A systematic review of psychological group interventions for adult refugees in resettlement countries: development of a stepped care approach to mental health treatment

ABSTRACT

Objective

While previous systematic reviews have focused on individual interventions for refugees, the current study aims to contribute to the literature by systematically reviewing the effectiveness of group and community-based interventions, to provide insight into ways current treatments can be scaled and integrated into stepped-care interventions.

Method

A systematic review was conducted. In September 2022, PsycINFO, PubMed, Scopus, Embase and CINAHL were systematically searched and findings were analysed using narrative thematic analysis.

Results

Key findings were that in general the group format was effective, especially when paired with an intervention such as cognitive behavioural therapy. The findings also point to barriers and facilitators for accessing group interventions, including language, cultural safety, and gender considerations.

Conclusion

In general, while groups were not typically seen as a replacement for individual therapy, the included studies suggested the complementary value of group modalities, as well as their utility as an early access intervention. Ultimately, the existing body of research concerning group interventions indicates that treatments delivered in a group format have utility and scalability and should be considered for integration into stepped models of care for people with refugee backgrounds.

KEY POINTS

What is already known about this topic:

1. Stepped care enhances access to mental health care.

2. Refugees have a higher vulnerability to developing mental illness and lower access to services.

3. Group programmes are often more culturally responsive for refugees.

What this topic adds:

1. Stepped care should include group-based and community interventions at the lower tiers of stepped care models.

2. In-language culturally adapted group interventions are generally effective and accessible for refugees.

3. To enhance accessibility, practitioners should consider providing transport and childcare as part of facilitating group-based interventions.

KEYWORDS:

• Systematic review
• stepped-care
• refugees
• group interventions
• community interventions
• psychological interventions

Acknowledgements

The authors would like to thank Vikki Langton, a research librarian at the University of Adelaide, for assistance with database searching. We also thank the authors of studies who kindly responded to our requests for additional data.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

As a review, the data for this study is the papers that are included. These are fully referenced and can therefore be freely found.

Ethical approval

There is no ethical approval relevant to this study, as a systematic review with no human or animal involvement.

Supplementary material

Supplemental data for this article can be accessed at https://doi.org/10.1080/00050067.2024.2343745.

Additional information

Funding

This project did not have any funding, so there is no funding to declare.