Working with unaccompanied asylum-seeking young people: cultural considerations and acceptability of a cognitive behavioural group approach
Open accessAbstract
This paper outlines a psychological skills group for unaccompanied asylum-seeking young people with a focus on cultural adaptations in the context of a UK mental health service. Unaccompanied asylum-seeking young people have typically experienced multiple losses, traumatic experiences, significant disruption and psychosocial stressors. These experiences occur during a key developmental period and outside of the context of a supportive family environment. Mental health difficulties are estimated to be present in 41–69% of this population. Prevalence rates are higher than among children seeking asylum with their families or children who are not from refugee or asylum-seeking backgrounds. Cognitive behavioural approaches were considered to be applicable and useful when working with this client group. Group approaches may offer unique benefits for this population through peer support and normalization. The group described was planned around three key themes: physical health needs, emotional wellbeing and resilience-building. A number of adaptations were made to meet the needs of this population which included engagement, considering physical health needs, sleep, language needs, issues related to power, race and status, and thinking about the needs of the group as young people. Attendance ratings, session rating scale outcomes, preliminary effectiveness data and qualitative feedback from young people identified that this is an acceptable approach for these young people. Unaccompanied asylum-seeking young people require a broad package of care; however, making adaptations to routine practice allowed access to evidence-based interventions to support mental health and wellbeing.
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A third wave group intervention (CBT, ACT, DBT, CFT) with unaccompanied minors (n = 14) seemed to observe significant improvement in behavioral difficulties but not in PTSD symptoms.
“A third wave group intervention (i.e., CBT, ACT, DBT, CFT) with UM (n = 14), seemed to observe significant improvement in behavioral difficulties but not in PTSD symptoms [74].”
From Examining cognitive behavioral therapy interventions for unaccompanied minors: a systematic review and qualitative research synthesis. (2025) · cites this paper as [74]
The Clinical outcomes section (page not provided) reports reliable improvement in SDQ difficulties scores for four of eight young people with paired data; the paper describes a group of 14 unaccompanied young people using CBT and techniques informed by ACT, DBT and CFT. It does not establish that PTSD symptoms failed to improve: the authors state that the PTSD measure was not used to monitor group outcomes. (LLM, conf=0.88)
Experimental — accuracy not yet measuredSignificant improvements in mental health and psychological flexibility were observed for third wave interventions.
“Significant improvements in MH and psychological flexibility were also observed for third wave interventions [74, 76].”
From Examining cognitive behavioral therapy interventions for unaccompanied minors: a systematic review and qualitative research synthesis. (2025) · cites this paper as [74]
The Supporting engagement with the group section says the intervention used strategies informed by Acceptance and Commitment Therapy. Clinical outcomes reports statistically reliable improvement on the mental-health SDQ measure for four of eight young people with paired data. It does not report psychological flexibility outcomes or isolate the effect of the third-wave strategies from the rest of the group intervention. (LLM, conf=0.86)
Experimental — accuracy not yet measuredThree studies (16.7%) were classified as third wave CBT interventions.
“Three studies (16.7%) were classified as third wave CBT interventions [74–76].”
From Examining cognitive behavioral therapy interventions for unaccompanied minors: a systematic review and qualitative research synthesis. (2025) · cites this paper as [74]
Only five studies investigated acceptability with participants using qualitative methodology.
“Only five studies investigated acceptability with participants [65, 71, 74, 75, 78] using qualitative methodology.”
From Examining cognitive behavioral therapy interventions for unaccompanied minors: a systematic review and qualitative research synthesis. (2025) · cites this paper as [74]
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- To discuss the relevance of cognitive behavioural therapeutic approaches to this client group. (3) To describe culturally informed ways of working within an outpatient mental health setting. (4) To review the acceptability of this approach for young people and the process as professionals.
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Hutchinson, R., King, N., & Majumder, P. (2022) · International Journal of Social Psychiatry · doi:10.1177/00207640211057727 · Cited by 16 · see citing works
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“[74 ]. the results is limited by small sample sizes.”
Influential
- Authors
- King, D., & Said, G.
- Affiliations
- Royal Holloway University of London (GB)
- University College London (GB)
- Venue
- The Cognitive Behaviour Therapist
- Publisher
- Cambridge University Press (CUP)
- Published
- 2019
- Volume
- 12
- ISSN
- 1754-470X (ISSN-L)
- OpenAlex
- W2910081626
- Cited by
- 31
- References
- 79
- Citations by year
- 2026: 5 · 2025: 5 · 2024: 7 · 2023: 4 · 2022: 3 · 2021: 3 · 2020: 2 · 2019: 2
- FWCI
- 2.92
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Cognitive Behaviour Therapist (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
- Social Sciences › Psychology › Social Psychology › Counseling Practices and Supervision
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Keywords
- cognitive behavioral therapy, group therapy, cultural adaptation, acceptability, mental health service delivery, resilience, emotional well-being, peer support, trauma, language barriers, sleep, refugee youth
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