Skip to main content
Top
Published in: Child and Adolescent Psychiatry and Mental Health 1/2023

Open Access 01-12-2023 | Research

Changes in life satisfaction among unaccompanied asylum-seeking and refugee minors who participated in teaching recovery techniques (TRT)

Authors: Anne Kristine Solhaug, Espen Røysamb, Brit Oppedal

Published in: Child and Adolescent Psychiatry and Mental Health | Issue 1/2023

Login to get access

Abstract

Background

Unaccompanied asylum-seeking and refugee minors report low life satisfaction and high levels of mental health problems, nevertheless they often do not seek or receive help for their problems. Teaching Recovery Techniques (TRT) is a low-threshold, five sessions intervention developed to reduce distressing war- and disaster-related trauma reactions among children and youth. In this study, we investigate if TRT can contribute to increased life satisfaction among unaccompanied asylum-seeking and refugee minors.

Methods

Asylum-seeking and resettled unaccompanied minors participated in TRT carried out in 15 locations throughout Norway, n = 147, mean age = 16.61 (SD = 1.80), 88% boys, and 67% from Afghanistan. Life satisfaction was measured by the Cantril Ladder before the intervention, and two- and eight weeks post-intervention. We also included indices of intervention compliance and contextual variables, such as asylum status. We applied a pre- and post-intervention design with linear mixed model analyses to investigate change in life satisfaction.

Results

Life satisfaction significantly increased from pre- to post- intervention, but not for youth whose asylum application had been rejected or who were still awaiting a decision. Indices of intervention compliance were associated with an increase in life satisfaction.

Conclusions

TRT is a potential useful intervention to enhance life satisfaction among unaccompanied asylum-seeking and refugee minors and can be a measure to support positive development among youth at risk for mental health problems. However, TRT initiatives should consider the participant’s stage of asylum process, because harsh immigration policies may overburden the coping capacity. Without further adaptation, TRT seems most useful for youth granted residence. The manual has been revised to include asylum-related stressors.

