Abstract:Background: Preventative and treatment programs for people at risk of developing psychological problems after exposure to war trauma have mushroomed in the last decade. However, there is still much contention about evidence-based and culturally sensitive interventions for children. The aim of this study was to examine the efficacy of the Teaching Recovery Techniques in improving the emotional and behavioral outcomes of war-affected children resettled in Australia.Methods and Findings: A cluster randomized cont… Show more
“…Two studies were part of doctoral theses (Ooi, 2012, pilot study; Schauer, 2008), three were short reports in an omnibus volume (Išpanović-Radojković, Petrović, Davis, Tenjović, & Minčić, 2002; Šehović, 2002; Šestan, 2002), and 17 were original articles. All identified publications were in English.Figure 1.PRISMA flow diagram of the literature search.
…”
Section: Resultsmentioning
confidence: 99%
“…The studies included children of diverse psychopathological status: children stemming from a war-affected area irrespective of their individual distress to children with full-blown PTSD diagnosis. Sample sizes ranged from N = 4 (Ooi, 2012) to N = 399 (Tol et al, 2012). …”
Section: Resultsmentioning
confidence: 99%
“…Thirteen out of 23 studies examined the effect of evidence-based treatments, such as interpersonal therapy (IPT) (Betancourt et al, 2012a), strict cognitive behavioural therapy (CBT) (Catani et al, 2009; Onyut et al, 2005; Pfeiffer & Goldbeck, 2017; Schauer, 2008; Schottelkorb et al, 2012), eclectic CBT with other elements (Ehntholt, Smith, & Yule, 2005; Möhlen, Parzer, Resch, & Brunner, 2005; Ooi, 2012; Ooi et al, 2016; Šehović, 2002; Tol et al, 2012), or eye movement desensitization and reprocessing (EMDR; within a psychodynamic therapy) (Oras, De Ezpeleta, & Ahmad, 2004). …”
Section: Resultsmentioning
confidence: 99%
“…In 13 studies, the interventions were provided in a school setting (Ehntholt et al, 2005; Ellis et al, 2013; Fazel et al, 2009; Išpanović-Radojković et al, 2002; Kalantari et al, 2012; Lange-Nielsen et al, 2012; O’Shea et al, 2000; Ooi, 2012; pilot; Ooi et al, 2016; Schauer, 2008; Schottelkorb et al, 2012; Thabet et al, 2005; Tol et al, 2012). In 12 studies, trained lay persons (e.g.…”
Section: Resultsmentioning
confidence: 99%
“…PTSD outcomes were reported for 10 active CBT treatment groups (Catani et al, 2009; Ehntholt et al, 2005; Onyut et al, 2005; Ooi et al, 2016; both treatment and later treated waitlist group; Pfeiffer & Goldbeck, 2017; Schauer, 2008; Schottelkorb et al, 2012; Tol et al, 2012; separately for boys/girls), and depression outcomes for seven active CBT treatment groups (Ehntholt et al, 2005; Onyut et al, 2005; Ooi et al, 2016; treatment and later treated waitlist group; Schauer, 2008; Tol et al, 2012; separately for boys/girls). The combined pre-post effect sizes were SMC = 0.79, 95% CI [0.47, 1.11] for PTSD (total N = 394), and SMC = 0.30, 95% CI [0.18, 0.43] for depression (total N = 337) (Figures 2 and 3, respectively).…”
Background: The United Nations reported that in 2016 over 65 million people worldwide have forcibly left home. Over 50% are children and adolescents; a substantial number has been traumatized and displaced by war.
Objective: To provide an overview of the effectiveness of psychosocial interventions in this group we conducted a narrative review and a meta-analysis of intervention studies providing data on posttraumatic stress symptoms (PTSS), depression, anxiety, grief, and general distress.
