Culturally Grounded Group-Based Trauma Interventions for Refugees: A Systematic Review

Background: Refugees within the post-migration context experience higher rates of mental health symptoms due to a variety of pre- and post-migration factors. These include exposure to war, violence, forced displacement, family separation, loss, and chronic stressors related to resettlement such as social isolation, language barriers, economic hardship, and limited access to culturally and linguistically appropriate care. However, there is a lack of research in understanding best practices in culturally grounded interventions aimed at improving well-being outcomes. Traditional mental health services often rely on individualized, Western-oriented models of treatment that may not align with the cultural values, lived experiences, or healing preferences of refugee communities. Recent research shows group interventions are a potential pathway to mental health treatment for refugees.

Methods: This systematic review aimed to assess best practices among group-based interventions within the refugee context, provide guidance on best practices within group-based interventions for this population, and examine the impact of group-based interventions on the mental health outcomes of adult refugees in the post-migration context in high-income countries. A systematic literature search was conducted. A total of 2,243 studies were identified, with 19 meeting the inclusion criteria to be from a peer-reviewed journal article; published from 2003 to 2023; written in English; have a study population of refugees in the post-resettlement context in a high-income country; include a group-based intervention model; and be quantitative or mixed methods. Extracted data focused on intervention structure, therapeutic modality, group composition, cultural adaptations, facilitation approaches, and mental health outcomes. Methodological quality was also assessed to better contextualize findings.

Results: Results demonstrated that group-based interventions improve mental health symptoms, including post-traumatic stress disorder, depression, and anxiety. Additional positive outcomes reported across some studies included improved quality of life, reduced distress, and enhanced well-being. Interventions varied widely in format and included modalities such as cognitive behavioral therapy, culturally adapted cognitive behavioral therapy, psychoeducation, mindfulness-based interventions, EMDR group protocols, and other multimodal or community-based approaches. Studies also varied on their use of culturally grounded mechanisms in developing and implementing interventions. Some interventions incorporated strong cultural adaptation through community collaboration, shared language, gender-specific groups, ethnically or linguistically matched participants, and use of facilitators or interpreters familiar with participants’ cultural contexts. Others provided only limited detail on cultural tailoring. Across studies, group-based interventions were frequently justified as a way to increase social connectedness, improve engagement, and offer a more culturally congruent and accessible model of care for refugee communities.

Conclusions: Future research is needed to understand the longitudinal impacts of group-based interventions on mental health and better support current practices to facilitate access to intervention implementation. More rigorous and methodologically consistent studies are needed, particularly those with larger sample sizes, longer follow-up periods, and clearer reporting of intervention design and cultural adaptation processes. Findings suggest that group-based interventions are a promising and potentially culturally responsive approach to supporting refugee mental health in high-income post-resettlement settings, but stronger evidence is needed to identify which intervention components are most effective, for whom, and under what conditions.