Trial Registration

ClinicalTrials.gov (16/54,571, registered 30.01.2019).
Literature
1.
go back to reference United Nations High Commisioner for Refugees. Assistance to unaccompanied refugee minors. Geneva,: UNHCR; 2005. United Nations High Commisioner for Refugees. Assistance to unaccompanied refugee minors. Geneva,: UNHCR; 2005.
2.
go back to reference Hedlund D, Salmonsson L, Sohlberg T. Unaccompanied girls with precarious odds. J Refug Stud. 2021;34(4):3871–87. Hedlund D, Salmonsson L, Sohlberg T. Unaccompanied girls with precarious odds. J Refug Stud. 2021;34(4):3871–87.
3.
go back to reference Jakobsen M, Demott MA, Wentzel-Larsen T, Heir T. The impact of the asylum process on mental health: a longitudinal study of unaccompanied refugee minors in Norway. BMJ Open. 2017;7(6):1–8.CrossRef Jakobsen M, Demott MA, Wentzel-Larsen T, Heir T. The impact of the asylum process on mental health: a longitudinal study of unaccompanied refugee minors in Norway. BMJ Open. 2017;7(6):1–8.CrossRef
4.
go back to reference Keles S, Friborg O, Idsøe T, Sirin S, Oppedal B. Depression among unaccompanied minor refugees: the relative contribution of general and acculturation-specific daily hassles. Ethn Health. 2016;21(3):300–17.CrossRefPubMed Keles S, Friborg O, Idsøe T, Sirin S, Oppedal B. Depression among unaccompanied minor refugees: the relative contribution of general and acculturation-specific daily hassles. Ethn Health. 2016;21(3):300–17.CrossRefPubMed
5.
go back to reference Bean T, Eurelings-Bontekoe E, Mooijaart A, Spinhoven P. Factors associated with mental health service need and utilization among unaccompanied refugee adolescents. Adm Policy Ment Health. 2006;33(3):342–55.CrossRefPubMed Bean T, Eurelings-Bontekoe E, Mooijaart A, Spinhoven P. Factors associated with mental health service need and utilization among unaccompanied refugee adolescents. Adm Policy Ment Health. 2006;33(3):342–55.CrossRefPubMed
6.
go back to reference von Werthern M, Grigorakis G, Vizard E. The mental health and wellbeing of unaccompanied refugee minors (URMs). Child Abuse Negl. 2019;98:104146.CrossRef von Werthern M, Grigorakis G, Vizard E. The mental health and wellbeing of unaccompanied refugee minors (URMs). Child Abuse Negl. 2019;98:104146.CrossRef
7.
go back to reference Majumder P. Unaccompanied refugee minors’ experiences of mental health services. University of Leicester; 2015. Majumder P. Unaccompanied refugee minors’ experiences of mental health services. University of Leicester; 2015.
8.
go back to reference Sønsterudbråten S, Tyldum G, Raundalen M. Et trygt sted å vente - omsorgspraksiser på asylmottak for enslige mindreårige. Oslo: Fafo; 2018. p. 05. Report No. Sønsterudbråten S, Tyldum G, Raundalen M. Et trygt sted å vente - omsorgspraksiser på asylmottak for enslige mindreårige. Oslo: Fafo; 2018. p. 05. Report No.
9.
go back to reference Oppedal B, Solhaug AKN, Friborg O, Biele G. Mestring i mottak og kommuner. Implementering og evaluering av Teaching Recovery Techniques i asylmottak, omsorgssentre og bosettingskommuner i Norge. 2019. Oppedal B, Solhaug AKN, Friborg O, Biele G. Mestring i mottak og kommuner. Implementering og evaluering av Teaching Recovery Techniques i asylmottak, omsorgssentre og bosettingskommuner i Norge. 2019.
11.
go back to reference Yule W, Dyregrov A, Raundalen M, Smith P. Children and war: the work of the Children and War Foundation. Eur J Psychotraumatol. 2013;4(1):18424.CrossRef Yule W, Dyregrov A, Raundalen M, Smith P. Children and war: the work of the Children and War Foundation. Eur J Psychotraumatol. 2013;4(1):18424.CrossRef
12.
go back to reference van der Boor CF, Amos R, Nevitt S, Dowrick C, White RG. Systematic review of factors associated with quality of life of asylum seekers and refugees in high-income countries. Confl Health. 2020;14(1):1–25. van der Boor CF, Amos R, Nevitt S, Dowrick C, White RG. Systematic review of factors associated with quality of life of asylum seekers and refugees in high-income countries. Confl Health. 2020;14(1):1–25.
14.
