An initial evaluation of narrative exposure therapy as a treatment of posttraumatic stress disorder among Sudanese refugees in Cairo, delivered by lay counselors

Abstract

Background The growing worldwide refugee crisis highlights the needs for increased access to mental health services, including in the large urban cities in the Middle East to which refugees are frequently displaced and in which access to such services is limited. The current study offers an initial evaluation of narrative exposure therapy as a treatment for posttraumatic stress disorder among Sudanese refugees in Cairo, delivered by lay counselors. Sudanese refugees with no prior background in counseling were given 27 h of training in narrative exposure therapy. They then delivered this to seven members of the same refugee community with a diagnosis of posttraumatic stress disorder at a local community center, and this was evaluated using a pre-post design and a focus-group with the intervention recipients. Results Despite the small sample size, over the course of the intervention there was significant decrease in trauma and anxiety symptoms, and a close to significant decrease in depression. Moreover, the focus group participants generally spoke positively about their experiences. Conclusions To the best of the authors’ knowledge, this is the first study to examine the viability of lay counselors delivering narrative exposure therapy to refugees with posttraumatic stress disorder in a complex urban setting. The findings suggest that this approach has promise and support the case for a randomized control trial of narrative exposure therapy delivered in this manner in such a setting.

A systematic review of digital storytelling as psychotherapy for people with mental health needs.

“…Therefore, according to King (2012), the possibility that patients can develop selfunderstanding by incorporating events, feelings, and thoughts that had been discarded portrays the power of narrative psychotherapy. Moreover, studies that examined the effectiveness of narrative exposure therapy as a form of storytelling intervention in different countries reported a significant positive effect on patients' recovery from trauma spectrum disorders, especially posttraumatic stress disorder (PTSD; Ellis & Jones, 2022;Kaltenbach et al, 2020;Lely et al, 2022;Raghuraman et al, 2021) Thus, previous studies on digital storytelling in mental health support its use as a best practice psychotherapeutic method to depict patients' actual experiences and promote well-being (De Vecchi et al, 2016;Stargatt et al, 2022), narratively reconstruct and forecast causal paths over time (Currie & Sterelny, 2017) and share research evidence with a secular audience (Ilic ́-García, et al, 2022). However, the study of the mental health effects of digital storytelling using role-playing game media is rare.…”

“…Therefore, according to King (2012), the possibility that patients can develop self-understanding by incorporating events, feelings, and thoughts that had been discarded portrays the power of narrative psychotherapy. Moreover, studies that examined the effectiveness of narrative exposure therapy as a form of storytelling intervention in different countries reported a significant positive effect on patients’ recovery from trauma spectrum disorders, especially posttraumatic stress disorder (PTSD; Ellis & Jones, 2022; Kaltenbach et al, 2020; Lely et al, 2022; Raghuraman et al, 2021)…”

Narrative exposure therapy to address PTSD symptomology with refugee and migrant children and youth: A review.

“…Evidence suggests that NET outperforms non-trauma-focused therapies such as general counseling and general cognitive-behavioral therapy (Grech & Grech, 2020). Although the comparative impact of NET is less clear when compared directly with PTSD-specific therapies such as eye movement desensitization and reprocessing and trauma-focused cognitive-behavioral therapy (Gene-Cos, 2006), NET carries the advantage of being highly adaptable to diverse cultural contexts and can be implemented by professionals and trained nonprofessionals alike (Ellis & Jones, 2022; Grech & Grech, 2020). NET’s adaptability and range of implementation options makes it advantageous in environments such as refugee contexts, where resources are limited.…”