Collective and Transgenerational Trauma in Psychotherapeutic Treatment: Implications for Refugee and Post-Conflict Contexts
Main Article Content
Abstract
Background: Refugees and populations affected by war, genocide, and forced displacement are exposed not only to individual traumatic events but also to collective and transgenerational forms of trauma. While psychotherapeutic research and practice have traditionally focused on individual trauma-related disorders, growing evidence highlights the relevance of historical, collective, and intergenerational processes in shaping mental health outcomes in post-conflict affected populations.
Objectives: This review aims to synthesize and critically integrate current evidence on collective and transgenerational trauma and to discuss their implications for psychotherapeutic treatment in refugee and post-conflict populations. This article is based on a narrative and integrative review of the literature, drawing on clinical, psychosocial, and public mental health perspectives as well as key theoretical models and empirical findings in the field.
Findings: Collective and transgenerational trauma operates through complex interactions between psychosocial, familial, sociocultural, and structural mechanisms. In refugee populations, ongoing post-migration stressors, discrimination, and social marginalization may reactivate historical trauma and contribute to chronic psychological distress. Trauma-related distress is best understood as a multilevel and temporally extended process shaped by the interaction of individual, collective, and structural factors. While trauma-focused psychotherapies remain central to treatment, approaches focusing exclusively on individual symptom reduction may not fully address the broader collective and contextual dimensions of trauma.
Conclusions: Effective psychotherapeutic care for refugees and post-conflict populations requires integrative approaches that combine evidence-based trauma-focused therapies with attention to collective histories, cultural meaning systems, and community-based support structures. Such approaches are essential for addressing the long-term psychological consequences of collective violence and displacement and have important implications for clinical practice, mental health service planning, and public mental health strategies in European healthcare systems.
Article Details
How to Cite
KIZILHAN, Jan Ilhan; AG, Zelal.
Collective and Transgenerational Trauma in Psychotherapeutic Treatment: Implications for Refugee and Post-Conflict Contexts.
Medical Research Archives, [S.l.], v. 14, n. 5, may 2026.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/7433>. Date accessed: 02 june 2026.
doi: https://doi.org/10.18103/mra.v14i5.7433.
Section
Review Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
1. United Nations High Commissioner for Refugees. Global Trends. UNHCR. https://www.unhcr.org/global-trends. Published April 6, 2024.
2. World Health Organization. Guidelines for the Management of Conditions Specifically Related to Stress. Geneva: World Health Organization; 2013. Available from: https://www.who.int/publications/i/item/9789241505406.
3. Bisson JI, Roberts NP, Andrew M, Cooper R, Lewis C. Psychological therapies for chronic post-traumatic stress disorder (PTSD) in adults. Cochrane Database Of Systematic Reviews. 2013;2015(8):CD003388. doi:10.1002/14651858.cd003388.pub4
4. Lewis C, Roberts NP, Gibson S, Bisson JI. Dropout from psychological therapies for post-traumatic stress disorder (PTSD) in adults: systematic review and meta-analysis. European Journal Of Psychotraumatology. 2020;11(1):1709709. doi:10.1080/20008198.2019.1709709
5. Schauer M, Neuner F, Elbert T. Narrative exposure therapy: A short-term treatment for traumatic stress disorders. Hogrefe; 2011.
6. Robjant K, Fazel M. The emerging evidence for Narrative Exposure Therapy: A review. Clinical Psychology Review. 2010;30(8):1030-1039. doi:10.1016/j.cpr.2010.07.004
7. Kizilhan JI. Mental Health and Collective Trauma among Yazidi Genocide Survivors. Journal Of Mental Health Disorders. 2025;5(1):47-49. doi:10.33696/mentalhealth.5.036
8. Kleber RJ. Trauma and Public Mental Health: A Focused Review. Frontiers in Psychiatry. 2019;10:451. doi:10.3389/fpsyt.2019.00451
9. Brave Heart MYH, & DeBruyn, LM. The American Indian Holocaust: Healing historical Unresolved grief. American Indian And Alaska Native Mental Health Research. 1998;8(2):60-82. doi:10.5820/aian.0802.1998.60
10. Danieli Y. International Handbook of Multigenerational Legacies of Trauma. Plenum Press; 1998. doi:10.1007/978-1-4757-5567-1
11. Sotero MM. A conceptual model of historical trauma. Journal of Health Disparities Research and Practice. 2006;1(1):93–108.
