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Promoting well-being in refugee children: An exploratory controlled trial of a positive psychology intervention delivered in Greek refugee camps

Published online by Cambridge University Press:  17 January 2020

Sevasti Foka ,
Kristin Hadfield Open the ORCID record for Kristin Hadfield [Opens in a new window] ,
Michael Pluess  and
Isabelle Mareschal
Sevasti Foka
Affiliation:
Department of Biological and Experimental Psychology, Queen Mary University of London, London, UK
Kristin Hadfield*
Affiliation:
Department of Biological and Experimental Psychology, Queen Mary University of London, London, UK
Michael Pluess
Affiliation:
Department of Biological and Experimental Psychology, Queen Mary University of London, London, UK
Isabelle Mareschal
Affiliation:
Department of Biological and Experimental Psychology, Queen Mary University of London, London, UK
*
Author for Correspondence: Kristin Hadfield, Department off Biological and Experimental Psychology, G. E. Fogg Building, Queen Mary University of London, Mile End Rd, Bethnal Green, LondonE1 4NS, UK; E-mail: k.hadfield@qmul.ac.uk.
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Abstract

Rigorously evaluated interventions that target protective factors and positive resources rather than ameliorating negative outcomes in child refugees are rare. To address this, we developed and evaluated a short, group-based resilience-building intervention called Strengths for the Journey (SFJ), which was designed for war-affected children. We conducted a quasi-randomized pilot study of the SFJ intervention with 72 7- to 14-year-old forcibly displaced children (Mage = 10.76, 64.8% female) in three refugee camps in Lesvos, Greece. Intervention effectiveness was assessed by measuring pre-post changes in well-being, self-esteem, optimism, and depressive symptoms from before (T1) to immediately after the intervention/wait-list task (T2). Four focus group interviews were conducted with 31 of the participants to discuss their views on the effects of the intervention and the continued use of the skills that were learned. Using repeated-measures ANOVAs, we found improvements in well-being, F (1, 46) = 42.99, ηp2 = .48, self-esteem, F (1, 56) = 29.11, ηp2 = .40, optimism, F (1, 53) = 27.16, ηp2 = .34, and depressive symptoms, F (1, 31) = 62.14, ηp2 = .67, in the intervention group compared with the wait-listed group (p < .05). Focus group participants highlighted the importance of SFJ in developing a sense of togetherness and building their strengths. Child refugees in low-resource settings may benefit from brief, first-line interventions that target protective factors such as well-being, hope, self-esteem, and belonging.

Keywords

adversityevaluationinterventionrefugeesresilience
Type
Regular Articles
Information
Development and Psychopathology , Volume 33 , Issue 1 , February 2021 , pp. 87 - 95
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Copyright
Copyright © Cambridge University Press 2020

