How effective is group intervention in the treatment for unaccompanied and accompanied refugee minors with mental health difficulties: A systematic review
Abstract
Background: Unaccompanied refugee minors (URM) are at significantly higher risk of trauma exposure and mental illness. Research examining the most effective treatments for this population is limited. Aims: To study the available research evidence on outcomes from various group interventions in this population. The objective is to investigate if these can be used clinically in future interventions. Methods: Systematic review was carried out for patient outcomes where group therapy was used as treatment in URM. Studies with ARM (Accompanied refugee minors) were included because of similarities between these groups and because many studies were mixed population. Results: Seventeen papers met eligibility criteria with a total of N = 1,119 participants. About 80% studies with a quantitative component reported improvements, and 69% of the studies that carried out statistical analyses reported statistically significant improvements in mental health symptoms. Every qualitative measure reported positive outcome for the participants. Studies with URM tended to show improved outcomes more often than studies exclusively with ARM. Conclusions: The evidence demonstrates the efficacy of group therapy in improving mental health outcomes, although the number of studies with robust methodology is small. Group intervention has potential to improve engagement and outcomes of URM with mental illness. Future direction for research is discussed.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Even in studies where no significant quantitative symptom improvements were observed, the qualitative data still provided evidence for progress in other domains such as improved interpersonal relationships and self-care.
“Similar to previous reviews [80], results indicate that even in studies where no significant quantitative symptom improvements were observed, the qualitative data still provided evidence for progress in other domains (i.e., improved interpersonal relationships and self-care; [78]).”
From Examining cognitive behavioral therapy interventions for unaccompanied minors: a systematic review and qualitative research synthesis. (2025) · cites this paper as [80]
The methodological drawbacks observed in this study have been reported in previous literature between 2018 and 2021.
“As the methodological drawbacks observed in this study have been reported in previous literature between 2018 and 2021 [45, 80, 84, 87] it is alarming that significant strides towards addressing these limitations have yet to be addressed.”
From Examining cognitive behavioral therapy interventions for unaccompanied minors: a systematic review and qualitative research synthesis. (2025) · cites this paper as [80]
Cites
Gulliver, A., Griffiths, K. M., & Christensen, H. (2010) · BMC Psychiatry · doi:10.1186/1471-244x-10-113 · Cited by 3,292 · see citing works
Fazel, M., Wheeler, J., & Danesh, J. (2005) · The Lancet · doi:10.1016/s0140-6736(05)61027-6 · Cited by 2,292 · see citing works
The mental health of refugee children
Fazel, M. S. (2002) · Archives of Disease in Childhood · doi:10.1136/adc.87.5.366 · Cited by 469 · see citing works
Tyrer, R. A., & Fazel, M. S. (2014) · PLoS ONE · doi:10.1371/journal.pone.0089359 · Cited by 461 · see citing works
Ehntholt, K. A., Smith, P. A., & Yule, W. (2005) · Clinical Child Psychology and Psychiatry · doi:10.1177/1359104505051214 · Cited by 298 · cited 4× · see citing works
“Only one (Ehntholt et al., 2005) contained a control group; the rest were before-after trials.”
BackgroundInfluentialGroup crisis intervention for children during ongoing war conflict
Thabet, A. A., Vostanis, P., & Karim, K. (2005) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-005-0466-7 · Cited by 168 · see citing works
The mental health of unaccompanied refugee minors on arrival in the host country
Vervliet, M., Demott, M. A. M., Jakobsen, M., Broekaert, E., Heir, T., & Derluyn, I. (2014) · Scandinavian Journal of Psychology · doi:10.1111/sjop.12094 · Cited by 152 · see citing works
Kalantari, M., Yule, W., Dyregrov, A., Neshatdoost, H., & Ahmadi, S. J. (2012) · OMEGA - Journal of Death and Dying · doi:10.2190/om.65.2.d · Cited by 150 · see citing works
Critical Incident Stress Management (CISM): A Statistical Review of the Literature
Everly, G. S., Flannery, R. B., & Eyler, V. (2002) · Psychiatric Quarterly · doi:10.1023/a:1016068003615 · Cited by 104 · see citing works
Sarkadi, A., Ådahl, K., Stenvall, E., Ssegonja, R., Batti, H., Gavra, P., Fängström, K., & Salari, R. (2018) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-017-1093-9 · Cited by 94 · see citing works
Pfeiffer, E., Sachser, C., Rohlmann, F., & Goldbeck, L. (2018) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12908 · Cited by 89 · cited 11× · see citing works
“(One study (Pfeiffer et al., 2018) has been included in this due to having only one ARM out of 99 participants.)”
