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Table 1 Study aims and intervention

From: How does context influence the delivery of mental health interventions for asylum seekers and refugees in low- and middle-income countries? A qualitative systematic review

First Author Year Study LMIC country Study aims Intervention name Description of intervention Study method
Aladro 2020 Colombia What factors influence the implementation of PM+ for Venezuelans Problem Management Plus (PM+) PM+ “is composed of four core strategies: stress management (‘Managing Stress’), problem solving (‘Managing Problems’), behavioural activation (‘Get Going, Keep Doing’) and strengthening social support” (p. 87). Includes breathing exercises, task-orientated activities and identifying sources of support Semi-structured interviews and focus group discussion
Brown et al 2020 Lebanon To culturally and contextually adapt the EASE program for Palestinian, Lebanese and Syrian adolescents in the north of Lebanon Early Adolescents Skills for Emotions (EASE) EASE is focused on “four key empirically supported strategies: understanding my feelings (emotion identification), calming my body (diaphragmatic breathing), changing my actions (behavioral activation), and solving my problems (problem solving). Additionally, three adjunctive caregiver sessions aim to promote positive parenting practices to improve the caregiver–child relationship and enhance confidence when responding to adolescent distress” (p. 3) Session notes, supervision notes, and a debrief session at the end of the implementation
Burchert et al 2019 Egypt The adaptation, implementation and scaling-up of Step by Step for Syrians in Germany, Sweden and Egypt Step by Step (SbS) SbS is an ‘e-mental health intervention’ consisting of “three core components: the content, the guidance model (e.g., from a human helper) and the delivery system (e.g., web or app). Each of these components can be adjusted and extended to respond to diverse implementation contexts. It is modularized and rooted in evidence-based cognitive behavioral therapy techniques such as behavioural activation, psychoeducation, stress management, increasing social support and relapse prevention” (p. 3) Interviews and focus group discussions
Chapman & Claessens 2019 Egypt “To monitor activities and hold focus group discussion with Syrian and Egyptian participants in the activities to collect feedback about the project and re-adjust where required” (p. 9) Community-based psycho-social support It is a community-based, non-specialised psychosocial support delivered through local community centres providing psychosocial support sessions, child friendly spaces with special activities, parenting sessions, specialized psychosocial support Focus group discussions
Greene et al 2019 Tanzania “To evaluate the implementation of an integrated intimate partner violence and mental health intervention” (p. 6) for Congolese refugee women Nguvu “The Nguvu intervention was designed as an 8-session intervention that begins with a single individual session of advocacy counseling followed by six group sessions focused primarily on cognitive processing therapy and a final group session of advocacy counselling” (p. 9) Interviews
Gürle 2019 Turkey Exploring the power of drama and art as tools for Syrian children to learn about emotion regulation Storytelling and image theatre “The workshop combined both verbal and nonverbal means of expression and primarily employed drama techniques, such as storytelling and image theatre” (p. 166). It included five sessions of two hours Observation
Hakki 2020 Turkey To aid Syrian women “to explore changes in their roles and their adversity-activated development after fleeing Syria due to the current conflict” (p. 187) Theatre of the Oppressed (ToO) “ToO is theatre. It has three main methods: invisible theatre, forum theatre and image theatre. There were five sessions in total, each session between 90–100 min long, twice a week, and led by one facilitator. The main activities during the sessions were built on a game taken from the ToO approach called ‘What is the story?’ using a shadow theatre technique” (p. 189) Storytelling methods and group discussion with two open questions
Makhoul et al 2011 Lebanon To assess the benefits of participating in a community-based research project in a Palestinian refugee camp
of Beirut, for Palestinian youth mentors
Youth Mentor Training Programme for Qaderoon The training for youth mentors began with a three-day workshop. They were then observed during the intensive two-week summer program and provided with feedback. Youth mentors then helped deliver the Qaderoon intervention In-depth interviews
