Narrative Exposure Therapy for Treating PTSD With Psychotic Features

Katsounari, Ioanna

doi:10.1177/1534650114559831

Cited by 6 publications

(6 citation statements)

References 33 publications

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“…Furthermore, NET seemed to improve the long-term outcome of biofeedback on chronic pain. The four single case studies provide further evidence of feasibility to treat patients with severe PTSD disorder, and/or severe comorbidities or challenges, including a severely dissociative client who was unable to speak (Neuner et al, 2002) or a psychotic client suffering from PTSD and paranoid features (Katsounari, 2015). In line with the observation that dissociative symptoms significantly reduce with NET treatment, Halvorsen et al (2014) reanalyzed data from a RCT (Stenmark et al, 2013) and found that symptoms of dissociation neither moderated treatment outcome nor predicted the dropout rate in NET.…”

Section: Review Of Adult Net Studies Not Included In the Meta-analysesmentioning

confidence: 85%

Systematic review and meta-analyses of the long-term efficacy of narrative exposure therapy for adults, children and perpetrators

Siehl

Robjant

Crombach

2020

Psychotherapy Research

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Objective: Narrative Exposure Therapy (NET) is a short-term trauma-focused intervention originally developed for treating survivors of war and torture. The neurobiological theoretical foundations of NET would suggest that the approach should have long term beneficial effects. We tested this assumption and also provided an extensive overview of all NET studies for adults, for children (KIDNET), and for perpetrators (Forensic Offender Rehabilitation NET; FORNET). Method: Following a systematic literature review, we conducted meta-analyses with all studies that had control conditions, and with all Randomized Controlled Trials (RCTs). We assessed between-groups short-(< 6 months) and long-term (≥ 6 months) effect sizes for symptoms of posttraumatic stress disorder (PTSD) and depression. Results: In a total of 56 studies from 30 countries comparing 1370 participants treated with NET to 1055 controls, we found large between group effect sizes regarding the reduction of PTSD symptoms in favor of NET. Analyses of RCTs with active controls yielded small to medium effect sizes in the short-term, and large effect sizes in the long-term. Conclusions: NET, KIDNET, and FORNET yield beneficial and sustainable treatment results for severely traumatized individuals living in adverse circumstances. Studies in highly developed health care systems comparing NET with other evidence-based trauma-focused interventions are needed.

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Section: Review Of Adult Net Studies Not Included In the Meta-analysesmentioning

confidence: 85%

Systematic review and meta-analyses of the long-term efficacy of narrative exposure therapy for adults, children and perpetrators

Siehl

Robjant

Crombach

2020

Psychotherapy Research

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“…There is growing awareness that the sociopolitical and historical contexts of trauma experiences have a major influence on the expression of PTSD (Katsounari, 2015). For instance, Barr et al (2022) recently identified that exposure to anti-transgender bias and higher levels of non-affirmation were associated with greater PTSD severity, even after controlling for exposure to other traumas.…”

Section: Theoretical and Research Basis For Treatmentmentioning

confidence: 99%

Narrative Exposure Therapy for Treating Post-Traumatic Stress Among Transgender Youth of Color With Selective Mutism

Casas

Conn

2023

Clinical Case Studies

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Rates of post-traumatic stress (PTS) are greater among transgender and non-binary (TGNB) youth compared to their cisgender peers. This disparity has been linked to increased experiences of trauma among TGNB youth, including greater exposure to child abuse, discrimination, hate crimes, and familial and peer bullying and rejection. Few studies to date have examined the use of trauma-focused interventions with TGNB youth. Narrative Exposure Therapy (NET) has been identified as a potentially impactful treatment for PTS for communities who experience oppression and human rights violations given its social justice-oriented “testimonial” approach and focus on meaning-making around traumatic experiences. While narrative-based approaches are often considered “best practice” for trauma interventions, youth may present with comorbid conditions that present barriers or often preclude them from receiving trauma treatment, such as selective mutism (SM). In this case series, we describe the use of NET for treating PTS symptoms in two transgender youth with comorbid SM, as well as adaptations to support their engagement and progress in treatment. Treatment progress was observed in reduction of PTS symptoms, increase in self-reported resilience and positive well-being, and full remission of SM, with treatment gains observed 6-months post-discharge. From these cases, we identified that (1) NET is a brief treatment that can address PTS and SM symptoms among TGNB youth; (2) NET is able to be adapted to enhance engagement in a narrative-based, trauma-focused therapy for youth with PTS and SM; and (3) NET can also increase self-perceived resilience and a sense of positive well-being for TGNB youth.

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“…This was evident in her ability to label emotions and connect them to thoughts and body sensations in NET was a significant asset in treatment. Orientation to emotion regulation strategies significantly aided engagement and coping in exposure-based PTSD treatment, especially during the experience of increased distress and panic attacks commonly experienced in exposure-based treatments (Katsounari, 2015), which should be considered as an adjunct to exposure-based treatments.…”

Section: Recommendations To Clinicians and Studentsmentioning

confidence: 99%

Skills Training in Affective and Interpersonal Regulation for Refugees Integrated With Narrative Exposure Therapy: A Case Study on the Treatment of PTSD and Emotion Dysregulation for Refugees and Asylum-Seekers

Tissue

Specker

Hoffman

et al. 2022

Clinical Case Studies

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The prevalence of post-traumatic stress disorder (PTSD) in individuals affected by war and conflict is high, with approximately 1 in 3 refugees and asylum-seekers meeting diagnostic criteria for PTSD. PTSD in refugees and asylum-seekers is associated with significant emotion dysregulation which may arise from chronic trauma exposure and post-migration stressors and lead to impaired day-to-day functioning. There is evidence that treatments that target emotion regulation skills prior to implementing exposure-based therapies lead to improved treatment response and reduced attrition in survivors of interpersonal traumas such as sexual abuse. The current case study details the use of a novel adaptation of one such treatment – Skills Training in Affective and Interpersonal Regulation for refugees and asylum-seekers (STAIR-R). In this case study, we report on the implementation of STAIR-R in combination with Narrative Exposure Therapy (NET) with Sara, a 60-year-old Iraqi woman who presented with high levels of nightmares, avoidance and emotion dysregulation following exposure to war- and conflict-related trauma and post-migration stressors. In this case study, we explore the intersection of emotion regulation skills training (in STAIR-R) and exposure therapy (in NET), and the potential for this combined intervention to improve emotion regulation skills, enhance coping with post-migration stressors and facilitate engagement with exposure-based treatment for PTSD.

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Narrative Exposure Therapy for Treating PTSD With Psychotic Features

Cited by 6 publications

References 33 publications

Systematic review and meta-analyses of the long-term efficacy of narrative exposure therapy for adults, children and perpetrators

Systematic review and meta-analyses of the long-term efficacy of narrative exposure therapy for adults, children and perpetrators

Narrative Exposure Therapy for Treating Post-Traumatic Stress Among Transgender Youth of Color With Selective Mutism

Skills Training in Affective and Interpersonal Regulation for Refugees Integrated With Narrative Exposure Therapy: A Case Study on the Treatment of PTSD and Emotion Dysregulation for Refugees and Asylum-Seekers

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