Review: Cultural adaptations to psychosocial interventions for families with refugee/asylum‐seeker status in the United Kingdom – a systematic review

Abstract

Background Young people with refugee or asylum‐seeker status (R/AS) often present with complex mental health needs, in the context of traumatic life experiences. Generic mental health services in the United Kingdom (UK) may be ill‐equipped to manage the unique experiences of these young people. Culturally adapted interventions (CAI) could provide a culturally sensitive approach to mental health support for refugee children experiencing difficult symptoms. A systematic review was conducted to determine the different types of cultural adaptation in the included studies, and to determine the efficacy of CAIs in comparison to generic treatment. Methods Systematic searches of eleven databases were completed in December 2020. Any psychosocial interventions conducted in the United Kingdom aimed at providing mental health support for refugee young people and families were included. This was to ensure the potential inclusion of all studies regardless of their adherence to the traditional framework of assessment and intervention in high‐income countries, for example randomised control trials. Results Eleven studies of varying methodology, participant group, intervention type and outcome measures were included in this review. Studies used a variety of cultural adaptations including surface‐level and deep‐level adaptations. Studies showed some support for the use of CAIs with young people with R/AS, with varying degrees of symptom reduction. It was not possible to compare the effectiveness of CAIs against ‘treatment‐as‐usual’, nor to determine the effectiveness of different CAI components. Conclusions Whilst there is evidence for the use of CAIs with R/AS young people, the heterogeneity between studies limits the generalisability of these results. The available research is not sufficient to provide conclusive evidence of the use of CAIs over ‘treatment‐as‐usual’. Research and clinical implications are highlighted. Future research could examine the most effective components of CAIs and aim to increase the evidence base of interventions for young people and families with R/AS.

Co‐designing a theory‐informed, multicomponent intervention to increase vaccine uptake with Congolese migrants: A qualitative, community‐based participatory research study (LISOLO MALAMU)

“…Our findings align with other research which highlights preferences for face‐to‐face 58,59 and oral communication 60,61 among migrant populations, as well as strategies that build or reinforce trust 59,62,63 . They also align with systematic reviews that have indicated that culturally adapted interventions may be effective in community settings 64,65 . However, our use of sociocultural elements and community members to facilitate engagement with the intervention went beyond the surface‐level cultural adaptations common to behavioural interventions, such as language translation or reading level adjustments, 65 representing an advancement on current literature.…”

A Systematic Review of Evidence-Based Interventions for Afghan Refugee Mental Health: A Cultural Adaptation Analysis

“…Given the wide diversity in treatment modalities, local implementation factors, measurement tools, and participant demographics such as age, it is not possible to unequivocally determine the effectiveness of programs based on their approach to cultural adaptations. Recent systematic reviews exploring extant psychosocial support programs for refugees have reported similar challenges given the great heterogeneity between evaluation studies (Spanhel et al, 2021; Taylor et al, 2023). As such, we report observations regarding the performance of interventions in this systematic review depending on their level of cultural adaptations without making any directional claims.…”

“…Peripheral adaptations can fall short in benefiting from these relevant and necessary sources of wisdom, potentially contributing to limitations in the extent to which EBI can be effective (Wessells, 2021). We join forces with other scholars who advocate for further rigorous explorations into how levels and types of cultural adaptations can impact program effectiveness and success (Taylor et al, 2023).…”

Review: Can digital mental health interventions bridge the ‘digital divide’ for socioeconomically and digitally marginalised youth? A systematic review

“…The final agreed summary scores are represented as a percentage, with higher scores indicating higher methodological quality. This approach to quality assessment has been used effectively in other reviews of DMHIs (Ashford, Olander, & Ayers, 2016; Gindidis, Stewart, & Roodenburg, 2019; Strudwick et al., 2021) and mental health interventions for marginalised populations (Lawrence, Rooke, & Creswell, 2017; Taylor, Radford, & Calia, 2022; Wright, Jordan, & Lazzarino, 2021).…”