Practitioner review: assessment and treatment of refugee children and adolescents who have experienced war-related trauma.
BACKGROUND
Increasingly clinicians are being asked to assess and treat young refugees, who have experienced traumatic events due to war and organised violence. However, evidence-based guidance remains scarce.


METHODS
Published studies on the mental health difficulties of refugee children and adolescents, associated risk and protective factors, as well as effective interventions, particularly those designed to reduce war-related post-traumatic stress disorder (PTSD) symptoms, were identified and reviewed. The findings are summarised.


RESULTS
Young refugees are frequently subjected to multiple traumatic events and severe losses, as well as ongoing stressors within the host country. Although young refugees are often resilient, many experience mental health difficulties, including PTSD, depression, anxiety and grief. An awareness of relevant risk and protective factors is important. A phased model of intervention is often useful and the need for a holistic approach crucial. Promising treatments for alleviating symptoms of war-related PTSD include cognitive behavioural treatment (CBT), testimonial psychotherapy, narrative exposure therapy (NET) and eye movement desensitisation and reprocessing (EMDR). Knowledge of the particular needs of unaccompanied asylum-seeking children (UASC), working with interpreters, cross-cultural differences, medico-legal report writing and the importance of clinician self-care is also necessary.


CONCLUSIONS
More research is required in order to expand our limited knowledge base.
Ehntholt
Kimberly A
KA
South London & Maudsley NHS Trust and Institute of Psychiatry, London, UK. kim.ehntholt@slam.nhs.uk
Yule
William
W
D000293:Adolescent; D002648:Child; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003469:Culture; D003887:Desensitization, Psychologic / Q000379:methods*; D005133:Eye Movements / Q000502:physiology; D006117:Grief; D006801:Humans; D008016:Life Change Events; D033262:Narration; D012036:Refugees / Q000523:psychology* / Q000706:statistics & numerical data*; D012307:Risk Factors; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D011795:Surveys and Questionnaires; D014857:Warfare