Abstract
Global conflicts and wars can have catastrophic impacts on children’s social-emotional and learning outcomes, which require evidence-based interventions to help mitigate these traumatic and educational effects. This scoping review aimed to identify approaches designed to support students and/or teachers and parents/caregivers in educational contexts when students have been exposed to war or global conflict. Following the PRISMA approach for conducting systematic reviews and using keywords under categories of “Trauma,” “War,” and “School,” a total of 41 articles were identified. Results revealed that the most common types of interventions provided to students included manualised psychological programmes (n = 19) and arts-based interventions (n = 19), followed by storying (n = 14) and providing students with psychosocial support (n = 14). Other programme types included culturally-informed programmes (n = 8) and sport and movement-based approaches (n = 7). Most interventions focused on supporting the psychosocial well-being of students (n = 27), with fewer programmes focused on supporting teachers (n = 14) and parents/caregivers (n = 4). However, support provided to teachers and parents/caregivers was typically aimed at improving student well-being, rather than directly addressing the well-being needs of the adults themselves. The challenges and limitations of these approaches were identified, and implications have been suggested for practice, policy, and research. Greater awareness and application of multi-tiered trauma-informed approaches to support students exposed to war and conflict, and their teachers and parents/caregivers are required.
Introduction
Children living in areas affected by war and conflict are commonly exposed to large-scale social disruption and traumatic events, with millions experiencing direct violence, displacement, and loss (ISSOP Migration Working Group [ISSOP], 2018). In 2023, globally, there were an estimated 114 million people displaced due to war, violence, and persecution, with around 40% of these being children (United Nations Office of the High Commissioner for Refugees [UNHCR], 2023a). Due to the Ukrainian war alone, an estimated 2.5 million children (almost half the country’s school-aged population) have been displaced from their homes and are now living in other European countries (United Nations Office of the High Commissioner for Refugees [UNHCR], 2023b). In regions such as Syria, Yemen, Afghanistan, Iraq, parts of Africa, and South America, children have been subject to ongoing conflict, with millions of children worldwide affected by physical and sexual violence, abduction, loss of family members, destruction of housing, exploitation, and loss of safety (ISSOP, 2018). Along with profound challenges to their mental and emotional well-being, youth exposed to war and armed conflict face significant educational disadvantages and school non-completion (Aghajafari et al., 2020; UNHCR, 2023b).
Children exposed to war and conflict experience higher rates of anxiety, depression, and posttraumatic stress disorder (PTSD) compared to other children (Badri et al., 2020; Scherer et al., 2020). Vasic et al. (2021) found 53% of youth living in two refugee centres in Serbia displayed PTSD symptomology and increased substance use, particularly youth with limited years of education. Youth exposed to war often experience disrupted education, either through loss of access to educational opportunities or damage to educational infrastructure (Haque et al., 2022). To improve access to education among youth exposed to war, many countries develop legal frameworks to protect the rights of all children to education (Dupuy et al., 2022). However, children exposed to war continue to face significant barriers to education, with less than half consistently attending school (UNHCR, 2023b). Barriers can be due to complications from relocation to another country, such as language barriers where the child does not speak the language of the host country, differences in education curricula across countries, children lacking documentation to show their current academic achievement, and delays accessing education because of the uncertainty of war (Aydin & Kaya, 2019; Graham et al., 2016; Stermac et al., 2013; UNHCR, 2023b). Children who continue to reside in their own country also face a number of barriers to education including school closure or damage, school evacuation or relocation, and family or teacher displacement (Muthanna et al., 2022).
The long-term education implications for children exposed to war include loss of post-school work opportunities, delayed entry into tertiary education, altered work and career trajectories in adulthood, and intergenerational poverty (McLean Hilker, 2011). These long-term effects can also impact a country’s capacity to recover from and be resilient to future conflicts (McLean Hilker, 2011). An educated population plays a critical role in rebuilding countries following war, including promoting economic growth, political stability, social cohesion, and fostering long-term peace (Rasheed & Munoz, 2016). When educational systems are disrupted by war and conflict, the workforce is underprepared, governance can remain weak, and countries may have reduced capacities to address and prevent future conflicts (Runde et al., 2023). This highlights the critical importance of prioritising education in post-conflict recovery efforts (Rasheed & Munoz, 2016).
The concept of trauma-informed education has gained significant traction in recent years, with schools being identified as well-placed to provide support to young people exposed to trauma (Willis & Nagel, 2015; Winkler et al., 2015). Trauma-informed education involves creating a safe and supportive learning environment by understanding, recognising, and responding to the effects of trauma on students (Baker & Naidoo, 2024; Barrett & Berger, 2021; Ciaccia & John, 2016). This includes creation of safe learning spaces for students, training for staff and teachers to improve their knowledge and skills to address student trauma, and educational policies that focus on supporting students, and sometimes teachers and parents/caregivers, exposed to trauma (Ritblatt & Hokoda, 2023). However, researchers have found that teachers regularly experience challenges to implementing trauma-informed practices with students exposed to trauma. These challenges include limited professional development, inadequate school policies, and greater burnout and secondary trauma as a result of responding to students impacted by trauma (Berger & Nott, 2024).
