School-based psychosocial interventions for refugee and conflict-affected adolescents in Middle Eastern countries: a systematic review and meta-analysis.

BACKGROUND

This study evaluated the effectiveness of school-based psychosocial interventions for conflict-affected adolescents in the Middle Eastern countries.

METHODS

We searched PubMed, Scopus, and Web of Science from inception to August 2025 for studies evaluating school-based interventions targeting mental health outcomes in refugee adolescents in Middle East. Eligible studies included randomized controlled trials, cohort studies, and pre-post intervention designs. Random-effects meta-analyses were conducted for single-arm (pre-post) and double-arm (intervention versus control) comparisons, using R programming for statistical analysis.

RESULTS

Nine studies involving predominantly Syrian, Palestinian, and Afghan refugee adolescents met the inclusion criteria. Single-arm analyses demonstrated significant reductions in post-traumatic stress disorder (PTSD) symptoms [mean raw score change (MRAW) = -7.50, 95% confidence interval (CI): -10.53 to -4.46], anxiety (MRAW = -9.33, 95% CI: -16.43 to -2.23), and emotional-behavioral difficulties (MRAW = -2.21, 95% CI: -3.20 to -1.22). Double-arm analyses showed significant effects for PTSD/stress [standardized mean difference (SMD) = -0.63, 95% CI: -1.26 to -0.001] and emotional-behavioral difficulties (SMD = -3.47, 95% CI: -6.55 to -0.40), but not for depression or anxiety when compared with controls.

CONCLUSIONS

School-based psychosocial interventions demonstrate effectiveness in reducing trauma-related symptoms and improving emotional regulation among conflict-affected adolescents in Middle Eastern contexts, although substantial heterogeneity warrants cautious interpretation. While findings support their potential integration into humanitarian education programming, conclusions should be considered in light of variability in study design and populations.