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. Although randomised controlled trials have demonstrated impressive support for Narrative Exposure Therapy in conflict settings, several issues remain to be addressed prior to large scale use of the therapy within traditional cultures.