BackgroundInfluentialGörmez, V., Kılıç, H. N., Örengül, A. C., Demir, M. N., Mert, E. B., Makhlouta, B., Kınık, K., & Semerci, B. (2017) · Psychiatry and Clinical Psychopharmacology · doi:10.1080/24750573.2017.1304748 · Cited by 78 · see citing works
Rousseau, C., Beauregard, C., Daignault, K., Petrakos, H., Thombs, B. D., Steele, R. J., Vasiliadis, H., & Hechtman, L. T. (2014) · PLoS ONE · doi:10.1371/journal.pone.0104704 · Cited by 66 · see citing works
Demott, M. A. M., Jakobsen, M., Wentzel‐Larsen, T., & Heir, T. (2017) · Scandinavian Journal of Psychology · doi:10.1111/sjop.12395 · Cited by 58 · see citing works
Ooi, C. S., Rooney, R. M., Roberts, C. M., Kane, R. T., Wright, B. R., & Chatzisarantis, N. L. D. (2016) · Frontiers in Psychology · doi:10.3389/fpsyg.2016.01641 · Cited by 57 · see citing works
Evaluation of a Trauma‐Focused Group Intervention for Unaccompanied Young Refugees: A Pilot Study
Pfeiffer, E., & Goldbeck, L. (2017) · Journal of Traumatic Stress · doi:10.1002/jts.22218 · Cited by 56 · cited 1× · see citing works
“Quantitative studies with unaccompanied refugee minors Other than RCTs, there was one study (Pfeiffer & Goldbeck, 2017) with only quantitative outcome measures that assessed URMs (Supplemental Table S1).”
ResultGroup therapy with Southeast Asian refugees
Kinzie, J. D., Leung, P., Bui, A. T. M., Ben, R., Keopraseuth, K., Riley, C. M., Fleck, J., & Ades, M. (1988) · Community Mental Health Journal · doi:10.1007/bf00756658 · Cited by 47 · see citing works
Pfeiffer, E., Sachser, C., Tutus, D., Fegert, J. M., & Plener, P. L. (2019) · Child and Adolescent Psychiatry and Mental Health · doi:10.1186/s13034-019-0277-0 · Cited by 39 · cited 1× · see citing works
“New group therapies have been developed to overcome the prevalent barriers to individual therapy, such as lack of therapists, translators or availability of resources (Pfeiffer et al., 2019).”
BackgroundPotential barriers in the therapeutic relationship in unaccompanied refugee minors in mental health
Majumder, P., Vostanis, P., Karim, K., & O’Reilly, M. J. (2018) · Journal of Mental Health · doi:10.1080/09638237.2018.1466045 · Cited by 36 · see citing works
Self-citationVan der Gucht, K., Glas, J., De Haene, L., Kuppens, P., & Raes, F. (2019) · Journal of Child and Family Studies · doi:10.1007/s10826-019-01336-5 · Cited by 32 · see citing works
King, D., & Said, G. (2019) · The Cognitive Behaviour Therapist · doi:10.1017/s1754470x18000260 · Cited by 31 · see citing works
EMDR Group Treatment of Children Refugees—A Field Study
Perilli, S., Giuliani, A., Pagani, M., Mazzoni, G. P., Maslovaric, G., Maccarrone, B., Mahasneh, V., & Morales, D. P. R. (2019) · Journal of EMDR Practice and Research · doi:10.1891/1933-3196.13.2.143 · Cited by 25 · see citing works
Hurn, R., & Barron, I. G. (2018) · Journal of EMDR Practice and Research · doi:10.1891/1933-3196.12.4.208 · Cited by 22 · see citing works
Pre-Post Study to Assess EMDR-Based Group Therapy for Traumatized Refugee Preschoolers
Lempertz, D., Wichmann, M. L.-Y., Enderle, E., Stellermann-Strehlow, K., Pawils, S., & Metzner, F. (2020) · Journal of EMDR Practice and Research · doi:10.1891/1933-3196.14.1.31 · Cited by 21 · see citing works
Development and implementation of a group based mental health intervention for unaccompanied minors
Garoff, F., Kangaslampi, S., & Peltonen, K. (2018) · Scandinavian Journal of Psychology · doi:10.1111/sjop.12497 · Cited by 19 · see citing works
Using Storytelling in Psychotherapeutic Group Work with Young Refugees
Schwartz, S., & Melzak, S. (2005) · Group Analysis · doi:10.1177/0533316405052385 · Cited by 16 · see citing works
Efficiency savings: preparing for a bleak future?
Majumder, P. (2012) · British Journal of Healthcare Management · doi:10.12968/bjhc.2012.18.3.136 · Cited by 2 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
Soltan, F., Cristofalo, D., Marshall, D. C., Purgato, M., Taddese, H. B., Vanderbloemen, L., Barbui, C., & Uphoff, E. (2022) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd013657.pub2 · Cited by 29 · see citing works
Giles, C. J., Västhagen, M., van Leuven, L., Edenius, A., Ghaderi, A., & Enebrink, P. (2024) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-024-02424-8 · Cited by 12 · see citing works
“Much of the current review and meta-literature concerning forcibly displaced children and youth has aimed to synthesize evidence of the efficacy of psychological treatment s [34–37].”