Teachers commonly report having limited education and professional development specific to supporting students affected by war and trauma (Aydin & Kaya, 2019; Barrett & Berger, 2021; Toros et al., 2024). In addition, studies have found that school policies fail to recognise the additional barriers that students displaced by war often experience, such as linguistic difficulties, which may impact appropriate delivery and outcomes of trauma-informed programmes in schools (Aydin & Kaya, 2019; Blanchet-Cohen et al., 2017). While there have been prior literature reviews on trauma-informed practices within educational contexts, they have tended to be general in scope and not specific to conflict or war-affected youth (Aghajafari et al., 2020; Avery et al., 2021; Maynard et al., 2019). This includes a protocol for an upcoming umbrella review on trauma-informed interventions in schools (McGraw et al., 2022), which is likely to omit relevant studies due to the lack of war-related search terms. Furthermore, there are existing reviews on interventions to support children and youth affected by conflict and war (Brown et al., 2017; Bürgin et al., 2022), however these reviews are not specific to educational settings. A recent review of trauma interventions to support students exposed to interpersonal violence did include students exposed to violence in the context of war, however unlike the current review, this study excluded students’ experiences of war without interpersonal violence (Wichmann et al., 2023). In the context of growing trauma-informed practice and trauma interventions in educational settings, there is a pressing need to systematically explore the existing literature on approaches and interventions within education to support students exposed to war and conflicts. It is also important to investigate trauma-informed approaches for teachers and parents/caregivers given their central role in supporting students impacted by trauma.
Research Aims and Questions
The general aim of this scoping review was to explore extant research on trauma-informed approaches and trauma interventions in education to support students affected by war and conflicts, and/or their teachers and parents/caregivers. The aim was to include both trauma-informed and trauma intervention literature given that both terms are often used interchangeably in educational literature. In addition, contemporary trauma-informed school models often include both universal trauma-informed support for all students, as well as targeted trauma interventions for students affected by trauma (Berger, 2019; Dorado et al., 2016). This study was guided by the following three research questions:
What approaches are used in education to support students exposed to war and global conflicts, and/or their teachers and parents/caregivers?
What are the characteristics of approaches used in education to support students exposed to war and global conflicts, and/or their teachers and parents/caregivers?
What outcomes have been observed for students, teachers, and/or parents/caregivers as a result of implementation of programmes for war and conflict-exposed students.
This review is intended to provide foundations for the development of effective and targeted trauma-informed educational strategies that support students affected by war and global conflict. By doing so, it seeks to provide teachers, policymakers, practitioners, and researchers with a comprehensive understanding of how to support the emotional well-being of students from conflict-affected regions.
Method
Contrary to systematic literature reviews where specific and clearly defined review questions are examined, a scoping review method is chosen to understand the scope and volume of literature on specific research topics that have not been explored extensively (Munn et al., 2018). This scoping review was conducted in accordance with the Preferred Reporting for Systematic Reviews and Meta-Analysis (PRISMA-ScR) guidelines for scoping reviews (Tricco et al., 2018).
Search Strategy
A scoping literature search was performed in January 2024 to include literature published from 2013 till date (2024) in five databases: Embase, PsycINFO, Medline, ERIC, and Scopus. Peer-reviewed articles in English were sourced to capture contemporary evidence. Search terms were developed by the authors in consultation with an experienced librarian who consulted on the methodology and appropriate MESH terms. A search strategy targeted three concepts using synonyms for: “trauma-informed,” “war or global conflict,” and “education” (see Supplemental Table S1). The preliminary search was based on title, abstract, and keywords, using Boolean logic to combine different search terms. Different terms were used in each database for proximity searching. For example, “ADJ” (adjacent) was used in Ovid databases, including Medline, PsycINFO, and Embase, “NEAR” was used in ERIC, and “w/n” (within) was used in Scopus. These proximity searches were used to identify articles using terms that appeared near each other (e.g., traumaADJ3informed). The search was tested using a gold set of five eligible articles to ensure rigour of the search. Additionally, potentially relevant articles were identified by screening the reference lists of all included articles.
Inclusion and Exclusion Criteria
Articles were eligible for review if they (a) described, discussed, or examined an approach or intervention delivered in education across a range of settings (i.e., early childhood, primary school, secondary school, high school, online, refugee camps), and (b) aimed to support students exposed to war or global conflicts, including refugee and migrant children. It is notable that educational settings were not restricted to schools; education provided in other contexts, such as refugee camps or online platforms for children affected by war, were also included. The review was also not restricted by age range of students, given that the age of school attendance can differ between countries. The terms “student” and “child(ren)” are used interchangeably to refer to minors of school age, as defined by the studies included in this review. Study design was not restricted to capture all available literature in this area. For example, qualitative studies, experimental studies, cross-sectional studies, and mixed methods studies were all eligible for inclusion. The only articles excluded from this review were existing review articles. Articles were also excluded if they (a) did not focus on supporting students exposed to war or global conflict, (b) the approach was not implemented in the educational context (e.g., therapy provided by psychologists in clinical settings), and (c) the article was not subject to peer review (e.g., grey literature, dissertations). Articles were eligible for inclusion if they focused on supporting students directly (e.g., delivery of a psychosocial programme with students) and/or indirectly (e.g., delivery of professional development programme to teachers to improve how they support students).
