Dropout from psychological interventions for refugees and asylum seekers: A meta-analysis.

BACKGROUND: Refugees and asylum seekers often suffer from migration stressors and related psychopathology. However, providing this population with psychological treatment has a number of barriers (e.g., culture and language differences), which are widely thought to hinder the success and continuation of treatment. OBJECTIVE: The current systematic review and meta-analysis aims to provide first comprehensive evidence on the prevalence and predictors of dropout in treatment provided for refugees and asylum seekers. METHOD: We synthesized the existing evidence on dropout from psychological and psychosocial interventions provided to adult refugees and asylum seekers resettled in high-income countries. Specifically, we meta-analyzed the prevalence of dropout from treatment and explored the factors that predict dropout. Our database search in Pubmed, PsycINFO, Web of Science, and PTSDpubs identified 28 eligible randomized controlled trials (RCTs; 2,691 participants; 39 active treatment conditions), published up to January 31, 2021. RESULTS: Results showed a weighted average dropout rate of 19.14%, 95% confidence interval 14.66, 24.60 across studies and treatment conditions. Subgroup analyses and meta-regressions revealed no statistically significant predictors for dropout. However, several refugee-specific variables (e.g., longer mean duration in country of resettlement, lower rate of insecure asylum status) may merit closer attention in future research. CONCLUSIONS: These findings suggest that, in contrast to widespread assumption, the estimated average dropout rate is comparable to those reported in nonrefugee populations. However, more research is needed to establish the underlying mechanisms of dropout, which may differ across populations. (PsycInfo Database Record (c) 2021 APA, all rights reserved).