title: Interventions for children affected by war: an ecological perspective on psychosocial support and mental health care.
abstract: BACKGROUND
  Children and adolescents exposed to armed conflict are at high risk of developing mental health problems. To date, a range of psychosocial approaches and clinical/psychiatric interventions has been used to address mental health needs in these groups.
  
  
  OBJECTIVE
  To provide an overview of peer-reviewed psychosocial and mental health interventions designed to address mental health needs of conflict-affected children, and to highlight areas in which policy and research need strengthening.
  
  
  METHODS
  We used standard review methodology to identify interventions aimed at improving or treating mental health problems in conflict-affected youth. An ecological lens was used to organize studies according to the individual, family, peer/school, and community factors targeted by each intervention. Interventions were also evaluated for their orientation toward prevention, treatment, or maintenance, and for the strength of the scientific evidence of reported effects.
  
  
  RESULTS
  Of 2305 studies returned from online searches of the literature and 21 sources identified through bibliography mining, 58 qualified for full review, with 40 peer-reviewed studies included in the final narrative synthesis. Overall, the peer-reviewed literature focused largely on school-based interventions. Very few family and community-based interventions have been empirically evaluated. Only two studies assessed multilevel or stepped-care packages.
  
  
  CONCLUSIONS
  The evidence base on effective and efficacious interventions for conflict-affected youth requires strengthening. Postconflict development agendas must be retooled to target the vulnerabilities characterizing conflict-affected youth, and these approaches must be collaborative across bodies responsible for the care of youth and families.
authors: Department of Global Health and Population, Harvard School of Public Health, Boston, MA 02115, USA. Theresa_ Betancourt@harvard.edu
authors: Theresa S
authors: TS
authors: Betancourt
authors: Sarah E
authors: SE
authors: Meyers-Ohki
authors: Alexandra P
authors: AP
authors: Charrow
authors: Wietse A
authors: WA
authors: Tol
mesh_terms: D000293:Adolescent; D002648:Child; D006801:Humans; D001523:Mental Disorders / Q000209:etiology / Q000517:prevention & control / Q000628:therapy*; D008605:Mental Health Services / Q000592:standards*; D011613:Psychotherapy / Q000379:methods / Q000592:standards*; D014857:Warfare
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