School of Behavioral Sciences


Doctor of Education in Community Care and Counseling (EdD)


Daniel Marston


Refugees, Children, Adolescents, Expressive Therapies, Trauma


Counseling | Social and Behavioral Sciences


Millions of displaced families are seeking refuge in countries that are not their own due to war, violence, persecution, political unrest, and natural disasters. This global crisis is forcing researchers and practitioners to consider how refugees are coping with trauma associated with their migration process. Effective therapeutic approaches are needed in a global effort to address the traumatic impact of forced migration. This meta-analytical study investigates the effectiveness of expressive therapeutic modalities, including play, art, music, sandplay, theatre, and writing therapies, in helping children and adolescents cope with refugee trauma. A theoretical understanding of the neurobiological and human ecosystemic frameworks conceptualizes both the impact of trauma on human development and the appropriate responses to this impact. These frameworks motivate this study’s exploration of expressive therapies. Seventeen pre-post and between group comparison studies were analyzed using a random effects model. The combined effect size for pre-post comparisons was medium (g = 0.58); whereas the combined effect size for between-group comparisons was small (g = 0.32). Overall, art therapy was found to be most effective in treating stress symptoms. Heterogeneity tests, however, suggest effect sizes cannot be interpreted meaningful due to substantial variance. Nevertheless, findings of this meta-analysis indicate that expressive therapies may be among beneficial modalities to integrate with other trauma-informed approaches.

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