Narrative Exposure Therapy

Abstract

Pregnant and parenting adolescents often experience high rates of intimate partner violence (IPV) and its sequelae posttraumatic stress disorder (PTSD) and depression. Narrative Exposure Therapy (NET) is an innovative intervention that has demonstrated strong preliminary evidence in improving mental health. The specific aims of this article are threefold: a) provide a brief background about IPV-related PTSD and depression among pregnant and parenting adolescents, b) describe NET’s theoretical principals, its therapeutic process, and provide review of existing evidence and c) to discuss NET as a potential treatment to address that mental health burden among adolescents experiencing IPV-related PTSD and depression.

Psychological Intervention and Treatment for Posttraumatic Stress Disorder During Pregnancy: A Systematic Review and Call to Action

“…There is a significant need to determine the efficacy and effectiveness of both exposure-based treatments and those that do not involve providing a detailed trauma account. Thus, exposure-based therapies, such as PE, NET, and TF-CBT, are promising approaches to systematically explore in future research alongside other evidence-based treatments, such as CPT (National Institute for Health and Clinical Excellence, 2014;Volpe, Quinn, Resch, Douglas, et al, 2017;Volpe, Quinn, Resch, Sommers, et al, 2017). For pregnant women with subthreshold PTSD symptoms or women who prefer not to engage in trauma-focused treatment, interventions such as SMC and SS may be beneficial.…”

“…Psychological interventions and treatments for PTSD are likely acceptable and feasible during pregnancy, as suggested by the studies reviewed herein. Moreover, prior research has demonstrated that integrated approaches within medical settings as well as community-based approaches may be effective, cost-saving, and could potentially minimize mental health stigma (Arch et al, 2012;Malebranche et al, 2017;Volpe, Quinn, Resch, Sommers, et al, 2017). Further, technology-based approaches should also be considered given treatment barriers both preceding and exacerbated by the COVID-19 pandemic (Torous & Wykes, 2020).…”

“…Individuals may be more likely to engage in treatment when it is offered by obstetricians, nurses, and nurse-midwives as a matter of routine, much like any medical condition or pregnancy complication. Additionally, community-based participatory approaches to clinical intervention research are important to mitigate the sense of fear, stigma, and distrust of the medical profession, particularly among populations in which individuals are less likely to disclose symptoms and engage in treatment (Fripp & Carlson, 2017;Hasselle et al, 2019;Volpe, Quinn, Resch, Sommers, et al, 2017). Testing a combination of integrated prenatal care and community-based approaches may be needed to ensure the most effective treatments are being delivered to the individuals who need them.…”

Narrative storytelling as mental health support for women experiencing gender-based violence in Afghanistan

“…This conceptual diagram of how women in Afghanistan safe houses describe the therapeutic effects of storytelling largely contradicts biomedical understandings of how individuals recover from trauma through telling personal narratives. Whereas cognitive behavioural therapy (CBT) and exposure therapies (PE and NET) focus on the telling and retelling of a specific traumatic event as a means of alleviating symptoms of trauma (Volpe et al, 2017), our results highlighted the presence of multiple traumatic events and a need for participants to discuss these traumas in the context of narratives that reaffirm positive self-identities in the face of persistent patriarchal and structural gender violence. Doing so presents a major challenge to biomedical approaches to M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPT trauma focused on 'maladaptive' cognitions by highlighting the social, rather than individual, nature of the trauma and its related symptoms.…”

Effects of Narrative Exposure Therapy for Treating Depressive and Anxious Disorders: A Systematic Review and Meta-Analysis

“…With a follow-up period of less than a month, NET was found to be more effective in reducing negative emotions associated with change but not in reducing feelings of stigma or increasing social support. One study found that when NET was used for the successful treatment of serious illnesses, it could also help people feel better emotionally [ 49 ]. However, the strength of the data was deemed insufficient to assess the effect of story exposure treatment on patients with negative emotions since only 3 of the 12 studies investigated social support [ 33 - 35 ].…”