Table 1.
Summary of intervention studies conducted with people from Myanmar
| Author (Year) | Study population | Intervention description | Outcomes reported | Key limitations |
|---|---|---|---|---|
| Annan et al. (2016) | 479 families from Myanmar living on the Thai–Myanmar border | A locally adapted version of the evidence-based Strengthening Families Program: 12 weekly sessions of 2 h each in which parents and children participated separately in skills groups for the first hour, and then came together for supervised practice and interaction for the second hour | Significant reductions in child externalizing problems (reported by both children and adults) and attention problems (reported by adults) among treatment children compared with wait-list control children as measured by the Child Behavior Checklist and Youth Self-Report; significant increase in psychosocial protective factors as reported by children | Comparison group was a wait-list control; as a meal was provided at each session, an active control such as meal participation would ensure the effects are attributable to the intervention itself |
| Aye (2007) | 174 people attending 10-day meditation courses at three different centers | 10-day Vipassana meditation training at three different Buddhist meditation centers: approximately 10 h of meditation practice per day with alternating sitting and walking sessions. During sitting sessions, practitioners attempt to concentrate on their breathing or specific objects provided by instructor. Walking meditation focused on moment-to-moment awareness | Significant reductions in anxiety, stress, and aggression and an increase in self-confidence using the Self-Rating Anxiety Scale, Personal Distress Scale, Frustration and Aggression Scale, and the Bernreuter Personality Inventory | No comparison group, differences in intervention instructions between centers |
| Bolton et al. (2014) | 347 Burmese Refugees in Thailand with trauma exposure and elevated depression and/or post-traumatic stress | Common Elements Treatment Approach (CETA): a manualized psychotherapy that incorporates components common to many evidence-based treatments. Typically consisting of 8–12 sessions with components selected according to the client's symptom presentation | Significant pre–post reduction in symptoms of depression, post-traumatic stress, anxiety, and functional impairment relative to a wait-list control group. No significant reduction in substance use | Loss to follow-up was higher than in comparable studies elsewhere |
| Kasai et al. (2017) | 97 people from Myanmar practicing meditation and 81 Myanmar nurses with no meditation experience | Vipassana meditation at a Buddhist monastery: 1 h sitting meditation sessions occurring 10 times per day. During contemplation practitioners attempt to sit silently with clear minds and concentrate only on their breathing. Participants had been practicing meditation from <1 year to more than 7 years | Participants in the meditation group had significantly lower depression, anger, and fatigue scores, and significantly higher vigor scores, than the comparison nurses using the Profile of Mood States – Short Form. No difference in confusion or tension/anxiety. No overall difference between groups in psychological flexibility measured by the Acceptance and Action Questionnaire II, although scores on this measure decreased (indicating greater psychological flexibility) with increasing length of meditation experience | Group comparisons made based on cross-sectional assessment (no pre–post) among respondents who self-selected into either the meditation or control condition, precluding causal inference |
| Kyaing (2002) | 200 participants in a 10-day meditation course and 200 service personnel at an auto industry enterprise | 10-day Vipassana meditation training at a Buddhist meditation center: 10 h of guided sitting meditation per day. Silence is practiced while not meditating. During contemplation practitioners attempt to sit silently concentrating only on their breathing for 3.5 days. This is followed by 6.5 days of attempting to directly observe the changing nature of body and mind | Significant pre–post reductions in anxiety and stress for Vipassana course participants, whereas control group reported increases using the Self-Rating Anxiety Scale and the Personal Distress Scales | Author noted difficulties in finding a matched control group for comparison. Participants self-selected into the meditation condition |
