A Systematic Review and Network Meta-Analysis of the Effectiveness of Psychological and Psychosocial Interventions for Reducing Posttraumatic Stress, Anxiety, or Depression Among Immigrant and Refugee Children and Youth

Immigrant and refugee children and youth are at heightened risk for posttraumatic stress disorder (PTSD), anxiety, and depression, yet the comparative efficacy of psychological and psychosocial interventions remains unclear. This systematic review and network meta-analysis evaluated interventions for reducing these outcomes among immigrant and refugee children and youth. Eligible studies included randomized and non-randomized trials of psychological or psychosocial interventions with comparison conditions and pre-post measures of PTSD, anxiety, or depression. Thirty studies met inclusion criteria. Random-effects network meta-analyses were conducted using standardized mean differences (SMDs). Twelve intervention categories were identified across clinical, school, community, and humanitarian settings. For PTSD symptoms, narrative exposure therapy (SMD = 1.69, 95% CI [0.75, 2.64]), eye movement desensitization and reprocessing (EMDR; SMD = 1.67 [0.83, 2.50]), cognitive-behavioral therapy (CBT; SMD = 1.20 [0.56, 1.83]), and integrative therapies (SMD = 0.92 [0.24, 1.60]) were significantly more effective than inactive controls. For anxiety symptoms, EMDR (SMD = 0.82 [0.24, 1.41]), CBT (SMD = 0.67 [0.19, 1.14]), and crisis management (SMD = 0.63 [0.14, 1.12]) showed significant effects relative to inactive controls. For depression, no intervention demonstrated a statistically significant advantage over inactive control, although several interventions showed positive estimates with substantial uncertainty and heterogeneity. Findings support trauma-oriented interventions for reducing PTSD and anxiety symptoms, while evidence for depression remains limited and inconsistent.