A critical review of psychological treatments of posttraumatic stress disorder in refugees

Nickerson, Angela; Bryant, Richard A.; Silove, Derrick; Steel, Zachary

doi:10.1016/j.cpr.2010.10.004

Cited by 457Migration, Health and TraumaPosttraumatic Stress Disorder ResearchPsychoanalysis and Psychopathology Research

A critical review of psychological treatments of posttraumatic stress disorder in refugees

Nickerson, Angela, Bryant, Richard A., Silove, Derrick, Steel, Zachary·2011·Clinical Psychology Review

DOI 10.1016/j.cpr.2010.10.004

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Abstract

Despite much research evidence that refugees suffer from elevated rates of posttraumatic stress disorder (PTSD), relatively few studies have examined the effectiveness of psychological treatments for PTSD in refugees. The field of refugee mental health intervention is dominated by two contrasting approaches, namely trauma-focused therapy and multimodal interventions. This article firstly defines these two approaches, then provides a critical review of 19 research studies that have been undertaken to investigate the efficacy of these treatments. Preliminary research evidence suggests that trauma-focused approaches may have some efficacy in treating PTSD in refugees, but limitations in the methodologies of studies caution against drawing definitive inferences. It is clear that research assessing the treatment of PTSD in refugees is lagging behind that available for other traumatized populations. The review examines important considerations in the treatment of refugees. A theoretical framework is offered that outlines contextual issues, maintaining factors, change mechanisms and the distinctive challenges to traditional trauma-focused treatments posed by the needs of refugees with PTSD.

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The number of psychological treatments tested with refugee populations is low.
“The number of psychological treatments tested with refugee populations is low (Nickerson, Bryant, Silove, & Steel, 2011)”
From Intrusive memories of trauma: A target for research bridging cognitive science and its clinical application (2019) · cites this paper as Nickerson, Bryant, Silove, & Steel, 2011
The treatment evidence base for help-seeking refugees and asylum seekers is sparse and limited mainly to trauma-specific treatments.
“The treatment evidence base for help-seeking refugees and asylum seekers is sparse and limited mainly to trauma-specific treatments [13–16]”
From A brief transdiagnostic psychological intervention for Afghan asylum seekers and refugees in Austria: A randomized controlled trial (2020) · cites this paper as [12]
PMLDs are seldom addressed in psychological therapies or empirical research investigations.
“yet they are seldom addressed in psychological therapies or empirical research investigations [12].”
From A brief transdiagnostic psychological intervention for Afghan asylum seekers and refugees in Austria: A randomized controlled trial (2020) · cites this paper as [12]