Review Procedure and Data Extraction
As shown in the PRISMA chart (Figure 1), after removing duplicates, 3,389 records were screened at the title and abstract level for potential inclusion against the criteria. All records were independently screened by two reviewers using Covidence software. Any discrepancies between the two reviewers were settled through discussion and agreement. A total of 239 papers were then independently read in full by two authors to assess eligibility for inclusion. Any discrepancies were again resolved through consultation between the two reviewers. A total of 41 articles were included in the scoping review.
PRISMA chart.
Data were extracted from each included study by two authors. Extracted data (where available) included (a) study characteristics (e.g., year of publication, geographical location, study setting, and study design [including rating of the evidence based on NHMRC guidelines]), (b) programme/approach description and components (e.g., programme name, skills targeted, format, frequency, and programme length), (c) participants (e.g., sample size, mean age in years, gender, ethnicity, and socioeconomic status), (d) study measures used, and (e) intervention outcomes. Bias due to publication distortion can be a concern when conducting evidence reviews. The authors worked to mitigate the risk of publication distortion by having two authors review articles and extract data. The review also included all types of studies (e.g., qualitative and quantitative) and sought to report all findings (including unexpected or unsupported results) from the included studies.
Results
Characteristics of Included Articles
Forty-one articles were included in this scoping review. The characteristics of each article are outlined in Table 1. The numbers presented in brackets below correspond to the reference number for each study listed in Table 1.
Critical Findings on Study Characteristics.
Note. Articles above were arranged by year of publication in descending order. H = home country where the war and/or global conflicts occur; R = resettled country where refugee students were supported; C = child-level outcomes; T = teacher-level outcomes; P = parent-level outcomes; SEL = social and emotional learning; RCT = Randomised Control Trials.
Of the 41 included articles, 14 (34%) described the support provided for students in their home country where the war and/or conflict occurred [1, 3, 11–13, 18, 23, 29, 35–37, 39–41], and 27 articles (66%) focused on supporting refugee students in their resettled country [2, 4–10, 14–17, 19–22, 24–28, 30–34, 38]. Specifically, seven studies were conducted in the United States, five in Turkey and Australia, respectively, three in Canada and Israel, respectively, two in Bangladesh and Palestine, respectively, and one each in Gaza, the UK, Finland, Belgium, Sweden, Bosnia, Uganda, Jordon, Lebanon, Kosovo, Burundi, and Rwanda. One programme was conducted virtually and one was conducted with students in the United States and Germany. The studies drew on a combined sample of 7,141 students, with 12 articles not reporting the student sample size and two articles drawing on the same sample of students [25, 27]. The cultural diversity of students included those exposed to war in Gaza, Ukraine, Bangladesh, Africa, Bosnia, Afghanistan, Syria, Rwanda, Lebanon, Kosovo, Burundi, and Israel. Ten studies explicitly used trauma-informed terminology (e.g., trauma-aware, trauma-sensitive) [2, 3, 4, 8, 10, 14, 19, 21, 24, 33]. The remaining 31 articles described approaches aimed at supporting students exposed to war, including efforts in education settings to help refugee students heal from trauma [1, 5, 6, 7, 9, 11–13, 15, 16–18, 20, 22, 23, 25–32, 34–41].
Characteristics of Evidence
To differentiate the types of evidence provided in each study, we adopted the National Health and Medical Research Council (NHMRC, 2009) Levels of Evidence criteria. The NHMRC Levels of Evidence is a frequently used hierarchy to rate the quality of evidence from one (highest quality evidence) to a rating of four (lowest level of evidence). A rating of one is reserved for systematic reviews of Randomised Control Trials (RCTs) (I), two is assigned to RCTs (II), a rating of three is assigned to pseudorandomised controlled trials (III-1), comparative studies with concurrent controls (III-2), and comparative studies without concurrent controls (III-3), and a rating of four is allocated to case series with pre-post study design (IV). This review identified five RCTs, three pseudorandomised controlled trials, one comparative study without a concurrent control, and 13 articles which used a pre-post study design. Nineteen articles did not meet criteria as empirical research, including nine descriptive articles which merely described a programme, six qualitative studies, two protocol articles, and two feasibility studies (see Table 1).
