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Oepen R, Gruber H. Art-based interventions and art therapy to promote health of migrant populations - a systematic literature review of current research. Arts Health 2023:1-19. [PMID: 37667588 DOI: 10.1080/17533015.2023.2252003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 08/09/2023] [Indexed: 09/06/2023]
Abstract
BACKGROUND This review aims to identify and analyse studies on art-based interventions and art therapy that are intended to promote better physical, mental and social health outcomes in culturally and linguistically diverse migrant populations. METHOD A systematic literature review was used to address the following questions: 1) What published studies over the past five years examined health outcomes? 2) What are the identifying characteristics of the studies? 3) What kinds of effect did these studies describe? 4) What implications do the findings have for future research in this field? RESULTS Art-based interventions and art therapy can significantly reduce traumatic stress symptoms and anxiety, enhance well-being by giving people greater life satisfaction and hope, and improve the social behaviour of children and adolescents. CONCLUSION In order to address humanitarian concerns in this field, researchers may apply innovative approaches to engage people from a refugee background in meaningful reflections on their lives.
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Affiliation(s)
- Renate Oepen
- Department of Art Therapies and Therapeutic Science, Alanus University of Arts and Social Sciences, Alfter/Bonn, Germany
| | - Harald Gruber
- Department of Art Therapies and Therapeutic Science, Alanus University of Arts and Social Sciences, Alfter/Bonn, Germany
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2
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Oberg C, Sharma H. Post-Traumatic Stress Disorder in Unaccompanied Refugee Minors: Prevalence, Contributing and Protective Factors, and Effective Interventions: A Scoping Review. CHILDREN (BASEL, SWITZERLAND) 2023; 10:941. [PMID: 37371174 DOI: 10.3390/children10060941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 05/15/2023] [Accepted: 05/23/2023] [Indexed: 06/29/2023]
Abstract
In 2021, there were close to 37 million children displaced worldwide. There were 13.7 million refugees and an additional 22.8 million internally displaced. In Europe, this included 23,255 unaccompanied minors seeking asylum, up 72% compared with 2020 (13,550). The objective was to review the current literature regarding PTSD in unaccompanied refugee minors (URM). The authors searched Ovid Medline, Embase, and Cochrane Library from 1 January 2008 through 15 January 2019. Thirty full texts were chosen that specifically studied unaccompanied refugee minors (URM). The results showed that URM had a prevalence of post-traumatic stress disorder (PTSD of 17-85% across the studies reviewed. There were numerous factors that contributed to PTSD, including cumulative stress and trauma, guilt, shame, and uncertainty about legal status. Protective factors included resilience, a trusted mentor, belonging to a social network, religion, having an adult mentor, and having a family (even if far away). Immigrant youth can thrive most easily in multiculturally affirming countries. Five interventions demonstrated effectiveness, comprising trauma-focused cognitive behavioral therapy (TF-CBT); "Mein Weg", a TF-CBT combined with a group-processing mixed therapy approach; teaching recovery techniques (TRT), narrative exposure therapy for children (KIDNET), and expressive arts intervention (EXIT). The significant mental health conditions include depression, anxiety, internalizing and externalizing behaviors, and frequently PTSD. It is fair to conclude that the high levels of mental health problems experienced in URM are due to exposure to traumatic experiences, separation from parents, and lack of social support.