Method: We searched PILOTS, MEDLINE, WoS, Embase, CENTRAL, LILACS, PsycINFO, ASSIA, CSA, and SA for studies on treatment outcomes for war-traumatized displaced children and adolescents. Between-group effect sizes (ES) and pre-post ES were reconstructed for each trial. Overall pre-post ES were calculated using a random effects model.
Results: The narrative review covers 23 studies with a variety of treatments. Out of the 35 calculated between-group ES, only six were significant, all compared to untreated controls. Two of them indicated significant adverse effects on symptoms of general distress or depression. When calculating pre-post effect sizes, the positive between-group results of cognitive behavioural therapy (CBT) and interpersonal therapy (IPT) were reproduced and singular other treatments showed significant positive effects. However, the mean pre-post effects for PTSS and depression could not be interpreted due to the high heterogeneity of the included studies (PTSS: ES = 0.78; I2 = 88.6%; depression: ES = 0.35; I2 = 93.1%). Only the mean pre-post effect for seven active CBT treatment groups for depression (ES = 0.30, 95% CI [0.18, 0.43]) was interpretable (Q = 3.3, df = 6, p = .77).
Conclusion: Given the large number of children and adolescents displaced by war there were regrettably few treatment studies available, and many of them were of low methodological quality. The effect sizes lagged behind the effects observed in traumatized minors in general, and often were small or non-significant. However, CBT and IPT showed promising results that need further replication.
“…Two studies were part of doctoral theses (Ooi, 2012, pilot study; Schauer, 2008), three were short reports in an omnibus volume (Išpanović-Radojković, Petrović, Davis, Tenjović, & Minčić, 2002; Šehović, 2002; Šestan, 2002), and 17 were original articles. All identified publications were in English.Figure 1.PRISMA flow diagram of the literature search.
…”
Section: Resultsmentioning
confidence: 99%
“…The studies included children of diverse psychopathological status: children stemming from a war-affected area irrespective of their individual distress to children with full-blown PTSD diagnosis. Sample sizes ranged from N = 4 (Ooi, 2012) to N = 399 (Tol et al, 2012). …”
Section: Resultsmentioning
confidence: 99%
“…Thirteen out of 23 studies examined the effect of evidence-based treatments, such as interpersonal therapy (IPT) (Betancourt et al, 2012a), strict cognitive behavioural therapy (CBT) (Catani et al, 2009; Onyut et al, 2005; Pfeiffer & Goldbeck, 2017; Schauer, 2008; Schottelkorb et al, 2012), eclectic CBT with other elements (Ehntholt, Smith, & Yule, 2005; Möhlen, Parzer, Resch, & Brunner, 2005; Ooi, 2012; Ooi et al, 2016; Šehović, 2002; Tol et al, 2012), or eye movement desensitization and reprocessing (EMDR; within a psychodynamic therapy) (Oras, De Ezpeleta, & Ahmad, 2004). …”
Section: Resultsmentioning
confidence: 99%
“…In 13 studies, the interventions were provided in a school setting (Ehntholt et al, 2005; Ellis et al, 2013; Fazel et al, 2009; Išpanović-Radojković et al, 2002; Kalantari et al, 2012; Lange-Nielsen et al, 2012; O’Shea et al, 2000; Ooi, 2012; pilot; Ooi et al, 2016; Schauer, 2008; Schottelkorb et al, 2012; Thabet et al, 2005; Tol et al, 2012). In 12 studies, trained lay persons (e.g.…”
Section: Resultsmentioning
confidence: 99%
“…PTSD outcomes were reported for 10 active CBT treatment groups (Catani et al, 2009; Ehntholt et al, 2005; Onyut et al, 2005; Ooi et al, 2016; both treatment and later treated waitlist group; Pfeiffer & Goldbeck, 2017; Schauer, 2008; Schottelkorb et al, 2012; Tol et al, 2012; separately for boys/girls), and depression outcomes for seven active CBT treatment groups (Ehntholt et al, 2005; Onyut et al, 2005; Ooi et al, 2016; treatment and later treated waitlist group; Schauer, 2008; Tol et al, 2012; separately for boys/girls). The combined pre-post effect sizes were SMC = 0.79, 95% CI [0.47, 1.11] for PTSD (total N = 394), and SMC = 0.30, 95% CI [0.18, 0.43] for depression (total N = 337) (Figures 2 and 3, respectively).…”
Background: The United Nations reported that in 2016 over 65 million people worldwide have forcibly left home. Over 50% are children and adolescents; a substantial number has been traumatized and displaced by war.