go back to reference Dodge R, Daly AP, Huyton J, Sanders LD. The challenge of defining wellbeing.Int J Wellbeing. 2012;2(3). Dodge R, Daly AP, Huyton J, Sanders LD. The challenge of defining wellbeing.Int J Wellbeing. 2012;2(3).
15.
go back to reference Diener E, Suh E. Measuring quality of life: Economic, social, and subjective indicators. Soc Indic Res. 1997;40(1):189–216.CrossRef Diener E, Suh E. Measuring quality of life: Economic, social, and subjective indicators. Soc Indic Res. 1997;40(1):189–216.CrossRef
16.
go back to reference Currie C, Zanotti C, Morgan A, Currie D, de Looze M, Roberts C, et al. Social determinants of health and well-being among young people: Health Behaviour in School-Aged children (HBSC) study: international report from the 2009/2010 survey. World Health Organization. Regional Office for Europe; 2012. Currie C, Zanotti C, Morgan A, Currie D, de Looze M, Roberts C, et al. Social determinants of health and well-being among young people: Health Behaviour in School-Aged children (HBSC) study: international report from the 2009/2010 survey. World Health Organization. Regional Office for Europe; 2012.
17.
go back to reference Ghazinour M, Richter J, Eisemann M. Quality of life among Iranian refugees resettled in Sweden. J Immigr Minor Health. 2004;6(2):71–81.CrossRef Ghazinour M, Richter J, Eisemann M. Quality of life among Iranian refugees resettled in Sweden. J Immigr Minor Health. 2004;6(2):71–81.CrossRef
18.
go back to reference Gottvall M, Sjölund S, Arwidson C, Saboonchi F. Health-related quality of life among Syrian refugees resettled in Sweden. Qual Life Res. 2019;29(2):505–14.CrossRefPubMedPubMedCentral Gottvall M, Sjölund S, Arwidson C, Saboonchi F. Health-related quality of life among Syrian refugees resettled in Sweden. Qual Life Res. 2019;29(2):505–14.CrossRefPubMedPubMedCentral
19.
go back to reference Akinyemi OO, Owoaje ET, Ige OK, Popoola OA. Comparative study of mental health and quality of life in long term refugees and host populations in Oru-Ijebu, Southwest Nigeria. BMC Res Notes. 2012;5(1):1–9.CrossRef Akinyemi OO, Owoaje ET, Ige OK, Popoola OA. Comparative study of mental health and quality of life in long term refugees and host populations in Oru-Ijebu, Southwest Nigeria. BMC Res Notes. 2012;5(1):1–9.CrossRef
20.
go back to reference Seglem KB, Oppedal B, Røysamb E. Daily hassles and coping dispositions as predictors of psychological adjustment a comparative study of young unaccompanied refugees and youth in the resettlement country. Int J Behav Dev. 2014;38(3):293–303.CrossRef Seglem KB, Oppedal B, Røysamb E. Daily hassles and coping dispositions as predictors of psychological adjustment a comparative study of young unaccompanied refugees and youth in the resettlement country. Int J Behav Dev. 2014;38(3):293–303.CrossRef
21.
go back to reference Iasiello M, van Agteren J, Keyes CL, Cochrane EM. Positive mental health as a predictor of recovery from mental illness. J Affect Disord. 2019;251:227–30.CrossRefPubMedPubMedCentral Iasiello M, van Agteren J, Keyes CL, Cochrane EM. Positive mental health as a predictor of recovery from mental illness. J Affect Disord. 2019;251:227–30.CrossRefPubMedPubMedCentral
22.
go back to reference Barron IG, Abdallah G, Smith P. Randomized control trial of a CBT trauma recovery program in palestinian schools. J Loss Trauma. 2013;18(4):306–21.CrossRef Barron IG, Abdallah G, Smith P. Randomized control trial of a CBT trauma recovery program in palestinian schools. J Loss Trauma. 2013;18(4):306–21.CrossRef
23.
go back to reference Punamäki R-L, Peltonen K, Diab M, Qouta SR. Psychosocial interventions and emotion regulation among war-affected children: randomized control trial effects. Traumatology. 2014;20(4):241.CrossRef Punamäki R-L, Peltonen K, Diab M, Qouta SR. Psychosocial interventions and emotion regulation among war-affected children: randomized control trial effects. Traumatology. 2014;20(4):241.CrossRef
24.