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Affiliation(s)
- Charles Oberg
- Global Pediatrics Program, Department of Pediatrics, School of Medicine, University of Minnesota, Minneapolis, MN 55455, USA
| | - Hayley Sharma
- Department of Internal Medicine and Pediatrics, Indiana University School of Medicine, Indianapolis, IN 46202, USA
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3
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Grzymała-Moszczyńska H, Różańska-Mglej M. Challenges for the Mental Health of Refugee Artists: Perspectives of the ADAPT Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20095694. [PMID: 37174214 PMCID: PMC10178664 DOI: 10.3390/ijerph20095694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 04/25/2023] [Accepted: 04/27/2023] [Indexed: 05/15/2023]
Abstract
This study aimed to address the mental health challenges faced by refugee artists who are grantees of ICORN-the International Cities of Refuge Network-from the perspective of the extended conceptual ADAPT model. The study employed exploratory qualitative research, and data were collected through semi-structured interviews with ICORN artists in Poland, Norway, and Sweden. For data analysis, Interpretive Phenomenological Analysis (IPA) was used, whereas for the presentation of the results, the framework of the ADAPT model was applied. The results showed that the super-ordinate themes that emerged from the IPA analysis related directly to the ADAPT model and could mostly be assigned to its basic pillars: (1) Security; (2) Bonds and Networks; (3) Justice; (4) Roles and Identities; and (5) Existential Meaning. However, the model was insufficient for capturing the full diversity of experiences described by the respondents. Therefore, an extension of the model in the form of two additional pillars, Art and Body and Mind, was proposed. The findings confirm that the ADAPT model is adequate for systematizing and depicting in detail the experiences of migrants/refugees. However, further modifications of the model are necessary, particularly the additional pillar Body and Mind, which has the potential to become a separate category in other migrants'/refugees' assessment frameworks. Moreover, Art itself could be seen as a universal bridging factor between the refugee and the host population, contributing to the refugees' adaptation to the host society.
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Affiliation(s)
- Halina Grzymała-Moszczyńska
- Department for the Psychology of Religion and Spirituality, Institute of Psychology, Jesuit University Ignatianum, 31-501 Kraków, Poland
| | - Małgorzata Różańska-Mglej
- Faculty of Philosophy, Institute of Religious Studies, Jagiellonian University, 31-044 Kraków, Poland
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Solhaug AK, Røysamb E, Oppedal B. Changes in life satisfaction among unaccompanied asylum-seeking and refugee minors who participated in teaching recovery techniques (TRT). Child Adolesc Psychiatry Ment Health 2023; 17:50. [PMID: 37072831 PMCID: PMC10114353 DOI: 10.1186/s13034-023-00595-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 03/21/2023] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND Unaccompanied asylum-seeking and refugee minors report low life satisfaction and high levels of mental health problems, nevertheless they often do not seek or receive help for their problems. Teaching Recovery Techniques (TRT) is a low-threshold, five sessions intervention developed to reduce distressing war- and disaster-related trauma reactions among children and youth. In this study, we investigate if TRT can contribute to increased life satisfaction among unaccompanied asylum-seeking and refugee minors. METHODS Asylum-seeking and resettled unaccompanied minors participated in TRT carried out in 15 locations throughout Norway, n = 147, mean age = 16.61 (SD = 1.80), 88% boys, and 67% from Afghanistan. Life satisfaction was measured by the Cantril Ladder before the intervention, and two- and eight weeks post-intervention. We also included indices of intervention compliance and contextual variables, such as asylum status. We applied a pre- and post-intervention design with linear mixed model analyses to investigate change in life satisfaction. RESULTS Life satisfaction significantly increased from pre- to post- intervention, but not for youth whose asylum application had been rejected or who were still awaiting a decision. Indices of intervention compliance were associated with an increase in life satisfaction. CONCLUSIONS TRT is a potential useful intervention to enhance life satisfaction among unaccompanied asylum-seeking and refugee minors and can be a measure to support positive development among youth at risk for mental health problems. However, TRT initiatives should consider the participant's stage of asylum process, because harsh immigration policies may overburden the coping capacity. Without further adaptation, TRT seems most useful for youth granted residence. The manual has been revised to include asylum-related stressors. TRIAL REGISTRATION ClinicalTrials.gov (16/54,571, registered 30.01.2019).
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Affiliation(s)
- Anne Kristine Solhaug
- Department of Childhood and Families, Norwegian Institute of Public Health, PO Box 222, Skøyen, Oslo, 0213, Norway.