12. Yehuda R, Daskalakis NP, Bierer LM, u. a. Holocaust Exposure Induced Intergenerational Effects on FKBP5 Methylation. Biological Psychiatry. 2016;80(5):372-380. doi:10.1016/j.biopsych.2015.08.005
13. Matheson K, Seymour A, Landry J, Ventura K, Arsenault E, Anisman H. Canada’s Colonial Genocide of Indigenous Peoples: A Review of the Psychosocial and Neurobiological Processes Linking Trauma and Intergenerational Outcomes. International Journal Of Environmental Research And Public Health. 2022;19(11):6455. doi:10.3390/ijerph19116455
14. Miller KE, Rasmussen A. War exposure, daily stressors, and mental health in conflict and post-conflict settings: Bridging the divide between trauma-focused and psychosocial frameworks. Social Science & Medicine. 2010;70(1):7-16. doi:10.1016/j.socscimed.2009.09.029
15. Silove D, Ventevogel P, Rees S. The contemporary refugee crisis: an overview of mental health challenges. World Psychiatry. 2017;16(2):130-139. doi:10.1002/wps.20438
16. Summerfield D. The invention of post-traumatic stress disorder and the social usefulness of a psychiatric category. BMJ. 2001;322(7278):95-98. doi:10.1136/bmj.322.7278.95
17. Machleidt W, Calliess IT. Psychiatrisch-psychotherapeutische Behandlung von Migranten und Transkulturelle Psychiatrie. In: Psychiatrie und Psychotherapie. München: Urban und Fischer; 2003:281-201
18. Bar-Tal D. Sociopsychological Foundations of Intractable Conflicts. American Behavioral Scientist. 2007;50(11):1430-1453. doi:10.1177/0002764207302462
19. Canetti D, Elad-Strenger J, Lavi I, Guy D, Bar-Tal D. Exposure to Violence, Ethos of Conflict, and Support for Compromise. Journal Of Conflict Resolution. 2016;61(1):84-113. doi:10.1177/0022002715569771
20. Halperin E, Porat R, Tamir M, Gross JJ. Can Emotion Regulation Change Political Attitudes in Intractable Conflicts? From the Laboratory to the Field. Psychological Science. 2012;24(1):106-111. doi:10.1177/0956797612452572
21. Rosler N, Hameiri B, Bar-Tal D, Christophe D, Azaria-Tamir S. Current and Future Costs of Intractable Conflicts—Can They Create Attitude Change? Frontiers in Psychology. 2021;12:681883. doi:10.3389/fpsyg.2021.681883
22. Kizilhan JI. Die Jesiden: Religion, Kultur und Trauma. Psychosozial-Verlag; 2014.
23. Öztürk H, Günderci A, Tekin A. Forced migration-related traumatic experiences and collective memory in Ezidi asylum-seekers coming to Diyarbakir province from Shingal region. Social Psychiatry And Psychiatric Epidemiology. 2019;55(1):63-70. doi:10.1007/s00127-019-01749-z
24. Danieli Y. The Treatment and Prevention of Long-term Effects and Intergenerational Transmission of Victimization: A Lesson From Holocaust Survivors and Their Children. In: Trauma and Its Wake. Bd 1. 1. Aufl. Routledge; 1985.
25. Lev-Wiesel R. Intergenerational Transmission of Trauma across Three Generations: A Preliminary Study. Qualitative Social Work. 2007;6(1):75-94. doi:10.1177/1473325007074167
26. Alexander JC, Eyerman R, Giesen B, Smelser NJ, Sztompka P. Cultural Trauma and Collective Identity. University of California Press; 2004.
27. Volkan VD. Transgenerational Transmissions and Chosen Traumas: An Aspect of Large-Group Identity. Group Analysis. 2001;34(1):79-97. doi:10.1177/05333160122077730
28. Celik F. The Alevi of Dersim: A psychosocial approach to the effects of the massacre, time and space. In: Alevis in Europe: Voices of Migration, Culture, and Identity. 1. Aufl. Oxon Routledge; 2017:46-68. https://www.academia.edu/43983532/The_Alevi_of_Dersim_A_psychosocial_approach_to_the_effects_of_the_massacre_time_and_space_F%C4%B0L%C4%B0Z_%C3%87EL%C4%B0K
29. Brave Heart MYH. The return to the sacred path: Healing the historical trauma and historical unresolved grief response among the lakota through a psychoeducational group intervention. Smith College Studies in Social Work. 1998;68(3):287-305. doi:10.1080/00377319809517532
30. United Nations Office of the High Commissioner for Human Rights. Assessment of human rights concerns in the Xinjiang Uyghur Autonomous Region. United Nations; 2022.
31. Byler D. Terror capitalism: Uyghur dispossession and masculine domination. Duke University Press; 2021.
32. Faimon MB. Ties that Bind: Remembering, Mourning, and Healing Historical Trauma. The American Indian Quarterly. 2004;28(1):238-251. doi:10.1353/aiq.2005.0007
33. The Aboriginal Healing Foundation. Historic Trauma and Aboriginal Healing. Ottawa, Ontario: Anishinabe Printing; 2014.
