European Child & Adolescent Psychiatry

, Volume 27, Issue 4, pp 447–466 | Cite as

Dealing with difference: a scoping review of psychotherapeutic interventions with unaccompanied refugee minors

  • Gwladys Demazure
  • Sydney Gaultier
  • Nicolas Pinsault
Review

Abstract

Unaccompanied refugee minors (URMs) are a population at risk for developing mental problems, post-traumatic stress disorder, anxiety, and/or depression. Therapists working with URMs often have to overcome language and cultural barriers, while taking into account these young people’s specific needs. A growing literature describes a wide range of interventions designed to reduce psychopathologies and improve well-being. We summarized the different interventions used with URMs to get an overview of techniques used for reducing psychopathologies and difficulties of URMs and to give recommendations to help professionals. We searched eight databases for articles and books, imposing no restrictions on publication date or geographical region, and using English and French keywords. We included all studies (RCTs, case series, case study) that assessed an intervention with one or more URMs. Seventeen studies, reported in papers or book chapters, met the criteria for inclusion in our analysis. Only one RCT has been conducted with URMs but because of small sample size we cannot conclude on its efficacy. Other studies are case series or case studies and because of their study design, we cannot conclude whether one intervention is superior to others. Further research, with higher level of evidence, is needed to determine which types of intervention are most effective when working with URMs.

Keywords

Scoping review Unaccompanied refugee minors Psychotherapeutic interventions Psychopathology Post-traumatic stress disorder 

Notes

Acknowledgements

The authors wish to thank Mr. Quentin Rahms for proofreading the manuscript.

Author contributions

All authors have contributed equally in providing summaries of research studies, writing and approving the final manuscript.

Compliance with ethical standards

Funding

No funding sources were provided for this study.

Conflict of interest

The authors declare that they have no competing interests.

