Interventions With Children Engaged in Armed Conflict: A Global Systematic Review
While the issue of youth gang involvement has received considerable attention in academia, there is a paucity of research assessing the evidence base of interventions targeting this vulnerable population. Similarly, although the phenomenon of child soldiers has gained global awareness, there remains a gap in knowledge regarding effective interventions. Though embedded in different national and local contexts, child soldiers and gang-affiliated youth often face similar challenges. Therefore, researchers and practitioners working with either population can learn from effective interventions that support recovery and reintegration for children in armed conflict. The purpose of this systematic review is to qualitatively assess interventions for children who have participated in armed conflict.
Method
PRISMA standards for systematic reviews guided a computerized search of PsycINFO, Social Service Abstracts, Social Work Abstracts, and Google Scholar using a combination of the following search terms: “youth”, “child*”, “adolescent*”, “juvenile”, “gang”; “intervention”, “therapy”, “skills”, “outcome*”, “vocation”; “child soldier”, “armed conflict”, and “reintegration”. The search yielded 489 results. Given the embryonic stage of research in this area, the following broad inclusion criteria were utilized: 1) sample included youth aged 10-18 engaged in armed conflict; 2) publication occurred between 1992-2012 in a peer-reviewed journal; and, 3) intervention was delivered in a non-institutional setting. Seven studies met the inclusion criteria.
Results
All studies on gang youth (n=3) were conducted in the United States, while all studies on child soldiers (n=4) were conducted in Africa. Of the included studies, three were quantitative, two were mixed-methods, and two were qualitative. Only one study was a randomized control trial. Three were quasi-experimental; one utilized a pretest/posttest design with a control group that was not randomly assigned and two involved a pretest/posttest design without a comparison group. One study was longitudinal. The remaining two studies were qualitative; one employed face to face interviews and the other used focus groups. Interventions ranged from community-wide to family- and individual-centered. All but one intervention took place in community organizations or schools. A variety of outcomes were targeted; the most common targets were psychosocial (n=5) and behavioral (n=3) outcomes. Six out of seven interventions documented positive outcomes. One intervention was ineffective; this program was unique because it was an add-on to a life skills class and implementation quality was poor. Each of these interventions including outcomes will be discussed.
Conclusions & Implications
Although there were few studies that met our inclusion criterion, a strength of the effective interventions reviewed was their theoretically substantiated, multi-level approach to reintegration and recovery. Randomization is challenging under the community conditions in which gangs and child soldiers develop, however, this body of evidence could be strengthened tremendously with additional quasi-experimental studies that include a control group. Despite these methodological challenges, these studies point to the potential of effective social work interventions with children engaged in armed conflict, a highly traumatized and stigmatized group. Given the varied circumstances in which these interventions took place, our conclusions are tempered by the reality that these interventions will require cross-cultural adaptation.