A Scoping Review of Family Interventions for Immigrant/Refugee Children, Exploring Intergenerational Trauma

Background/Rationale

Immigrant and refugee children face tremendous mental health challenges due to exposure to conflicts, persecution, and traumatic events during migration, as well as structural racism post-migration. The repercussions of such trauma can transverse generations through familial, cultural, and sociohistorical pathways. Family-based interventions are well-suited for immigrant/refugee communities, because of their collectivist culture and emphasis on family. Few studies have evaluated family-based interventions that target intergenerational trauma within the families of immigrant/refugee children. This study synthesizes available research evidence on the effectiveness of family-based trauma interventions for immigrant/refugee children and their caregivers by focusing on intergenerational outcomes.

Method

A scoping review was conducted on peer-reviewed studies published in the United States and globally from 1990 to 2023. Four electronic databases were searched using the key terms, ‘intergenerational trauma’, ‘immigrant’, ‘refugee’, ‘child’, ‘family’ or ‘caregiver’, ‘family-based trauma’, and ‘intervention’. Only quantitative studies that involved and reported outcomes for both immigrant/refugee children and family caregivers were included. The study followed the PRISMA-ScR checklist.

Result

The search yielded 1,721 articles and five studies met the final inclusion criteria. All five studies were quasi-experimental studies with pretest and posttest designs. The methodological rigor was evaluated and indicated an overall medium quality. The interventions included two parenting programs, two multifamily programs, and one school-based program, all of which incorporated cultural adaptation processes such as translation, modification of intervention, and collaboration with communities or interpreters. All studies contained samples of immigrant/refugee children who were non-US-born; two studies also included racial/ethnic minority children who were US-born. Most caregivers were parents, low-income, and non-US-born. All five interventions showed effectiveness in reducing the child’s trauma-related stress or symptoms. However, the impact on parental mental health or PTSD symptoms was mixed, with two studies showing no significant improvement or even an increased level of distress post-intervention. Three studies found improvements in parenting skills post-intervention. Components addressing intergenerational trauma were present in all studies. These included measuring intergenerational congruence, family coping, family and parent adjustment, and PTSD symptoms in the context of child-caregiver relationship.

Conclusion

This study shows promising system-based interventions (e.g. multifamily, parenting groups, and school interventions) for addressing intergenerational trauma among immigrant and refugee populations. All five studies found effectiveness in reducing the child’s trauma-related symptoms. However, more studies on trauma-related outcomes of caregivers are needed. The identification of only five studies underscores the urgency of addressing the lack of research on intergenerational trauma among immigrant/refugee children and their families.

The review highlights the need for employing a holistic approach to understand and address intergenerational trauma experienced by immigrant/refugee families to make social work interventions more culturally relevant. It is important to have greater involvement of immigrant/refugee communities in the development, implementation, and evaluation of family-based trauma interventions. Such enhanced community engagement in research process not only furthers racial justice but also fosters equitable access to mental health services for marginalized populations.