The effectiveness of narrative exposure therapy: a review, meta-analysis and meta-regression analysis

Abstract

Background: Narrative exposure therapy (NET) is a short-term psychological treatment for post-traumatic stress disorder (PTSD) that has been investigated in various contexts among traumatized refugees and other trauma survivors. Sustained treatment results have been reported, but the methodological quality of the trials needs a more thorough examination. Objective: To evaluate the effectiveness of NET for survivors of trauma, using a quality assessment, an updated meta-analysis, and a meta-regression analysis. Method: Following a systematic literature selection, the methodological quality of the included studies was assessed; Non-controlled and controlled effect sizes (Hedges' g) were estimated using a random effects model. Predictor analyses were performed. Non-controlled effect sizes for PTSD and depression included symptom change at post-treatment and follow-up time-points. Controlled effect sizes included post-treatment comparisons of NET with non-active and active comparators: both trauma-focused (TF) and non-trauma-focused (non-TF) interventions. Results: The selected studies showed high external validity; methodological quality was equivalent to other guideline-supported TF interventions. In 16 randomized controlled trials, involving 947 participants, large non-controlled effect sizes were found for PTSD symptoms, at post-treatment (g = 1.18, 95% confidence interval [0.87; 1.50]) and follow-up (g = 1.37 [0.96; 1.77]). For depression symptoms, medium non-controlled effect sizes were found, at post-treatment (g = 0.47 [0.23; 0.71]) and follow-up (g = 0.

Psychological and Psychosocial Interventions for PTSD, Depression and Anxiety Among Children and Adolescents in Low- and Middle-Income Countries: A Meta-Analysis

“…Promising interventions that could be implemented have already been constructed, examples of such interventions are KIDNET and EASE (52)(53)(54). Narrative exposure therapy (NET) has been evaluated in several high quality trials and has been shown to be effective in treating PTSD in adults (55). KIDNET is a narrative exposure therapy for children, which also has been shown to be effective in reducing symptoms of PTSD and increasing levels of functioning (54).…”

Predictors of change during Narrative Exposure Therapy for displaced populations: A repeated measures design

“…The theoretical basis of NET has been well documented, and its effectiveness has been examined in various studies and contexts [34,35,53]. Yet, specific factors contributing to positive outcomes or constraining its feasibility are largely unidentified.…”

“…Narrative Exposure Therapy NET is an evidence-based short-term psychotherapy targeting PTSD symptoms, specifically appropriate for multiple trauma in divergent cultural settings. For the study population in question the method is found to be feasible [37], and is considered the first choice TFT [34]. The NET protocol includes 12-16 sessions of individual trauma focused exposure, performed weekly or twice a week by trained mental health professionals.…”

“…In an umbrella review of prevalence and intervention studies on common mental disorders in asylum seekers and refugees, Turrini et al [33] found that narrative exposure therapy (NET) was the bestsupported TFT for reducing PTSD symptoms. In a meta-analysis of NET [34], it was found that NET is effective in reducing PTSD and depression symptoms across diverse, predominantly war-affected refugee populations [35]. Since it is a first-choice treatment for the study population, NET was chosen as the TFT applied in the present study [34].…”

“…In a meta-analysis of NET [34], it was found that NET is effective in reducing PTSD and depression symptoms across diverse, predominantly war-affected refugee populations [35]. Since it is a first-choice treatment for the study population, NET was chosen as the TFT applied in the present study [34].…”