| | - Espen Røysamb
- Department of Childhood and Families, Norwegian Institute of Public Health, PO Box 222, Skøyen, Oslo, 0213, Norway
- Promenta Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Brit Oppedal
- Department of Childhood and Families, Norwegian Institute of Public Health, PO Box 222, Skøyen, Oslo, 0213, Norway
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5
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Moutsou I, Georgaca E, Varaklis T. Psychotherapeutic and Psychosocial Interventions with Unaccompanied Minors: A Scoping Review. Healthcare (Basel) 2023; 11:healthcare11060918. [PMID: 36981575 PMCID: PMC10048295 DOI: 10.3390/healthcare11060918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/15/2023] [Accepted: 03/20/2023] [Indexed: 03/30/2023] Open
Abstract
Unaccompanied minors (UAMs) are considered a particularly vulnerable population, facing severe threats regarding their physical and mental health. As their number has increased in recent years worldwide, research on mental health interventions has become necessary. The implementation of psychotherapeutic interventions has been documented, but psychosocial interventions seem to not have been consistently studied. In this review, we summarize the psychotherapeutic and psychosocial interventions with UAMs that have been studied up to now. Following the PRISMA guidelines for scoping reviews, we searched four databases and included studies and practice papers; there were no restrictions on publication date, geographical region, language, or method. We identified 46 studies on psychotherapeutic interventions and 16 studies on psychosocial interventions that met the inclusion criteria. Psychotherapeutic interventions were mainly based on cognitive behavioural, psychodynamic, narrative, art and transcultural approaches and aimed at improving UAMs' trauma, mental health and wellbeing, as well as professionals' skills and therapeutic protocols. Several studies showed promising results, with the cognitive behavioural approaches being the most researched. However, more research is needed in order to draw conclusions in terms of effectiveness. Psychosocial interventions followed various approaches and aimed at UAMs' empowerment, wellbeing, support and integration, as well as at improving caregivers' skills. Nonetheless, they seem not only very heterogeneous but also understudied, and we believe that a focus on them would be very useful. Methodological limitations and their implications for future research are discussed.
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Affiliation(s)
- Irene Moutsou
- School of Psychology, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
| | - Eugenie Georgaca
- School of Psychology, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
| | - Theofilos Varaklis
- School of Psychology, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
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6
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Thabet A, Ghandi S, Barker EK, Rutherford G, Malekinejad M. Interventions to enhance psychological resilience in forcibly displaced children: a systematic review. BMJ Glob Health 2023; 8:bmjgh-2021-007320. [PMID: 36731918 PMCID: PMC9896216 DOI: 10.1136/bmjgh-2021-007320] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 03/07/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Children represent nearly 40% of forcibly displaced populations and are subject to stressors that affect well-being. Little is known about the effects of interventions to enhance psychological resilience in these children, outside clinical settings. METHODS We conducted a systematic review, following Cochrane methods. Eligible studies tested resilience-enhancing interventions outside clinical settings in forcibly displaced children/adolescents. We included longitudinal quantitative studies with comparator conditions irrespective of geographical scope or language. We searched articles published between January 2010 and April 2020 in PubMed, Embase, Cochrane Library, Web of Science, PsycINFO and the WHO's Global Index Medicus. To standardise effect sizes across the different reported outcomes, we transformed reported mean differences to standardised mean differences using Hedge's g statistic with associated 95% CI. We pooled data for meta-analysis where appropriate. We used Cochrane tools to assess study risk of bias and used Grading of Recommendations Assessment, Development and Evaluation to determine evidence quality for meta-analysed outcomes. RESULTS Searches yielded 4829 results. Twenty-three studies met inclusion criteria. Studies reported 18 outcomes measured by 48 different scales; only 1 study explicitly measured resilience. Eight studies were randomised controlled trials; the rest were non-randomised pre-post studies. Interventions were diverse and typically implemented in group settings. Studies reported significant improvement in outcomes pertinent to behavioural problems, coping mechanisms and general well-being but not to caregiver support or psychiatric symptoms. In meta-analysis, resilience was improved (gav=0.194, 95% CI 0.018 to 0.369), but anxiety symptoms and quality of life were not (gav=-0.326, 95% CI -0.782 to 0.131 and gav=0.325, 95% CI -0.027 to 0.678, respectively). Risk of bias varied. Quality of evidence for most graded outcomes was very low. CONCLUSIONS The multiplicity of study designs, intervention types, outcomes and measures incumbered quantifying intervention effectiveness. Future resilience research in this population should use rigorous methods and follow reporting guidelines. PROSPERO REGISTRATION NUMBER CRD42020177069.
