A Systematic Review: Understanding the effects of story-based interventions for refugee children at risk for mental health conditions. Open Access

Abstract

The United Nations Convention on the Rights of the Child articulates the promotion and dissemination of children’s books for a child’s social, spiritual, and physical and mental health (UNICEF 1989). However, there is a gap in the literature about the potential effects of children’s books, or story-based interventions for refugee children. With the high prevalence of depression, anxiety, and post-traumatic stress disorder (PTSD) symptoms among refugee children, it is vital to develop culturally appropriate and empirically tested interventions to lessen the barriers of language, service utilization, and stigma associated with mental health interventions (Attanayake et al., 2009; Bogic, Njoku, & Priebe, 2015; Lustig et al., 2003). Thus, this systematic narrative synthesis aims to understand the effects of story-based interventions for refugee children at risk for mental health issues.  

The synthesis found three main themes surrounding story-based interventions for refugee children. First, studies with refugee participants from multiple populations recruited and conducted their interventions in higher income countries, whereas interventions targeting a specific refugee population recruited and conducted their intervention at the conflict site or refugee camp. Second, the intervention strategies varied across the studies depending on intervention length, group v. individual-based approaches, and professional v. non-professional facilitators. Third, story-based interventions involving characters, otherwise known as children’s book interventions, are best suited for children younger than 7 years of age. This is important because refugee children who are younger than 7 years of age may not have the language capacity to understand their own complex emotions and traumas from their pervious experiences. Thus, children’s book interventions for children 7 years of age and younger should develop main characters who experience similar refugee experiences and emotions as the refugee children. Additionally, this review found components of story-based interventions to be a promising supplemental tool for future mental health therapies because the approach invites refugee children to bring their experiences and cultural backgrounds into the intervention to work through their emotions associated with traumatic events. However, further research is required, not only to understand the influence and measurement of cultural background, but the priority of mental health needs for the refugee children. 

Table of Contents

Chapter 1      Introduction 1

Introduction and Rationale 1

Chapter 2      Literature Review 4

Introduction 4

Theories, Models, and Applications 6

Conclusion and Significance 12

Chapter 3      Methodology 14

Introduction 14

Research Design and Study Characteristics 14

Data Extraction and Analysis 15

Outcome Measures 16

Chapter 4      Results 18

Introduction 18

Refugee Populations and Context 19

Intervention Design 20

Storytelling v. Autobiography 25

Chapter 5      Discussions and Conclusions 28

Introduction 28

Interpretation of the Results 28

Application Across Refugee Populations 32

Children’s Books as an Intervention 32 33

Conclusions, Implications, and Recommendations 35

References 38

Appendix 1 45

Figure 1: Diagram of Identified Literature 45

Table 1: Summary of Study Populations and Intervention Components 46

Table 2: Summary of Intervention Measures and Results 50

Appendix 2 53

APA Magination Press Preliminary Proposal 53

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Psychology, Social Health Sciences, Public Health Health Sciences, Mental Health
Keyword	story-based intervention mental health child refugee
Committee Chair / Thesis Advisor	Rachel Waford, PhD, Emory University

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