Trauma treatment outcomes for PTSD in refugee and asylum-seeking minors with uncertain residence status: a systematic review

Introduction: Refugee and asylum-seeking minors with an uncertain residence status are at risk of being refused treatment for PTSD due to claims that residence stability is required for a successful outcome. Objective: To synthesize research on the effectiveness of trauma treatment for PTSD in refugee and asylum-seeking minors with an uncertain residence status. Further objectives were to investigate whether there is any evidence that an uncertain residence status predicts treatment outcome and adherence to the treatment. Methods: Data searches were performed in Cinahl, Cochrane Library, PsychINFO and PubMed. A total of 741 articles were screened for eligibility, of which 23 were included in the systematic review. Results: Significant reductions in PTSD symptoms were reported in 17 of the 23 studies (2 RCTs and 16 NRSIs). The median effect size, reported in 11 studies was high, 0.97 (IQR 0.44 -1.23). No adverse effects were reported. The trauma treatment forms were mainly CBT, NET and EMDR. There was very little evidence to support whether an uncertain residence status would be a factor that predicts treatment outcomes or adherence to treatment. On average, adherence to treatment was 76%. Conclusion: Trauma treatment, such as CBT, NET and EMDR, for minors living under uncertain residence status can reduce levels of PTSD symptoms with a moderate to high effect size. The result thereby challenges the notion that residence stability is required for a successful trauma treatment outcome.