Murray et al 2018 Ethiopia To assess implementation aspects of a common elements treatment approach developed among children in three Somali refugee camps on the Ethiopian/Somali border Common Elements Treatment Approach for youth (CETA) “CETA is an approach that teaches cognitive-behavioral therapy elements common to evidence-based treatments” (p. 5). It includes elements on ‘engagement’, ‘behvioural activation’, ‘imaginal global exposure’ and ‘cognitive coping’ Semi-structured interviews
Nakkash et al 2019 Lebanon To describes “the context of Palestinian refugees in Lebanon, the intervention, the process evaluation plan and results” (p. 595) ‘Qaderoon’ (We are Capable) ‘Qaderoon’ (We Are Capable) is a public health intervention. It is “a year-long social skill building intervention for children (11–14 years), their parents and teachers aimed at promoting mental health of refugee children and increasing their attachment to school” (p. 596) Observation, meetings, discussions and interviews
Rebolledo 2019 Bangladesh To promote psychosocial wellbeing by increasing sense of identity and community in Rohingya refugees in Bangladesh Healing Ceremonies Programme “Healing ceremonies were divided into three sessions (music, art and symbols of strength) to reflect Rohingya culture” (p. 279) Focus group discussions
Sim et al 2018 Thailand “To generate evidence around what works to protect Burmese children from the negative effects of forced migration” (p. 7) Happy Families Program “It was a group-based parenting and family skills intervention for children aged 8 to 12 and their caregivers. Caregivers and their children participated in parallel group sessions each week, followed by joint activities in which each family practiced the skills that they had learned” (p. 8) Semi-structured interviews
Sullivan et al 2019 Bangladesh The 'project utilises Rohingya community health workers... to pilot the use of peer-to-peer teaching of low-cost tools for potential alleviation of mental health complaints' (p.252) Acupuncture and mindful breathing It consisted of peer-to-peer teaching of simple relaxation techniques: four acupressure points and breathing exercises. “All six techniques were taught in 90-min group sessions to Rohingya CHWs by explanation, demonstration and practice in same-sex pairs” (p. 254) Reflective discussion group
Tay et al 2019 Malaysia “To describe the theoretical underpinnings of Integrative Adapt Therapy, the formulation, development, refinement and cultural adaptation of a treatment manual to guide the intervention, amongst refugees from Myanmar in Malaysia and Bangladesh” (p. 2) Integrative Adapt Therapy (IAT) “The Integrative Adapt Therapy integrates universal principles of the Adaptation and Development After Persecution and Trauma model with the particularities of the culture, history of conflict and living context of each refugee community” (p. 1) Focus group discussions
Tol et al 2011 Uganda To adapt and pilot a guided, multi-media, self-help intervention, Self-Help Plus in South Sudanese refugees in Uganda Self-Help Plus (SH+) “The intervention is based on principles of Acceptance and Commitment Therapy. The SH+ package comprises a pre-recorded audio course and an illustrated self-help manual. The audio-course can be delivered to groups of 20–30 people by lay facilitators trained over a short period. The course consists of five weekly 2-h sessions that include individual exercises and small group discussions (p. 3). In addition, it provides participants with an illustrated manual Semi-structured interviews
Vijayakumar et al 2017 India “To assess the effectiveness and acceptability of Contact and Use of Safety Planning Cards in reducing suicidal behaviour among Sri Lankan refugees residing in camps in Tamil Nadu” (p. 590) Contact and Use of Safety Planning Cards “The safety planning card consisted of an individualised list of coping strategies containing names and contact numbers of persons in the individual’s immediate family, social circle and health services who could be contacted during a suicidal crisis” (p. 590) Household survey and focus group discussions
Yassin et al 2018 Lebanon “To present findings from an evaluation of the refugee camp mental health program conducted among Palestinian Refugees in Lebanon” (p. 2) Médecins Sans Frontières programme The program provided free access to mental health care services. “The team provided free access to mental health care services, free access to mental health care services, and provided prescribed medications. Both individual and family psychological consultations were available to all camp residents” (p. 2) Semi-structured interviews and focus group discussions
Zaghrout-Hodali 2019 Palestine To describe people’s experiences of eye movement desensitization and reprocessing therapy Eye Movement Desensitization and Reprocessing (EMDR) “EMDR is an integrative psychotherapy with protocols that include the use of bilateral stimulation and focus on past trauma, present situations, and future possibilities in enabling the client to reprocess disturbing memories to an adaptive resolution” (p. 248) Discussions