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.
Similar content being viewed by others
References
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
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
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
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
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
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
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
UNHCR (2015) Europe Refugee Emergency—BRIEFING NOTE Unaccompanied and separated children. http://data.unhcr.org/mediterranean/download.php?id=85. Assessed 17 May 2016
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
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
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
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
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
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
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
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
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
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
Majumder P (2014) Unaccompanied refugee minors’ experiences of mental health services. University of Leicester
Bræin MK, Christie HJ (2011) Therapy with unaccompanied refugees and asylum-seeking minors. J Natl Netw Prof Prev Child Abus Negl 30–31:102–116
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
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
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
American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn. American Psychiatric Publishing, Washington
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
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
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
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
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
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
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
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 27:427–439
Mouchenik Y (2016) La psychothérapie transculturelle. In: Bossuroi M (ed) La Psychol. Clin. Transcult. InPress, Paris, pp 117–125
Moro M-R, Baubet T (2009) Les soins en situations transculturelle. Psychopathol. Transcult. Elsevier Masson, Paris, pp 151–167
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
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
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 381–405
Unterhitzenberger J, Rosner R (2016) Case report: manualized trauma-focused cognitive behavioral therapy with an unaccompanied refugee minor girl 1:1–5
Mehraby N (2002) Unaccompanied child refugees: a group experience. Psychother Aust 8:30–36
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
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 211–237
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
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
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 76–94
Mok TA (2015) A long-term therapeutic journey with an Asian “parachute kid”. Asian Am J Psychol. https://doi.org/10.1037/a0039378
Foa EB, Keane TM, Friedman MJ, Cohen JA (2009) Effective treatments for PTSD, Second. The Guilford Press, New York
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
Freedman B (1987) Equipoise and the ethics of clinical research. N Engl J Med 317:141–145. https://doi.org/10.1056/NEJM198707163170304
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
Nardini C (2014) The ethics of clinical trials. ecancermedicalscience 8:1–9. https://doi.org/10.3332/ecancer.2014.387
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
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
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
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
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
Terr LC (1991) Childhood traumas: an outline and overview. Am J Psychiatry 148:10–20. https://doi.org/10.1176/ajp.148.1.10
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
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
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
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
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
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
Dugard P, File P, Todman J (2011) Single-case and small-n experimental designs: a practical guide to randomization tests, Second. Routledge, New York
Acknowledgements
The authors wish to thank Mr. Quentin Rahms for proofreading the manuscript.
Author information
Authors and Affiliations
Contributions
All authors have contributed equally in providing summaries of research studies, writing and approving the final manuscript.
Corresponding author
Ethics declarations
Funding
No funding sources were provided for this study.
Conflict of interest
The authors declare that they have no competing interests.
Additional information
This article is part of the focused issue ‘Mental health issues in refugees’.
Rights and permissions
About this article
Cite this article
Demazure, G., Gaultier, S. & Pinsault, N. Dealing with difference: a scoping review of psychotherapeutic interventions with unaccompanied refugee minors. Eur Child Adolesc Psychiatry 27, 447–466 (2018). https://doi.org/10.1007/s00787-017-1083-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00787-017-1083-y