34. Kellermann NPF. Transmission of Holocaust Trauma - An Integrative View. Psychiatry. 2001;64(3):256-267. doi:10.1521/psyc.64.3.256.18464
35. Steel Z, Chey T, Silove D, Marnane C, Bryant RA, Van Ommeren M. Association of Torture and Other Potentially Traumatic Events With Mental Health Outcomes Among Populations Exposed to Mass Conflict and Displacement. JAMA. 2009;302(5):537. doi:10.1001/jama.2009.1132
36. World Health Organization. Mental health of refugees. WHO; 2023. https://www.who.int/news-room/fact-sheets/detail/mental-health-of-refugees
37. Fazel M, Reed RV, Panter-Brick C, Stein A. Mental health of displaced and refugee children resettled in high-income countries: risk and protective factors. The Lancet. 2012;379(9812):266-282. doi:10.1016/s0140-6736(11)60051-2
38. World Health Organization. International Classification of Diseases (11th Revision). WHO; 2019. https://icd.who.int
39. Cloitre M, Shevlin M, Brewin CR, u. a. The International Trauma Questionnaire: development of a self‐report measure of ICD‐11 PTSD and complex PTSD. Acta Psychiatrica Scandinavica. 2018;138(6):536-546. doi:10.1111/acps.12956
40. Maercker A. Development of the new CPTSD diagnosis for ICD-11. Borderline Personality Disorder And Emotion Dysregulation. 2021;8(1):7. doi:10.1186/s40479-021-00148-8
41. Kizilhan JI, Wenzel T. Concepts of Transgenerational and Genocidal Trauma and the Survivors of ISIS Terror in Yazidi Communities and Treatment Possibilities. International Journal of Mental Health & Psychiatry. 2020;13(8).
42. Kizilhan JI, Noll-Hussong M, Wenzel T. Transgenerational Transmission of Trauma across Three Generations of Alevi Kurds. International Journal Of Environmental Research And Public Health. 2021;19(1):81. doi:10.3390/ijerph19010081
43. El-Awad U, Eves R, Hachenberger J, u. a. Post-migration stress mediates associations between potentially traumatic peri-migration experiences and mental health among Middle Eastern refugees in Germany. BMC Public Health. 2025;25(1):2582. doi:10.1186/s12889-025-23660-w
44. Heptinstall E, Sethna V, Taylor E. PTSD and depression in refugee children. European Child & Adolescent Psychiatry. 2004;13(6):373-380. doi:10.1007/s00787-004-0422-y
45. Rask S, Suvisaari J, Koskinen S, u. a. The ethnic gap in mental health: A population-based study of Russian, Somali and Kurdish origin migrants in Finland. Scandinavian Journal of Public Health. 2015;44(3):281-290. doi:10.1177/1403494815619256
46. Steel JL, Dunlavy AC, Harding CE, Theorell T. The Psychological Consequences of Pre-Emigration Trauma and Post-Migration Stress in Refugees and Immigrants from Africa. Journal Of Immigrant And Minority Health. 2017;19(3):523-532. doi:10.1007/s10903-016-0478-z
47. Li SSY, Liddell BJ, Nickerson A. The Relationship Between Post-Migration Stress and Psychological Disorders in Refugees and Asylum Seekers. Current Psychiatry Reports. 2016;18(9):82. doi:10.1007/s11920-016-0723-0
48. Gameon JA, Skewes MC. Historical trauma and substance use among American Indian people with current substance use problems. Psychology Of Addictive Behaviors. 2021;35(3):295-309. doi:10.1037/adb0000729
49. Pride T, Lam A, Swansburg J, u. a. Trauma-informed Approaches to Substance Use Interventions with Indigenous Peoples: A Scoping Review. Journal Of Psychoactive Drugs. 2021;53(5):460-473. doi:10.1080/02791072.2021.1992047
50. Wesley-Esquimaux CC. The intergenerational transmission of historic trauma and grief. In Indigenous Affairs. 2008;4(7):6–12.
51. Beckmann J, Wenzel T, Hautzinger M, Kizilhan JI. Training of psychotherapists in post-conflict regions: A Community case study in the Kurdistan Region of Iraq. Frontiers in Psychiatry. 2022;13:947903. doi:10.3389/fpsyt.2022.947903
52. Kizilhan JI, Weigelt A. Kultursensible Psychotherapie. In: Verhaltenstherapie Das Lehrbuch Für Medizin Und Psychologie. 1. Aufl. Kohlhammer; 2025:619-627.
53. Kellermann, N. P. F. Epigenetic transmission of Holocaust trauma: Can nightmares be inherited? Israel Journal of Psychiatry and Related Sciences. 2013;50(1):33–39.
54. Dalgaard NT, Montgomery E. Disclosure and silencing: A systematic review of the literature on patterns of trauma communication in refugee families. Transcultural Psychiatry. 2015;52(5):579-593. doi:10.1177/1363461514568442
55. Melander M, Dahlblom K, Jegannathan B, Kullgren G. Exploring communication of traumatic experiences from Khmer Rouge genocide survivors to their offspring: In-depth interviews with both generations. International Journal Of Social Psychiatry. 2016;62(4):327-333. doi:10.1177/0020764016631364
56. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. American Psychiatric Publishing; 2013.
