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Übersicht

Begleitete minderjährige Geflüchtete

Eine systematische Übersicht über psychologische Interventionen mit Familieneinbezug

Published Online:May 17, 2019https://doi.org/10.1026/0942-5403/a000285

Abstract

Zusammenfassung. Aufgrund erhöhter psychopathologischer Vulnerabilität bei minderjährigen Geflüchteten (MG), sind wirksame psychotherapeutische Interventionen versorgungsrelevant. Die Mehrzahl MG flieht im Familienverbund. Die Familie wirkt dabei einerseits als stabilisierende Ressource, anderseits als Stressor, so dass der Einbezug der Eltern in die Therapie von Bedeutung ist. Dieses Reviews gibt einen Überblick über den aktuellen Forschungsstand zur Wirksamkeit psychotherapeutischer Maßnahmen mit Familieneinbezug bei begleiteten minderjährigen Geflüchteten (BMG). Insgesamt konnten fünf Studien identifiziert werden. Für die Kinder wurden in vier der fünf, für die Mütter in zwei der fünf Studien signifikante Effekte berichtet. Insgesamt ist die Befundlage gering und die Qualität der Primärstudien oft unzureichend. Replikationen der Ergebnisse unter Berücksichtigung der methodischen Qualität sowie die Implementierung weiterer Maßnahmen sind notwendig.


Accompanied Refugee Minors: A Systematic Review of Psychological Interventions With Family Inclusion

Abstract. In 2016, approximately 22.5 million people fled their country of origin. More than half of this group was under the age of 18 years. The media and research focused on unaccompanied refugee minors (URM), although accompanied refugee minors (ARM) account for the largest number of minors leaving their country. Just like URM, ARM constitute a high-risk group with regard to psychological disorders, as they experience numerous stressors before, during, and after flight. Owing to the current refugee situation and the high vulnerability of this group to develop mental disorders, effective psychotherapeutic interventions are needed, especially considering family members since they might contribute to the attenuation but also to the increase of stress. Here, we provide an overview of the current state of research and the effectiveness of therapeutic interventions with family inclusion for ARM. A comprehensive search of 10 databases was conducted. The selection criteria – such as reporting quantitative psychological outcomes by pre- and post-measurements, observance of at least one control group, and examining the effectiveness of psychotherapeutic interventions with family inclusion for accompanied minor refugees – were met by five studies. The interventions were either trauma focused with or without exposure, or not trauma specific, and were directed either at children or their mothers. Effect sizes based on the given statistical information were calculated. Of the five studies, four reported significant results for children and two for mothers. However, the overall evidence in this field is sparse and the methodological quality often unsatisfactory. Narrative exposure therapy for children (KIDNET) and trauma systems therapy (TST) had positive effects, as did psychosocial interventions. A critical examination of the studies displays methodological impairments, since the sample sizes are often small, power and drop-out analyses are lacking, and information of treatment fidelity is missing. However, the inclusion of family members in the psychotherapeutic process of ARM seems promising and important with regard to social support, stabilization, and resources. Therefore, replication of such studies needs to be of higher methodological quality, and the exploration and evaluation of further interventions with family inclusion are required. Further, it is essential to adapt standardized diagnostic instruments and therapy manuals to the cultural and linguistic background of refugee minors. The development and evaluation of therapy manuals including language-specific translators are advisable as this can ease therapy for refugee minors and reduce the concerns of therapists about translator-based therapy.

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