Characteristics of the Approaches
The approaches captured in the present review have been grouped into two primary contexts: approaches delivered by professionals to support students exposed to war and/or global conflict in their home country (n = 14; 34%), and approaches delivered by professionals to support these students (e.g., war refugee students) in their resettled countries (n = 27; 66%). These two groupings have been used to provide specific recommendations, where available, for the different living circumstances of war-affected students. Under each of the context, the approaches have been further separated into three levels: interventions for students, parents, and teachers (See Supplemental Table S3a–c). Twenty-six of the approaches were designed to support students aged 5 to 17 who had been exposed to war and/or global conflict, four interventions were designed to support teachers, seven interventions were designed to support students and teachers, one intervention was designed to support students and parents/caregivers, two interventions were designed to support students, teachers, and parents/caregivers, and one intervention was designed to support teachers and parents/caregivers. No interventions were delivered only to parents/caregivers, without including students and/or teachers.
Students from diverse backgrounds were supported through the interventions delivered to students (n = 36 1 ), including children affected by the Ukrainian war, Bosnian war, conflicts in Northern Uganda, and rocket attacks in Israel. In students’ home country, the support primarily focuses on reducing students’ stress-related symptoms [1, 39, 40], enhancing their sense of safety [37], self-worth [3, 37], and resilience in crisis [13, 35, 36], and fostering students’ survival skills [29], peaceful values [18, 23, 39], gratitude [12], prosocial behaviour [35], psychological capacities [11, 29, 40], and quality of life (QoL) [39]. In the resettled country, support for students focused on helping them to process their displacement experience [15, 22], instil peace and hope [16, 23, 32], helping students to settle into a new country [20, 22, 33], fostering students’ sense of belonging [2], resilience [2, 5, 7, 9, 15, 25–27], psychological stress reduction and well-being [5, 6, 7, 9, 17, 27, 30, 31], cultural adaptation [4, 20, 33], language acquisition [21, 28, 33], and developing a range of social emotional competencies [14, 21, 24, 26, 34], self-expression [24], self-confidence [7, 25, 27], self-regulation [17], social skills [6, 7, 20], and prosocial behaviours [34] of students.
Initiatives also sought to support students indirectly through their teachers (n = 14 2 ) and parents (n = 4 3 ). For teachers in war-affected countries, their resilience in crisis [37, 41], well-being [41], and trauma-informed knowledge, capacity, and competency [1, 8, 10, 19, 22, 23, 29, 37, 38] were targeted in initiatives captured in this scoping review. For teachers supporting refugee students in a resettled country, their capacity to provide refugee students with a safe space for shared vulnerability, experiences, and affirmation [22, 24], and cultural humility and competence [5, 9] were targeted in the interventions explored. Parent support, where evident, focuses on strengthening coping strategies [5], resilience and well-being [7, 9, 19], and improving parenting skills [7, 19] for children impacted by trauma.
Form of Trauma Support for Students Exposed to War
To differentiate between different settings of students exposed to war, we have grouped the different approaches into those that were provided in the students’ home country (where the conflict occurred), and those provided in the resettled countries (where students have sought refuge from war).
Approaches Provided in Home Country
Out of the 14 articles describing trauma intervention approaches provided in home country context where the war or conflict occurred, 12 included supports for students using diverse approaches [1, 3, 11–13, 18, 23, 29, 36, 37, 39, 40]. Nine of these were delivered in school settings, one in a makeshift educational space during a military siege, and two in refugee camps. The most commonly used approach was arts-based, which included art therapy [3], an arts-based peace education curriculum [18], art and storytelling workshops to promote students’ well-being [30], and the use of arts (e.g., painting, sculpting, music, drama) to help students’ express feelings of anxiety and trauma [37, 39, 40]. Psychosocial support was also commonly seen, with programmes including a teacher-led universal psychosocial programme informed by cognitive behaviour therapy (CBT; The Better Learning Programme level 2 [BLP-2]) [1] and evaluated using a RCT design, a hybrid trauma-informed psychosocial support for education in emergencies focused on social-emotional learning (SEL) content (Colours of Kindness) [3], para-counsellor-led play-based learning with psychosocial support for children in crisis settings (Humanitarian Play Lab [HPL] [13]), and psychoeducation delivered as part of a multi-layered trauma-informed care package (The classroom-based intervention [CBI]) and evaluated using a RCT design [40]. It is notable that the psychosocial supports described above were delivered through or as a part of structured, manualised programme. Storying, such as story writing [18] and storytelling [29, 36, 37] was also applied in initiatives delivered in students’ home countries. For example, students were encouraged to write their personal stories, along with other creative approaches (e.g., painting, sculpting, relaxation, guided imagery, movement activities, music) to express their experiences of trauma in a safe space. Apart from engaging students in schools, teachers maintained contact with students via phone calls during war to provide continuous support, help students process their traumatic experiences, build students’ confidence, and strengthen their sense of belonging (Shacham, 2015).
