Bhutanese Refugee Youth: The Importance of Assessing and Addressing Psychosocial Needs in a School Setting

School-based mental health support for migrant children and young people: A scoping review

Schools are increasingly considered as critical to the identification and support of child and adolescent mental health difficulties. However, research often fails to capture critical aspects of context and culture, such as migration, in assessing both the accessibility and effectiveness of school-based interventions. Although migrant youth may be at risk for poor mental health, little is known about the barriers and facilitators they face in accessing mental health support in schools. This scoping review aims to map existing research into school-based mental health interventions for migrant children and young people and, in particular, identify potential cultural and contextual effects related to accessibility. Drawing on scoping review methodology, we searched seven psychology, education, and health databases (i.e., Education Research Complete, British Education Index, ERIC, Web of Science, EMBASE, Medline, and PsycInfo) for studies published between 2002 and 2023. Study selection and data extraction were performed independently by reviewers. Narrative and thematic synthesis were used to analyze included papers and address the research questions. Thirty-eight studies met our inclusion criteria and are presented in this review. Our findings reveal a lack of targeted school-based mental health interventions for migrant young people despite the clear need among this growing population. Furthermore, few studies directly addressed issues of accessibility. Despite the range of migrant groups considered, the primary barriers and facilitators to access identified were contextual, cultural, and systemic, such as stigma, acculturative stressors, and partnerships between families, schools, and mental health services. The results of this scoping review highlight the need for a more intersectional framework for the design and implementation of school-based mental health support for migrant youth, arguably one that positions migration as a key social determinant of health and in particular, child and adolescent mental health.

Promoting positive development among refugee adolescents

Of the estimated 35.3 million refugees around the world (UNHCR, Figures at a Glance, 2022), approximately 50% are children under the age of 18. Refugee adolescents represent a unique group as they navigate developmental tasks in an unstable and often threatening environment or in resettlement contexts in which they often face marginalization. In addition to physiological, social, and psychological changes that mark adolescence, refugee youth often face traumatic experiences, acculturative stress, discrimination, and a lack of basic resources. In this consensus statement, we examine research on refugee adolescents' developmental tasks, acculturative tasks, and psychological adjustment using Suárez-Orozco and colleague's integrative risk and resilience model for immigrant-origin children and youth proposed by Suárez-Orozco et al. Finally, we discuss recommendations-moving from proximal to more distal contexts.

The effectiveness of therapeutic interventions on psychological distress in refugee children: A systematic review

OBJECTIVE

To systematically review existing research exploring the effectiveness of psychological interventions in reducing symptoms of distress amongst refugee and asylum-seeker children.

METHOD

Six databases were searched to identify English studies presenting original empirical quantitative data (published before September 2022) testing the efficacy of psychological interventions for children from refugee and asylum-seeking backgrounds. Quality of studies were assessed through the Appraisal Tool for Cross-Sectional Studies as well as the Cochrane Risk of Bias Tool. Relevant data were extracted to facilitate a narrative synthesis.

RESULTS

Seventy-one eligible articles were identified (n > 10,000). A number of cognitive-behavioral, psychosocial, and trauma-focused interventions that catered specifically to children and their families were identified. A synthesis of these results suggest that interventions may assist in the reduction of various psychopathologies, although the effects were mixed across intervention types.

CONCLUSIONS

While the review yielded promising findings, most findings were derived from small pilot and empirical studies, leading to difficulties with drawing conclusions. There remains a need for studies using more rigorous research methodologies to expand and ratify this valuable knowledge base.

CLINICAL SIGNIFICANCE

 Forced displacement is at an all-time high. Many children are being forced to seek asylum and refuge, and they become vulnerable to the development of poor mental health, with limited understanding surrounding how to appropriately intervene. This review aims to equip clinicians with increased knowledge and confidence in working therapeutically alongside clients from refugee or asylum-seeking background, with the goal of fostering positive mental health and wellbeing.

Adolescent Connectedness: A Scoping Review of Available Measures and Their Psychometric Properties

Introduction

Adolescent connectedness, a key component of positive youth development, is associated with various positive health outcomes. Several measures have been developed to assess this construct. However, no study has summarized data on the existing measures of adolescent connectedness. We conducted this scoping review to fill this gap. We specifically aimed to: (i) identify the existing measures of adolescent connectedness, (ii) determine the most frequently used measures among the identified measures, and (iii) summarize the psychometric properties of these measures with a keen interest in highlighting their cross-cultural utility and validity.

Methods

We searched CINAHL, Embase, PsycInfo, PubMed, and Web of Science databases for relevant articles published since database inception to 7th February 2021. Our search structure contained the key words "Adolescents", "Connectedness", and "Measures". We also searched Open Gray for potentially relevant gray literature.

Results

We identified 335 measures from 960 eligible studies assessing various domains of adolescent connectedness, including school, family, community, peer, ethnic, racial, cultural, religious/spiritual, and self-connectedness. Most of the included studies (72.1%) were from North America and Europe. Most of the measures (n = 132, 39.4%) were measures of school connectedness among adolescents. Of the identified measures, 60 of them met our criteria of frequently used measures (i.e., the top five most used measures per domain of connectedness). These frequently used measures were used across 481 of the included studies with 400 of them reporting their psychometric properties. The reported reliability of these measures was adequate (Cronbach's alpha ≥ 0.70) in 89.8% of these studies. These measures also appeared to be valid in terms of their face, content, construct, criterion, convergent, discriminant, concurrent, predictive, measurement invariance, and cross-cultural validity.

