narrative exposure therapy

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.

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.

Don't fault RCTs for not testing systems of care

Among Mundt and colleagues’ (2014) criticisms of NET is that testing a particular intervention implies that it is meant to be delivered irrespective of systems of care. But trauma-focused treatments should be judged based on the specific problems they target; larger sets of problems are the purview of health systems research.

Experiences with Narrative Exposure Therapy across three income contexts

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.