57. Kizilhan JI, Noll-Hussong M. Individual, collective, and transgenerational traumatization in the Yazidi. BMC Medicine. 2017;15(1):198. doi:10.1186/s12916-017-0965-7
58. Hinton DE, Hinton AL, Eng K, Choung S. PTSD and Key Somatic Complaints and Cultural Syndromes among Rural Cambodians: The Results of a Needs Assessment Survey. Medical Anthropology Quarterly. 2012;26(3):383-407. doi:10.1111/j.1548-1387.2012.01224.x
59. Kirmayer LJ, Narasiah L, Munoz M, u. a. Common mental health problems in immigrants and refugees: general approach in primary care. Canadian Medical Association Journal. 2011;183(12):E959-E967. doi:10.1503/cmaj.090292
60. Kohrt BA, Hruschka DJ. Nepali Concepts of Psychological Trauma: The Role of Idioms of Distress, Ethnopsychology and Ethnophysiology in Alleviating Suffering and Preventing Stigma. Culture Medicine And Psychiatry. 2010;34(2):322-352. doi:10.1007/s11013-010-9170-2
61. Rees S, Silove D. Sakit Hati: A state of chronic mental distress related to resentment and anger amongst West Papuan refugees exposed to persecution. Social Science & Medicine. 2011;73(1):103-110. doi:10.1016/j.socscimed.2011.05.004
62. Coker EM. “Traveling Pains”: Embodied Metaphors of Suffering Among Southern Sudanese Refugees in Cairo. Culture Medicine And Psychiatry. 2004;28(1):15-39. doi:10.1023/b:medi.0000018096.95218.f4
63. National Institute for Health and Care Excellence. Process and methods: Developing NICE guidelines: the manual; 2018. https://www.nice.org.uk/process/pmg20
64. Shapiro F. Eye movement desensitization and reprocessing (EMDR) therapy: Basic principles, protocols, and procedures. The Guilford Press; 2018.
65. Neuner F, Onyut PL, Ertl V, Odenwald M, Schauer E, Elbert T. Treatment of posttraumatic stress disorder by trained lay counselors in an African refugee settlement: A randomized controlled trial. Journal Of Consulting And Clinical Psychology. 2008;76(4):686-694. doi:10.1037/0022-006x.76.4.686
66. Carter RT. Racism and Psychological and Emotional Injury. The Counseling Psychologist. 2007;35(1):13-105. doi:10.1177/0011000006292033
67. Kirkinis K, Pieterse AL, Martin C, Agiliga A, Brownell A. Racism, racial discrimination, and trauma: a systematic review of the social science literature. Ethnicity And Health. 2018;26(3):392-412. doi:10.1080/13557858.2018.1514453
68. Pascoe EA, Richman LS. Perceived discrimination and health: A meta-analytic review. Psychological Bulletin. 2009;135(4):531-554. doi:10.1037/a0016059
69. Kizilhan JI. Psychotherapy in a Multicultural Society. In: Oxford University Press eBooks. ; 2020:803-817. doi:10.1093/oxfordhb/9780198817338.013.54
70. Barbato A, Vallarino M, Rapisarda F, Lora A, Caldas De Almeida JM, European Union. Access To Mental Health Care in Europe – Consensus Paper.; 2016. https://health.ec.europa.eu/system/files/2016-12/ev_20161006_co04_en_0.pdf
71. Wiegand HF, Hölzel L, Tüscher O, Lieb K, Falkai P, Adorjan K. Mental health services in Germany – Structures, outcomes and future challenges. International Review Of Psychiatry. 2025;37(3-4):253-270. doi:10.1080/09540261.2025.2479601
72. Atzil-Slonim D, Martin J, Lutz W. Leveraging Novel Technologies and Artificial Intelligence to Advance Practice-Oriented Research. Administration and policy in mental health. Published online October 25, 2024. doi: https://doi.org/10.1007/s10488-023-01309-3
73. Deutsches Zentrum für Integrations- und Migrationsforschung (DeZIM). Rassismus und Seine Symptome: Bericht Des Nationalen Diskriminierungs- und Rassismusmonitors.; 2023. https://www.rassismusmonitor.de/fileadmin/user_upload/NaDiRa/Rassismus_Symptome/2023-11-07_NaDiRa-2023_Pressematerialien.pdf
74. Dahmer L. «Rassismus ist bis heute ein blinder Fleck in der Psychotherapie». À Jour! Psychotherapie-Berufsentwicklung. 2021;7(1):28-30. doi:10.30820/2504-5199-2021-1-28
