Trauma-focused therapy for refugees: meta-analytic findings

Abstract

High levels of trauma-related psychological distress have been documented among ethnically diverse refugees. As the number of refugees worldwide continues to grow, determining the efficacy of established methods of trauma-focused therapy for this population is crucial. This meta-analysis examined the results of randomized controlled trials of psychotherapeutic intervention for traumatized adult refugees. Comparisons of 13 trauma-focused therapies to control groups from 12 studies were included in the analysis. The aggregate effect size for the primary outcome, posttraumatic stress disorder (PTSD), was large in magnitude, Hedge's g = .91, p < .001, 95% CI [.56, 1.52]. The aggregate effect size for depression, assessed in 9 studies, was also large g = .63, p < .001, 95% CI [.35, .92]. We used metaregression to evaluate potential moderators of the PTSD effect size. Number of sessions significantly predicted magnitude of the effect size, and studies that utilized an active control group (e.g., supportive counseling) had significantly smaller effect size than those with a passive control group. There was no difference in outcome for studies where an interpreter was used to facilitate sessions and those where no interpreter was used. There also was no difference in outcome based on type of PTSD assessment. Results provide evidence in the efficacy of trauma-focused models for treating refugees, and also shed light on important areas for future research.