Other approaches included movement- and sports-based methods (e.g., movement activities [37], and structured movement and dance [40]), as well as a digital platform that supplemented school-based programmes, offering students lessons on peace and humanity [23]. Cultural considerations were evident in three programmes [11, 13, 29], such as the use of Palestinian folk tales to recognise community resistance. One unique form – “war school” – was described in the context of the Bosnian war, where mixed-age underground classrooms provided a safe space for students during conflict (Lucić, 2021). In situations where certain curriculum could not be taught (e.g., mathematics, science), supplementary educational activities, such as arts and storytelling, were employed by teachers. Consistent educational experiences during crises, acting as cultural tools, were shown to mediate challenging conditions and foster students’ psychological resilience (Lucić, 2021).
Approaches Provided in Resettled Countries
Out of the 27 included articles describing support for children exposed to war or conflicts in resettled countries, 24 described support provided to students. This included support provided to students in school settings during school hours (n = 21) and two in afterschool programmes. Many utilised arts-based approaches (n = 11), manualised curricula/programmes (n = 11), storying (n = 9), and psychosocial support (n = 6). Often, multiple approaches were seen in initiatives [2, 4–6, 7, 14, 16, 17, 22, 24, 30–32, 34]. Gordon (2024) described how a therapeutic space was established in a British secondary school for displaced Ukrainian students, where art therapy was provided in a safe space to support these students process trauma, and foster a sense of safety, belonging, and resilience [2]. Similarly, the School-Based Creative Expression Programme [6], an 8-week initiative focusing on storying and drawing to help refugee children navigate their stories of (forced) migration, was evaluated by Kevers et al. (2022) using a RCT and described as promoting the mental health of these students. Jungle Tracks [16], a 10-session therapeutic programme, also incorporated storying and drawing to instil hope and activate the innate healing capacities of refugee children and adolescents attending schools in Australia (Fernandes et al., 2020).
Sports- and movement-based approaches were mentioned in five articles [14, 17, 20, 25, 27]. The Emotions Program Outside the Clinic with Wellness Education for Refugees [EMPOWER] [14], a trauma-informed SEL programme, provided a variety of wellness activities and physical education for Afghan refugee students in U.S. schools (Rosenberg et al., 2022). This programme included yoga-based physical education, games, and art to promote students’ social and emotional competence. Another school-based trauma-informed intervention, Somatic Soothing and Emotional Regulation Skill Development (SSERSD) [17], focused on mindfulness, yoga, physical activities, and other somatic practices to reduce the intensity of physiological and somatic trauma symptoms in refugee youth. This intervention, implemented in U.S. classrooms for English language learners, included yoga exercises, stretching, self-defence moves, breathing techniques, self-hugging, and heart rate monitoring by placing the hand on the chest. These activities helped refugee students to recognise the physical sensations and appearance of their bodies in connection with their emotions, while teaching them how to use body movements to counteract negative emotions (Mancini, 2020).
Cultural considerations and adaptations were evident in five articles [4, 14, 22, 26, 32]. The Trauma Healing Club [4], a 12-week curriculum for African refugee populations in the United States, incorporated culturally responsive practices such as African drumming, which aimed to integrate the students’ community and culture into their schools (Elswick et al., 2022). Another culturally adaptive approach involved employing teachers from the same Syrian refugee populations in non-formal education schools in Lebanon, with the aim to establish trust with displaced children [22]. Other approach includes peace education [32], where children and youth from Bosnian, Syria, and Afghanistan, were supported in community centres in Chicago, and camp-like housing in Germany, in valuing peace.
Support for Teachers and Parents
Fourteen articles included components aimed at teachers (see Supplemental Table S3b), with six provided to teachers who support students in home country contexts where the war occur [1, 23, 29, 35, 37, 41], and eight targeting teachers working with refugee students in their resettled countries [5, 8-10, 19, 22, 28, 38]. The predominant focus for teachers was placed on providing professional development for them in both contexts. In some instances, training was designed to enable teachers to deliver manualised programmes to students [1, 5, 9, 28, 35]. In other cases, the training aimed to help teachers integrate specific principles or strategies (e.g., psychosocial strategies, humanitarian education approaches, resilience-building) into their teaching practices for students [10, 19, 22, 23, 29, 37, 38, 41]. Only three initiatives included support for educators’ mental well-being and resilience. Teachers in conflict-affected countries were invited to participate in a 10-day counselling intervention to help them process their own traumatic experiences of the conflict and heal [29]. Two initiatives aimed to support teachers’ resilience as part of the programme [37, 41]. For example, Building Resilience Intervention (BRI) utilise brief teaching training to provide teachers with resilience-building tools both for themselves and for their students exposed to recurrent rocket attacks in Israel [41]. All the above programmes with components supporting teachers’ mental well-being and resilience were provided in students’ home country where the war or global conflict occur. Other support for teachers included (a) a manual outlining the steps to deliver manualised curricula [1], (b) a manual describing evidence-based activities to support students exposed to recurrent rocket attacks in Israel [41], (c) a digital platform allowing teachers to engage with peace and humanity education with students [23], and (d) newsletters accompanying the teacher training on support for refugee students in schools [38].