75. Kahraman, B. Wozu Rassismuskritik in der Psychotherapie-Profession? Psychotherapeutenjournal. 2023;22(4):344–353.
76. Kupfer A, Enge R. Rassismus, Trauma und Beratung. Trauma und Gewalt. 2023;17(1):4-20. doi:10.21706/tg-17-1-4
77. Kahraman, B. Wozu Rassismuskritik in der Psychotherapie-Profession? Psychotherapeutenjournal. 2023;22(4):344–353.
78. Kupfer A, Enge R. Rassismus, Trauma und Beratung. Trauma und Gewalt. 2023;17(1):4-20. doi:10.21706/tg-17-1-4
79. Norris FH, Stevens SP, Pfefferbaum B, Wyche KF, Pfefferbaum RL. Community Resilience as a Metaphor, Theory, Set of Capacities, and Strategy for Disaster Readiness. American Journal Of Community Psychology. 2008;41(1-2):127-150. doi:10.1007/s10464-007-9156-6
80. Im H, Verbillis-Kolp S, Atiyeh S, u. a. Implementation Evaluation of Community-Based Mental Health and Psychosocial Support Intervention for Refugee Newcomers in the United States. Health & Social Care in The Community. 2023;2023:1-20. doi:10.1155/2023/6696415
81. Fuhr DC. Global Mental Health: The relevance of implementing low intensity psychological interventions in Germany. Public Health Forum. 2025;33(3):241-243. doi:10.1515/pubhef-2025-0055
82. Grabbe L, Duva IM, Nicholson WC. The Community Resiliency Model, an interoceptive awareness tool to support population mental wellness. Cambridge Prisms Global Mental Health. 2023;10:e43. doi:10.1017/gmh.2023.27
83. Habimana S, Biracyaza E, Habumugisha E, Museka E, Mutabaruka J, Montgomery SB. Role of Community Resiliency Model Skills Trainings in Trauma Healing Among 1994 Tutsi Genocide Survivors in Rwanda. Psychology Research And Behavior Management. 2021;Volume 14:1139-1148. doi:10.2147/prbm.s319057
84. Marris W. GUIDE: Trauma-Informed Community Change. CTIPP. Published 19. Juli 2023. https://www.ctipp.org/post/guide-to-trauma-informed-community-change
2. World Health Organization. Guidelines for the Management of Conditions Specifically Related to Stress. Geneva: World Health Organization; 2013. Available from: https://www.who.int/publications/i/item/9789241505406.
3. Bisson JI, Roberts NP, Andrew M, Cooper R, Lewis C. Psychological therapies for chronic post-traumatic stress disorder (PTSD) in adults. Cochrane Database Of Systematic Reviews. 2013;2015(8):CD003388. doi:10.1002/14651858.cd003388.pub4
4. Lewis C, Roberts NP, Gibson S, Bisson JI. Dropout from psychological therapies for post-traumatic stress disorder (PTSD) in adults: systematic review and meta-analysis. European Journal Of Psychotraumatology. 2020;11(1):1709709. doi:10.1080/20008198.2019.1709709
5. Schauer M, Neuner F, Elbert T. Narrative exposure therapy: A short-term treatment for traumatic stress disorders. Hogrefe; 2011.
6. Robjant K, Fazel M. The emerging evidence for Narrative Exposure Therapy: A review. Clinical Psychology Review. 2010;30(8):1030-1039. doi:10.1016/j.cpr.2010.07.004
7. Kizilhan JI. Mental Health and Collective Trauma among Yazidi Genocide Survivors. Journal Of Mental Health Disorders. 2025;5(1):47-49. doi:10.33696/mentalhealth.5.036
8. Kleber RJ. Trauma and Public Mental Health: A Focused Review. Frontiers in Psychiatry. 2019;10:451. doi:10.3389/fpsyt.2019.00451
9. Brave Heart MYH, & DeBruyn, LM. The American Indian Holocaust: Healing historical Unresolved grief. American Indian And Alaska Native Mental Health Research. 1998;8(2):60-82. doi:10.5820/aian.0802.1998.60
10. Danieli Y. International Handbook of Multigenerational Legacies of Trauma. Plenum Press; 1998. doi:10.1007/978-1-4757-5567-1
11. Sotero MM. A conceptual model of historical trauma. Journal of Health Disparities Research and Practice. 2006;1(1):93–108.
12. Yehuda R, Daskalakis NP, Bierer LM, u. a. Holocaust Exposure Induced Intergenerational Effects on FKBP5 Methylation. Biological Psychiatry. 2016;80(5):372-380. doi:10.1016/j.biopsych.2015.08.005
13. Matheson K, Seymour A, Landry J, Ventura K, Arsenault E, Anisman H. Canada’s Colonial Genocide of Indigenous Peoples: A Review of the Psychosocial and Neurobiological Processes Linking Trauma and Intergenerational Outcomes. International Journal Of Environmental Research And Public Health. 2022;19(11):6455. doi:10.3390/ijerph19116455
14. Miller KE, Rasmussen A. War exposure, daily stressors, and mental health in conflict and post-conflict settings: Bridging the divide between trauma-focused and psychosocial frameworks. Social Science & Medicine. 2010;70(1):7-16. doi:10.1016/j.socscimed.2009.09.029
15. Silove D, Ventevogel P, Rees S. The contemporary refugee crisis: an overview of mental health challenges. World Psychiatry. 2017;16(2):130-139. doi:10.1002/wps.20438
16. Summerfield D. The invention of post-traumatic stress disorder and the social usefulness of a psychiatric category. BMJ. 2001;322(7278):95-98. doi:10.1136/bmj.322.7278.95
17. Machleidt W, Calliess IT. Psychiatrisch-psychotherapeutische Behandlung von Migranten und Transkulturelle Psychiatrie. In: Psychiatrie und Psychotherapie. München: Urban und Fischer; 2003:281-201
18. Bar-Tal D. Sociopsychological Foundations of Intractable Conflicts. American Behavioral Scientist. 2007;50(11):1430-1453. doi:10.1177/0002764207302462
19. Canetti D, Elad-Strenger J, Lavi I, Guy D, Bar-Tal D. Exposure to Violence, Ethos of Conflict, and Support for Compromise. Journal Of Conflict Resolution. 2016;61(1):84-113. doi:10.1177/0022002715569771
20. Halperin E, Porat R, Tamir M, Gross JJ. Can Emotion Regulation Change Political Attitudes in Intractable Conflicts? From the Laboratory to the Field. Psychological Science. 2012;24(1):106-111. doi:10.1177/0956797612452572
21. Rosler N, Hameiri B, Bar-Tal D, Christophe D, Azaria-Tamir S. Current and Future Costs of Intractable Conflicts—Can They Create Attitude Change? Frontiers in Psychology. 2021;12:681883. doi:10.3389/fpsyg.2021.681883