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The UCL–Lancet Commission on Migration and Health: the health of a world on the move
Abubakar, I., Aldridge, R. W., Devakumar, D., Orcutt, M., Burns, R., Barreto, M. L., Dhavan, P., Fouad, F. M., Groce, N., Guo, Y., et al. (2018) · The Lancet · doi:10.1016/s0140-6736(18)32114-7 · Cited by 941 · see citing works
The contemporary refugee crisis: an overview of mental health challenges
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The Relationship Between Post-Migration Stress and Psychological Disorders in Refugees and Asylum Seekers
Li, S. S. Y., Liddell, B. J., & Nickerson, A. (2016) · Current Psychiatry Reports · doi:10.1007/s11920-016-0723-0 · Cited by 746 · see citing works
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The Social Determinants of Refugee Mental Health in the Post-Migration Context: A Critical Review
Hynie, M. (2018) · The Canadian Journal of Psychiatry · doi:10.1177/0706743717746666 · Cited by 659 · see citing works
Mental health and psychosocial support in humanitarian settings: linking practice and research
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The Lancet Psychiatry Commission on psychological treatments research in tomorrow's science
Holmes, E. A., Ghaderi, A., Harmer, C. J., Ramchandani, P. G., Cuijpers, P., Morrison, A. P., Roiser, J. P., Bockting, C. L. H., O'Connor, R. C., Shafran, R., et al. (2018) · The Lancet Psychiatry · doi:10.1016/s2215-0366(17)30513-8 · Cited by 624 · see citing works
Treatment of complex PTSD: results of the ISTSS expert clinician survey on best practices.
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School and Community-Based Interventions for Refugee and Asylum Seeking Children: A Systematic Review
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Common mental disorders in asylum seekers and refugees: umbrella review of prevalence and intervention studies
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Perceptions of mental health and perceived barriers to mental health help-seeking amongst refugees: A systematic review
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Strengthening mental health care systems for Syrian refugees in Europe and the Middle East: integrating scalable psychological interventions in eight countries
Sijbrandij, M., Acartürk, C., Bird, M., Bryant, R. A., Burchert, S., Carswell, K., de Jong, J. T. V. M., Dinesen, C., Dawson, K. S., Chammay, R. E., et al. (2017) · European Journal of Psychotraumatology · doi:10.1080/20008198.2017.1388102 · Cited by 298 · see citing works
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Psychosocial interventions for post-traumatic stress disorder in refugees and asylum seekers resettled in high-income countries: Systematic review and meta-analysis
Nosè, M., Ballette, F., Bighelli, I., Turrini, G., Purgato, M., Tol, W., Priebe, S., & Barbui, C. (2017) · PLOS ONE · doi:10.1371/journal.pone.0171030 · Cited by 276 · see citing works
Intrusive memories of trauma: A target for research bridging cognitive science and its clinical application
Iyadurai, L., Visser, R. M., Lau-Zhu, A., Porcheret, K., Horsch, A., Holmes, E. A., & James, E. L. (2019) · Clinical Psychology Review · doi:10.1016/j.cpr.2018.08.005 · Cited by 255 · see citing works
Challenging future, challenging past: the relationship of social integration and psychological impairment in traumatized refugees
Schick, M., Zumwald, A., Knöpfli, B., Nickerson, A., Bryant, R. A., Schnyder, U., Müller, J., & Morina, N. (2016) · European Journal of Psychotraumatology · doi:10.3402/ejpt.v7.28057 · Cited by 233 · see citing works
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Integration or Isolation? Refugees’ Social Connections and Wellbeing
Strang, A. B., & Quinn, N. (2019) · Journal of Refugee Studies · doi:10.1093/jrs/fez040 · Cited by 219 · see citing works
Community-based mental health treatments for survivors of torture and militant attacks in Southern Iraq: a randomized control trial
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Trauma-focused therapy for refugees: Meta-analytic findings.
Lambert, J. E., & Alhassoon, O. M. (2015) · Journal of Counseling Psychology · doi:10.1037/cou0000048 · Cited by 199 · see citing works
Posttraumatic stress disorder and prolonged grief in refugees exposed to trauma and loss
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Women and Suicidal Behavior
Canetto, S. S., & Chen, J. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108561716.042 · Cited by 194 · see citing works
EMDR for Syrian refugees with posttraumatic stress disorder symptoms: results of a pilot randomized controlled trial
Acartürk, C., Konuk, E., Çetinkaya, M., Şenay, İ., Sijbrandij, M., Cuijpers, P. J., & Aker, T. (2015) · European Journal of Psychotraumatology · doi:10.3402/ejpt.v6.27414 · Cited by 187 · see citing works
