Article

Narrative Exposure Therapy for 7-to 16-year-olds: A Randomized Controlled Trial With Traumatized Refugee Children

University of Konstanz and Vivo, Konstanz, Germany.
Journal of Traumatic Stress (Impact Factor: 2.72). 08/2010; 23(4):437-45. DOI: 10.1002/jts.20548
Source: PubMed

ABSTRACT

The authors examined the effectiveness of narrative exposure therapy for children (KIDNET) in treating posttraumatic stress disorder (PTSD) in refugee children living in exile. Twenty-six children traumatized by organized violence were randomly assigned to KIDNET or to a waiting list. Significant treatment by time interactions on all PTSD-relevant variables indicated that the KIDNET group, but not the controls, showed a clinically significant improvement in symptoms and functioning. Success of the KIDNET group remained stable at 12-month follow-up. This study confirms previous findings that, if left untreated, PTSD in children may persist for an extended period. However, it also shows that it is possible to effectively treat chronic PTSD and restore functioning in traumatized refugee children in only 8 treatment sessions.

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    • "A. Köbach et al. demonstrated superiority in comparison with active (e.g., Bichescu, Neuner, Schauer, & Elbert, 2007; Catani et al., 2009; Hensel-Dittmann et al., 2011; Ertl et al., 2011; Neuner, Schauer, Klaschik, Karunakara, & Elbert, 2004) and inactive (e.g., Crombach & Elbert, 2014b; Hermenau, Hecker, Schaal, Mädl, & Elbert, 2013; Adenauer et al., 2011; Ruf et al., 2010) control conditions with regard to the reduction of PTSD severity/diagnosis and related disorders. Cohen's d effect sizes are large. "
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    ABSTRACT: Background: Depending on the exposure to traumatic stressors and combat, 20% to 50% of ex-combatants present with trauma-related disorders, and more than half of the members of armed groups have a proclivity to violence. Therefore, psychotherapeutic assistance should address both, trauma-related suffering and the lowered threshold for aggressive behaviour. Objective: Supporting the demobilization process of ex-combatants in the eastern DR-Congo, we implemented a version of Narrative Exposure Therapy adapted for Forensic Offender Rehabilitation (FORNET). Method: In two successive dissemination stages (DS), local counsellors conducted FORNET. In DS1, they were trained by clinical experts, and in DS2, the by then experienced counsellors trained and supervised a second group of local counsellors (DS2). The training consisted of a 3-week workshop covering theoretical concepts and practical therapeutic skills. In DS1 and DS2, a total of 98 demobilizing combatants received an intervention; treatment-as-usual served as the control condition. Posttraumatic stress disorder, appetitive aggression, depression severity and drug dependence were assessed prior to the intervention and 6 and 12months later; additionally, we assessed reintegration success. Results: Six months post-intervention, FORNET significantly reduced Posttraumatic stress disorder symptoms but had less effect on the trait of appetitive aggression; moreover, beneficial effects were found for depression severity and drug dependence as well as for reintegration indices. Treatment gains were retained at 12months. Conclusions: Individuals without previous training in psychotherapy can learn to effectively apply the brief intervention FORNET and support the demobilization process in ongoing conflicts. The study suggests that it is possible to pass down psychotherapeutic techniques over generations of counsellors.
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    • "Thus, reducing secrecy may be a promising target in the treatment of sexually abused children. Research shows that disclosing traumatic experiences (e.g., through writing and/or talking) in therapy is associated with a range of positive outcomes for adults as well as children (Bradley & Follingstad, 2001; Deblinger, Mannarino, Cohen, Runyon, & Steer, 2011; Graham-Bermann, Kulkarni, & Kanukollu, 2011; Ruf et al., 2010; Van der Oord, Lucassen, Van Emmerik, & Emmelkamp, 2010). Also, traumatized children show better recovery when they are supported by their mother when discussing the impact of traumatic experiences, compared to support by a therapist only (Berkowitz, Smith Stover, & Marans, 2011). "
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    • "Meanwhile, a number of studies showing the effectiveness of NET have been conducted completely independent from the originators of NET (Zang et al., 2013; Hijazi, 2012; Hijazi et al., 2014; Gwozdziewycz and Mehl-Madrona, 2013; Ejiri et al., 2012; D omen et al., 2012) and thus the NET procedure has been successfully implemented in a variety of countries (e.g., Zech and Vandenbussche, 2010; Jongedijk, 2012, 2014). NET is available in special adaptations for offenders (FORNET; Elbert et al., 2012; Hermenau et al., 2013; Crombach and Elbert, 2014) and for children and adolescents (KIDNET; Schauer et al., 2005, 2004/2011; Onyut et al., 2005; Catani et al., 2009; Ruf et al., 2010; Hermenau et al., 2012; Neuner et al., 2008a; Ruf and Schauer, 2012). "
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    ABSTRACT: This article was originally published in the International Encyclopedia of the Social & Behavioral Sciences, 2nd edition, published by Elsevier, and the attached copy is provided by Elsevier for the author's benefit and for the benefit of the author's institution, for non-commercial research and educational use including without limitation use in instruction at your institution, sending it to specific colleagues who you know, and providing a copy to your institution's administrator. All other uses, reproduction and distribution, including without limitation commercial reprints, selling or licensing copies or access, or posting on open internet sites, your personal or institution's website or repository, are prohibited. For exceptions, permission may be sought for such use through Elsevier's permissions site at:
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