Acceptance and Commitment Therapy for Unaccompanied Refugee Minors: A Mixed-Methods Study ABSTRACT The present thesis consisted of four studies investigating whether ACT would be beneficial to UM in shelters in Cyprus. In Study 1, a systematic review and qualitative research synthesis examined the evidence of effectiveness and acceptability of cognitive behavioral therapy (CBT) and third-wave approaches (i.e., ACT) in improving the quality of life and psychological symptoms of UM. Third wave studies showed preliminary evidence for improvements in psychological flexibility and mindfulness in UM, as well as improvements in psychological symptoms. Study 2 is a cluster randomized controlled trial that was carried out in six shelters across Cyprus. 101 UM participated in the trial (49 males, 52 females), aged between 13 and 18 years old (M age=15.97, SD=1.23). Statistically significant improvements were observed for psychological flexibility at post-intervention and 1-month follow-up in the treatment group. Study 3 qualitatively examined whether ACT is an acceptable and culturally appropriate intervention for UM. Thematic analysis demonstrated that ACT is an acceptable and culturally appropriate approach for UM. UM reported increased acceptance of internal and external events, increased emotional awareness, reduced unhelpful thinking patterns, feeling less stressed, managing negative memories, increased confidence, improved sleep, and concentration. UM began incorporating exercises learned into their day-to-day lives. The intervention also fostered feelings of group support and normalisation of difficulties. Study 4 presents an account of the obstacles/challenges and solutions of working with UM in shelters, acting as a guide for clinicians and researchers. Overall, findings from this thesis suggest that ACT is an effective, acceptable, and culturally appropriate intervention for UM.
Last Updated on February 7, 2026