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The efficacy of eye movement desensitization and reprocessing for post-traumatic stress disorder and depression among Syrian refugees: Results of a randomized controlled trial
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Mental health and quality of life among asylum seekers and refugees living in refugee housing facilities in Sweden
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An overview of systematic reviews on mental health promotion, prevention, and treatment of common mental disorders for refugees, asylum seekers, and internally displaced persons
Uphoff, E., Robertson, L., Cabieses, B., V, Villalón, F., Purgato, M., Churchill, R. C., & Barbui, C. (2020) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd013458.pub2 · Cited by 137 · see citing works
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Changes in Post-migration Living Difficulties Predict Treatment Outcome in Traumatized Refugees
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PTSD in asylum-seeking male adolescents from Afghanistan
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Assessing trauma in a transcultural context: challenges in mental health care with immigrants and refugees
Wylie, L., Meyel, R. V., Harder, H., Sukhera, J. I., Luc, C., Ganjavi, H., Elfakhani, M., & Wardrop, N. (2018) · Public health reviews · doi:10.1186/s40985-018-0102-y · Cited by 118 · see citing works
Evidence-based psychological interventions for adult survivors of torture and trauma: A 30-year review
McFarlane, C. A., & Kaplan, I. (2012) · Transcultural Psychiatry · doi:10.1177/1363461512447608 · Cited by 113 · see citing works
Psychological, social and welfare interventions for psychological health and well-being of torture survivors
Patel, N., Kellezi, B., & Williams, A. C. D. C. (2014) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd009317.pub2 · Cited by 110 · see citing works
Brief Narrative Exposure Therapy for Posttraumatic Stress in Iraqi Refugees: A Preliminary Randomized Clinical Trial
Hijazi, A. M., Lumley, M. A., Ziadni, M. S., Haddad, L., Rapport, L. J., & Arnetz, B. B. (2014) · Journal of Traumatic Stress · doi:10.1002/jts.21922 · Cited by 101 · see citing works
The psychological impact of torture
Williams, A. C. D. C., & Merwe, J. V. D. (2013) · British Journal of Pain · doi:10.1177/2049463713483596 · Cited by 102 · see citing works
A systematic review of psychosocial interventions for adult refugees and asylum seekers
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Unaccompanied migrant children in the United States: Predictors of placement stability in long term foster care
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Cultural adaptations of cognitive behavioral therapy
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Mental health among older refugees: the role of trauma, discrimination, and religiousness
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A comparison of Narrative Exposure Therapy and Prolonged Exposure therapy for PTSD
Mørkved, N., Hartmann, K., Aarsheim, L. M., Holen, D., Milde, A. M., Bomyea, J. A., & Thorp, S. R. (2014) · Clinical Psychology Review · doi:10.1016/j.cpr.2014.06.005 · Cited by 91 · see citing works
The mental health and wellbeing of Unaccompanied Refugee Minors (URMs)
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Authors: Nickerson, A., Bryant, R. A., Silove, D., & Steel, Z.
Affiliations: UNSW Sydney (AU)
Corresponding author: Bryant, Richard A.
ORCID: Nickerson, Angela
Bryant, Richard A.
Silove, Derrick
Steel, Zachary
Venue: Clinical Psychology Review
Publisher: Elsevier BV
Published: 2011-04
Volume: 31
Issue: 3
Pages: 399-417
ISSN: 0272-7358 (ISSN-L)
DOI: 10.1016/j.cpr.2010.10.004
OpenAlex: W2005367970
Semantic Scholar: e70717af712017a067b9d0dca1583861d7e05f2c
Cited by: 457
References: 139
Citations by year: 2026: 17 · 2025: 10 · 2024: 20 · 2023: 22 · 2022: 27 · 2021: 24 · 2020: 105 · 2019: 25 · 2018: 39 · 2017: 34 · 2016: 42 · 2015: 29 · 2014: 24 · 2013: 16 · 2012: 13
FWCI: 1.78
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: Clinical Psychology Review (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
Keywords: post-traumatic stress disorder, refugees, psychological intervention, trauma-focused psychotherapy, multimodal intervention, refugee mental health, treatment efficacy, mechanisms of change
MeSH terms: Humans, Life Change Events, Mental Health, Psychotherapy, Refugees, Stress Disorders, Post-Traumatic, Stress, Psychological, Treatment Outcome

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A critical review of psychological treatments of posttraumatic stress disorder in refugees

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