22. Kizilhan JI. Die Jesiden: Religion, Kultur und Trauma. Psychosozial-Verlag; 2014.
23. Öztürk H, Günderci A, Tekin A. Forced migration-related traumatic experiences and collective memory in Ezidi asylum-seekers coming to Diyarbakir province from Shingal region. Social Psychiatry And Psychiatric Epidemiology. 2019;55(1):63-70. doi:10.1007/s00127-019-01749-z
24. Danieli Y. The Treatment and Prevention of Long-term Effects and Intergenerational Transmission of Victimization: A Lesson From Holocaust Survivors and Their Children. In: Trauma and Its Wake. Bd 1. 1. Aufl. Routledge; 1985.
25. Lev-Wiesel R. Intergenerational Transmission of Trauma across Three Generations: A Preliminary Study. Qualitative Social Work. 2007;6(1):75-94. doi:10.1177/1473325007074167
26. Alexander JC, Eyerman R, Giesen B, Smelser NJ, Sztompka P. Cultural Trauma and Collective Identity. University of California Press; 2004.
27. Volkan VD. Transgenerational Transmissions and Chosen Traumas: An Aspect of Large-Group Identity. Group Analysis. 2001;34(1):79-97. doi:10.1177/05333160122077730
28. Celik F. The Alevi of Dersim: A psychosocial approach to the effects of the massacre, time and space. In: Alevis in Europe: Voices of Migration, Culture, and Identity. 1. Aufl. Oxon Routledge; 2017:46-68. https://www.academia.edu/43983532/The_Alevi_of_Dersim_A_psychosocial_approach_to_the_effects_of_the_massacre_time_and_space_F%C4%B0L%C4%B0Z_%C3%87EL%C4%B0K
29. Brave Heart MYH. The return to the sacred path: Healing the historical trauma and historical unresolved grief response among the lakota through a psychoeducational group intervention. Smith College Studies in Social Work. 1998;68(3):287-305. doi:10.1080/00377319809517532
30. United Nations Office of the High Commissioner for Human Rights. Assessment of human rights concerns in the Xinjiang Uyghur Autonomous Region. United Nations; 2022.
31. Byler D. Terror capitalism: Uyghur dispossession and masculine domination. Duke University Press; 2021.
32. Faimon MB. Ties that Bind: Remembering, Mourning, and Healing Historical Trauma. The American Indian Quarterly. 2004;28(1):238-251. doi:10.1353/aiq.2005.0007
33. The Aboriginal Healing Foundation. Historic Trauma and Aboriginal Healing. Ottawa, Ontario: Anishinabe Printing; 2014.
34. Kellermann NPF. Transmission of Holocaust Trauma - An Integrative View. Psychiatry. 2001;64(3):256-267. doi:10.1521/psyc.64.3.256.18464
35. Steel Z, Chey T, Silove D, Marnane C, Bryant RA, Van Ommeren M. Association of Torture and Other Potentially Traumatic Events With Mental Health Outcomes Among Populations Exposed to Mass Conflict and Displacement. JAMA. 2009;302(5):537. doi:10.1001/jama.2009.1132
36. World Health Organization. Mental health of refugees. WHO; 2023. https://www.who.int/news-room/fact-sheets/detail/mental-health-of-refugees
37. Fazel M, Reed RV, Panter-Brick C, Stein A. Mental health of displaced and refugee children resettled in high-income countries: risk and protective factors. The Lancet. 2012;379(9812):266-282. doi:10.1016/s0140-6736(11)60051-2
38. World Health Organization. International Classification of Diseases (11th Revision). WHO; 2019. https://icd.who.int
39. Cloitre M, Shevlin M, Brewin CR, u. a. The International Trauma Questionnaire: development of a self‐report measure of ICD‐11 PTSD and complex PTSD. Acta Psychiatrica Scandinavica. 2018;138(6):536-546. doi:10.1111/acps.12956
40. Maercker A. Development of the new CPTSD diagnosis for ICD-11. Borderline Personality Disorder And Emotion Dysregulation. 2021;8(1):7. doi:10.1186/s40479-021-00148-8
41. Kizilhan JI, Wenzel T. Concepts of Transgenerational and Genocidal Trauma and the Survivors of ISIS Terror in Yazidi Communities and Treatment Possibilities. International Journal of Mental Health & Psychiatry. 2020;13(8).
