A systematic review of psychosocial interventions for adult refugees and asylum seekers
Abstract
Background: Europe is in the midst of the largest refugee migration since the Second World War; there is an urgent need to provide an updated systematic review of the current best evidence for managing mental distress in refugee populations.Aims: The aim of this review is to provide an exhaustive summary of the current literature on psychosocial interventions, both trauma- and non-trauma-focused, for refugee populations experiencing post-traumatic stress disorder (PTSD), depressive or anxiety symptoms. To produce recommendations for future research and current clinical practice.Method: Searches were conducted in PubMed, PsychINFO (Hosted by Ovid), PILOTS and Social Services Abstracts; 5305 articles were screened and 40 were included.Results: This review found medium to high quality evidence supporting the use of narrative exposure therapy (NET). A lack of culturally adapted treatments was apparent and there was less evidence to support standard cognitive behavioural therapy (CBT), Eye Movement Desensitisation and Reprocessing (EMDR) and multidisciplinary treatments.Conclusion: NET produced positive outcomes in refugees from a diverse range of backgrounds and trauma types. There is a general dearth of research in all intervention types: further research should include more “real-world” multidisciplinary interventions that better model clinical practice. Recommendations for evaluating local need, and creating a culturally sensitive workforce are discussed.
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Qualitative methodology has been used to evaluate treatment acceptability as it can elucidate participant beliefs regarding a treatment which may help to define the components of a treatment that are regarded as meaningful and to appraise cultural sensitivity.
“To evaluate treatment acceptability, qualitative methodology has been used as it can elucidate participant beliefs regarding a treatment which may help to define the components of a treatment that are regarded as meaningful and to appraise cultural sensitivity [44].”
From Examining cognitive behavioral therapy interventions for unaccompanied minors: a systematic review and qualitative research synthesis. (2025) · cites this paper as [44]
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“In many cases, immigrants are traumatized by the experiences of terrorists attacking travelling buses (62).”
BackgroundSteil, R., Lechner‐Meichsner, F., Johow, J., Krüger-Gottschalk, A., Mewes, R., Reese, J., Schumm, H., Weise, C., Nexhmedin Morina, B., & Ehring, T. W. (2021) · European Journal of Psychotraumatology · doi:10.1080/20008198.2021.1872967 · Cited by 21 · see citing works
“…have shown trauma-focused psychotherapy to be effective with medium to large effects (Kip, Priebe, Holling, & Morina, 2020; Lambert & Alhassoon, 2015; Morina, Malek, Nickerson, & Bryant, 2017; Nosè et al., 2017; Thompson, Vidgen, & Roberts, 2018; Tribe, Sendt, & Tracy, 2019; Turrini et al., 2019).”
Sambucini, D., Aceto, P., Begotaraj, E., & Lai, C. (2020) · Journal of Immigrant and Minority Health · doi:10.1007/s10903-020-01055-w · Cited by 21 · see citing works
Jowett, S., Argyriou, A., Scherrer, O., Karatzias, T., & Katona, C. (2021) · BJPsych Open · doi:10.1192/bjo.2021.1007 · Cited by 20 · see citing works
Interventions using the Qur’an to promote mental health: a systematic scoping review
Owens, J., Rassool, G. H., Bernstein, J., Latif, S., & Aboul-Enein, B. H. (2023) · Journal of Mental Health · doi:10.1080/09638237.2023.2232449 · Cited by 41 · see citing works
Opheim, E., Andersen, P. N., Jakobsen, M., Aasen, B., & Kvaal, K. S. (2019) · Frontiers in Psychology · doi:10.3389/fpsyg.2019.01558 · Cited by 18 · see citing works
“We answered the question with “No” for thirteen of the reviews (Lapp et al., 2010; Goodson et al., 2011; Haugen et al., 2012; Ho and Lee, 2012; Mello et al., 2013; Watts et al., 2013; Ehring et al., 2014; Jong et al., 2014; Chen et al., 2015; Haagen et al., 2015; Erford et al., 2016; Lenz et al., 2017; Tribe et al., 2…”
BackgroundHasha, W., Igland, J., Fadnes, L. T., Kumar, B. N., Haj-Younes, J., Strømme, E. M., Norstein, E. Z., Vårdal, R., & Díaz, E. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17249468 · Cited by 16 · see citing works
“However, there is a lack of evidence of the effect of group physiotherapy versus individual physical activity, as part of the treatment for chronic pain among refugees [29,30].”
