i-psy (intercultural psychiatry), Amsterdam, The Netherlands
Amsterdam Institute of Social Science Research, University of Amsterdam, Amsterdam, The Netherlands School of Medicine, Boston University, Boston, MA, USA.
Int J Soc Psychiatry. 2015 Feb;61(1):17-26. doi: 10.1177/0020764014535752. Epub 2014 May 27.
The prevalence of trauma-related problems among refugees and asylum seekers is extremely high due to adverse experiences associated with forced migration. Although the literature presents a considerable number of guidelines and theoretical frameworks for working with traumatized refugees and asylum seekers, the efficacy, feasibility and applicability of these interventions have little empirical evidence.
The purpose of this article is to critically review the literature to provide a rationale for developing culturally sensitive, evidence-based interventions for refugees and asylum seekers.
A literature review integrating research findings on interventions designed especially for traumatized asylum seekers and refugees was conducted. Retained studies had to use some quantitative measurements of post-traumatic stress and to have pre- and post-measurements to evaluate the efficacy of the intervention. Studies included in this review cover a wide variety of interventions, including trauma-focused interventions, group therapy, multidisciplinary interventions and pharmacological treatments.
The majority of studies with traumatized refugees and asylum seekers reported positive outcomes of the intervention in reducing trauma-related symptoms. There is evidence to support the suitability of cognitive-behavioral therapy (CBT) and narrative exposure therapy (NET) in certain populations of refugees. Other intervention studies are limited by methodological considerations, such as lack of randomization, absence of control group and small samples.
This review has again highlighted the shortage of guiding frameworks available to investigators and clinicians who are interested in tailoring interventions to work with refugees and asylum seekers. Theoretical, ethical and methodological considerations for future research are discussed.
由于与被迫迁移相关的负面经历,难民和寻求庇护者中与创伤相关的问题极为普遍。尽管文献提出了相当数量的针对创伤后难民和寻求庇护者的工作准则和理论框架,但这些干预措施的功效、可行性和适用性几乎没有经验证据。
本文旨在批判性地回顾文献,为制定针对难民和寻求庇护者的敏感文化、基于证据的干预措施提供依据。
对专门针对创伤后寻求庇护者和难民的干预措施的研究结果进行了文献综述。保留的研究必须使用一些创伤后应激的定量测量方法,并进行前后测量,以评估干预的效果。本综述涵盖了各种干预措施,包括创伤焦点干预、团体治疗、多学科干预和药物治疗。
大多数针对创伤后难民和寻求庇护者的研究报告称,干预措施在减轻与创伤相关的症状方面取得了积极的结果。有证据支持认知行为疗法(CBT)和叙事暴露疗法(NET)在某些难民群体中的适用性。其他干预研究受到方法学考虑的限制,例如缺乏随机化、缺乏对照组和样本量小。
本综述再次强调了对那些有兴趣针对难民和寻求庇护者定制干预措施的研究人员和临床医生来说,缺乏指导框架。讨论了未来研究的理论、伦理和方法学考虑因素。