go back to reference Qouta SR, Palosaari E, Diab M, Punamäki RL. Intervention effectiveness among war-affected children: a cluster randomized controlled trial on improving mental health. J Trauma Stress. 2012;25(3):288–98.CrossRefPubMed Qouta SR, Palosaari E, Diab M, Punamäki RL. Intervention effectiveness among war-affected children: a cluster randomized controlled trial on improving mental health. J Trauma Stress. 2012;25(3):288–98.CrossRefPubMed
25.
go back to reference Ehntholt KA, Smith PA, Yule W. School-based cognitive-behavioural therapy group intervention for refugee children who have experienced war-related trauma. Clin Child Psychol Psychiatry. 2005;10(2):235–50. Ehntholt KA, Smith PA, Yule W. School-based cognitive-behavioural therapy group intervention for refugee children who have experienced war-related trauma. Clin Child Psychol Psychiatry. 2005;10(2):235–50.
26.
go back to reference Sarkadi A, Ådahl K, Stenvall E, Ssegonja R, Batti H, Gavra P. Teaching recovery techniques: evaluation of a group intervention for unaccompanied refugee minors with symptoms of PTSD in Sweden. Eur Child Adolesc Psychiatry. 2018;27:467–79. Sarkadi A, Ådahl K, Stenvall E, Ssegonja R, Batti H, Gavra P. Teaching recovery techniques: evaluation of a group intervention for unaccompanied refugee minors with symptoms of PTSD in Sweden. Eur Child Adolesc Psychiatry. 2018;27:467–79.
27.
go back to reference Iasiello M, Van Agteren J. Mental health and/or mental illness: A scoping review of the evidence and implications of the dual-continua model of mental health.Evidence Base: A journal of evidence reviews in key policy areas. 2020(1):1–45. Iasiello M, Van Agteren J. Mental health and/or mental illness: A scoping review of the evidence and implications of the dual-continua model of mental health.Evidence Base: A journal of evidence reviews in key policy areas. 2020(1):1–45.
28.
go back to reference Durlak JA, DuPre EP. Implementation matters: a review of research on the influence of implementation on program outcomes and the factors affecting implementation. Am J Community Psychol. 2008;41(3):327–50.CrossRefPubMed Durlak JA, DuPre EP. Implementation matters: a review of research on the influence of implementation on program outcomes and the factors affecting implementation. Am J Community Psychol. 2008;41(3):327–50.CrossRefPubMed
29.
go back to reference Dane AV, Schneider BH. Program integrity in primary and early secondary prevention: are implementation effects out of control? Clin Psychol Rev. 1998;18(1):23–45.CrossRefPubMed Dane AV, Schneider BH. Program integrity in primary and early secondary prevention: are implementation effects out of control? Clin Psychol Rev. 1998;18(1):23–45.CrossRefPubMed
30.
go back to reference Berkel C, Mauricio AM, Schoenfelder E, Sandler IN. Putting the pieces together: an integrated model of program implementation. Prev Sci. 2011;12(1):23–33.CrossRefPubMedPubMedCentral Berkel C, Mauricio AM, Schoenfelder E, Sandler IN. Putting the pieces together: an integrated model of program implementation. Prev Sci. 2011;12(1):23–33.CrossRefPubMedPubMedCentral
31.
go back to reference Garvey C, Julion W, Fogg L, Kratovil A, Gross D. Measuring participation in a prevention trial with parents of young children. Res Nurs Health. 2006;29(3):212–22.CrossRefPubMed Garvey C, Julion W, Fogg L, Kratovil A, Gross D. Measuring participation in a prevention trial with parents of young children. Res Nurs Health. 2006;29(3):212–22.CrossRefPubMed
32.
go back to reference Baydar N, Reid MJ, Webster-Stratton C. The role of mental health factors and program engagement in the effectiveness of a preventive parenting program for Head Start mothers. Child Dev. 2003;74(5):1433–53.CrossRefPubMed Baydar N, Reid MJ, Webster-Stratton C. The role of mental health factors and program engagement in the effectiveness of a preventive parenting program for Head Start mothers. Child Dev. 2003;74(5):1433–53.CrossRefPubMed
33.
go back to reference Anagnostopoulos DC, Giannakopoulos G, Christodoulou NG. The synergy of the refugee crisis and the financial crisis in Greece: impact on mental health. Int J Soc Psychiatry. 2017;63(4):352–8.CrossRefPubMed Anagnostopoulos DC, Giannakopoulos G, Christodoulou NG. The synergy of the refugee crisis and the financial crisis in Greece: impact on mental health. Int J Soc Psychiatry. 2017;63(4):352–8.CrossRefPubMed