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References

Ager, A., Akesson, B., Stark, L., Flouri, E., Okot, B., McCollister, F., & Boothby, N. (2011). The impact of the school-based Psychosocial Structured Activities (PSSA) program on conflict-affected children in northern Uganda. Journal of Child Psychology and Psychiatry, 52, 1124–1133. doi:10.1111/j.1469-7610.2011.02407.xCrossRefGoogle ScholarPubMed
Allgaier, A. K., Pietsch, K., Frühe, B., Prast, E., Sigl-Glöckner, J., & Schulte-Körne, G. (2012). Depression in pediatric care: Is the WHO-Five Well-Being Index a valid screening instrument for children and adolescents? General Hospital Psychiatry, 34, 234–241. doi:10.1016/j.genhosppsych.2012.01.007CrossRefGoogle ScholarPubMed
Bech, P. (2004). Measuring the dimension of psychological general well-being by the WHO-5. Quality of Life Newsletter, 32, 15–16.Google Scholar
Berger, R. (2014) The ERASE-STRESS (ES) Programs: A teacher-delivered universal school-based programs in the aftermath of disasters In Mitchel, D. & Karr, V. (Eds.), Crises, conflict and disability: Ensuring equality (pp. 96–104). London, UK: Routledge.CrossRefGoogle Scholar
Berger, R., Benatov, J., Cuadros, R., VanNattan, J., & Gelkopf, M. (2018). Enhancing resiliency and promoting prosocial behavior among Tanzanian primary-school students: A school-based intervention. Transcultural Psychiatry, 55, 821–845. doi:10.1177/1363461518793749CrossRefGoogle ScholarPubMed
Bolier, L., Haverman, M., Westerhof, G. J., Riper, H., Smit, F., & Bohlmeijer, E. (2013). Positive psychology interventions: A meta-analysis of randomized controlled studies. BMC Public Health, 13, 119–139. doi:10.1186/1471-2458-13-119CrossRefGoogle ScholarPubMed
Bonanno, G. A., Romero, S. A., & Klein, S. I. (2015). The temporal elements of psychological resilience: An integrative framework for the study of individuals, families, and communities. Psychological Inquiry, 26, 139–169. doi:10.1080/1047840X.2015.992677CrossRefGoogle Scholar
Charlson, F., van Ommeren, M., Flaxman, A., Cornett, J., Whiteford, H., & Saxena, S. (2019). New WHO prevalence estimates of mental disorders in conflict settings: A systematic review and meta-analysis. The Lancet, 394, 240–248. doi:10.1016/S0140-6736(19)30934-1CrossRefGoogle ScholarPubMed
Crisp, J. (2000). A state of insecurity: The political economy of violence in Kenya's refugee camps. African Affairs, 99, 601–632. doi:10.1093/afraf/99.397.601CrossRefGoogle Scholar
Denov, M., Fennig, M., Rabiau, M. A., & Shevell, M. C. (2019). Intergenerational resilience in families affected by war, displacement, and migration: “It runs in the family”. Journal of Family Social Work, 22, 17–45. doi:10.1080/10522158.2019.1546810CrossRefGoogle Scholar
Elo, S., Kääriäinen, M., Kanste, O., Pölkki, T., Utriainen, K., & Kyngäs, H. (2014). Qualitative content analysis: A focus on trustworthiness. SAGE Open, 4, 1–10. doi:10.1177/2158244014522633.CrossRefGoogle Scholar
Ey, S., Hadley, W., Allen, D. N., Palmer, S., Klosky, J., Deptula, D., … Cohen, R. (2005). A new measure of children's optimism and pessimism: The Youth Life Orientation Test. Journal of Child Psychology and Psychiatry, 46, 548–558. doi:10.1111/j.1469-7610.2004.00372.xCrossRefGoogle ScholarPubMed
Fazel, M. (2018). Psychological and psychosocial interventions for refugee children resettled in high-income countries. Epidemiology and Psychiatric Sciences, 27, 117–123. doi:10.1017/S2045796017000695CrossRefGoogle ScholarPubMed
Fazel, M., & Betancourt, T. S. (2018). Preventive mental health interventions for refugee children and adolescents in high-income settings. The Lancet Child & Adolescent Health, 2, 121–132. doi:10.1016/S2352-4642(17)30147-5CrossRefGoogle ScholarPubMed
Foka, S., & Sergianni, C. (2019). Strengths for the journey: Resilience-building intervention manual. London: Queen Mary University of London.Google Scholar
Giannakopoulos, G., & Anagnostopoulos, D. C. (2016). Child health, the refugees crisis, and economic recession in Greece. The Lancet, 387, 1271. doi:10.1016/S0140-6736(16)30016-2CrossRefGoogle Scholar
Greene, S., & Hill, M. (2005). Researching children's experience: Methods and methodological issues In Greene, S. & Hogan, D. (Eds.), Researching children's experience: Approaches and methods (pp. 1–22). London, UK: Sage.CrossRefGoogle Scholar
Harris, M. A., Donnellan, M. B., & Trzesniewski, K. H. (2018). The Lifespan Self-Esteem Scale: Initial validation of a new measure of global self-esteem. Journal of Personality Assessment, 100, 84–95. doi:10.1080/00223891.2016.1278380CrossRefGoogle ScholarPubMed