| Letzelter & Gimenez (2015) | 1161 adults from Rakhine State, Myanmar receiving humanitarian support from ACF International | Support and self-help groups to enhance maternal and child care. Participants grouped in three categories: women, men, and mother in-laws. Average of seven sessions conducted per group, with groups meeting once every 2 weeks. Focus of the groups was to find solutions to enhance child, woman, and family wellbeing through care practices and increased support for women at family level | Pre–post assessments were completed using the Self-Reporting Questionnaire (SRQ-20) and qualitative data were analyzed with the Most Significant Change (MSC) technique. Improvements in SRQ-20 scores were reported in all groups: women, men, and mother in-laws | No comparison group, disparity in MSC results between sites attributed to misunderstandings by group facilitators in methodology and collection instructions |
| Ma (2011) | Community of Burmese immigrants in Australia | Community music band developed through a participatory research approach to address social isolation and internal group fragmentation | Qualitative feedback led to the author's conclusion that the band helped to develop social solidary | No comparison, no formal program evaluation |
| Paratharayil (2010) | Communities in Myanmar hit by Cyclone Nargis | Community kitchens: provision of nutritious meals and a safe space for collective sharing, facilitated by community leaders | Anecdotal reports of improved psychosocial wellbeing | No pre–post assessment reported |
| Paratharayil (2010) | Cyclone Nargis survivors in Myanmar who were having difficulty coping | Focused trauma care: up to 12 individual sessions including aspects such as psychological first aid, basic needs assessment, supportive counseling, and transcendental meditation | Anecdotal reports of improved ability to cope with grief | No pre–post assessment reported |
| Prag & Vogel (2013) | Nine Shan adolescents age 16–19 living in a refugee camp in Thailand | Therapeutic photography: a 5-week photojournalism class in which assignments encouraged students to examine their own stories, with weekly group discussions using therapeutic conversation techniques | Qualitative themes of post-traumatic growth found to be similar to themes found elsewhere, but with the addition of a cluster of responses related to an ‘ability to articulate the social narrative’ that was important to the students | No pre–post assessment to assess whether post-traumatic growth occurred, no comparison group |
| Rowe et al. (2016) | 30 school-aged Burmese refugees in the USA (age 11–20) | Burma Art Therapy Program (BAPT): 16 individual art therapy sessions of 50 min each delivered over a 6-month period. Sessions were a mix of structured and unstructured | Significant pre–post reduction in median anxiety scores using the Hopkins Symptoms Checklist (magnitude of change not reported). Change in depression scores not reported. Minor improvements in self-concept indicators (Piers-Harris Self-Concept Scale) and minor decrease in teacher-reported student difficulties (Strengths and Difficulties Questionnaire) were not statistically significant. Provider focus groups reported improved child wellbeing that they felt were not captured in quantitative assessments |
No comparison group, small sample size, not all comparisons reported |
| Tanaka (2013) | Karen children aged 2–5 attending nursery schools in Karen refugee camps in Thailand | Nursery school program designed to promote wellbeing through a child-centered curriculum in which teachers provided emotional and social support, promoted socialization and cooperation, and used positive discipline | Longer attendance predicted higher scores on positive development but was not associated with emotional/behavioral problems | Assessment conducted at a single time point; assessing impact by comparing children by duration of attendance is likely to be confounded by other factors |
| Van Wyk et al. (2012) | 62 newly arrived Burmese refugees in Australia | Individualized resettlement program consisting of assessment, social assistance, referrals, and possible exposure to a variety of therapeutic interventions (including psychoeducation and skills-based, expressive, supportive, couples/family, cognitive behavioral, and exposure therapies) | Significant pre–post reductions in post-traumatic stress disorder, anxiety, and depression assessed using the Harvard Trauma Questionnaire, Hopkins Symptom Checklist, and Post-Migration Living Difficulties checklist | No comparison group, guidelines for intervention decisions not clearly outlined |
| Vukovich & Mitchell (2015) | 57 PLWHA, LGBTQ, and former political prisoners living in Myanmar | Sharing Circles: a manualized eight-session psychotherapy group consisting of interactive and narrative tasks, body mapping, role playing, gestalt psychotherapeutic activities, lifeline and memory book, meditation, and self-care | Significant pre–post reductions in depression symptoms and psychosocial stressors assessed using the Brief Patient Health Questionnaire | No comparison group |