A Systematic Review on the Effects of Psychosocial Interventions on Quality of Life and Functioning Outcomes Among Populations Experiencing Ongoing Threat

Humanitarian emergencies increasingly involve ongoing traumatic stress, characterised by a lack of environmental safety that is often required for recovery. Evaluating quality of life (QoL) and functioning is essential in these contexts, as symptom reduction alone may not capture the multidimensional nature of resilience and social adaptation under continuous threat. This systematic review aims to evaluate the effectiveness of psychosocial interventions on nonsymptom-focused outcomes-specifically QoL and functioning-for populations facing ongoing violence or interpersonal violence. Following PRISMA guidelines, a systematic search of PubMed, Medline and PsycINFO was conducted. Interventions were categorised using layers two to four of the International Red Cross and Red Crescent Movement's MHPSS framework. Data from 18 studies (17 unique studies) comprising 3165 participants were synthesised using a narrative approach. Evidence indicates that both trauma- and present-focused interventions were likely to improve QoL and functioning despite ongoing threat. Comparison between interventions remained inconclusive. There were also discrepancies between informants regarding intervention outcomes. Future research should include operationalisation of 'ongoing threat' where possible and include and standardise nonsymptom-focused outcomes when evaluating interventions.