34.
go back to reference Unterhitzenberger J, Wintersohl S, Lang M, König J, Rosner R. Providing manualized individual trauma-focused CBT to unaccompanied refugee minors with uncertain residence status: a pilot study. Child Adolesc Psychiatry Ment Health. 2019;13(1):1–10.CrossRef Unterhitzenberger J, Wintersohl S, Lang M, König J, Rosner R. Providing manualized individual trauma-focused CBT to unaccompanied refugee minors with uncertain residence status: a pilot study. Child Adolesc Psychiatry Ment Health. 2019;13(1):1–10.CrossRef
35.
go back to reference Pfeiffer E, Sachser C, Tutus D, Fegert JM, Plener PL. Trauma-focused group intervention for unaccompanied young refugees:“Mein Weg”—predictors of treatment outcomes and sustainability of treatment effects. Child Adolesc Psychiatry Ment Health. 2019;13(1):18.CrossRefPubMedPubMedCentral Pfeiffer E, Sachser C, Tutus D, Fegert JM, Plener PL. Trauma-focused group intervention for unaccompanied young refugees:“Mein Weg”—predictors of treatment outcomes and sustainability of treatment effects. Child Adolesc Psychiatry Ment Health. 2019;13(1):18.CrossRefPubMedPubMedCentral
36.
go back to reference Lidén H, Aasen B, Seeberg ML, Staver AB. Fra bosetting til voksenliv: Den kommunale tjenestekjeden for enslige mindreårige flyktninger. Oslo, Norway: Institutt for samfunnsforskning; 2020. p. 1. Report No. Lidén H, Aasen B, Seeberg ML, Staver AB. Fra bosetting til voksenliv: Den kommunale tjenestekjeden for enslige mindreårige flyktninger. Oslo, Norway: Institutt for samfunnsforskning; 2020. p. 1. Report No.
37.
go back to reference Smith P, Perrin S, Dyregrov A, Yule W. Principal components analysis of the impact of event scale with children in war. Pers Individ Differ. 2003;34(2):315–22.CrossRef Smith P, Perrin S, Dyregrov A, Yule W. Principal components analysis of the impact of event scale with children in war. Pers Individ Differ. 2003;34(2):315–22.CrossRef
38.
go back to reference Perrin S, Meiser-Stedman R, Smith P. The Children’s revised impact of event scale (CRIES): Validity as a screening instrument for PTSD. Behav Cogn Psychother. 2005;33(4):487–98.CrossRef Perrin S, Meiser-Stedman R, Smith P. The Children’s revised impact of event scale (CRIES): Validity as a screening instrument for PTSD. Behav Cogn Psychother. 2005;33(4):487–98.CrossRef
39.
go back to reference Cantril H. Pattern of human concerns. 1965. Cantril H. Pattern of human concerns. 1965.
41.
go back to reference Levin KA, Currie C. Reliability and validity of an adapted version of the Cantril ladder for use with adolescent samples. Soc Indic Res. 2014;119(2):1047–63.CrossRef Levin KA, Currie C. Reliability and validity of an adapted version of the Cantril ladder for use with adolescent samples. Soc Indic Res. 2014;119(2):1047–63.CrossRef
42.
go back to reference Salari R, Malekian C, Linck L, Kristiansson R, Sarkadi A. Screening for PTSD symptoms in unaccompanied refugee minors: a test of the CRIES-8 questionnaire in routine care. Scand J Public Health. 2017;45(6):605–11.CrossRefPubMed Salari R, Malekian C, Linck L, Kristiansson R, Sarkadi A. Screening for PTSD symptoms in unaccompanied refugee minors: a test of the CRIES-8 questionnaire in routine care. Scand J Public Health. 2017;45(6):605–11.CrossRefPubMed
44.
go back to reference Bates D, Maechler M, Bolker B, Walker S. Fitting linear mixed-effects models using lme4. J Stat Softw. 2015;67(1):1–48.CrossRef Bates D, Maechler M, Bolker B, Walker S. Fitting linear mixed-effects models using lme4. J Stat Softw. 2015;67(1):1–48.CrossRef
45.
go back to reference Giannopoulou I, Dikaiakou A, Yule W. Cognitive-behavioural group intervention for PTSD symptoms in children following the Athens 1999 earthquake: a pilot study. Clin Child Psychol Psychiatry. 2006;11(4):543–53.CrossRefPubMed Giannopoulou I, Dikaiakou A, Yule W. Cognitive-behavioural group intervention for PTSD symptoms in children following the Athens 1999 earthquake: a pilot study. Clin Child Psychol Psychiatry. 2006;11(4):543–53.CrossRefPubMed