42. Kizilhan JI, Noll-Hussong M, Wenzel T. Transgenerational Transmission of Trauma across Three Generations of Alevi Kurds. International Journal Of Environmental Research And Public Health. 2021;19(1):81. doi:10.3390/ijerph19010081
43. El-Awad U, Eves R, Hachenberger J, u. a. Post-migration stress mediates associations between potentially traumatic peri-migration experiences and mental health among Middle Eastern refugees in Germany. BMC Public Health. 2025;25(1):2582. doi:10.1186/s12889-025-23660-w
44. Heptinstall E, Sethna V, Taylor E. PTSD and depression in refugee children. European Child & Adolescent Psychiatry. 2004;13(6):373-380. doi:10.1007/s00787-004-0422-y
45. Rask S, Suvisaari J, Koskinen S, u. a. The ethnic gap in mental health: A population-based study of Russian, Somali and Kurdish origin migrants in Finland. Scandinavian Journal of Public Health. 2015;44(3):281-290. doi:10.1177/1403494815619256
46. Steel JL, Dunlavy AC, Harding CE, Theorell T. The Psychological Consequences of Pre-Emigration Trauma and Post-Migration Stress in Refugees and Immigrants from Africa. Journal Of Immigrant And Minority Health. 2017;19(3):523-532. doi:10.1007/s10903-016-0478-z
47. Li SSY, Liddell BJ, Nickerson A. The Relationship Between Post-Migration Stress and Psychological Disorders in Refugees and Asylum Seekers. Current Psychiatry Reports. 2016;18(9):82. doi:10.1007/s11920-016-0723-0
48. Gameon JA, Skewes MC. Historical trauma and substance use among American Indian people with current substance use problems. Psychology Of Addictive Behaviors. 2021;35(3):295-309. doi:10.1037/adb0000729
49. Pride T, Lam A, Swansburg J, u. a. Trauma-informed Approaches to Substance Use Interventions with Indigenous Peoples: A Scoping Review. Journal Of Psychoactive Drugs. 2021;53(5):460-473. doi:10.1080/02791072.2021.1992047
50. Wesley-Esquimaux CC. The intergenerational transmission of historic trauma and grief. In Indigenous Affairs. 2008;4(7):6–12.
51. Beckmann J, Wenzel T, Hautzinger M, Kizilhan JI. Training of psychotherapists in post-conflict regions: A Community case study in the Kurdistan Region of Iraq. Frontiers in Psychiatry. 2022;13:947903. doi:10.3389/fpsyt.2022.947903
52. Kizilhan JI, Weigelt A. Kultursensible Psychotherapie. In: Verhaltenstherapie Das Lehrbuch Für Medizin Und Psychologie. 1. Aufl. Kohlhammer; 2025:619-627.
53. Kellermann, N. P. F. Epigenetic transmission of Holocaust trauma: Can nightmares be inherited? Israel Journal of Psychiatry and Related Sciences. 2013;50(1):33–39.
54. Dalgaard NT, Montgomery E. Disclosure and silencing: A systematic review of the literature on patterns of trauma communication in refugee families. Transcultural Psychiatry. 2015;52(5):579-593. doi:10.1177/1363461514568442
55. Melander M, Dahlblom K, Jegannathan B, Kullgren G. Exploring communication of traumatic experiences from Khmer Rouge genocide survivors to their offspring: In-depth interviews with both generations. International Journal Of Social Psychiatry. 2016;62(4):327-333. doi:10.1177/0020764016631364
56. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. American Psychiatric Publishing; 2013.
57. Kizilhan JI, Noll-Hussong M. Individual, collective, and transgenerational traumatization in the Yazidi. BMC Medicine. 2017;15(1):198. doi:10.1186/s12916-017-0965-7
58. Hinton DE, Hinton AL, Eng K, Choung S. PTSD and Key Somatic Complaints and Cultural Syndromes among Rural Cambodians: The Results of a Needs Assessment Survey. Medical Anthropology Quarterly. 2012;26(3):383-407. doi:10.1111/j.1548-1387.2012.01224.x
59. Kirmayer LJ, Narasiah L, Munoz M, u. a. Common mental health problems in immigrants and refugees: general approach in primary care. Canadian Medical Association Journal. 2011;183(12):E959-E967. doi:10.1503/cmaj.090292
60. Kohrt BA, Hruschka DJ. Nepali Concepts of Psychological Trauma: The Role of Idioms of Distress, Ethnopsychology and Ethnophysiology in Alleviating Suffering and Preventing Stigma. Culture Medicine And Psychiatry. 2010;34(2):322-352. doi:10.1007/s11013-010-9170-2
61. Rees S, Silove D. Sakit Hati: A state of chronic mental distress related to resentment and anger amongst West Papuan refugees exposed to persecution. Social Science & Medicine. 2011;73(1):103-110. doi:10.1016/j.socscimed.2011.05.004
62. Coker EM. “Traveling Pains”: Embodied Metaphors of Suffering Among Southern Sudanese Refugees in Cairo. Culture Medicine And Psychiatry. 2004;28(1):15-39. doi:10.1023/b:medi.0000018096.95218.f4
63. National Institute for Health and Care Excellence. Process and methods: Developing NICE guidelines: the manual; 2018. https://www.nice.org.uk/process/pmg20
64. Shapiro F. Eye movement desensitization and reprocessing (EMDR) therapy: Basic principles, protocols, and procedures. The Guilford Press; 2018.