Four programmes included elements to support parents/caregivers, in addition to the support for children exposed to war and/or conflicts [5, 9, 19, 21] (see Supplemental Table S3c). All these programmes are provided in students’ resettled countries. Similar to the support provided for teachers, the focus was also on training, with focused content including teaching coping strategies [5], family resilience, well-being, and parenting skills [9, 19]. One initiative, Parent-Teacher Cooperatives (PTs), included consultations for parents [19] to support their application of trauma-informed skills in the community. Apart from trainings and consultations, one notable programme, “Mindful Movement” [21], engaged Syrian parents/caregivers of children resettled in Turkish preschools who exhibit PTSD symptoms. This programme utilised trauma-sensitive yoga practices, which aimed to help parents cultivate mindful awareness, ease their nervous system, reduce stress, in addition to providing trauma-informed support for their children [21].
Outcomes Reported in the Included Articles
Aggregated findings reported by the empirical articles included in this review are presented in Supplemental Table S1. Most of the articles reported improvements in students’ mental health and well-being [1, 6, 15–17, 29, 31, 34, 36, 39, 40], academic functioning [1, 3, 12, 27, 28, 33], self-esteem [2, 7, 24], social functioning [2, 7, 15, 18, 27, 35], cultural integration in the new country [20, 30, 33], hope for the future [28, 33], and socio-emotional competence [1, 12, 27]. Some reported improvements in teachers’ knowledge of how to support students exposed to war and/or conflicts [8, 10, 19, 22, 37, 41], and improvements in their own coping strategies [37]. Some reported improvements in parents/caregivers’ parenting skills to support students impacted by trauma, improvements in their capacity to cope [7, 19], and improved parent-child relationships [7]. Of the five RCT evaluations included in this review, students who completed the BLP-2 intervention reported reduced levels of stress-related symptoms, improved school functioning, improved academic performance, and improved capacity to self-regulate [1], students who participated in the School-Based Creative Expression Programme experienced alleviated posttraumatic stress [6], and students exposed to the Teaching Recovery Techniques (TRT) programme experienced reduced depressive symptoms, which was maintained for 3 months [34], and increased prosocial behaviour and psychosocial well-being 6 months after the programme [36]. The CBI programme was not found to improve students’ mental health [40].
Discussion
The aim of this review was to explore approaches used in educational contexts to support students exposed to war and global conflict, and/or their parents/caregivers and teachers. Critical findings and implications have been summarised in Table 2.
Critical Findings and Implications on Practice, Policy, and Research.
First, this review found that there are diverse programmes adopted and evaluated in educational settings for students exposed to war. These include direct approaches that target students, as well as indirect approaches that target teachers and/or parents of students exposed to war. Direct approaches targeting students comprised different intervention modalities including mindfulness exercises, expressive arts, and social-emotional skill-building, as well as movement and sport education approaches. Similar approaches were applied with students living in their home country and those who had migrated to a new country due to war, including arts-based, psychosocial-focused, movement-oriented, and sports-based interventions. This consistency may provide some direction for future programmes delivered to students exposed to war and conflict. However, the low quality of evidence identified through this review, including only five RCT studies, suggests that more needs to be done to evaluate the effectiveness and long-term benefits of these programmes for students, and/or their parents and teachers.
Second, consistent with contemporary research, the majority of interventions for teachers focused on providing them with professional development to improve how they support students, rather than interventions design to directly support the mental well-being of teachers. There is growing emphasis that trauma interventions in educational contexts should include support for both students and their teachers (Berger & Nott, 2024), including in low- and middle-income countries and humanitarian contexts (Ndetei et al., 2023). Third, another limited area of research focused on addressing the needs of parents/caregivers of students exposed to war. It is critical that parents/caregivers are provided with guidance and support to ensure that they can adequately support students exposed to trauma (Berger et al., 2020). This is traditionally achieved through delivery of whole-school trauma-informed interventions, which are designed to support the well-being of students, teachers, and parents/caregivers. A review of whole-school trauma-informed interventions found that programmes shared common elements of trauma-informed teacher training, student support, teacher self-care, student-teacher-parent collaboration, and parenting skills training (Avery et al., 2021). The current review identified only two interventions designed to support students, as well as their teachers and parents/caregivers.
In the context of war and global conflict, the general lack of programmes designed to support the mental well-being of teachers and parents is a significant oversight given that these adults are often exposed to the same potentially traumatic events as their students/children. Research on the effects of disasters on teachers has found that teachers experience significant stressors in their work and at home due to their exposure (Berger et al., 2018, 2022). These stressors include taking care of the health and well-being of their students, as well as their own health and well-being and that of their own children (Berger et al., 2022). Research has identified that the well-being of teachers and parents can significantly affect the mental health and academic outcomes of students (Arens & Morin, 2016; Harding et al., 2019), including in low- and middle-income countries (Honda et al., 2023). Teachers can also be indirectly impacted by the traumatic experiences of their students, with research showing that teachers are at risk of burnout and secondary trauma from exposure to traumatised students (Berger & Nott, 2024). The results of this review indicated that all of the programmes designed to support teachers’ well-being were provided in students’ home country rather than in the resettled countries of students. This is at odds with growing understanding of the negative impact that indirect exposure to students’ trauma can have on the mental well-being of teachers (Berger & Nott, 2024).