BackgroundSeruwagi, G. K., Nakidde, C., Lugada, E., Ssematiko, M., Ddamulira, D. P., Masaba, A., Luswata, B., Ochen, E. A., Okot, B. J., Muhangi, D., et al. (2022) · Conflict and Health · doi:10.1186/s13031-022-00451-3 · Cited by 16 · see citing works
The Use of Art Therapy in Alleviating Mental Health Symptoms in Refugees: A Literature Review
Zadeh, R., & Jogia, J. (2023) · International Journal of Mental Health Promotion · doi:10.32604/ijmhp.2023.022491 · Cited by 18 · see citing works
Promoting mental health in migrants: a GHQ12-evaluation of a community health program in Sweden
Wrede, O., Löve, J., Jonasson, J. M., Panneh, M., & Priebe, G. E. (2021) · BMC Public Health · doi:10.1186/s12889-021-10284-z · Cited by 16 · see citing works
Kaltenbach, E., Hermenau, K., Schauer, M., Dohrmann, K., Elbert, T. R., & Schalinski, I. (2020) · BMC Psychiatry · doi:10.1186/s12888-020-02720-y · Cited by 16 · see citing works
Conceptual frameworks of barriers and facilitators to perinatal mental healthcare: the MATRIx models
Webb, R., Ford, E. M., Easter, A., Shakespeare, J., Holly, J., Hogg, S., Coates, R., Ayers, S., & the MATRIx Study Team (2023) · BJPsych Open · doi:10.1192/bjo.2023.510 · Cited by 18 · see citing works
“52,53 Future research should investigate if this is the case in perinatal populations.”
The treatment of PTSD in refugees and asylum seekers using imagery rescripting within an NHS setting
Steel, C., Young, K., Akbar, S., Chessell, Z. J., Stevens, A., Vann, M., & Arntz, A. R. (2022) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465822000650 · Cited by 15 · see citing works
“These outcomes are in line with recent systematic reviews which evidenced the effectiveness of psychological interventions in this group, but concluded that wider social and welfare interventions are also likely to be required (Hamid et al., 2019; Tribe et al., 2019).”
Improving the assessment and treatment of pain in torture survivors
Williams, A. C. D. C., & Hughes, J. H. (2020) · BJA Education · doi:10.1016/j.bjae.2019.12.003 · Cited by 14 · see citing works
Khairat, M., Hodge, S., & Duxbury, A. (2023) · Psychology and Psychotherapy Theory Research and Practice · doi:10.1111/papt.12470 · Cited by 14 · see citing works
Matheson, C., & Weightman, E. (2020) · Journal of Mental Health · doi:10.1080/09638237.2020.1803229 · Cited by 13 · see citing works
“The literature on psychotherapy for refugees (Tribe et al., 2019) often mentions practical and social factors such as immigration status, housing need, and coping with loss of family and home, as obstacles to engaging in trauma therapy, and advocates either adapted modalities (Hinton & Good, 2016; Schauer et al.”
BackgroundA mental health framework from the voices of refugees
Kanagaratnam, P., Pandalangat, N., Silver, I., & Toner, B. B. (2021) · International Journal of Social Psychiatry · doi:10.1177/00207640211052922 · Cited by 10 · see citing works
“To date, the evidence is lacking for effective assessment (Campbell, 2007; Hollifield et al., 2002; McColl et al., 2010) and treatment interventions for refugees (Aroche & Coello, 2004; Bernardes et al., 2010; Crumlish & O’Rourke, 2010; Johnson & Thompson, 2008; Tribe et al., 2019).”
BackgroundNarrative-based psychotherapies for mood disorders: A scoping review of the literature
Hawke, L. D., Nguyen, A. T. P., Rodak, T., Yanos, P. T., & Castle, D. J. (2023) · SSM - Mental Health · doi:10.1016/j.ssmmh.2023.100224 · Cited by 11 · see citing works
Abu-Ras, W. M., Almoayad, F. A., Bakry, H., Alammari, D., Kelly, P. J., & Aboul-Enein, B. H. (2024) · International Journal of Social Psychiatry · doi:10.1177/00207640241259995 · Cited by 14 · see citing works
“…the efficacy of psychological interventions, with Thompson specifically delving into the treat-ment of PTSD. van Wyk and Schweitzer (2014) and Tribe et al. (2019) both emphasize the necessity for more rigorous research methods and recognize the potential benefits of narrative exposure…”
BackgroundUsing Imagery Rescripting to Treat Posttraumatic Stress Disorder in Refugees: A Case Study
Lechner‐Meichsner, F., Ehring, T. W., Krüger-Gottschalk, A., Nexhmedin Morina, B., Plankl, C., & Steil, R. (2022) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2022.06.002 · Cited by 12 · see citing works
Higgins, A., Murphy, R., Barry, J., Eustace‐Cook, J., Monahan, M., Kroll, T., Hevey, D., Doyle, L., & Gibbons, P. (2020) · Journal of Mental Health · doi:10.1080/09638237.2020.1714002 · Cited by 10 · see citing works
Due, C., Gartley, T., & Ziersch, A. M. (2024) · Australian Psychologist · doi:10.1080/00050067.2024.2343745 · Cited by 9 · see citing works
“These findings are supported by other reviews (e.g., see Slobodin & de Jong, 2015; Tribe et al., 2019).”