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Affiliation(s)
- Aya Thabet
- Institute for Global Health Sciences, University of California, San Francisco, California, USA
| | - Sonia Ghandi
- Institute for Global Health Sciences, University of California, San Francisco, California, USA
| | - Erin K Barker
- Institute for Global Health Sciences, University of California, San Francisco, California, USA
| | - Geroge Rutherford
- Institute for Global Health Sciences, University of California, San Francisco, California, USA,Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - Mohsen Malekinejad
- Institute for Global Health Sciences, University of California, San Francisco, California, USA,Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
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7
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Cowling MM, Anderson JR. The effectiveness of therapeutic interventions on psychological distress in refugee children: A systematic review. J Clin Psychol 2023. [PMID: 36634291 DOI: 10.1002/jclp.23479] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 12/19/2022] [Accepted: 12/27/2022] [Indexed: 01/14/2023]
Abstract
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.
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Affiliation(s)
- Misha M Cowling
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Australia
| | - Joel R Anderson
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Australia.,Australian Research Centre in Sex, Health, & Society, La Trobe University, Melbourne, Australia
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8
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Elkis-Abuhoff DL, Gaydos M, Poland E, Sena S. Exploring the effects of nature-based art therapy on happiness and life satisfaction. ARTS IN PSYCHOTHERAPY 2022. [DOI: 10.1016/j.aip.2022.101966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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9
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Annous N, Al-Hroub A, El Zein F. A Systematic Review of Empirical Evidence on Art Therapy With Traumatized Refugee Children and Youth. Front Psychol 2022; 13:811515. [PMID: 35707659 PMCID: PMC9189733 DOI: 10.3389/fpsyg.2022.811515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 04/14/2022] [Indexed: 11/13/2022] Open
Abstract
The current global refugee crisis revealed that refugee children, youth, and adults are uniquely vulnerable to traumatic events. Yet, there are only a few studies available that report robust systematic data on art therapy interventions with mental health in recent refugee populations. The purpose of the study is to synthesize and evaluate (a) the available research evidence on the use of art therapy in reducing post-traumatic stress disorder (PTSD) levels in refugees, and (b) the quality of empirical evidence for each of the reviewed studies. The authors adopted the Council for Exceptional Children (CEC) evidence-based practice (EBP) standards and quality indicators to evaluate the methodological soundness of the reviewed studies and the evidence-based classification of art therapy as a treatment intervention. We systematically searched electronic databases of pertinent review articles for the period from 2010 to 2020 using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Systematic searches identified 70 research articles but yielded eight eligible journals as per the inclusion criteria. Results indicated that, though considered a promising treatment approach, art therapy is presently classified as an intervention that falls under the category of practice with insufficient evidence. The findings suggest the need for further methodologically sound experimental studies to strengthen the evidence behind art therapy as an intervention to reduce PTSD symptoms in refugees around the world.
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Affiliation(s)
| | - Anies Al-Hroub
- American University of Beirut, Beirut, Lebanon
- *Correspondence: Anies Al-Hroub
| | - Farah El Zein
- Emirates College for Advanced Education, Abu Dhabi, United Arab Emirates
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10
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Soltan F, Cristofalo D, Marshall D, Purgato M, Taddese H, Vanderbloemen L, Barbui C, Uphoff E. Community-based interventions for improving mental health in refugee children and adolescents in high-income countries. Cochrane Database Syst Rev 2022; 5:CD013657. [PMID: 35532139 PMCID: PMC9083014 DOI: 10.1002/14651858.cd013657.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND An unprecedented number of people around the world are experiencing forced displacement due to natural or man-made events. More than 50% of refugees worldwide are children or adolescents. In addition to the challenges of settling in a new country, many have witnessed or experienced traumatic events. Therefore, refugee children and adolescents are at risk of developing mental health problems such as post-traumatic stress disorder, and require appropriate and effective support within communities. OBJECTIVES To assess the effectiveness and acceptability of community-based interventions (RCTs only) in comparison with controls (no treatment, waiting list, alternative treatment) for preventing and treating mental health problems (major depression, anxiety, post-traumatic stress disorder, psychological distress) and improving mental health in refugee children and adolescents in high-income countries. SEARCH METHODS Databases searches included the Cochrane Common Mental Disorders Controlled Trials Register (all available