Refugees and asylum seekers are exposed to multiple burdensome experiences and suffer from ongoing post-migration stressors that are known to affect the physical and mental health. In psychological treatment offered to refugees and asylum seekers, dropout is an important challenge. The current practice-oriented review aims to provide for the first time knowledge on the prevalence, prediction and prevention of dropout in psychological treatment for refugees and asylum seekers. Due to the limited empirical evidence for this specific population, we synthesized refugee-specific research but also reviewed the existing evidence on dropout from treatment in general and specifically discuss how the findings can be adapted to refugee populations. The review integrates literature from online databases, grey literature, hand search and expert contacts. Prevalence rates of dropout from psychological treatment in Western samples are reported at about 20%. For refugees and asylum seekers, evidence from single efficacy trials showed considerable variability in dropout rates (0%–64.7%). Further, for refugees and asylum seekers, specific sociodemographic variables, high initial impairment, deviating expectations and perceptions of mental health and psychological treatment, as well as external barriers seem to be important predictors for dropout. To prevent dropout, it is important to develop and promote cultural competencies, adapt the treatment to refugee-specific needs and focus on role induction, preparation for treatment, fostering the therapeutic alliance and strengthening hope. Future specific research on dropout in treatment offered to refugees and asylum seekers is needed.

中文翻译：

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预测和预防难民研究、评估和治疗中的辍学

难民和寻求庇护者面临多重繁重的经历，并遭受着已知会影响身心健康的持续移民后压力。在为难民和寻求庇护者提供的心理治疗中，辍学是一个重要的挑战。目前以实践为导向的审查旨在首次提供有关难民和寻求庇护者心理治疗辍学率、预测和预防的知识。由于针对这一特定人群的经验证据有限，我们综合了针对难民的研究，但也回顾了一般治疗中辍学的现有证据，并具体讨论了如何使研究结果适应难民人群。该评论整合了来自在线数据库、灰色文献、手动搜索和专家联系的文献。据报道，西方样本中心理治疗的辍学率约为 20%。对于难民和寻求庇护者，来自单一功效试验的证据显示辍学率存在很大差异（0%–64.7%）。此外，对于难民和寻求庇护者来说，特定的社会人口变量、高初始损伤、对心理健康和心理治疗的期望和认知偏差以及外部障碍似乎是辍学的重要预测因素。为防止辍学，重要的是发展和促进文化能力，使治疗适应难民的具体需求，并专注于角色引导、治疗准备、培养治疗联盟和增强希望。未来需要对提供给难民和寻求庇护者的治疗辍学进行具体研究。