Narrative exposure therapy for PTSD.

Author(s):  
Frank Neuner ◽  
Thomas Elbert ◽  
Maggie Schauer
2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Natalie R. Stevens ◽  
Michelle L. Miller ◽  
Christina Soibatian ◽  
Caitlin Otwell ◽  
Anne K. Rufa ◽  
...  

Abstract Background Prenatal posttraumatic stress disorder (PTSD) is a significant complication of pregnancy linked to increased risk of adverse perinatal outcomes. Although 1 in 5 pregnant trauma-exposed individuals have PTSD, most PTSD treatment trials exclude participants who are pregnant, and none focus on treatment specifically during pregnancy. Moreover, access to mental health treatment is particularly challenging in low-resource settings with high rates of trauma. This study examined implementation of Narrative Exposure Therapy (NET), a short-term evidence-based PTSD treatment, in an urban prenatal care setting. Partial telehealth delivery was used to increase accessibility. Study aims were to examine (a) feasibility, (b) acceptability, and (c) case-based treatment outcomes associated with NET participation. Method Eight pregnant participants (median age = 27, median gestational week in pregnancy = 22.5) received up to six sessions of NET with partial telehealth delivery. PTSD and depression symptoms were assessed at pre-treatment intake (T1), at each session (T2), and 1-week post-treatment (T3). A multiple case study approach was used to examine recruitment and engagement, retention, treatment completion, treatment barriers, use of telehealth, participants’ experiences of treatment, and PTSD and depression symptoms. Results Nine of the 16 participants (56%) who were invited to participate engaged in treatment, and one dropped out after the first session. Eight participants completed the minimum “dose” of 4 NET sessions (N = 8/9, 89%). Seven participants gave the highest ratings of treatment acceptability. The most frequently reported barriers to treatment were competing priorities of work and caring for other children. Pre-post treatment symptom measures revealed clinically meaningful change in PTSD severity for nearly all participants (7/8, 88%). Conclusions Results suggest that a brief exposure therapy PTSD treatment can be successfully implemented during pregnancy, suggesting promising results for conducting a larger-scale investigation. Trial registration ClinicalTrials.gov, NCT04525469. Registered 20 August 2020–Retrospectively registered, https://register.clinicaltrials.gov/prs/app/template/EditRecord.vm?epmode=View&listmode=Edit&uid=U00058T2&ts=3&sid=S000A59A&cx=-w1vnvn


2021 ◽  
pp. 11-24
Author(s):  
Katy Robjant ◽  
Danie Meyer ◽  
Elisabeth Kaiser ◽  
Elisa Kaltenbach ◽  
Maggie Schauer

e-NET: La terapia dell'esposizione narrativa virtuale sfide e opportunità nell'offrire trattamenti per il trauma da remoto. Nell'ambito della salute mentale, a fronte dei diversi tentativi di accrescere l'accesso a cure basate sull'evidenza, soltanto un numero ristretto di pazienti riceve trattamenti trauma-focali adeguati. L'innovazione tecnologica è sempre più centrale nella facilitazione di scambi comunicativi virtuali rendendo non più necessario che il terapeuta e il paziente si trovino nello stesso luogo fisico. La e-NET, cioè la versione online del trattamento della Terapia dell'Esposizione Narrativa, rappresenta un'opzione ecologica ed economica per offrire terapie focalizzate sul trauma, oltre i confini e le restrizioni di movimento, superando le barriere per raggiungere popolazioni che non hanno, solitamente, un accesso semplice ai trattamenti. I traduttori e i professionisti sanitari possono accedere alla stanza virtuale della terapia in qualsiasi momento e non solo per offrire il trattamento ma anche per formare, dare supporto e fare supervisioni a terapeuti che lavorano sul trauma in tutto il mondo. L'articolo affronta le opportunità e le sfide di questo approccio innovativo, che si radica nel protocollo NET tradizionale, e propone casi clinici. I test post-trattamento dimostrano che la procedura è fattibile ed efficace e che sia necessaria una valutazione scientifica rigorosa come prossimo passo.


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