Hermans, M. P., Kooistra, J., Cannegieter, S. C., Rosendaal, F. R., Mook-Kanamori, D. O., & Nemeth, B. (2017). Healthcare and disease burden among refugees in long-stay refugee camps at Lesbos, Greece. European Journal of Epidemiology, 32, 851–854. doi:10.1007/s10654-017-0269-4CrossRefGoogle ScholarPubMed
Hodes, M., & Vostanis, P. (2018). Practitioner review: Mental health problems of refugee children and adolescents and their management. Journal of Child Psychology and Psychiatry, 60, 716–731. 10.1111/jcpp.13002CrossRefGoogle ScholarPubMed
Hsieh, H. F., & Shannon, S. E. (2005). Three approaches to qualitative content analysis. Qualitative Health Research, 15, 1277–1288. doi:10.1177/1049732305276687CrossRefGoogle ScholarPubMed
Kadir, A., Battersby, A., Spencer, N., & Hjern, A. (2019). Children on the move in Europe: A narrative review of the evidence on the health risks, health needs and health policy for asylum seeking, refugee and undocumented children. BMJ Paediatrics Open, 3, 1–15. doi:10.1136/bmjpo-2018-000364CrossRefGoogle ScholarPubMed
Kousiakis, S., James, A., & Benasuly, D. (2016). Don't forget us: Voices of young refugees and migrants in Greece. Norwegian Refugee Council and Mercy Corps. Retrieved from https://www.nrc.no/globalassets/pdf/reports/dont-forget-us_screen_09.30am_180117.pdfGoogle Scholar
Marques, S. C., Lopez, S. J., & Pais-Ribeiro, J. L. (2011). “Building hope for the future”: A program to foster strengths in middle-school students. Journal of Happiness Studies, 12, 139–152. doi:10.1007/s10902-009-9180-3CrossRefGoogle Scholar
Masten, A. S. (2014). Global perspectives on resilience in children and youth. Child Development, 85, 6–20. doi:10.1111/cdev.12205CrossRefGoogle ScholarPubMed
Médecins Sans Frontières. (2018). MSF activity update—March 2018. Retrieved from https://www.msf.org/greece-msf-activity-update-%E2%80%93-march-2018Google Scholar
Measham, T., Guzder, J., Rousseau, C., Pacione, L., Blais-McPherson, M., & Nadeau, L. (2014). Refugee children and their families: Supporting psychological well-being and positive adaptation following migration. Current Problems in Pediatric and Adolescent Health Care, 44, 208–215. doi:10.1016/j.cppeds.2014.03.005CrossRefGoogle ScholarPubMed
Miller-Graff, L. E., & Cummings, E. M. (2017). The Israeli–Palestinian conflict: Effects on youth adjustment, available interventions, and future research directions. Developmental Review, 43, 1–47. doi:10.1016/j.dr.2016.10.001CrossRefGoogle Scholar
Miller, K. E., & Rasmussen, A. (2017). The mental health of civilians displaced by armed conflict: An ecological model of refugee distress. Epidemiology and Psychiatric Sciences, 26, 129–138. doi:10.1017/S2045796016000172CrossRefGoogle ScholarPubMed
Moghames, P., McEwen, F., & Pluess, M. (2018). Mental health research among Syrian refugees in Lebanon: Challenges and solutions. Humanitarian Exchange, 72, 39–42.Google Scholar
Motti-Stefanidi, F. (2014). Immigrant youth adaptation in the Greek school context: A risk and resilience developmental perspective. Child Development Perspectives, 8, 180–185. doi:10.1111/cdep.12081CrossRefGoogle Scholar
Motti-Stefanidi, F. (2015). Risks and resilience in immigrant youth adaptation: Who succeeds in the Greek school context and why? European Journal of Developmental Psychology, 12, 261–274. doi:10.1080/17405629.2015.1020787CrossRefGoogle Scholar
Motti-Stefanidi, F., Asendorpf, J. B., & Masten, A. S. (2012). The adaptation and well-being of adolescent immigrants in Greek schools: A multilevel, longitudinal study of risks and resources. Development and Psychopathology, 24, 451–473. doi:10.1017/S0954579412000090CrossRefGoogle ScholarPubMed
Newnham, E. A., Kashyap, S., Tearne, J., & Fazel, M. (2018). Child mental health in the context of war: An overview of risk factors and interventions for refugee and war-affected youth. In Morina, N. & Nickerson, A. (Eds.), Mental health of refugee and conflict-affected populations (pp. 37–63). Cham, Switzerland: Springer.CrossRefGoogle Scholar
Panter-Brick, C., Dajani, R., Eggerman, M., Hermosilla, S., Sancilio, A., & Ager, A. (2018). Insecurity, distress and mental health: Experimental and randomized controlled trials of a psychosocial intervention for youth affected by the Syrian crisis. Journal of Child Psychology and Psychiatry, 59, 523–541. doi:10.1111/jcpp.12832CrossRefGoogle ScholarPubMed