Conclusions

There exists a wide array of measures of adolescent connectedness. Sixty of these measures have been frequently used across studies and appear to be reliable and/or valid. However, this evidence is mostly from North America and Europe. This is a reflection of the limitation of this review where only studies published in English were considered. It might also reflect the paucity of research in other regions of the world. More research is needed for clearer insights.

The Need to Belong: a Deep Dive into the Origins, Implications, and Future of a Foundational Construct

The need to belong in human motivation is relevant for all academic disciplines that study human behavior, with immense importance to educational psychology. The presence of belonging, specifically school belonging, has powerful long- and short-term implications for students’ positive psychological and academic outcomes. This article presents a brief review of belonging research with specific relevance to educational psychology. Following this is an interview with Emeritus Professors Roy Baumeister and Mark Leary, foundational pioneers in belonging research which reflects upon their influential 1995 paper, “The need to belong: Desire for interpersonal attachments as a fundamental human motivation,” to explore the value and relevance of belonging for understanding human behavior and promoting well-being.

The Refugee and Immigrant Core Stressors Toolkit (RICST): Understanding the Multifaceted Needs of Refugee and Immigrant Youth and Families Through a Four Core Stressors Framework

Research indicates that refugee and immigrant youth commonly face four core stressors during resettlement in a new country and culture: trauma, acculturative stress, resettlement stress, and isolation. This Four Core Stressors framework can be used to educate providers about these populations’ unique needs and support assessment of relevant socioecological factors influencing health. To facilitate education, training, and dissemination of this framework and complement existing provider resources, we developed the Refugee & Immigrant Core Stressors Toolkit (RICST), a free, web-based toolkit that provides an overview of the Four Core Stressors framework, assessment questions across the four domains, scaffolding to identify needs and points of triage, and recommended interventions. Public hosting of the RICST via REDCap began in March 2018. In addition to the toolkit, users are prompted to provide location of service delivery, intended purpose of use, and interface feedback. Between March 2018 and October 2020, the RICST was used over 2300 times across 6 continents. Most providers used the toolkit to learn more about the needs of refugee and immigrant youth in general, and several noted that it is a valuable educational tool for staff unfamiliar with these populations. Open-ended qualitative feedback indicated high usability. Amidst historically high levels of forced displacement, tools to support provider effectiveness in working with these populations are increasingly needed. The RICST shows promise as an educational, assessment, and treatment-planning tool for providers working with refugee and immigrant families globally. Future directions include location-specific resource mapping and culture-specific intervention strategies.

Influencing Factors of Depression among Adolescent Asians in North America: A Systematic Review

Background: Asian American adolescents experience rates of depression comparable to or greater than those of other ethnic minorities. The purpose of this systematic review is to summarize psychosocial factors related to depressive symptoms of Asian American adolescents between the ages of 10 to 19. Methods: Various electronic databases were systematically searched to identify research articles published from 2000 to 2021, and the psychosocial factors influencing depression among Asian adolescents in North America were examined. Results: A total of 81 studies were included in this systematic review. Consistent findings on relationships between depressive symptoms and influencing factors included (a) acculturative stress, (b) religious or spiritual significance for females, (c) parent–child cohesion, (d) harsh parenting style, (e) responsive parenting style, (f) racial or ethnic discrimination, (g) being bullied, (h) positive mentor presence, and (i) exposure to community violence. Collectively, the majority of included studies suggest that depressive symptoms were more likely found among Asian American adolescents who (a) are older, (b) are female, (c) have immigrant status, (d) exhibit coping behaviours, (e) face academic challenges, (f) face a poor socioeconomic situation, (g) perceive parent–child conflict, (h) perceive maternal disconnectedness, and (i) perceive negative peer relations. A number of conflictive findings also existed. Discussion/Conclusions: This systematic review provides a summary of the various psychosocial factors on individual, familial, and social levels, which influenced the depressive symptoms of Asian American adolescents. Such findings offer a starting point to examine what factors should be necessarily included in related depression-preventive intervention design and evaluation. Culturally sensitive care, strengthened family–school–community collaboration, and targeted research efforts are needed to meet the needs of Asian adolescents experiencing a range of depressive symptoms.

Understanding the needs of children returning from formerly ISIS-controlled territories through an emotional security theory lens: Implications for practice

BACKGROUND

Children who spent time in territories formerly controlled by the Islamic State of Iraq and Syria (ISIS) and who are now being reintegrated into their countries of origin have experienced significant trauma and may present with adjustment or mental health problems.

OBJECTIVE

In this paper we describe how Emotional Security Theory (EST; Davies & Cummings, 1994) and its more recent formulation, EST-reformulated (EST-R; Davies & Martin, 2013, 2014), provide a theoretical lens to aid in understanding the ways in which traumatic experiences under ISIS may have an enduring impact on a child's development and well-being.

METHODS & RESULTS

The core assumption of EST is that maintaining safety and security is a central goal for a child growing up in the context of conflict. Children living in conflict zones under ISIS rule may have developed emotional insecurity, which in turn is theorized to lead to developmental cascades across multiple domains of functioning and at times result in clinically significant distress. This theoretical understanding can guide intervention, as it suggests that the foci of intervention must (1) minimize social signals indicative of threat while also (2) reducing behavioral response patterns that limit opportunities for exploration and prosocial affiliation. Trauma Systems Therapy is a multidisciplinary child trauma treatment model that addresses both stressors in the social environment and related emotional dysregulation.

CONCLUSIONS

Challenges and considerations related to implementing such a comprehensive treatment approach in low- and middle-income countries are discussed.