years), CENTRAL/CDSR (2021, Issue 2), Ovid MEDLINE, Embase, six other databases, and two trials registries to 21 February 2021. We checked reference lists of included study reports. SELECTION CRITERIA: Studies of any design were eligible as long as they included child or adolescent refugees and evaluated a community-based mental health intervention in a high-income country. At a second stage, we selected randomised controlled trials. DATA COLLECTION AND ANALYSIS For randomised controlled trials, we extracted data relating to the study and participant characteristics, and outcome data relating to the results of the trial. For studies using other evaluation methods, we extracted data relating to the study and participant characteristics. W derived evidence on the efficacy and availability of interventions from the randomised controlled trials only. Data were synthesised narratively. MAIN RESULTS We screened 5005 records and sought full-text manuscripts of 62 relevant records. Three randomised controlled trials were included in this review. Key concerns in the risk of bias assessments included a lack of clarity about the randomisation process, potential for bias is outcome measurement, and risk of bias in the selection of results. Primary outcomes There was no evidence of an effect of community-based interventions when compared with a waiting list for symptoms of post-traumatic stress (mean difference (MD) -1.46, 95% confidence interval (CI) -6.78 to 3.86: 1 study; low-certainty evidence), symptoms of depression (MD 0.26, 95% CI -2.15 to 2.67: 1 study; low-certainty evidence), and psychological distress (MD -10.5, 95% CI -47.94 to 26.94; 1 study; very low-certainty evidence). There were no data on adverse events. Secondary outcomes Three trials reported on short-term changes in child behaviour, using different measures, and found no evidence of an effect of the intervention versus a waiting list (low to very low certainty). None of the trials reported on quality of life or well-being, participation and functioning, or participant satisfaction. AUTHORS' CONCLUSIONS There is insufficient evidence to determine the efficacy and acceptability of community-based mental health interventions for refugee children and adolescents.
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Affiliation(s)
- Fatima Soltan
- Faculty of Medicine, School of Public Health, Imperial College London, London, UK
| | - Doriana Cristofalo
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - David Marshall
- Cochrane Common Mental Disorders, Centre for Reviews and Dissemination, University of York, York, UK
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Marianna Purgato
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
- Cochrane Global Mental Health, University of Verona, Verona, Italy
| | - Henock Taddese
- Faculty of Medicine, School of Public Health, Imperial College London, London, UK
| | - Laura Vanderbloemen
- Faculty of Medicine, School of Public Health, Imperial College London, London, UK
- College of Health Sciences, VinUniversity, Hanoi, Vietnam
| | - Corrado Barbui
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
- Cochrane Global Mental Health, University of Verona, Verona, Italy
| | - Eleonora Uphoff
- Cochrane Common Mental Disorders, Centre for Reviews and Dissemination, University of York, York, UK
- Centre for Reviews and Dissemination, University of York, York, UK
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11
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Hutchinson R, King N, Majumder P. How effective is group intervention in the treatment for unaccompanied and accompanied refugee minors with mental health difficulties: A systematic review. Int J Soc Psychiatry 2022; 68:484-499. [PMID: 34818939 DOI: 10.1177/00207640211057727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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.
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Affiliation(s)
| | | | - Pallab Majumder
- University of Nottingham, UK.,Nottnghamshire Healthcare NHS Foundation Trust, UK
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12
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Morison L, Simonds L, Stewart SJF. Effectiveness of creative arts-based interventions for treating children and adolescents exposed to traumatic events: a systematic review of the quantitative evidence and meta-analysis. Arts Health 2021; 14:237-262. [PMID: 34969356 DOI: 10.1080/17533015.2021.2009529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND The effect of interventions based on the creative arts for children and adolescents exposed to traumatic events was estimated for measures of post-traumatic stress disorder (PTSD) and other psychological symptoms. METHOD Using a pre-registered protocol, relevant journal articles were identified through searches of: PsycInfo; Psychology and Behavioural Sciences Collection; CINAHL and PsycArticles. Data were pooled using a random effects model, and effect estimates were reported as Hedges' g. RESULTS Pooled effect estimates indicated that arts-based interventions significantly reduced PTSD symptom scores compared to pre-intervention (15 studies, g = -.67, p < .001) and a control group (7 studies, g = -.50, p < .001). Significant reductions were also found for measures of negative mood, but results were mixed for externalizing problems and anxiety. CONCLUSIONS Despite variations in study quality, intervention approaches and types of trauma experience, the results tentatively suggest that creative arts-based interventions may be effective in reducing symptoms of trauma and negative mood.