ResultBrooks, M. (2019) · The Cognitive Behaviour Therapist · doi:10.1017/s1754470x19000023 · Cited by 9 · see citing works
“psychotherapy intervention which is firmly supported to treat PTSD in refugee populations and survivors of torture (Nickerson et al., 2011; Tribe et al., 2017).”
BackgroundKananian, S., Kip, A., Schumm, H., Giesebrecht, J., Nicolai, A., Schade‐Brittinger, C., Reese, J., Weise, C., Mewes, R., Nexhmedin Morina, B., et al. (2022) · BMJ Open · doi:10.1136/bmjopen-2022-061274 · Cited by 9 · see citing works
Morroni, D., Konstantinou, P., Gkleka, C., Kassianos, A. P., & Karekla, M. (2025) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-024-02500-z · Cited by 8 · see citing works
“To eval - uate treatment acceptability, qualitative methodology has been used as it can elucidate participant beliefs regarding a treatment which may help to define the components of a treatment that are regarded as meaningful and to appraise cultural sensitivity [ 44].”
Menon, S., Katona, C., & Glover, N. (2024) · Mental Health Science · doi:10.1002/mhs2.85 · Cited by 8 · see citing works
Uygun, E. (2020) · Psychiatry Investigation · doi:10.30773/pi.2018.0275 · Cited by 8 · see citing works
“56 Psychiatry Investig 2020;17(1):55-60 Why Syrians Seek Asylum from Turkey to Europe”
BackgroundIntegrating Cultural Beliefs About Illness in Counseling With Refugees: A Phenomenological Study
Bartholomew, T. T., Gundel, B. E., Kang, E., Joy, E. E., Aguiñiga, S. M., Robbins, K. A., & Li, H. (2021) · Journal of Cross-Cultural Psychology · doi:10.1177/00220221211038374 · Cited by 8 · see citing works
“Cultural adaptations, however, are few despite their believed utility (Tribe et al., 2019).”
BackgroundInfluentialSettling Ulysses: An Adapted Research Agenda for Refugee Mental Health
Namer, Y., & Razum, O. (2017) · International Journal of Health Policy and Management · doi:10.15171/ijhpm.2017.131 · Cited by 7 · see citing works
The relation between post-migration stressors and trauma treatment outcomes: a scoping review
Mässing, A., & Cardeña, E. (2025) · European Journal of Psychotraumatology · doi:10.1080/20008066.2025.2570929 · Cited by 5 · see citing works
“Furthermore, it is not justified to delay or deny these patients healthcare or support (De Jongh et al., 2016; Gušić et al., 2019; Ter Heide et al., 2016; Thompson et al., 2018; Tribe et al., 2019; Turrini et al., 2024).”
Lessons to learn from the analysis of routine health data from Moria Refugee Camp on Lesvos, Greece
Hart, P. L., Zahos, H., Salt, N., Schofield, R., Mahroof-Shaffi, S., Simonek, T., & Harkensee, C. (2022) · Journal of Public Health · doi:10.1093/pubmed/fdac127 · Cited by 5 · see citing works
Leiler, A., Wasteson, E., Holmberg, J., & Bjärtå, A. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17238953 · Cited by 4 · see citing works
Steil, R., Görg, N., Kümmerle, S., Lechner‐Meichsner, F., Gutermann, J., & Müller‐Engelmann, M. (2021) · Verhaltenstherapie · doi:10.1159/000514724 · Cited by 5 · see citing works
“Für eine kultursensitiv adaptierte Form der kognitiven Verhaltenstherapie (u.a. Hinton et al. [2005]) werden im Vergleich zu Wartelisten in einer Metaanalyse große Effekte auf die PTBS-Symptomatik berichtet [Tribe et al., 2019].”