Objective: To provide an overview of the effectiveness of psychosocial interventions in this group we conducted a narrative review and a meta-analysis of intervention studies providing data on posttraumatic stress symptoms (PTSS), depression, anxiety, grief, and general distress.
Method: We searched PILOTS, MEDLINE, WoS, Embase, CENTRAL, LILACS, PsycINFO, ASSIA, CSA, and SA for studies on treatment outcomes for war-traumatized displaced children and adolescents. Between-group effect sizes (ES) and pre-post ES were reconstructed for each trial. Overall pre-post ES were calculated using a random effects model.
Results: The narrative review covers 23 studies with a variety of treatments. Out of the 35 calculated between-group ES, only six were significant, all compared to untreated controls. Two of them indicated significant adverse effects on symptoms of general distress or depression. When calculating pre-post effect sizes, the positive between-group results of cognitive behavioural therapy (CBT) and interpersonal therapy (IPT) were reproduced and singular other treatments showed significant positive effects. However, the mean pre-post effects for PTSS and depression could not be interpreted due to the high heterogeneity of the included studies (PTSS: ES = 0.78; I2 = 88.6%; depression: ES = 0.35; I2 = 93.1%). Only the mean pre-post effect for seven active CBT treatment groups for depression (ES = 0.30, 95% CI [0.18, 0.43]) was interpretable (Q = 3.3, df = 6, p = .77).
Conclusion: Given the large number of children and adolescents displaced by war there were regrettably few treatment studies available, and many of them were of low methodological quality. The effect sizes lagged behind the effects observed in traumatized minors in general, and often were small or non-significant. However, CBT and IPT showed promising results that need further replication.
According to the definition of the Refugee Convention, a refugee is 'someone who is unable or unwilling to return to their country of origin, owing to a well-founded fear of being persecuted for reasons of race, religion, nationality, membership of a particular social group, or political opinion' (UN General Assembly, 1951). It is well established that refugees, including children, have high prevalence rates of mental health problems (Cayabyab, O'Reilly, Murphy, & O'Gorman, 2020). These include post-traumatic stress disorder (PTSD), depression, anxiety and behavioural problems (Bronstein & Montgomery, 2011). Without intervention, these child mental health problems are likely to continue, especially when compounded by post-migration stressors (Tam, Houlihan, & Melendez-Torres, 2015). The majority of mental health studies have been carried out with children seeking asylum or being resettled in high-income countries (HIC-Fazel & Betancourt, 2018), despite the fact that the greatest proportion of refugees are resettled in low-and middle-income countries (LMIC-UNHCR, 2018). This particularly applies to the population influx from Syria in recent years (Javanbakht, Rosenberg, Haddad, & Arfken, 2018). Child mental health problems are associated with a range of risk factors pre-, during and post-migration (Reed, Fazel, Jones, Panter-Brick, & Stein, 2012). Whilst earlier research predominantly focused on the impact of war-induced trauma, hence research on trauma-reprocessing interventions, more recently, there has been increasing attention on post-migration risk factors whilst children settle into their host communities (Eruyar, Huemer, & Vostanis, 2017). These factors include poverty, parenting and family functioning, parental mental health, cultural and language barriers, peer relationships, school and community exclusion (Bronstein & Montgomery, 2011; Reed et al., 2012). Likewise in the general population, individual factors were also found to be important in explaining mental health problems of refugee children. Older age, being female, biological predisposition and maladaptive
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