Panter-Brick, C., Hadfield, K., Dajani, R., Eggerman, M., Ager, A., & Ungar, M. (2018). Resilience in context: A brief and culturally grounded measure for Syrian refugee and Jordanian host-community adolescents. Child Development, 89, 1803–1820. doi:10.1111/cdev.12868CrossRefGoogle ScholarPubMed
Pluess, M., Boniwell, I., Hefferon, K., & Tunariu, A. (2017). Preliminary evaluation of a school-based resilience-promoting intervention in a high-risk population: Application of an exploratory two-cohort treatment/control design. PloS One, 12, 1–18. doi:10.1371/journal.pone.0177191CrossRefGoogle Scholar
Quinlan, D. M., Swain, N., Cameron, C., & Vella-Brodrick, D. A. (2015). How ‘other people matter’ in a classroom-based strengths intervention: Exploring interpersonal strategies and classroom outcomes. The Journal of Positive Psychology, 10, 77–89. doi:10.1080/17439760.2014.920407CrossRefGoogle Scholar
Reed, R. V., Fazel, M., Jones, L., Panter-Brick, C., & Stein, A. (2012). Mental health of displaced and refugee children resettled in low-income and middle-income countries: Risk and protective factors. The Lancet, 379, 250–265. doi:10.1016/S0140-6736(11)60050-0CrossRefGoogle ScholarPubMed
Roberts, R. E., Andrews, J. A., Lewinsohn, P. M., & Hops, H. (1990). Assessment of depression in adolescents using the Center for Epidemiologic Studies Depression Scale. Psychological Assessment: A Journal of Consulting and Clinical Psychology, 2, 122–128. doi:10.1037/1040-3590.2.2.122CrossRefGoogle Scholar
Silove, D., Ventevogel, P., & Rees, S. (2017). The contemporary refugee crisis: An overview of mental health challenges. World Psychiatry, 16, 130–139. doi:10.1002/wps.20438CrossRefGoogle ScholarPubMed
Sin, N. L., & Lyubomirsky, S. (2009). Enhancing well-being and alleviating depressive symptoms with positive psychology interventions: A practice-friendly meta-analysis. Journal of Clinical Psychology, 65, 467–487. doi:10.1002/jclp.20593CrossRefGoogle ScholarPubMed
Sleijpen, M., Mooren, T., Kleber, R. J., & Boeije, H. R. (2017). Lives on hold: A qualitative study of young refugees’ resilience strategies. Childhood, 24, 348–365. doi:10.1177/0907568217690031CrossRefGoogle ScholarPubMed
Topp, C. W., Østergaard, S. D., Søndergaard, S., & Bech, P. (2015). The WHO-5 Well-Being Index: A systematic review of the literature. Psychotherapy and Psychosomatics, 84, 167–176. doi:10.1159/000376585CrossRefGoogle ScholarPubMed
Tyrer, R. A., & Fazel, M. (2014). School and community-based interventions for refugee and asylum seeking children: A systematic review. PloS One, 9, e89359. doi:10.1371/journal.pone.0089359CrossRefGoogle ScholarPubMed
UNHCR. (2018). Figures at a glance. Retrieved from: https://www.unhcr.org/figures-at-a-glance.htmlGoogle Scholar
UNICEF. (2018). Refugee and migrant children arriving on Greek Islands up by one-third in 2018—UNICEF. Retrieved from: https://www.unicef.org/eca/press-releases/refugee-and-migrant-children-arriving-greek-islands-one-third-2018-unicefGoogle Scholar
United Nations Children's Emergency Fund. (2011). Humanitarian action for children: Building resilience. New York, NY: United Nations Children Emergency Fund.Google Scholar
Veronese, G., Castiglioni, M., Tombolani, M., & Said, M. (2012). ‘My happiness is the refugee camp, my future Palestine’: Optimism, life satisfaction and perceived happiness in a group of Palestinian children. Scandinavian Journal of Caring Sciences, 26, 467–473. doi:10.1111/j.1471-6712.2011.00951.xCrossRefGoogle Scholar
Veronese, G., Castiglioni, M., Tombolani, M., & Said, M. (2012). “My happiness is the refugee camp, my future Palestine”: Optimism, life satisfaction and perceived happiness in a group of Palestinian children. Scandinavian Journal of Caring Sciences, 26, 467–473. doi: 10.1111/j.1471-6712.2011.00951.xCrossRefGoogle Scholar
Vogler, P. (2007). Into the jungle of bureaucracy: Negotiating access to camps at the Thai-Burma border. Refugee Survey Quarterly, 26, 51–60. doi:10.1093/rsq/hdi0242CrossRefGoogle Scholar
Werner, E. E. (2012). Children and war: Risk, resilience, and recovery. Development and Psychopathology, 24, 553–558. doi:10.1017/S0954579412000156CrossRefGoogle ScholarPubMed
Yaylaci, F. T. (2018). Trauma and resilient functioning among Syrian refugee children. Development and Psychopathology, 30, 1923–1936. doi:10.1017/S0954579418001293CrossRefGoogle ScholarPubMed
Zenner, C., Herrnleben-Kurz, S., & Walach, H. (2014). Mindfulness-based interventions in schools—A systematic review and meta-analysis. Frontiers in Psychology, 5, 1–20. doi:10.3389/fpsyg.2014.00603CrossRefGoogle ScholarPubMed
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