65. Neuner F, Onyut PL, Ertl V, Odenwald M, Schauer E, Elbert T. Treatment of posttraumatic stress disorder by trained lay counselors in an African refugee settlement: A randomized controlled trial. Journal Of Consulting And Clinical Psychology. 2008;76(4):686-694. doi:10.1037/0022-006x.76.4.686
66. Carter RT. Racism and Psychological and Emotional Injury. The Counseling Psychologist. 2007;35(1):13-105. doi:10.1177/0011000006292033
67. Kirkinis K, Pieterse AL, Martin C, Agiliga A, Brownell A. Racism, racial discrimination, and trauma: a systematic review of the social science literature. Ethnicity And Health. 2018;26(3):392-412. doi:10.1080/13557858.2018.1514453
68. Pascoe EA, Richman LS. Perceived discrimination and health: A meta-analytic review. Psychological Bulletin. 2009;135(4):531-554. doi:10.1037/a0016059
69. Kizilhan JI. Psychotherapy in a Multicultural Society. In: Oxford University Press eBooks. ; 2020:803-817. doi:10.1093/oxfordhb/9780198817338.013.54
70. Barbato A, Vallarino M, Rapisarda F, Lora A, Caldas De Almeida JM, European Union. Access To Mental Health Care in Europe – Consensus Paper.; 2016. https://health.ec.europa.eu/system/files/2016-12/ev_20161006_co04_en_0.pdf
71. Wiegand HF, Hölzel L, Tüscher O, Lieb K, Falkai P, Adorjan K. Mental health services in Germany – Structures, outcomes and future challenges. International Review Of Psychiatry. 2025;37(3-4):253-270. doi:10.1080/09540261.2025.2479601
72. Atzil-Slonim D, Martin J, Lutz W. Leveraging Novel Technologies and Artificial Intelligence to Advance Practice-Oriented Research. Administration and policy in mental health. Published online October 25, 2024. doi: https://doi.org/10.1007/s10488-023-01309-3
73. Deutsches Zentrum für Integrations- und Migrationsforschung (DeZIM). Rassismus und Seine Symptome: Bericht Des Nationalen Diskriminierungs- und Rassismusmonitors.; 2023. https://www.rassismusmonitor.de/fileadmin/user_upload/NaDiRa/Rassismus_Symptome/2023-11-07_NaDiRa-2023_Pressematerialien.pdf
74. Dahmer L. «Rassismus ist bis heute ein blinder Fleck in der Psychotherapie». À Jour! Psychotherapie-Berufsentwicklung. 2021;7(1):28-30. doi:10.30820/2504-5199-2021-1-28
75. Kahraman, B. Wozu Rassismuskritik in der Psychotherapie-Profession? Psychotherapeutenjournal. 2023;22(4):344–353.
76. Kupfer A, Enge R. Rassismus, Trauma und Beratung. Trauma und Gewalt. 2023;17(1):4-20. doi:10.21706/tg-17-1-4
77. Kahraman, B. Wozu Rassismuskritik in der Psychotherapie-Profession? Psychotherapeutenjournal. 2023;22(4):344–353.
78. Kupfer A, Enge R. Rassismus, Trauma und Beratung. Trauma und Gewalt. 2023;17(1):4-20. doi:10.21706/tg-17-1-4
79. Norris FH, Stevens SP, Pfefferbaum B, Wyche KF, Pfefferbaum RL. Community Resilience as a Metaphor, Theory, Set of Capacities, and Strategy for Disaster Readiness. American Journal Of Community Psychology. 2008;41(1-2):127-150. doi:10.1007/s10464-007-9156-6
80. Im H, Verbillis-Kolp S, Atiyeh S, u. a. Implementation Evaluation of Community-Based Mental Health and Psychosocial Support Intervention for Refugee Newcomers in the United States. Health & Social Care in The Community. 2023;2023:1-20. doi:10.1155/2023/6696415
81. Fuhr DC. Global Mental Health: The relevance of implementing low intensity psychological interventions in Germany. Public Health Forum. 2025;33(3):241-243. doi:10.1515/pubhef-2025-0055
82. Grabbe L, Duva IM, Nicholson WC. The Community Resiliency Model, an interoceptive awareness tool to support population mental wellness. Cambridge Prisms Global Mental Health. 2023;10:e43. doi:10.1017/gmh.2023.27
83. Habimana S, Biracyaza E, Habumugisha E, Museka E, Mutabaruka J, Montgomery SB. Role of Community Resiliency Model Skills Trainings in Trauma Healing Among 1994 Tutsi Genocide Survivors in Rwanda. Psychology Research And Behavior Management. 2021;Volume 14:1139-1148. doi:10.2147/prbm.s319057
84. Marris W. GUIDE: Trauma-Informed Community Change. CTIPP. Published 19. Juli 2023. https://www.ctipp.org/post/guide-to-trauma-informed-community-change