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Review
. 2025 Dec;16(1):2494362.
doi: 10.1080/20008066.2025.2494362. Epub 2025 May 19.

Effectiveness of trauma-focused treatments for refugee children: a systematic review and meta-analyses

Merel E Velu  1   2 , Rebecca M Kuiper  3 , Michaela Schok  2 , Marieke Sleijpen  1 , Carlijn de Roos  4 , Trudy Mooren  1   2
Affiliations
Review

Effectiveness of trauma-focused treatments for refugee children: a systematic review and meta-analyses

Merel E Velu et al. Eur J Psychotraumatol. 2025 Dec.

Abstract
in English, Spanish

ABSTRACTBackground: Prevalence of posttraumatic stress disorder (PTSD) in refugees is higher compared to the general population, and barriers in accessing mental health care are often experienced. With staggering numbers of people seeking refuge around the world, and 40% being 18 years or younger, effective trauma-focused therapies for refugee children with PTSD are highly needed.Objective: A systematic review and meta-analyses were conducted to provide an overview of, and to analyse, intervention studies using PTSD measures in young refugees, assessing treatment effectiveness and addressing efforts to mitigate barriers to mental health care.Method: Eleven databases were searched for studies evaluating trauma-focused treatments (TFT) for refugee children (0-18). Meta-analyses were conducted for all included studies grouped together; and second, per intervention type, using posttreatment measures and follow-up measures. Pooled between-group effect sizes (ESs) and pre-post ESs, using a random-effects model were calculated.Results: A total of 47 studies was retrieved, with 32 included in the meta-analyses. The narrative review highlighted positive outcomes in reducing posttraumatic stress symptoms for CBT-based interventions, EMDR therapy, KIDNET, and other treatments such as art therapy. Meta-analyses revealed medium pooled pre-post ESs for CBT-based interventions (ES = -.55) and large for EMDR therapy (ES = -1.63). RCT and CT studies using follow-up measures showed promising outcomes for KIDNET (ES = -.49). High heterogeneity of the included studies limited interpretation of several other combined effects. Results should be interpreted with caution due to the generally low quality of the included studies. All studies addressed efforts to minimize treatment barriers.Conclusion: More high-quality studies are urgently needed to inform treatment recommendations. Evidence-based therapies, such as CBT-based interventions, EMDR therapy, and KIDNET, demonstrate promising findings but need further replication. Strategies to overcome barriers to treatment may be necessary to reach this population.

Antecedentes: La prevalencia del trastorno de estrés postraumático (TEPT) en refugiados es más alta en comparación con la población general, y las barreras para acceder a la atención de salud mental son frecuentemente experimentadas. Con un número alarmante de personas que buscan refugio alrededor del mundo, y cuando 40% son menores de 18 años o menos, se necesitan urgentemente terapias eficaces centradas en el trauma para los niños refugiados con TEPT.

Objetivo: Una revisión sistemática y meta-análisis fueron llevados a cabo para proporcionar una mirada general de, y para analizar, los estudios de intervención usando las medidas de TEPT en refugiados jóvenes, evaluando la efectividad del tratamiento y abordando los esfuerzos por mitigar las barreras de atención de salud mental.

Método: Se buscaron estudios evaluando los tratamientos centrados en el trauma (TFT en su sigla en inglés) para niños refugiados (0–18) en once bases de datos. Los meta-análisis se llevaron a cabo para todos los estudios incluidos agrupados; y luego, por tipo de intervención, usando medidas al postratamiento y de seguimiento. Se calcularon los tamaños del efecto entre los grupos (ESs en su sigla en inglés) y ESs antes y después, usando un modelo de efectos aleatorios que fueron calculados.

Resultados: Un total de 47 estudios fueron extraídos, con 32 siendo incluidos en el meta-análisis. La revisión narrativa subrayó los resultados positivos en reducir los síntomas de estrés postraumático para las intervenciones basadas en TCC, terapia EMDR, KIDNET, y otros tratamientos como arte-terapia. Los meta-análisis revelaron ESs agrupados antes y después medianos para las intervenciones basadas en TCC (ES = −.55) y grandes para la terapia EMDR (ES = −1.63). Estudios de RCT y CT que utilizaron medidas de seguimiento mostraron resultados prometedores para KIDNET (ES = −.49). La alta heterogeneidad de los estudios incluidos limitó la interpretación de varios otros efectos combinados. Los resultados deberían ser interpretados con precaución debido a la baja calidad general de los estudios incluidos. Todos los estudios abordaron esfuerzos para minimizar las barreras al tratamiento.

Conclusión: Se necesitan urgentemente estudios de más alta calidad para recomendaciones de tratamiento definitivas. Las terapias basadas en la evidencia, tales como intervenciones basadas en TCC, terapia EMDR, y KIDNET, demostraron hallazgos prometedores, pero requieren mayor replicación. Es posible que se requieran estrategias para superar las barreras al tratamiento.

Keywords: CBT; EMDR; EMDR therapy; KIDNET; TCC; Tratamiento centrado en el trauma; Trauma-focused treatment; barreras culturales; children; cultural barriers; desplazados; displaced; intervenciones psicosociales; kidnet; niños; posttraumatic stress disorder; psychosocial interventions; refugees; refugiados; trastorno de estrés postraumático.

Plain language summary

A systematic review and meta-analysis evaluated intervention studies targeting PTSD in young refugees, analysing treatment effectiveness and barriers to mental health care.Meta-analyses revealed medium to large pre–post effect sizes for CBT-based interventions and EMDR therapy. Medium between-group effect sizes where shown for KIDNET when using follow-up measures, suggesting effectiveness over time. All studies addressed efforts to minimize treatment barriers.Due to high heterogeneity and generally low study quality, additional high-quality research is needed to inform treatment recommendations. Implementing strategies to overcome treatment barriers may be essential for effectively reaching this population.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

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PRISMA flow diagram.
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References

    1. Banoğlu, K., & Korkmazlar, Ü. (2022). Efficacy of the eye movement desensitization and reprocessing group protocol with children in reducing posttraumatic stress disorder in refugee children. European Journal of Trauma & Dissociation, 6(1), Article 100241. 10.1016/j.ejtd.2021.100241 - DOI
    1. Bosqui, T., McEwen, F. S., Chehade, N., Moghames, P., Skavenski, S., Murray, L., Karam, E., Weierstall-Pust, R., & Pluess, M. (2023). What drives change in children receiving telephone-delivered Common Elements Treatment Approach (t-CETA)? A multiple n = 1 study with Syrian refugee children and adolescents in Lebanon. Child Abuse & Neglect, 162(Pt 2), Article 106388. - PMC - PubMed
    1. Byrow, Y., Pajak, R., Specker, P., & Nickerson, A. (2020). Perceptions of mental health and perceived barriers to mental health help-seeking amongst refugees: A systematic review. Clinical Psychology Review, 75, Article 101812. 10.1016/j.cpr.2019.101812 - DOI - PubMed
    1. Cardeli, E., Phan, J., Mulder, L., Benson, M., Adhikari, R., & Ellis, B. H. (2020). Bhutanese refugee youth: The importance of assessing and addressing psychosocial needs in a school setting. Journal of School Health, 90(9), 731–742. 10.1111/josh.12935 - DOI - PubMed
    1. Catani, C., Kohiladevy, M., Ruf, M., Schauer, E., Elbert, T., & Neuner, F. (2009). Treating children traumatized by war and tsunami: A comparison between exposure therapy and meditation-relaxation in North-East Sri Lanka. BMC Psychiatry, 9(1), Article 22. 10.1186/1471-244X-9-22 - DOI - PMC - PubMed