Acceptability of Psychosocial Interventions for Refugees and Asylum Seekers: A Systematic Literature Review

Abstract

Acceptability is a vital component of psychosocial interventions, separate from (but related to) efficacy, and includes the attitudes, feelings, and thoughts of clients and therapists about the appropriateness of (and anticipated response to) an intervention. This systematic review summarized the evidence regarding acceptability of psychosocial interventions for people adults seeking refuge (i.e., refugees, asylum seekers, and internally displaced people who were at least 18 years old). We conducted a mixed-methods systematic review of acceptability, measured quantitatively (e.g., dropout, attendance) and qualitatively (e.g., client and therapist attitudes, cultural appropriateness). Cochrane procedures were utilized for conducting the systematic review, meta-analysis, and thematic analysis. The search strategy resulted in the identification of 102 studies (n > 8983 participants). Meta-analyses of quantitative data revealed a mean dropout rate of 16.9% and a mean attendance rate of 84.1% from a variety of psychosocial interventions. Thematic analysis of qualitative data generated seven themes; (a) openness and closeness, (b) presence and care, (c) somatic focus, (d) flexibility, (e) sensitivity towards gender and culture, (f) limiting discussion of trauma, and (g) conflicting priorities (i.e., relocation, work demands, transport difficulties, health issues, etc.). This review synthesized available data and highlighted important findings related to acceptability. These findings may be utilized in the provision of interventions for refugees and will aid in therapists adjusting their practice to improve its acceptability for this part of our population.