More than 5.6 million people have fled Syria since 2011, about half of them children. These children grow up with parents that often suffer from war-related mental health problems. In this study, w...

https://royalsocietypublishing.org/doi/pdf/10.1098/rsos.210362

Social cognition in refugee children: an experimental cross-sectional study of emotional processing with Syrian families in Turkish communities.

ABSTRACT Objective The number of forced migrants has been rising for years. Many forced migrants suffer from post‐traumatic stress disorder (PTSD), depression, and/or anxiety and need treatment. Here, we evaluate the effectiveness of psychological interventions (CBT, EMDR, expressive/art, mindfulness, mixed elements, NET and psychoeducation) in reducing symptoms of PTSD, depression, and anxiety in forced migrants. Design and Data Sources Systematic searches in PubMed and Web of Science and searches of preprint servers and grey literature were performed (final search date: 1 September 2023). Random‐effects frequentist and Bayesian meta‐analyses were used for data synthesis. Results We included 84 studies on treatment effects in adults (pooled N = 6302) and 32 on children and adolescents (pooled N = 1097). Our data show a reduction in symptoms of PTSD, depression and anxiety symptoms in both adults and child/adolescent forced migrants. Pooled pre‐ to post‐treatment effects (effect size Cohen's d ) ranged from −1.03 to −0.26 for PTSD, from −0.91 to −0.11 for depression and from −0.91 to −0.60 for anxiety, without there being differences in outcome per study design (i.e., RCT comparison vs. non‐RCT comparison vs. single arm treatment study). Treatment effects remained evident over follow‐up, and not a single type of treatment stood out as being superior to other treatment types. Structural differences in populations (e.g., regarding country of origin) over studies, however, could have hampered the validity of the comparisons between study characteristics such as treatment type. Conclusion Our findings support the effectiveness of psychological treatment in adult and child/adolescent forced migrants. 

Psychological Interventions for PTSD, Depression, and Anxiety in Child, Adolescent and Adult Forced Migrants: A Systematic Review and Frequentist and Bayesian Meta‐Analyses

In order to improve the quality of Distance English teaching, this study studies the teaching application system combined with behavioral cognition. In the research, relevant technologies such as settlement system integration, automatic scoring, data encryption, authority control and problem matching are introduced, and the system is improved. This process promotes the social and economic benefits brought by this kind of system with the help of various verification methods. At the same time, it also summarizes the advantages of Distance English teaching, and finally realizes the effective analysis of this kind of system. The design of the Distance English teaching application system is of great help to the follow-up teaching work. Therefore, we need to actively design such a system to optimize the quality of English teaching and lay a good foundation for teachers’ follow-up teaching.

/pdf/design-of-distance-english-teaching-application-system-3myoahe0.pdf

Design of Distance English Teaching Application System Combined with Behavioral Cognitive Settlement

Protecting children in crisis: An integrated approach to mass trauma response - clinical innovations, systems coordination, and evidence-based interventions

ABSTRACT Background: Refugees, asylum seekers, and internally displaced people experience a high burden of mental health problems owing to their experiencing traumas and stressful events. Objective: To summarise the available evidence and analyse the efficacy of brief psychological interventions (< 3 months) on improving mental health outcomes, including depression, anxiety, and post-traumatic stress disorder (PTSD)-related symptoms in refugees. Method: We searched Medline, EMBASE, PsycINFO, CINAHL, and Global Index Medicus from inception to 19 December 2023. We included controlled studies using any cognitive behavioural therapy (CBT) or CBT-based therapies delivered over a short time (< 3 months), which reported mental health outcomes pre-and post-intervention. We conducted meta-analyses using random effects to derive pooled summary statistics. The quality of the evidence was assessed with the Cochrane Risk of Bias (RoB2) and ROBINS-I tools. This study is registered on the Open Science Framework, DOI 10.17605/OSF.IO/9CXU4. Results: 34 eligible studies across 37 publications were retrieved for analysis, and 33 studies with 4479 participants were included in the meta-analysis. There was an overall improvement in immediate mental health outcomes for all three domains, with analysis of 13 studies on anxiety outcomes (SMD −1.12, 95% CI −1.72 to −0.52), 20 studies on depression (SMD −1.04, 95% CI −1.97 to −0.11), and 24 studies on PTSD (SMD −0.82, 95% CI −1.20 to −0.45). At 3 to 6-month follow-up, however, analysis of mental health outcomes shows no significant change from baseline, with a SMD of 0.24 (95% CI −0.94 to 1.42) across 4 studies, −0.73 (95% CI −2.14 to 0.68) across 9 studies, and 0.29 (95% CI −0.94 to 1.53) across 12 studies for anxiety, depression, and PTSD respectively. Conclusion: Low-quality evidence shows brief psychological interventions have a positive immediate effect on refugees and internally displaced people's mental well-being. However, these effects do not persist in the short-term follow up. Heterogeneity was high, even among subgroups, impacting our findings’ generalisability.

Brief CBT-based psychological interventions to improve mental health outcomes in refugee populations: a systematic review and meta-analysis

Background: High rates of post-traumatic stress disorder (PTSD) are documented within refugee populations. Although research supports effectiveness of trauma-focused cognitive behaviour therapy (TF-CBT) among Western populations, little research exists for its efficacy among refugees living in camps and settlements in developing nations. Aims:
 To investigate whether a culturally sensitive, group-based TF-CBT programme (EMPOWER) delivered in a Ugandan refugee settlement effectively reduced refugees’ post-traumatic stress symptoms (PTSS), and whether sociodemographic factors, trauma characteristics, or PTSS severity related to programme completion or treatment outcomes. Method and Results:
 Data linkages were conducted on information provided by 174 Congolese refugees living in a Ugandan settlement (mean age = 33.4 years, SD = 11.7; 49% male). Using a quasi-experimental design, participants who initially completed the intervention (n = 43) delivered across nine 90-minute sessions, reported significant reductions in self-reported PTSS with a large effect size. The delayed treatment group (n = 55) also reported significant treatment gains once they received the intervention. Participants who completed the programme reported significantly greater initial PTSS severity than those who dropped out, while no sociodemographic factors, trauma characteristics or PTSS were associated with better treatment outcomes. Discussion:
 A culturally sensitive, group-based TF-CBT programme delivered in a refugee settlement meaningfully reduces refugees’ PTSS severity and is equally effective for all participants, with the highest retention rates found among those in greatest need of treatment. Programmes such as this, with capacity to treat hundreds of people simultaneously, represent highly cost-effective, accessible, disseminable and effective treatment for PTSS among refugees living in humanitarian settings in developing nations.

/pdf/successfully-treating-refugees-post-traumatic-stress-1o7tvh8yej.pdf

Successfully treating refugees' post-traumatic stress symptoms in a Ugandan settlement with group cognitive behaviour therapy.

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Successfully treating refugees' post-traumatic stress symptoms in a Ugandan settlement with group cognitive behaviour therapy.