Narrative Exposure Therapy as a treatment for child war survivors with posttraumatic stress disorder: Two case reports and a pilot study in an African refugee settlement

Abstract

Background: Little data exists on the effectiveness of psychological interventions for children with posttraumatic stress disorder (PTSD) that has resulted from exposure to war or conflictrelated violence, especially in non-industrialized countries. We created and evaluated the efficacy of KIDNET, a child-friendly version of Narrative Exposure Therapy (NET), as a short-term treatment for children.

Treatment of post‐traumatic stress disorder in children using cognitive behavioural writing therapy

“…Similar to conventional exposure therapy, NET aims to reduce PTSD symptoms by confronting the patient with the memories of the traumatic event (Onyut et al, 2005). The focus of NET is to integrate the typically fragmented, gap-fi lled reports of traumatic experiences into a coherent narrative and to bring about the habituation of emotional responses to reminders of the traumatic event (Bichescu, Neuner, Schauer, & Elbert, 2007).…”

The effectiveness of psychosocial interventions in war-traumatized refugee and internally displaced minors: systematic review and meta-analysis

“…Fourteen of 20 pre-post effect sizes for PTSD were significant, ranging from small (SMC = 0.29, Lange-Nielsen et al, 2012) to large (SMC = 1.94, Onyut et al, 2005). Eight of the significant effects were achieved using CBT techniques, two in a meditation-relaxation condition (Catani et al, 2009; Schauer, 2008), one with a general education programme (Gupta & Zimmer, 2008), one with EMDR combined with psychodynamic therapy (Oras et al, 2004), one with a writing intervention (Lange-Nielsen et al, 2012), and a multilevel treatment particularly oriented to the needs of young refugees (Ellis et al, 2013).…”

“…O’Shea and colleagues did not report the reasons for the high attrition. Two studies reported intent-to-treat analyses (Betancourt et al, 2012a; Onyut et al, 2005). …”

“…Thirteen out of 23 studies examined the effect of evidence-based treatments, such as interpersonal therapy (IPT) (Betancourt et al, 2012a), strict cognitive behavioural therapy (CBT) (Catani et al, 2009; Onyut et al, 2005; Pfeiffer & Goldbeck, 2017; Schauer, 2008; Schottelkorb et al, 2012), eclectic CBT with other elements (Ehntholt, Smith, & Yule, 2005; Möhlen, Parzer, Resch, & Brunner, 2005; Ooi, 2012; Ooi et al, 2016; Šehović, 2002; Tol et al, 2012), or eye movement desensitization and reprocessing (EMDR; within a psychodynamic therapy) (Oras, De Ezpeleta, & Ahmad, 2004). …”

“…PTSD outcomes were reported for 10 active CBT treatment groups (Catani et al, 2009; Ehntholt et al, 2005; Onyut et al, 2005; Ooi et al, 2016; both treatment and later treated waitlist group; Pfeiffer & Goldbeck, 2017; Schauer, 2008; Schottelkorb et al, 2012; Tol et al, 2012; separately for boys/girls), and depression outcomes for seven active CBT treatment groups (Ehntholt et al, 2005; Onyut et al, 2005; Ooi et al, 2016; treatment and later treated waitlist group; Schauer, 2008; Tol et al, 2012; separately for boys/girls). The combined pre-post effect sizes were SMC = 0.79, 95% CI [0.47, 1.11] for PTSD (total N  = 394), and SMC = 0.30, 95% CI [0.18, 0.43] for depression (total N  = 337) (Figures 2 and 3, respectively).…”