BackgroundInfluentialSmith, A. C. G., & Crooks, C. V. (2022) · Child & Youth Care Forum · doi:10.1007/s10566-022-09695-9 · Cited by 5 · see citing works
Mediated communication and refugee resilience: A social psychological model
Pochwatko, G., & Naydonova, L. A. (2023) · Scientific Studios on Social and Political Psychology · doi:10.61727/sssppj/1.2023.28 · Cited by 4 · see citing works
Riisager, L. G., Huniche, L., Larsen, J. E., Christiansen, T. B., Kring, L. D., Palić, S., & Møeller, S. B. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1250552 · Cited by 4 · see citing works
Riisager, L. G., Larsen, J. E., Huniche, L., Christiansen, T. B., & Møeller, S. B. (2025) · JMIR Formative Research · doi:10.2196/66663 · Cited by 4 · see citing works
“While specialized treatments such as narrative exposure therapy have yielded promising outcomes [5,12], conventional psychotherapies often remain session-bound and do not fully engage with the everyday realities of refugee patients.”
Caring for Internally Displaced Older Adult Israelis during the 2023 Israel-Hamas War
Maytles, R., & Shrira, A. (2024) · American Journal of Geriatric Psychiatry · doi:10.1016/j.jagp.2024.01.224 · Cited by 4 · see citing works
Opaas, M., & Hartmann, E. (2021) · PubMed Central · doi:10.1097/nmd.0000000000001396 · Cited by 3 · see citing works
“…posttraumatic stress disorder (PTSD) and depression for those receiving the intervention compared with control conditions (e.g., treatment as usual [TAU]) (e.g., Kip et al., 2020; Lambert and Alhassoon, 2015; Raghuraman et al., 2021; Thompson et al., 2018; Tribe et al., 2019, Turrini et al., 2019).”
BackgroundMethodFigura, M., Simeone, S., Arcadi, P., Vellone, E., Alvaro, R., & Pucciarelli, G. (2025) · Archives of Psychiatric Nursing · doi:10.1016/j.apnu.2025.151879 · Cited by 3 · see citing works
Konstanzer Modellprojekt für psychisch belastete Geflüchtete
Bogatzki, L., Miredin, J., Millet, S., Lipinski, L., Molle, M., Rockstroh, B. S., Mier, D. U., & Odenwald, M. G. (2023) · Der Nervenarzt · doi:10.1007/s00115-023-01524-1 · Cited by 3 · see citing works
“Der Vergleich mit Interventionsstudi-en bei Geflüchteten mit PTBS erlaubt eine weitere Einordnung der Daten: Effektivität wurde gezeigt [13, 27, 28], jedoch weisen einige Studien sehr hohe Abbruchraten von über 50% auf (z. B. [25]).”
BackgroundMethodAgha, E., Cuddeback, G. S., & Crowder, J. C. (2023) · Social Work in Mental Health · doi:10.1080/15332985.2023.2285256 · Cited by 3 · see citing works
“Service providers emphasized the importance of examining the influence of culture on how the refugees conceptualize their behavioral health including psychological symptoms and somatic complaints (Tribe et al., 2017; Young & Chan, 2015).”
BackgroundMigration Mental Health: Immigrants, Refugees, and Displaced Persons
Kronick, R., Jarvis, G. E., & Kirmayer, L. J. (2023) · Springer eBooks · doi:10.1007/978-3-030-42825-9_127-1 · Cited by 3 · see citing works
Generation of fundamental soliton in the presence of initial linear chirp
Kaczmarek, T. (2004) · Prace Naukowe Uniwersytetu Ekonomicznego we Wrocławiu · Cited by 3 · see citing works
Lawoko, S., Seruwagi, G. K., Muhangi, D., Ochen, E. A., Okot, B. J., Lugada, E., Masaba, A., Ddamulira, D. P., Luswata, B., Nakidde, C., et al. (2021) · International Journal of Community Medicine and Public Health · doi:10.18203/2394-6040.ijcmph20211729 · Cited by 3 · see citing works
“Variables Total risk index(24-120) Hygiene risk index (9-45) Congestion risk index (8-40) International exposure risk index (3-15) Nutrition & physical activity risk index(4-20)”
BackgroundMigration Mental Health: Immigrants, Refugees, and Displaced Persons
Kronick, R., Jarvis, G. E., & Kirmayer, L. J. (2024) · Springer eBooks · doi:10.1007/978-3-030-51366-5_127 · Cited by 3 · see citing works
Burkinshaw, M., & Wilcockson, M. (2025) · International Journal of Migration Health and Social Care · doi:10.1108/ijmhsc-03-2024-0031 · Cited by 2 · see citing works
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Cassidy, G. P., McQuaid, J., Heatherington, L., & Su, A. C. J. (2023) · Journal of Traumatic Stress · doi:10.1002/jts.22917 · Cited by 2 · see citing works
Preventing Dropout in Research, Assessment and Treatment with Refugees - a guidelinePreprint
Semmlinger, V., & Ehring, T. W. (2020) · doi:10.31234/osf.io/nukv3 · Cited by 2 · see citing works
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Västhagen, M., Giles, C. J., Hollander, A., Ghaderi, A., van Leuven, L., Edenius, A., & Enebrink, P. (2026) · Transcultural Psychiatry · doi:10.1177/13634615251372854 · Cited by 2 · see citing works
“Overviews of psychosocial interventions for refugees and asylum seekers (systematic review, Tribe et al., 2019; review and meta-analysis, Turrini et al., 2019), and of family interventions for traumatized immigrants and refugees (systematic review, Slobodin & de Jong, 2015) do exist.”
