A randomised controlled pilot study: the effectiveness of narrative exposure therapy with adult survivors of the Sichuan earthquake

Abstract

BackgroundPost-Traumatic Stress Disorder (PTSD) is a common psychological reaction after large-scale natural disasters. Given the number of people involved and shortage of resources in any major disaster, brief, pragmatic and easily trainable interventions are needed. The aim of this study is to evaluate the efficacy of Narrative Exposure Therapy (NET) as a short-term treatment for PTSD using Chinese earthquake survivors.MethodsA randomized waiting-list control pilot study was conducted between December 2009 and March 2010, at the site of the Sichuan earthquake in Beichuan County, China. Adult participants with newly diagnosed Post Traumatic Stress Disorder (PTSD) were randomly allocated to Narrative Exposure Therapy (NET) or a Waiting-List (WL) condition. The latter received NET treatment after a two-week waiting period. To compare the effectiveness of NET in traumatised earthquake survivors, both groups were assessed on PTSD symptoms, general mental health, anxiety and depression, social support, coping style and posttraumatic change before and after treatment and two months post treatment.ResultsAdult participants (n=22) were randomly allocated to receive NET (n=11) or WL (n=11). Twenty two participants (11 in NET group, 11 in WL) were included in the analysis of primary outcomes. Compared with WL, NET showed significant reductions in PTSD symptoms, anxiety and depression, general mental stress and increased posttraumatic growth. The WL group later showed similar improvements after treatment. These changes remained stable for a two-month follow-up. Measures of social support and coping showed no stable effects.ConclusionsNET is effective in treating post-earthquake traumatic symptoms in adult Chinese earthquake survivors. The findings help advance current knowledge in the management of PTSD after natural disasters and inform future research. Larger sample sizes are needed to extend the present findings.Trial registrationChinese Clinical Trial Registry ChiCTR-TRC-12002473

Medical Rehabilitation in Natural Disasters: A Review

“…Participants' ages ranged from 9 to 76 years, and most were women (1 study included only survivors who were women 20 ). Three studies evaluated rehabilitation interventions in cohorts of limb fracture victims, 21-23 2 included SCI survivors, 24,25 1 evaluated newly diagnosed posttraumatic stress disorder (PTSD) victims, 26 and 1 included school children. 27 Rehabilitation interventions and outcome measures description Table 3 summarizes the rehabilitation interventions in included studies.…”

“…27 Rehabilitation interventions and outcome measures description Table 3 summarizes the rehabilitation interventions in included studies. Institution-based rehabilitation programs were evaluated in 6 studies, [21][22][23][24][25][26] 3 studies evaluated CBR, 20,27 and 1 study evaluated both institution-based rehabilitation and CBR. 28 The intervention types varied and ranged from comprehensive multidisciplinary rehabilitation programs to structured mental health community programs.…”

Rehabilitation of vulnerable groups in emergencies and disasters: A systematic review

“…[36,37] Disaster management experts believe that physical and physiological rehabilitation should be immediately started after response phase to disaster and it should continue in the community over the long term in order to improve and restore function of vulnerable peoples. [13,38,39] One of the studies emphasized social rehabilitation of vulnerable groups in order to ensure the participation of vulnerable groups in the planning and implementation World J Emerg Med, Vol 8, No 4, 2017 (2) intent to delegate responsibility; and (3) desire for a wide scope of social support.…”

“…Zhang et al [36] (2013) Zang et al [37] (2013) Vol 8, No 4, 2017 of services and activities from the day after the onset of the disaster based on the equal time and opportunity to governmental authorities and aid agencies. The strategies that can increase the participation of the vulnerable groups in meeting their needs include: (1) providing services with the cooperation of the people based on the capacity and potency; and (2) dependency of the vulnerable groups to the external services that should be gradually decreased.…”

“…Details of each study and their special features were reported regarding authors, year, study type, vulnerable group, sample size, type of rehabilitation, setting and duration of rehabilitation, disaster type, and main concepts. The studies were mainly conducted in Asian countries and United States, including India, [15,19,20,[25][26][27]31] China, [18,22,23,34,36,37] Pakistan, [16,28,30] Iran, [13,17,21] Indonesia, [29,32] Sri Lanka [35] and United States. [14,24,33] The results of the studies showed that 56% of the studies are about rehabilitation programs for women, 32% is for children, 24% is for elderly, and 16% is for disabled people.…”