A systematic review and meta-analysis of psychosocial interventions for 6–12-year-old children who have been forcibly displaced

Abstract

Background: Children who have been forcibly displaced are likely to experience psychosocial challenges given they may be dealing with past trauma and challenges of adapting to their new environment. Effective psychosocial interventions are needed to promote psychosocial wellbeing. Literature identifies the ages of 6–12 years (middle childhood), as key to addressing psychosocial development. To date, systematic reviews identifying effective psychosocial interventions for children have focused on adolescents.

Aim: We conducted a systematic review and meta-analysis to: 1) identify psychosocial interventions conducted in middle childhood with forcibly displaced children; 2) summarize the characteristics of the included interventions; 3) identify the methodological quality of the studies; and 4) identify effectiveness of the interventions.

Method: A comprehensive literature search was conducted across four databases and supplementary literature. Study design was classified according to the National Health and Medical Research Council Hierarchy of Evidence. Methodological quality was assessed using the QualSyst appraisal checklist. Intervention approaches were classified into activity codes using the ‘Who is Where When doing What’ (4Ws) tool. Intervention effects were explored through meta-analysis.

Results: Nineteen studies with 2386 children met the eligibility criteria. A total of 19 intervention approaches were identified. The interventions found to be most promising were Narrative Exposure Therapy for children and adolescents (KidNET), Cognitive Behavioural Therapy, Child-Centred Play Therapy, Eye Movement Desensitization and Reprocessing, and creative interventions. Unstructured play or education alone did not produce a beneficial intervention effect.

Conclusions: Middle childhood presents a unique opportunity to address psychosocial wellbeing with forcibly displaced children. While psychological-based activities in this review demonstrated effectiveness for symptom reduction, future intervention options should expand to include strengths- and resilience-based. Further research evaluating the effectiveness of psychosocial intervention for forcibly displaced children is required using randomised control designs, greater sample sizes, and longitudinal data.