Although multi-faceted trauma-informed interventions in education for students, teachers, and parents/caregivers are the most rigorous and comprehensive (Avery et al., 2021), in the context of war and global conflict, these types of interventions would require coordination between different policy makers, governmental agencies, humanitarian aids, school leadership, and teaching staff to ensure these programmes are implemented effectively. The majority of programmes identified through this review required specialised facilitators (e.g. mental health experts or counsellors), whereas only five required training of teachers to deliver the interventions. Two of the RCT evaluated programmes were delivered by teachers or a teacher in conjunction with an art therapist, and both were found to improve students’ mental health and well-being [1, 6]. Therefore, investigations of how existing school trauma programmes can be scaled through building the capacity of teachers are required. The scalability of trauma programmes through teacher training is essential to ensure that greater numbers of students and communities can be supported during and after war. However, based on literature showing the negative effects of exposure to students’ trauma on teachers (Berger & Nott, 2024), teacher training should also incorporate elements of self-care and access to counselling support.
The results of this review also identified several programmes that sought to establish cultural relevance and acceptability for the communities being targeted by the intervention delivered. Developing and implementing programmes with relevance to the diversity and cultural background of students and families could be a challenge without coordinated resources in both the home country of the students and the resettled country. It is likely to take time to design, adapt, and contextualise programmes to the diverse needs and background of students exposed to war and residing in their home country. It may also be easier to evaluate structured programmes in students’ resettled countries and in developed regions, due to political stability and safety issue compared to developing countries and humanitarian contexts. It is also likely that delivering interventions in students’ resettled countries is more feasible because their home countries may be experiencing significant resource constraints caused by the war and ongoing conflict. However, most of the programmes delivered in the resettled countries did not incorporate cultural elements and may not have catered to the cultural and language needs of all student participants, such as by treating all refugee students as one group, without considering unique linguistic, religious, and cultural needs within the group. Moreover, some of the facilitators trained to deliver the programmes were not from the same cultural background of the students. Understanding the cultural background and educational needs of students, such as knowledge of students’ previous education system, norms, customs, curriculum, and common pedagogies, is essential when supporting those exposed to trauma (Barrett & Berger, 2021).
Several studies highlighted psychological safety as a central component of the programmes, emphasising creation of psychologically “safe spaces”, establishing “trust and sensitive classrooms,” and promotion of “psychological safety” [2, 3, 22, 27, 36, 37]. Interestingly, only two of the studies explicitly addressed physical safety, such as establishing safe classroom spaces and homes [11, 29], which may reflect the search strategy and the predominance of educational or psychosocial programmes rather than interventions focused on environmental or structural safety. However, in the context of war, prioritising physical safety should be viewed as critical for promoting psychological safety of students exposed to war, as protection from immediate harm forms the foundation upon which psychological safety and recovery can occur. This gap suggests the need for more research and a review examining how physical safety is promoted among children in the context of war and how this interacts with psychological safety, and how both domains shape outcomes for students exposed to war.
Implications for Practice and Policy
The review showed the importance of developing and further evaluating educational strategies to support students affected by war and global conflict. In particular, the development of trauma-informed strategies should be happening to support whole-education communities, including students, teachers, and parents/caregivers. More programmes and research could also focus on culturally aligned trauma-informed programmes to promote students’ recovery from war-related trauma. Literature shows that supporting student’s cultural identity when they relocate to a new country helps to improve their resilience and cultural esteem (Ezekwem-Obi et al., 2025; Ting et al., 2023). Within the trauma-informed literature, it has also been recommended that programmes utilise cultural symbols and icons to improve cultural safety and responsiveness (Miller & Berger, 2022).
Cultural diversity is another critical yet often overlooked aspect of trauma-informed education. Refugee students in resettled countries often experience linguistic and cultural isolation, which can exacerbate trauma and hinder educational engagement (Aydin & Kaya, 2019; Blanchet-Cohen et al., 2017). While three of the programmes identified through this review mentioned integration of language support, more research is needed on multilingual trauma-informed strategies – such as bilingual teaching assistants, culturally-responsive literacy materials, and native-language trauma-informed learning tools. Trauma-informed education must go beyond generic linguistic accommodations to ensure diversity, inclusiveness, and cultural safety (Blitz et al., 2016).
However, this review included results across several countries and cultural groups, and therefore, it is not possible to draw firm conclusions about which specific programme components are most effective for students exposed to war. The heterogeneity of studies also limits the ability to identify best-practice delivery and facilitator training when implementing trauma-informed programmes with students exposed to war. As a result, evidence remains insufficient to guide precise recommendations for ideal programme design and implementation to improve outcomes for war-affected students. However, results of this review can be used to inform future programme and research planning to enhance the quality of evidence and outcomes for students exposed to war.
