Background: As displacement and forced migration continue to exhibit global growth trends, new and surviving generations of children are being born and spending their formative years in host countries. Refugee children who have not been exposed to traumatic events may still be at risk for adverse developmental and mental health outcomes via intergenerational trauma transmission. Objective: To identify and synthesize potential mechanisms of intergenerational trauma transmission in forcibly displaced families where parents have experienced direct warrelated trauma exposure, but children have no history of direct trauma exposure. Methods: PRISMA systematic review guidelines were adhered to. Searches were conducted across seven major databases and included quantitative, qualitative and mixed methods literature from 1945 to 2019. The search resulted in 752 citations and 8 studies (n = 1,684) met review inclusion criteria. Results: Findings suggest that parental trauma exposure and trauma sequelae indirectly affect child well-being via potential mechanisms of insecure attachment; maladaptive parenting styles; diminished parental emotional availability; decreased family functioning; accumulation of family stressors; dysfunctional intra-family communication styles and severity of parental symptomology. Conclusion: Further research is needed to assess independent intergenerational effects and mechanisms of trauma transmission in this population. Cruzando fronteras: una revisión sistemática de los mecanismos de transmisión intergeneracional del trauma en familias solicitantes de asilo y refugio Antecedentes: A medida que el desplazamiento y la migración forzada exhiben de manera continua tendencias de crecimiento global, las nuevas y sobrevivientes generaciones de niños nacen y pasan sus años de formación en los países de acogida. Los niños refugiados que no han estado expuestos a eventos traumáticos aún pueden estar en riesgo de consecuencias adversas para el desarrollo y la salud mental a través de la transmisión intergeneracional del trauma. Objetivo: Identificar y sintetizar mecanismos potenciales de transmisión intergeneracional de traumas en familias desplazadas por la fuerza donde los padres han experimentado una exposición directa al trauma relacionada con la guerra, pero los niños no tienen antecedentes de exposición directa al trauma. Métodos: Se siguieron las pautas de revisión sistemática PRISMA. Las búsquedas se realizaron en siete bases de datos principales e incluyeron literatura sobre métodos cuantitativos, cualitativos y mixtos desde 1945 al 2019. La búsqueda resultó en 752 citas y 8 estudios (n = 1.684) cumplieron con los criterios de inclusión de la revisión. Resultados: Los resultados sugieren que la exposición al trauma parental y las secuelas del trauma afectan indirectamente el bienestar del niño a través de mecanismos de apego inseguro; estilos de parentalidad maladaptativos; disminución de la disponibilidad emocional parental; disminución del funcionamiento familiar; acumulación de estresores famil...

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Background Despite recent advances in the development and provision of mental health and psychosocial support (MHPSS) in humanitarian settings, inadequate supervision remains a significant barrier to successful implementation. The present study sought to incorporate broad stakeholder engagement as part of the first phase of development of a new Integrated Model for Supervision (IMS) for use within MHPSS and protection services in humanitarian emergencies. Methods Semi-structured interviews were conducted with 26 global mental health professionals. Data was analysed thematically, using a combination of inductive and deductive methods. Codes and themes were validated through co-author cross-checks and through a webinar with an expert advisory group. Results Results reinforce the importance of effective supervision to enhance the quality of interventions and to protect supervisees’ wellbeing. Participants generally agreed that regular, supportive supervision on a one-to-one basis and as a separate system from line management, is the ideal format. The interviews highlight a need for guidance in specific areas, such as monitoring and evaluation, and navigating power imbalances in the supervisory relationship. Several approaches to supervision were described, including some solutions for use in low-resource situations, such as group, peer-to-peer or remote supervision. Conclusion An integrated model for supervision (IMS) should offer a unified framework encompassing a definition of supervision, consolidation of best practice, and goals and guidance for the supervisory process.

Recent research suggests that most young people exposed to school shootings demonstrate resilience, exhibiting no long-term dysfunction. However, a minority will experience severe and chronic symptoms. The likelihood of experiencing clinically significant reactions is influenced by pre-trauma functioning as well as peri-traumatic and post-traumatic factors. These include proximity to the trauma, peri-traumatic dissociation, post-traumatic emotional regulation difficulties, social support, and flexibility of coping styles. Research that separates the distinguishing features of young people with differing recovery styles is vital to tailor intervention. But methodological and design issues associated with such research necessitates caution in drawing conclusions. Variation in definitions and measures and the self-report nature of many of the studies are potential sources of bias. Greater uniformity across designs would enhance confidence and allow for improved evidence-based intervention.