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Affiliation(s)
- Linda Morison
- Department of Psychological Interventions, School of Psychology, University of Surrey, Guildford, UK
| | - Laura Simonds
- Department of Psychological Interventions, School of Psychology, University of Surrey, Guildford, UK
| | - Sarah-Jane F Stewart
- Department of Psychological Interventions, School of Psychology, University of Surrey, Guildford, UK
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13
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Zheng C, Ji H. Analysis of the intervention effect and self-satisfaction of sports dance exercise on the psychological stress of college students. Work 2021; 69:637-649. [PMID: 34120941 DOI: 10.3233/wor-213505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND College students are a high-risk subpopulation of psychological disorders. The problem of various adverse phenomena and consequences caused by excessive pressure on college students has gradually become the focus of social and psychological academic circles. However, studies related to individual self-concept and psychological pressure are rare. OBJECTIVE To explore the impact of sports dance exercises on college students' psychological pressure and improve the psychological effects of their self-satisfaction. METHODS College students were taken as research objects, randomly divided into a control group and an observation group. The observation group is intervened with sports dance exercises. The observation group was intervened with sports dance exercises. The stress response characteristic questionnaire and multidimensional self-satisfaction rating scale were utilized to measure college students' conditions before and after the intervention. Finally, the obtained data were statistically analyzed. RESULTS Generally, the psychological stress response of college students was mild, with self-satisfaction and various dimensions at a moderately higher level. No significant differences were discovered in the psychological stress response and self-satisfaction level between the control group and the observation group before intervention (P > 0.05), which were homogeneous. Compared with the data obtained before the intervention, after the intervention, the control group scores were slightly reduced in all dimensions of the psychological stress response and self-satisfaction. In contrast, the scores were significantly increased in the experimental group (P < 0.05). Psychological stress response could reliably explain 30.4%of the total self-satisfaction variance (P < 0.01). The negative self-evaluation was the most important variable affecting self-satisfaction, followed by poor interpersonal communication and poor sleeping quality. CONCLUSIONS Sports dance exercises could alleviate the psychological stress of college students and improve their self-satisfaction. Colleges and universities should include sports dance in the content of optional public courses and encourage more college students to actively participate in sports dance exercises to improve their mental health.
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Affiliation(s)
| | - Honghai Ji
- Changshu Institute of Technology, Changshu, Jiangsu, China
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14
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Vindbjerg E, Carlsson J, Mortensen EL, Makransky G, Nielsen T. A Rasch-based validity study of the Harvard Trauma Questionnaire. J Affect Disord 2020; 277:697-705. [PMID: 32911220 DOI: 10.1016/j.jad.2020.08.071] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 07/01/2020] [Accepted: 08/26/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND The Harvard Trauma Questionnaire (HTQ) is the predominant questionnaire for assessing PTSD in trauma-affected refugees. Although the scale is increasingly used for measuring treatment outcomes, it has never been specifically validated for such use. The current study does so by testing the HTQ with the Rasch model. METHODS The analysis is based on 641 Arabic and Persian speaking refugees, diagnosed with PTSD and undergoing psychiatric treatment in Denmark. The responses were tested against the assumptions of the Rasch model, including unidimensionality, local independence and the absence of differential item function across subgroups. RESULTS Results reveal two subscales that, when accounting for local dependence and differential item functioning, meet criteria for the Rasch model in the included samples: An arousal/intrusion subscale and an avoidance/numbing subscale. LIMITATIONS The included sample was highly chronic and suffered from major depressive disorder. Results may not be fully representative of less chronic populations, e.g. recently arrived refugees. CONCLUSIONS We recommend the use of the arousal/intrusion subscale and the avoidance/numbing subscale as an optimized way of summarizing responses to the HTQ, which remains simple to administer while effectively summarizing all the information available in the scores.