References

  1. 1.
    Vervliet M, Meyer DeMott MA, Jakobsen M et al (2014) The aspirations of Afghan unaccompanied refugee minors before departure and on arrival in the host country. Childhood 55:33–37.  https://doi.org/10.1177/0907568214533976 Google Scholar
  2. 2.
    Vervliet M, Lammertyn J, Broekaert E, Derluyn I (2014) Longitudinal follow-up of the mental health of unaccompanied refugee minors. Eur Child Adolesc Psychiatry 23:337–346.  https://doi.org/10.1007/s00787-013-0463-1 CrossRefPubMedGoogle Scholar
  3. 3.
    Derluyn I, Mels C, Broekaert E (2009) Mental health problems in separated refugee adolescents. J Adolesc Heal 44:291–297.  https://doi.org/10.1016/j.jadohealth.2008.07.016 CrossRefGoogle Scholar
  4. 4.
    Huemer J, Karnik NS, Voelkl-Kernstock S et al (2009) Mental health issues in unaccompanied refugee minors. Child Adolesc Psychiatry Ment Health 3:13.  https://doi.org/10.1186/1753-2000-3-13 CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Hodes M, Jagdev D, Chandra N, Cunniff A (2008) Risk and resilience for psychological distress amongst unaccompanied asylum seeking adolescents. J Child Psychol Psychiatry Allied Discip 49:723–732.  https://doi.org/10.1111/j.1469-7610.2008.01912.x CrossRefGoogle Scholar
  6. 6.
    Lustig SL, Kia-Keating M, Knight WG et al (2004) Review of child and adolescent refugee mental health. J Am Acad Child Adolesc Psychiatry 43:24–36.  https://doi.org/10.1097/01.chi.0000096619.64367.37 CrossRefPubMedGoogle Scholar
  7. 7.
    UNGA (2005) Assistance to unaccompanied refugee minors: report of the Secretary-General. http://www.unicef.org/protection/files/CRCGC6_EN.pdf. Assessed 23 Feb 2016
  8. 8.
    UNHCR (2015) Europe Refugee Emergency—BRIEFING NOTE Unaccompanied and separated children. http://data.unhcr.org/mediterranean/download.php?id=85. Assessed 17 May 2016
  9. 9.
    Etiemble A (2008) Parcours migratoires des mineurs isolés étrangers, catégorisation et traitement social de leur situation en France. E-Migrinter 180–185. http://infomie.net/IMG/pdf/emigrinter2008_02_tout.pdf. Assessed 12 Feb 2015
  10. 10.
    Eurostat (2017) 63 300 unaccompanied minors among asylum seekers registered in the EU in 2016. http://ec.europa.eu/eurostat/documents/2995521/8016696/3-11052017-AP-EN.pdf/30ca2206-0db9-4076-a681-e069a4bc5290. Assessed 18 Sept 2017
  11. 11.
    Dimitrova-Stull A (2015) Mineurs non accompagnés dans l’UE. État des lieux. http://www.europarl.europa.eu/RegData/etudes/BRIE/2015/565866/EPRS_BRI(2015)565866_FR.pdf. Assessed 17 May 2016
  12. 12.
    Bean T, Derluyn I, Eurelings-Bontekoe E et al (2006) Validation of the multiple language versions of the reactions of adolescents to traumatic stress questionnaire. J Trauma Stress 19:241–255.  https://doi.org/10.1002/jts.20093 CrossRefPubMedGoogle Scholar
  13. 13.
    Thommessen S, Laghi F, Cerrone C et al (2013) Internalizing and externalizing symptoms among unaccompanied refugee and Italian adolescents. Child Youth Serv Rev 35:7–10.  https://doi.org/10.1016/j.childyouth.2012.10.007 CrossRefGoogle Scholar
  14. 14.
    Bean T, Eurelings-Bontekoe E, Mooijaart A, Spinhoven P (2006) Factors associated with mental health service need and utilization among unaccompanied refugee adolescents. Adm Policy Ment Health Ment Health Serv Res 33:342–355.  https://doi.org/10.1007/s10488-006-0046-2 CrossRefGoogle Scholar
  15. 15.
    Bean T, Eurelings-Bontekoe E, Spinhoven P (2007) Course and predictors of mental health of unaccompanied refugee minors in the Netherlands: one year follow-up. Soc Sci Med 64:1204–1215.  https://doi.org/10.1016/j.socscimed.2006.11.010 CrossRefPubMedGoogle Scholar
  16. 16.
    Jensen TK, Skårdalsmo EM, Fjermestad KW (2014) Development of mental health problems—a follow-up study of unaccompanied refugee minors. Child Adolesc Psychiatry Ment Health 8:29.  https://doi.org/10.1186/1753-2000-8-29 CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Wallin AMM, Ahlstrom GI (2005) Unaccompanied young adult refugees in Sweden, experiences of their life situation and well-being: a qualitative follow-up study. Ethn Health 10:129–144.  https://doi.org/10.1080/13557850500071145 CrossRefPubMedGoogle Scholar
  18. 18.
    UNICEF (2016) Danger every step of the way: a harrowing journey to Europe for refugee and migrant children, pp 1–12. http://www.unicef.org/emergencies/childrenonthemove/files/Child_Alert_Final_PDF.pdf. Assessed 23 Nov 2016
  19. 19.
    Majumder P (2014) Unaccompanied refugee minors’ experiences of mental health services. University of LeicesterGoogle Scholar
  20. 20.
    Bræin MK, Christie HJ (2011) Therapy with unaccompanied refugees and asylum-seeking minors. J Natl Netw Prof Prev Child Abus Negl 30–31:102–116Google Scholar
  21. 21.
