Evaluating interventions for posttraumatic stress disorder in low and middle income countries: Narrative Exposure Therapy

This article provides a framework for evaluating randomised controlled efficacy trials for the treatment of posttraumatic stress disorder, in low and middle income countries, applied to Narrative Exposure Therapy. A list of methodological and conceptual indicators to evaluate trial data was developed and utilised to assess six trials. The efficacy of this therapy to reduce symptoms is mainly deduced from effects that were measured at long term follow-up points, and that had not been seen at relatively early follow-up points.

On the efficacy of Narrative Exposure Therapy: a reply to Mundt et al.

In their review article, Mundt et al. (2014), ‘Evaluating interventions for posttraumatic stress disorder in low and middle income countries: Narrative Exposure Therapy’, (Intervention, this issue) evaluated Narrative Exposure Therapy (NET) as an example of a short-term treatment for posttraumatic stress disorder that is applied in low and middle income, post conflict settings. They concluded that it is premature to recommend NET as a treatment approach.

Vertical trauma focussed interventions versus broader horizontal psychosocial interventions

Despite an influx of agencies conducting psychiatric and psychosocial interventions worldwide, there is scarce agreement regarding treatment goals and best practice to deal with trauma related mental disorders. A systematic review of posttraumaticc stress disorder treatments concluded that scientific evidence on treatment modalities did not reach the level of certainty that would be desired. This commentary ends by outlining the kind of evidence that would be required.

Do we really have enough evidence on Narrative Exposure Therapy to scale it up?

This invited commentary reflects on utilising Narrative Exposure Therapy protocols in very different cultural setting than those they were originally developed for, and is a response to Mundt et al. (this issue) and Neuner, Schauer & Elbert (this issue). The author discusses several key issues that should be considered, including: the allegiance effect, demand characteristics, clinical efficacy, and ecological validity.

Mental health of refugees and displaced persons in Syria and surrounding countries: a systematic review

Over the past two years, Syria went from being the third largest refugee hosting country in the world to the largest refugee producing country. This article provides the findings of a systematic literature review on the mental health and psychosocial support context, and the mental health profile of refugees (primarily Iraqi) and civilians in Syria.

‘I Can’t Go Home’. Forced migration and displacement following demobilisation: the complexity of reintegrating former child soldiers in Colombia

This paper examines the reintegration experiences of a group of demobilised youth who were associated with various armed groups during the course of ongoing armed conflict in Colombia. In particular, the paper traces how the realities of forced migration and displacement profoundly shape and inform their reintegration experiences.

Further thoughts on evaluating interventions for posttraumatic stress disorder in low and middle income countries

While agreeing that there are very few studies on Narrative Exposure Therapy, the author responds to the critique of Mundt et al. (elsewhere in this issue), by arguing that psychological interventions should not only, nor primarily, be evaluated by outcomes immediately after the end of the intervention.

Mental health, forced displacement and recovery: integrated mental health and psychosocial support for urban refugees in Syria

This article describes a pilot mental health and psychosocial support programme that was initiated by the United Nations High Commissioner for Refugees, after the massive influx of Iraqi refugees into Syria in 2006. The aim of the article is to provide: 1) an overall description of the programme for refugees within an urban setting, including initial outcome data; and 2) a description of applying a theoretical model to influence programme design and evaluation. This programme, based on good practice, began in 2008.