A growing concern in trauma-informed education is teacher burnout and secondary trauma. Educators working with war-affected students are at risk of experiencing emotional exhaustion, vicarious trauma, and compassion fatigue (Berger & Nott, 2024), which can lead to decreased effectiveness, increased turnover, and mental health struggles. While many interventions focus on equipping teachers with trauma-informed strategies, fewer address teacher well-being and self-care. Education settings should seek to incorporate peer support networks, mental health counselling for educators, and administrative policies aimed at reducing secondary trauma. Without adequate institutional and emotional support, teachers may struggle to implement trauma-informed approaches sustainably.
Beyond individual teacher support, trauma-informed interventions should also focus on fostering stronger family-school partnerships. Schools that actively engage parents in structured communication, workshops, and collaborative decision-making create a more stable support system for students exposed to war-related trauma. Research suggests that when parents are included in the educational process, student resilience and academic motivation improve (Assefa et al., 2022). Therefore, policymakers in education arena should promote policy to equip educators with strategies to effectively communicate and collaborate with parents and caregivers of students exposed to war and displacement.
Limitations and Future Directions
This scoping review captured the breadth of literature on trauma interventions to support students, teachers, and/or parents/caregivers exposed to war and global conflict. It was not limited to quantitative studies and drew on the extant peer-reviewed literature in this field. This review was also not limited to trauma-informed approaches and included trauma interventions for students exposed to war. It is important to note that trauma-informed practice is not always synonymous with trauma interventions. However, whole-school models of trauma-informed care show that education settings should be prepared to provide both universal support to all students as well as targeted intervention to students showing signs of psychological distress from trauma (Berger, 2019; Dorado et al., 2016).
This review should be used as a precursor for future research designed to evaluate trauma-informed programmes to support students exposed to war, including the longitudinal efficacy and sustainability of these programmes. Future systematic reviews could also investigate the appropriateness of measures used to evaluate the intended outcomes, as many instruments are developed in the Western context with English literacy required. In addition, some of the qualitative data was collected from the perspective of programme facilitators, rather than the lived experience of the students. There could be a language barrier in direct communication with the students, which may have limited the findings and conclusions drawn from this review. While the authors attempted to limit publication distortion bias, future research in this area should be conducted to validate the results of this review. Related to this, several authors did not specify the age range of “students” or “children” included in their research. These limits understanding of potentially important differences between older and younger students when delivering trauma-informed interventions in response to war.
Given the limitations of programme delivery in the conflict zones, future approaches could also utilise existing digital platforms to provide remote support through online education for affected students. Although the review highlights short-term trauma responses, there is limited focus on the longitudinal impact of war exposure on education and future career pathways. Studies indicate that disrupted schooling due to war can lead to reduced access to tertiary education, lower employment prospects, and increased risk of intergenerational poverty (McLean Hilker, 2011). Long-term studies on war-affected students who successfully transition into higher education or employment could inform policies aimed at breaking cycles of educational disadvantage.
A final limitation of the included studies is the limited and inconsistent reporting of participant demographic characteristics. Most studies reported only basic information such as country or cultural background and age or grade level, with little detail provided about other aspects of diversity. Important socio-cultural factors, including socioeconomic status, gender identity, religious background, and other indicators of diversity, were rarely reported. Although a small number of studies provided more comprehensive demographic information (e.g., parental education, family structure, migration and resettlement background, and languages spoken at home), this level of detail was not common. Future research should provide more comprehensive descriptions of participant diversity to better contextualise findings and support more inclusive interpretations of the evidence.
Conclusion
The results revealed limited interventions targeting the well-being of students and their teachers and parents/caregivers, which is inconsistent with contemporary whole-school trauma-informed practice. The review also highlights that many programmes may not align with the cultural beliefs and coping mechanisms of refugee populations. More research is needed to ensure that trauma-informed strategies incorporate local cultural traditions, religious beliefs, and indigenous knowledge systems. Collaborating with local educators and community leaders in war-affected regions may enhance the cultural appropriateness and therefore effectiveness of trauma-informed approaches in these contexts.
Supplemental Material
sj-docx-1-tva-10.1177_15248380261439144 – Supplemental material for A Scoping Review on Interventions in Educational Contexts to Support Students Exposed to War
Supplemental material, sj-docx-1-tva-10.1177_15248380261439144 for A Scoping Review on Interventions in Educational Contexts to Support Students Exposed to War by Emily Berger, Yihan Sun, Violette McGaw, Rachel Sing-Kiat Ting, Nivedita Nandakumar, Laura Jobson, Tara McDougall, Sean Cowlishaw, Olena Zhupanova, Tetiana Shyriaeva, Oksana Makarenko, David Falconer and Michael Phillips in Trauma, Violence, & Abuse
Footnotes
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Funding
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was funded by the Monash University 2024 Incubator Program under the Office of the Deputy Vice-Chancellor (Research).
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
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