Methods: This systematic review included evaluations of interventions that broadly targeted refugees, asylum seekers, or displaced persons as a result of political violence, with a focus on contemporary crises. The following databases were searched: PsychINFO, Pubmed, Web of Science, CINAHL, Eric, as well as the grey literature (e.g., think tank and NGO evaluation reports). Articles were included if they meet the following criteria: 1) experimental or quasi-experimental study design, 2) assessed child mental health and developmental outcomes, including socio-emotional, cognitive, and language outcomes, 3) were published since 2001. Studies were excluded if they did not include a control group or used an individual psychotherapy approach to treating children or their families. PRISMA procedures were followed; two reviewers independently screened all titles and abstracts for inclusion and exclusion criteria, followed by a full text review. Programs were assessed for their overall effectiveness on child outcomes, and comparisons were made between community (e.g., school-based) and parenting programs.
Results: Studies were categorized by type of intervention and delivery target. Results were categorized under eight main categories at three levels: 1) at the child level: mental health outcomes (e.g., depression, anxiety, ptsd), socio-emotional development (e.g., behavioral problems), and cognitive development; 2) at the parent level: mental health outcomes, psychosocial wellbeing (stress, coping), and parenting (e.g., harsh punishment, responsiveness, and stimulation); and 3) at the family level: family functioning and support. The quality of each study was assessed for risk of bias using the Cochrane Risk of Bias Assessment tool for Non-randomized Studies (RoBANS).
Conclusions and Implications: Programs that treat the whole family may be better suited to address mental health problems and the intergenerational effects of trauma. Community and family programs alone, however, may not be intense enough to address the complex issues refugees and their families face. Further research is needed to understand multi-system solutions to address mental health problems in refugee children, and to make up for educational disruptions. Furthermore, research on preventive interventions for children who do not yet display mental health symptoms is warranted.