The relation between post-migration stressors and trauma treatment outcomes: a scoping review

Background: People seeking refuge and asylum must often endure diverse adversities before, during, and after migration, making them more susceptible to develop psychological problems. The effect of post-migration stressors on responsiveness to psychological treatment is unclear.Objectives: To: (1) evaluate the scope of the literature on the relation between post-migration stressors (e.g. struggles related to legal status in the context of resettlement) and outcomes of interventions targeting PTSD and comorbid conditions, in adult refugees and asylum seekers; (2) identify conceptual and methodological limitations of the literature; and (3) present limitations and recommendations for future research.Methods: This review follows the guidelines of PRISMA-ScR for Scoping Reviews, and the Population, Concept, and Context (PCC) framework for identifying concepts pertaining to the review question and the search strategy.Results: From 1,151 studies found through PsycINFO, PubMed, Web of Science Select, and review of sources, we assessed the 14 studies that fulfilled our criteria and found various post-migration barriers and facilitators of treatment success. Obtaining a more secure immigration status, reported in four studies, was the most emphasized factor associated with clinical improvement. Although the quality of the studies was overall high, there were frequent study limitations including small sample sizes and inconsistent post-stressor measures.Conclusion: Recommendations for future research include more robust methodologies, including mixed and longitudinal designs, and consistently using valid tools to assess post-migration stressors. The studies provide evidence for the effectiveness of psychological treatment in reducing symptoms of distress, despite being implemented in the context of post-migration stress. Post-migration stressors, although they may hamper treatment results, are not an indication to withhold treatment but a sign that additional services may be needed, but uniform and consistent evaluation of post-migration stressors should be implemented.