Mechanisms | Cited reviews | Outcomes | Evidence Quality | |
---|---|---|---|---|
Basic services and security | ||||
1 | Creating safety and protection from harm | Ager et al. [17] | Protection outcomes (sense of safety, exual exploitation and rape, physical injuries, referrals, reporting); social and emotional wellbeing | Low: Program evaluations |
2 | Playing | Resilience; wellbeing; self-confidence; emotional regulation | Low: Case or cross-sectional studies | |
Strengthening family and community support | ||||
3 | Community capacity building | Apfel and Simon [1]; Ager et al. [17]; Peltonen & Punamäki [6] | Knowledge of protection systems; sense of order and sanity; PTSD; improved psychosocial wellbeing | Low: Program evaluations |
4 | Increasing social support | Resilience; PTSD; improved psychosocial wellbeing | Low: Program evaluation and clinical experience | |
5 | Family and caregiver capacity building | Ability of caregivers to provide consistent and reliable care; depression; PTSD; anxiety symptoms; hope | High: Statistical testing of mechanism | |
6 | Family and caregiver relationship strengthening. | Apfel and Simon [1]; Betancourt et al. [14]; Jordans, Pigott and Tol [36] | Further traumatic experience; psychosocial functioning; mental health; maternal mental health; depression; PTSD; anxiety symptoms; hope | High: Statistical testing of mechanism |
7 | Engaging with values, traditions, religious and non-religious beliefs, and ideologies | Apfel and Simon [1]; Betancourt et al. [14]; Tol, Song and Jordans [11] | Morale and healing; maintaining the right to be alive despite suicidal despair; drive to survive; community and personal restitution; empowerment; reintegration into communities; wellbeing | Low: Qualitative studies or clinical experience |
Focused non-specialist support | ||||
8 | Learning about the presenting problem, medication, and how to access services (psychoeducation) | Betancourt et al. [14] | Medication compliance; access to services; distress | Moderate: Statistic testing but of intervention not mechanism |
9 | Learning stress management skills | Peltonen & Punamäki [6] | PTSD; psychosocial wellbeing | Moderate: Statistic testing but of intervention not mechanism |
10 | Emotional regulation and bearing negative emotions | Chances of survival; resilience | Low: Program evaluation and clinical experience | |
11 | Problem solving | Jordans, Pigott and Tol [36] | Depression; PTSD; anxiety symptoms; hope | High: Statistical testing of mechanism |
 12 | Learned helpfulness | Helplessness; wellbeing | Moderate: Statistical testing but of intervention not mechanism | |
Specialist support | ||||
13 | Adverse mechanism: Pathologising normal reactions | Apfel and Simon [1] | Alienating participants | Low: Clinical experience |
14 | Trauma processing through narratives, exposure, dreaming or play | Apfel and Simon [1]; Betancourt et al. [14]; Jordans, Pigott and Tol [36]; Peltonen & Punamäki [6] | Memory integration; PTSD; depression; PTSD; anxiety symptoms; hope; psychosocial wellbeing | Moderate: Statistical testing but of intervention not mechanism |
15 | Restructuring unhelpful cognitions and appraisals | Peltonen & Punamäki [6] | PTSD; psychosocial wellbeing | Moderate: Statistical testing but of intervention not mechanism |
16 | Therapeutic rapport | Jordans, Pigott and Tol. [36] | PTSD; anxiety symptoms; hope | High: Statistical testing of mechanism |