Interventions for Children Affected by War

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. Aims—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. ©2013 President and Fellows of Harvard College Correspondence: Theresa S. Betancourt, ScD, MA, Department of Global Health and Population, Harvard School of Public Health, 651 Huntington Ave., Boston, MA 02115. [email protected]. Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article. NIH Public Access Author Manuscript Harv Rev Psychiatry. Author manuscript; available in PMC 2014 July 15. Published in final edited form as: Harv Rev Psychiatry. 2013 ; 21(2): 70–91. doi:10.1097/HRP.0b013e318283bf8f. N IH -P A A uhor M anscript N IH -P A A uhor M anscript N IH -P A A uhor M anscript 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.