    Gaultier S (2014) Mineurs isolés étrangers: entre exil et placement. Les enjeux psychiques de la réussite sociale. Le J des Psychol 5:55–59.  https://doi.org/10.3917/jdp.318.0055 CrossRefGoogle Scholar
  22. 22.
    Touhami F, Radjack R, Moro M-R (2015) Penser les enfants isolés, des objets pour dire le temps. Le Carnet PSY 188:36.  https://doi.org/10.3917/lcp.188.0036 CrossRefGoogle Scholar
  23. 23.
    Summerfield D (1997) The impact of war and atrocity on civilian populations: basic principles for NGO interventions and a critique of psychosocial trauma projects. https://www.freedomfromtorture.org/sites/default/files/documents/Summerfield-ImpactOfWar.pdf. Assessed 29 Nov 2016
  24. 24.
    American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn. American Psychiatric Publishing, WashingtonCrossRefGoogle Scholar
  25. 25.
    Courtney LB, Connor MP, Settipani CA et al (2011) History of cognitive-behavioral therapy (CBT) in youth. Child Adolesc Psychiatr Clin N Am 20:179–189.  https://doi.org/10.1016/j.chc.2011.01.011 CrossRefGoogle Scholar
  26. 26.
    Vickers B (2005) Cognitive model of the maintenance and treatment of post-traumatic stress disorder applied to children and adolescents. Clin Child Psychol Psychiatry 10:217–234.  https://doi.org/10.1177/1359104505051212 CrossRefGoogle Scholar
  27. 27.
    Ehntholt KA, Smith PA, Yule W (2005) School-based cognitive-behavioural therapy group intervention for refugee children who have experienced war-related trauma. Clin Child Psychol Psychiatry 10:235–250.  https://doi.org/10.1177/1359104505051214 CrossRefGoogle Scholar
  28. 28.
    Katsounari I (2013) Integrating psychodynamic treatment and trauma focused intervention in the case of an unaccompanied minor with PTSD. Clin Case Stud 13:352–367.  https://doi.org/10.1177/1534650113512021 CrossRefGoogle Scholar
  29. 29.
    Cohen JA, Mannarino AP, Kliethermes M, Murray LA (2012) Trauma-focused CBT for youth with complex trauma. Child Abus Negl 36:528–541.  https://doi.org/10.1016/j.chiabu.2012.03.007 CrossRefGoogle Scholar
  30. 30.
    Unterhitzenberger J, Eberle-Sejari R, Rassenhofer M et al (2015) Trauma-focused cognitive behavioral therapy with unaccompanied refugee minors: a case series. BMC Psychiatry 15:260.  https://doi.org/10.1186/s12888-015-0645-0 CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    About Families (2012) Systemic therapy: what difference does systemic therapy make to the outcomes for children and families?. http://aboutfamilies.files.wordpress.com/2012/12/erb_systemic-therapy_dec121.pdf. Assessed 20 Sept 2017
  32. 32.
    de Alda Ochoa, Martinez de Apellaniz I, Anton Romero J, Rodriguez Nieto A, Atabi Sakia H (2009) La importancia del trabajo con la familia en la atención a menores extranjeros no acompañados. Un estudio piloto. Apunt Psicol 27:427–439Google Scholar
  33. 33.
    Mouchenik Y (2016) La psychothérapie transculturelle. In: Bossuroi M (ed) La Psychol. Clin. Transcult. InPress, Paris, pp 117–125Google Scholar
  34. 34.
    Moro M-R, Baubet T (2009) Les soins en situations transculturelle. Psychopathol. Transcult. Elsevier Masson, Paris, pp 151–167CrossRefGoogle Scholar
  35. 35.
    Goguikian Ratcliff B, Suardi F (2006) L’interprète dans une consultation thérapeutique: conceptions de son rôle et difficultés éprouvées. Psychotherapies 26:37–49.  https://doi.org/10.3917/psys.061.0037 CrossRefGoogle Scholar
  36. 36.
    Radjack R, De Coignac AB, Sturm G et al (2012) Accueillir et soigner les mineurs isolés étrangers? Adolescence 80:421.  https://doi.org/10.3917/ado.080.0421 CrossRefGoogle Scholar
  37. 37.
    Melzak S (2009) Psychotherapeutic work with children and adolescents seeking refugee from political violence. In: Lanyado M, Horne A (eds) Handb. Child Adolesc. Psychother. Psychoanal. Approaches, 2nd edn. Routledge, London, pp 381–405Google Scholar
  38. 38.
    Unterhitzenberger J, Rosner R (2016) Case report: manualized trauma-focused cognitive behavioral therapy with an unaccompanied refugee minor girl 1:1–5Google Scholar
  39. 39.
    Mehraby N (2002) Unaccompanied child refugees: a group experience. Psychother Aust 8:30–36Google Scholar
  40. 40.
    Benoit de Coignac A, Baubet T (2013) Transes et construction identitaire chez les mineurs isolés étrangers. Adolescence 31(3):613.  https://doi.org/10.3917/ado.085.0613 CrossRefGoogle Scholar
  41. 41.
    Leconte J (2014) Travail psychologique auprès des mineurs isolés étrangers. In: Tison B (ed) La prise en Charg. Fam. Africaines en Fr. en Afrique, Regards croisés, L’Harmatta. Paris, pp 211–237Google Scholar
  42. 42.
    Leconte J (2012) Le voyage d’exil; temps hors cadre, temps hors norme Quelles conséquences pour les mineurs isolés étrangers? L’autre Clin Cult sociétés 13:194–204.  https://doi.org/10.1017/CBO9781107415324.004 Google Scholar
  43. 43.
