focused cognitive behavioural therapy (TF-CBT); interpersonal therapy (IPT); narrative exposure therapy (NET); narrative exposure therapy for children (KidNET); eye movement desensitisation reprocessing (EMDR); testimonial psychotherapy; and systemic, transcultural, art and multimodal therapies.…”

“…The seven reviews that we identified on the subject offer insight into the research efforts and gaps regarding the minors’ therapeutic and psychosocial support. However, four of them were published five to 17 years ago [ 19 , 20 , 22 , 23 ], while the rest examined very specific aspects of the subject, namely interventions that were examined exclusively through quantitative studies [ 21 ], psychosocial interventions during the first year of arrival [ 24 ] and group interventions [ 25 ]. Therefore, to our knowledge, there is not a recent review that covers all research methods and types of intervention for both psychotherapy and PSS regarding the population of UAMs.…”

The social determinants of mental health and disorder: evidence, prevention and recommendations

“…There is systematic review evidence from RCTs that providing psychosocial interventions to refugees is effective in reducing PTSD symptoms 382 . Encouragingly, brief in dividual 383 or groupbased 384,385 psychological and behavioural interventions appear to reduce depressive and internalizing symp toms in refugees, including children 386 and adolescents 384 , though these may not be sustained in the longterm postinter vention 385 , and some evidence is of low quality 386 . A recent systematic review also found evidence that communitybased inter ventions which provided refugees with greater bridging and linking social capital (i.e., building ties with others in the community, helping them nav igate new structures, systems and institutions) may be most effec tive in reducing mental health symptoms in this population 387 .…”