A systematic review and meta-analysis of psychosocial interventions for 6–12-year-old children who have been forcibly displaced Concettina Trimboli a, * , Lauren Parsons a , Caroline Fleay b , Dave Parsons a , Angus Buchanan a a Curtin School of Allied Health, Curtin University, Kent Street, Bentley, Australia b Centre for Human Rights Education, Curtin University, Kent Street, Bentley, Australia ARTICLE INFO Keywords: Psychosocial Interventions Children Forced displacement Humanitarian ABSTRACT Background: Children who have been forcibly displaced are likely to experience psychosocial challenges given they may be dealing with past trauma and challenges of adapting to their new environment. Effective psycho- social interventions are needed to promote psychosocial wellbeing. Literature identifies the ages of 6–12 years (middle childhood), as key to addressing psychosocial development. To date, systematic reviews identifying effective psychosocial interventions for children have focused on adolescents. Aim: We conducted a systematic review and meta-analysis to: 1) identify psychosocial interventions conducted in middle childhood with forcibly displaced children; 2) summarize the characteristics of the included interventions; 3) identify the methodological quality of the studies; and 4) identify effectiveness of the interventions. Method: A comprehensive literature search was conducted across four databases and supplementary literature. Study design was classified according to the National Health and Medical Research Council Hierarchy of Evi- dence. Methodological quality was assessed using the QualSyst appraisal checklist. Intervention approaches were classified into activity codes using the ‘Who is Where When doing What’ (4Ws) tool. Intervention effects were explored through meta-analysis. Results: Nineteen studies with 2386 children met the eligibility criteria. A total of 19 intervention approaches were identified. The interventions found to be most promising were Narrative Exposure Therapy for children and adolescents (KidNET), Cognitive Behavioural Therapy, Child-Centred Play Therapy, Eye Movement Desensitiza- tion and Reprocessing, and creative interventions. Unstructured play or education alone did not produce a beneficial intervention effect. Conclusions: Middle childhood presents a unique opportunity to address psychosocial wellbeing with forcibly displaced children. While psychological-based activities in this review demonstrated effectiveness for symptom reduction, future intervention options should expand to include strengths- and resilience-based. Further research evaluating the effectiveness of psychosocial intervention for forcibly displaced children is required using rand- omised control designs, greater sample sizes, and longitudinal data. 1. Introduction Addressing the needs of children who have been forcibly displaced is a growing concern. The United Nations High Commissioner for Refugees (UNHCR) estimated that at the end of 2020, 35 million children below 18 years of age had been forcibly displaced (UNHCR, 2021). Of interest to this study are children who have been forcibly displaced as per the United Nation's definition, which includes refugees (United Nations General Assembly; UNGA, 1951), asylum seekers (UNHCR, 2016), or those who have been internally displaced due to the effects of armed conflict, situations of generalized violence, and human rights (UN, 1998). There is considerable evidence that children who have been forcibly displaced are at significant risk of developing psychosocial problems due to the stressors that they may have been exposed to during displacement and resettlement, including violence, food insecurity, challenges of accessing health care and education, inadequate or unstable housing, and discrimination or bullying, which can make them vulnerable to a range of mental health and psychosocial problems (Fazel, Reed, Panter-Brick, & Stein, 2012; WHO, 2018). A recent systematic review of refugee and asylum seeker children in Europe reported prevalence rates of 19–53% for Post-Traumatic Stress Disorder (PTSD), 10–33% for depression, 9–32% for anxiety, and 20–35% for emotional and behavioural problems * Corresponding author. E-mail address: c.trimboli@postgrad.curtin.edu.au (C. Trimboli). Contents lists available at ScienceDirect SSM - Mental Health journal homepage: www.journals.elsevier.com/ssm-mental-health https://doi.org/10.1016/j.ssmmh.2021.100028 Received 22 March 2021; Received in revised form 20 August 2021; Accepted 29 September 2021 Available online 14 October 2021 2666-5603/Crown Copyright © 2021 Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/ by-nc-nd/4.0/). SSM - Mental Health 1 (2021) 100028