    Bouaziz N, El Husseini M, Rakotomalala C et al (2013) Comment accueillir le délire d’un adolescent étranger isolé en consultation transculturelle ? Adolescence 31(3):541.  https://doi.org/10.3917/ado.085.0541 CrossRefGoogle Scholar
  44. 44.
    Heaphy G, Ehntholt K, Sclare I (2007) Groupwork with unaccompanied young women. In: Kohli R, Mitchell F (eds) Work with unaccompanied asylum-seeking child. Issues Policy Pract. Palgrave MacMillan, New York, pp 76–94Google Scholar
  45. 45.
    Mok TA (2015) A long-term therapeutic journey with an Asian “parachute kid”. Asian Am J Psychol.  https://doi.org/10.1037/a0039378 Google Scholar
  46. 46.
    Foa EB, Keane TM, Friedman MJ, Cohen JA (2009) Effective treatments for PTSD, Second. The Guilford Press, New YorkGoogle Scholar
  47. 47.
    Barrett PM, Ollendick TH (2004) Handbook of interventions that work with children and adolescents. Handb Interv that Work with Child Adolesc Prev Treat.  https://doi.org/10.1002/9780470753385 CrossRefGoogle Scholar
  48. 48.
    Freedman B (1987) Equipoise and the ethics of clinical research. N Engl J Med 317:141–145.  https://doi.org/10.1056/NEJM198707163170304 CrossRefPubMedGoogle Scholar
  49. 49.
    Cochrane (2013) Supplementary guidance for authors undertaking reviews with the Cochrane consumers and communication review group. http://cccrg.cochrane.org/author-resources. Assessed 7 May 2017
  50. 50.
    Nardini C (2014) The ethics of clinical trials. ecancermedicalscience 8:1–9.  https://doi.org/10.3332/ecancer.2014.387 Google Scholar
  51. 51.
    Ryan R, Hill S, Broclain D et al (2013) Cochrane consumers & communication review group. Study Design Guide. http://cccrg.cochrane.org/author-resources. Assessed 7 May 2017
  52. 52.
    Kooistra B, Dijkman B, Einhorn TA, Bhandari M (2009) How to design a good case series. J Bone Jt Surg Am 91:21–26.  https://doi.org/10.2106/JBJS.H.01573 CrossRefGoogle Scholar
  53. 53.
    Chambless DL, Baker MJ, Baucom DH et al (1998) Update on empirically validated therapies, II. Clin Psychol 51:3–16.  https://doi.org/10.1037/e555332011-003 Google Scholar
  54. 54.
    Bouaziz N, Yeim S (2013) Les risques d’erreurs diagnostiques chez les mineurs isolés étrangers. Adolescence 31:625–632.  https://doi.org/10.3917/ado.085.0625 CrossRefGoogle Scholar
  55. 55.
    Sar V, Alioğlu F, Akyuz G et al (2016) Awareness of identity alteration and diagnostic preference between borderline personality disorder and dissociative disorders. J Trauma Dissociation.  https://doi.org/10.1080/15299732.2016.1267684 Google Scholar
  56. 56.
    Terr LC (1991) Childhood traumas: an outline and overview. Am J Psychiatry 148:10–20.  https://doi.org/10.1176/ajp.148.1.10 CrossRefPubMedGoogle Scholar
  57. 57.
    Tol WA, Song S, Jordans MJD (2013) Annual research review: resilience and mental health in children and adolescents living in areas of armed conflict—a systematic review of findings in low- and middle-income countries. J Child Psychol Psychiatry Allied Discip 54:445–460.  https://doi.org/10.1111/jcpp.12053 CrossRefGoogle Scholar
  58. 58.
    Fazel M, Reed RV, Panter-Brick C, Stein A (2012) Mental health of displaced and refugee children resettled in low-income and middle-income countries: risk and protective factors. Lancet 379:266–282.  https://doi.org/10.1016/S0140-6736(11)60051-2 CrossRefPubMedGoogle Scholar
  59. 59.
    Cohen JA, Mannarino AP, Deblinger E (2006) Treating trauma and traumatic grief in children and adolescents. Treat Trauma Trauma Grief Child Adolesc.  https://doi.org/10.1007/s10879-006-9043-8 Google Scholar
  60. 60.
    Lambert M, Barley D (2001) Research summary on the therapeutic relationship and psychotherapy outcome. Psychother Theory Res Pract 38:357–361.  https://doi.org/10.1037//0033-3204.38.4.357 CrossRefGoogle Scholar
  61. 61.
    Martin DJ, Garske JP, Davis MK (2000) Relationship of the therapeutic alliance with outcome and other variables: a meta-analytic review. J Consult Clin Psychol 68:438–450.  https://doi.org/10.1037/0022-006X.68.3.438 CrossRefPubMedGoogle Scholar
  62. 62.
    Graham JE, Karmakar AM, Ottenbacher KJ (2012) Small sample research designs for evidence-based rehabilitaton: issues and methods. Arch Phys Med Rehabil 93:1–13.  https://doi.org/10.1016/j.apmr.2011.12.017.Small CrossRefGoogle Scholar
  63. 63.
    Dugard P, File P, Todman J (2011) Single-case and small-n experimental designs: a practical guide to randomization tests, Second. Routledge, New YorkGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2017

Authors and Affiliations

  • Gwladys Demazure
    • 1
  • Sydney Gaultier
    • 1
  • Nicolas Pinsault
    • 2
    • 3
  1. 1.Laboratoire Interuniversitaire de Psychologie, LIP/PC2S, EA 4145Université Savoie Mont BlancChambéryFrance
  2. 2.CNRS, TIMC-IMAG, UMR 5525Univ. Grenoble-AlpesGrenobleFrance
  3. 3.Critical Thinking Federation FED 4270Univ. Grenoble-AlpesGrenobleFrance

Personalised recommendations