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Affiliation(s)
- Erik Vindbjerg
- Competence Centre for Transcultural Psychiatry, Mental Health Centre Ballerup, Copenhagen, Denmark.
| | - Jessica Carlsson
- Competence Centre for Transcultural Psychiatry, Mental Health Centre Ballerup, Copenhagen, Denmark
| | - Erik Lykke Mortensen
- Department of Public Health and Center for Healthy Aging, University of Copenhagen, Denmark
| | | | - Tine Nielsen
- UCL University College, Department of Applied Research in Education and Social Sciences, Odense, Denmark
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Koch SC, Riege RFF, Tisborn K, Biondo J, Martin L, Beelmann A. Effects of Dance Movement Therapy and Dance on Health-Related Psychological Outcomes. A Meta-Analysis Update. Front Psychol 2019; 10:1806. [PMID: 31481910 PMCID: PMC6710484 DOI: 10.3389/fpsyg.2019.01806] [Citation(s) in RCA: 95] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 07/22/2019] [Indexed: 12/14/2022] Open
Abstract
Background: Dance is an embodied activity and, when applied therapeutically, can have several specific and unspecific health benefits. In this meta-analysis, we evaluated the effectiveness of dance movement therapy(DMT) and dance interventions for psychological health outcomes. Research in this area grew considerably from 1.3 detected studies/year in 1996-2012 to 6.8 detected studies/year in 2012-2018. Method: We synthesized 41 controlled intervention studies (N = 2,374; from 01/2012 to 03/2018), 21 from DMT, and 20 from dance, investigating the outcome clusters of quality of life, clinical outcomes (with sub-analyses of depression and anxiety), interpersonal skills, cognitive skills, and (psycho-)motor skills. We included recent randomized controlled trials (RCTs) in areas such as depression, anxiety, schizophrenia, autism, elderly patients, oncology, neurology, chronic heart failure, and cardiovascular disease, including follow-up data in eight studies. Results: Analyses yielded a medium overall effect (d = 0.60), with high heterogeneity of results (I 2 = 72.62%). Sorted by outcome clusters, the effects were medium to large (d = 0.53 to d = 0.85). All effects, except the one for (psycho-)motor skills, showed high inconsistency of results. Sensitivity analyses revealed that type of intervention (DMT or dance) was a significant moderator of results. In the DMT cluster, the overall medium effect was small, significant, and homogeneous/consistent (d = 0.30, p < 0.001, I 2 = 3.47). In the dance intervention cluster, the overall medium effect was large, significant, yet heterogeneous/non-consistent (d = 0.81, p < 0.001, I 2 = 77.96). Results suggest that DMT decreases depression and anxiety and increases quality of life and interpersonal and cognitive skills, whereas dance interventions increase (psycho-)motor skills. Larger effect sizes resulted from observational measures, possibly indicating bias. Follow-up data showed that on 22 weeks after the intervention, most effects remained stable or slightly increased. Discussion: Consistent effects of DMT coincide with findings from former meta-analyses. Most dance intervention studies came from preventive contexts and most DMT studies came from institutional healthcare contexts with more severely impaired clinical patients, where we found smaller effects, yet with higher clinical relevance. Methodological shortcomings of many included studies and heterogeneity of outcome measures limit results. Initial findings on long-term effects are promising.
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Affiliation(s)
- Sabine C. Koch
- Department of Creative Arts Therapies and Therapy Sciences, Alanus University, Alfter, Germany
- School of Therapy Sciences, SRH University Heidelberg, Heidelberg, Germany
| | | | | | - Jacelyn Biondo
- Department of Creative Arts Therapies, Drexel University, Philadelphia, PA, United States
| | - Lily Martin
- Department of Creative Arts Therapies and Therapy Sciences, Alanus University, Alfter, Germany
| | - Andreas Beelmann
- Department of Psychology, Friedrich-Schiller-University, Jena, Germany
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