46.
go back to reference Meyer DeMott MA, Jakobsen M, Wentzel-Larsen T, Heir T. A controlled early group intervention study for unaccompanied minors: can expressive arts alleviate symptoms of trauma and enhance life satisfaction? Scand J Psychol. 2017;58(6):510–8.CrossRefPubMed Meyer DeMott MA, Jakobsen M, Wentzel-Larsen T, Heir T. A controlled early group intervention study for unaccompanied minors: can expressive arts alleviate symptoms of trauma and enhance life satisfaction? Scand J Psychol. 2017;58(6):510–8.CrossRefPubMed
47.
go back to reference Lykken D, Tellegen A. Happiness is a stochastic phenomenon. Psychol Sci. 1996;7(3):186–9.CrossRef Lykken D, Tellegen A. Happiness is a stochastic phenomenon. Psychol Sci. 1996;7(3):186–9.CrossRef
48.
go back to reference van Agteren J, Iasiello M, Lo L, Bartholomaeus J, Kopsaftis Z, Carey M et al. A systematic review and meta-analysis of psychological interventions to improve mental wellbeing.Nat Hum Behav. 2021:1–22. van Agteren J, Iasiello M, Lo L, Bartholomaeus J, Kopsaftis Z, Carey M et al. A systematic review and meta-analysis of psychological interventions to improve mental wellbeing.Nat Hum Behav. 2021:1–22.
49.
go back to reference Nickerson A, Bryant RA, Silove D, Steel Z. A critical review of psychological treatments of posttraumatic stress disorder in refugees. Clin Psychol Rev. 2010;31(3):399–417.CrossRefPubMed Nickerson A, Bryant RA, Silove D, Steel Z. A critical review of psychological treatments of posttraumatic stress disorder in refugees. Clin Psychol Rev. 2010;31(3):399–417.CrossRefPubMed
50.
go back to reference Helliwell JF, Layard R, Sachs JD, De Neve J-E, Aknin LB, Wang S, editors. World Happiness Report 2022. New York; 2022. Helliwell JF, Layard R, Sachs JD, De Neve J-E, Aknin LB, Wang S, editors. World Happiness Report 2022. New York; 2022.
51.
go back to reference Mueller J, Schmidt M, Staeheli A, Maier T. Mental health of failed asylum seekers as compared with pending and temporarily accepted asylum seekers. Eur J Public Health. 2011;21(2):184–9.CrossRefPubMed Mueller J, Schmidt M, Staeheli A, Maier T. Mental health of failed asylum seekers as compared with pending and temporarily accepted asylum seekers. Eur J Public Health. 2011;21(2):184–9.CrossRefPubMed
52.
go back to reference Nickerson A, Steel Z, Bryant R, Brooks R, Silove D. Change in visa status amongst Mandaean refugees: relationship to psychological symptoms and living difficulties. Psychiatry Res. 2011;187(1–2):267–74.CrossRefPubMed Nickerson A, Steel Z, Bryant R, Brooks R, Silove D. Change in visa status amongst Mandaean refugees: relationship to psychological symptoms and living difficulties. Psychiatry Res. 2011;187(1–2):267–74.CrossRefPubMed
53.
go back to reference Smith P, Dyregrov A, Yule W. Teaching recovery techniques adolescent unaccompanied minors. Bergen, Norway: Children and War Foundation; 2020. Smith P, Dyregrov A, Yule W. Teaching recovery techniques adolescent unaccompanied minors. Bergen, Norway: Children and War Foundation; 2020.
54.
go back to reference Bath H. The three pillars of trauma-informed care. Reclaiming Child Youth. 2008;17(3):17–21. Bath H. The three pillars of trauma-informed care. Reclaiming Child Youth. 2008;17(3):17–21.
55.
go back to reference Silove D, Ventevogel P, Rees S. The contemporary refugee crisis: an overview of mental health challenges. World J Psychiatry. 2017;16(2):130–9.CrossRef Silove D, Ventevogel P, Rees S. The contemporary refugee crisis: an overview of mental health challenges. World J Psychiatry. 2017;16(2):130–9.CrossRef
Metadata
Title
Changes in life satisfaction among unaccompanied asylum-seeking and refugee minors who participated in teaching recovery techniques (TRT)
Authors
Anne Kristine Solhaug
Espen Røysamb
Brit Oppedal
Publication date
01-12-2023
Publisher
BioMed Central
Published in
Child and Adolescent Psychiatry and Mental Health / Issue 1/2023
Electronic ISSN: 1753-2000
DOI
https://doi.org/10.1186/s13034-023-00595-x

Other articles of this Issue 1/2023

Child and Adolescent Psychiatry and Mental Health 1/2023 Go to the issue