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
“As the methodological drawbacks observed in this study have been reported in previous literature between 2018 and 2021 [ 45 , 80, 84, 87] it is alarming that signifi - cant strides towards addressing these limitations have yet to be addressed.”
Psychotherapeutic and Psychosocial Interventions with Unaccompanied Minors: A Scoping Review
Moutsou, I., Georgaca, E., & Varaklis, T. (2023) · Healthcare · doi:10.3390/healthcare11060918 · Cited by 7 · see citing works
“However, four of them were published five to 17 years ago [19,20,22,23], while the rest examined very specific aspects of the subject, namely interventions that were examined exclusively through quantitative studies [21], psychosocial interventions during the first year of arrival [24] and group interventions [25].”
BackgroundCadorin, C., Purgato, M., Turrini, G., Prina, E., Ferreira, M. C., Cristofalo, D., Bartucz, M. B., Witteveen, A. B., Sijbrandij, M., Papola, D., et al. (2024) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2024.33 · Cited by 8 · see citing works
“However, the prevalence rates varied substantially across studies, spanning from 4.6% to 43% for PTSD, 2.9% to 61.6% for depression, 32.6% to 38.2% for anxiety and 4% to 14.3% for behavioral problems (Hutchinson et al., 2022).”
BackgroundInfluentialYim, S. H., Said, G., & King, D. X. (2024) · Clinical Child Psychology and Psychiatry · doi:10.1177/13591045241252858 · Cited by 6 · see citing works
Art-thérapies et Mineurs Non Accompagnés : indications, dispositifs et efficacités
Fragonas, M., & Sudres, J. (2023) · Annales Médico-psychologiques revue psychiatrique · doi:10.1016/j.amp.2023.04.008 · Cited by 3 · see citing works
Migration 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
Migration 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
Fragonas, M., & Sudres, J. (2025) · Neuropsychiatrie de l Enfance et de l Adolescence · doi:10.1016/j.neurenf.2025.01.007 · Cited by 1 · see citing works
Treating Young Refugees with a Grief-Focused Group Therapy—A Feasibility Trial
Rummel, A.-M., Vogel, A., Rossi, R., Jacob, M., Achtner, M., Schnauder, J., Rosner, R., & Comteße, H. (2025) · Behavioral Sciences · doi:10.3390/bs15091285 · Cited by 1 · see citing works
“Furthermore, 69% of included group therapies for young refugees in a systematic review have demonstrated significant improvements in mental health symptoms, making it a suitable treatment option (Hutchinson et al., 2022).”
Tree of Life: Acceptability and Feasibility With Older Bosnian Women of Refugee Background
Khawaja, N. G., Murray, K. E., & Sadeed, S. (2022) · Psychotherapy and Counselling Journal of Australia · doi:10.59158/001c.71066 · Cited by 1 · see citing works
Potler, N. V., Villegas, S., Vieira, D. L., & Horwitz, S. M. (2025) · JCPP Advances · doi:10.1002/jcv2.70073
Gruppentherapeutische Unterstützung für junge Geflüchtete in der Schweiz
Benda, K., Kleiner, N., Rumpel, S., Stulz-Koller, A., von Wyl, A., & Wade-Bohleber, L. (2026) · Trauma und Gewalt · doi:10.21706/tg-20-1-48
Suryanti, M. S. D., Renyoet, C. C., & Muttaqin, M. Z. (2026) · International Social Work · doi:10.1177/00208728261421018
Frigaux, A., Boulay, C., Najdini, M., Demogeot, N., Filpa, C., Robin, M., & Essadek, A. (2026) · L Évolution Psychiatrique · doi:10.1016/j.evopsy.2026.03.001
- Authors
- Hutchinson, R., King, N., & Majumder, P.
- Affiliations
- University of Nottingham (GB)
- Corresponding author
- Majumder, Pallab
- Venue
- International Journal of Social Psychiatry
- Publisher
- SAGE Publications
- Published
- 2021-11-25
- Volume
- 68
- Issue
- 3
- Pages
- 484-499
- ISSN
- 0020-7640 (ISSN-L)
- 1741-2854
- OpenAlex
- W3214811021
- Cited by
- 16
- References
- 27
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 5 · 2023: 3 · 2022: 2
- FWCI
- 0.33
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Social Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
- Social Sciences › Education › Education and experiences of immigrants and refugees
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- unaccompanied refugee children, group therapy, group intervention, psychotherapy, trauma exposure, mental illness, treatment efficacy, refugee mental health
- MeSH terms
- Mental Disorders, Humans, Mental Health, Mental Health Services, Refugees, Stress Disorders, Post-Traumatic, Minors
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