L'efficacia degli interventi psicologici sulla depressione, ansia e somatizzazione nei migranti
Begotaraj, E., Paola, C. D., Sambucini, D., Ciacchella, C., Caroppo, E., & Lai, C. (2020) · RICERCHE DI PSICOLOGIA · doi:10.3280/rip2020-001012 · Cited by 1 · see citing works
Eye Movement Desensitization and Reprocessing desde la propuesta de valoración de Mario Bounge
Armijos, M. D. L. C., López, J. P. V., Valdivieso, M. J. E., Espinoza, R. E. G., Ávila, C. G. M., Villavicencio, E. I. G., & Martínez-Suárez, P. C. (2021) · Investigatio · doi:10.31095/investigatio.2021.16.3 · Cited by 1 · see citing works
Verbesserung der Schmerzerfassung und -therapie bei Überlebenden einer Folter
Williams, A. C. D. C., & Hughes, J. H. (2021) · Der Schmerz · doi:10.1007/s00482-021-00606-w · Cited by 1 · see citing works
“Andere systematische Übersichtsarbeiten zeichnen ein optimistischeres Bild [20].”
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The Psychological Impact of Residing in a Refugee Camp
Marshall, C. (2021) · Mental health and illness worldwide · doi:10.1007/978-981-10-0750-7_33-1
Mental Health and Treatment Considerations for Refugees
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The chronic traumatic stress treatment (CTS-T)
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Innovative Interventions to Improve Global Mental Health
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Mediated communication and refugee resilience: A social psychological model
Pochwatko, G., & Naydonova, L. (2023) · Scientific Studios on Social and Political Psychology · doi:10.61727/sssppj/1.2023.24
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“The adoption of control groups in studies aiming to assess psychotherapy training changes is essential (Tribe et al ., 2017), especially with regard to refugee populations.”
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“On the contrary, refugees and asylum seekers experience multiple losses—of home, culture, family, profession, language, friends, and future plans, leading to potential psychological impacts (Tribe et al., 2019; Tsegay, 2020, 2022).”
Tawil, N. E., Awad, T., Rouhana, Y., Zalaket, N., & Rahme, E. (2026) · BMC Psychiatry · doi:10.1186/s12888-026-08487-y
“Other studies extended their outcomes beyond PTSD to include depression and anxiety [12, 13, 41, 45] as well as cultural adaptability and acceptability [44, 45].”
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Psychological Adaptation and Migrant Well-Being From Trauma to Resilience
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- Authors
- Tribe, R. H., Sendt, K.-V., & Tracy, D. K.
- Affiliations
- King's College London (GB)
- Oxleas NHS Foundation Trust (GB)
- Corresponding author
- Tribe, Rachel H.
- Venue
- Journal of Mental Health
- Publisher
- Informa UK Limited
- Published
- 2017-05-09
- Volume
- 28
- Issue
- 6
- Pages
- 662-676
- ISSN
- 0963-8237 (ISSN-L)
- 1360-0567
- OpenAlex
- W2612433239
- Cited by
- 96
- References
- 87
- Citations by year
- 2026: 7 · 2025: 9 · 2024: 11 · 2023: 12 · 2022: 9 · 2021: 20 · 2020: 17 · 2019: 6 · 2018: 2 · 2017: 2
- FWCI
- 1.13
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Mental Health (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Keywords
- psychosocial interventions, refugees, asylum seekers, post-traumatic stress disorder, depression, anxiety, narrative exposure therapy, cognitive behavioral therapy, EMDR, culturally tailored interventions, trauma-focused interventions
- MeSH terms
- Anxiety, Depression, Humans, Implosive Therapy, Mental Health, Refugees, Stress Disorders, Post-Traumatic, Wounds and Injuries, Cognitive Behavioral Therapy, Treatment Outcome, Eye Movement Desensitization Reprocessing, Narrative Therapy
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