As members of an international nongovernmental organisation that operates across a variety of income contexts, and works with local counsellors to co-create local capacity in contexts ravaged by atrocities and deprivation, the authors offer their experiences with Narrative Exposure Therapy. The authors have found Narrative Exposure Therapy to be an effective clinical and training tool where practical considerations allow it. These considerations, including the high level of counsellor skill and the individual modality the therapy requires, should not be underestimated.