Narrative Exposure Therapy

Rating

Category: Allied Health Options

What is it?

Narrative exposure therapy (NET) is a form of trauma-focused cognitive behavioural therapy developed to meet the needs of traumatised survivors of war and torture.

NET combines elements of two trauma-focused PTSD therapies:

  • exposure therapy where the person is encouraged to repeatedly talk about the traumatic event and re-experience the associated emotions
  • testimony therapy where the person constructs a narration about their life from birth up to the present, with a focus on detailed reporting of the traumatic experiences of war and torture.

How does it work?

As with exposure therapy, one goal of NET is to reduce the symptoms of PTSD by confronting the person with the memories of the traumatic events; the aim being a reduction in the emotional response to the traumatic memory. The other goal is to help the person reorganise the distorted and fragmented autobiographic memory about the traumatic events which frequently contribute to PTSD in war and torture survivors.

Is it effective?

Only one small study examined NET to treat the PTSD symptoms of 43 Sudanese war and torture survivors living in a Ugandan refugee camp. This study found that four sessions of NET was more effective in reducing PTSD symptoms than four supportive counselling sessions or one psycho-education session. Although these results are promising, the number of participants was too small for results to be significant and further research is required to determine the effectiveness of NET for PTSD.

Are there any disadvantages?

The study did not formally consider adverse effects of NET. Narrative exposure therapy may not suit participants with insufficient cognitive and communication skills to engage meaningfully with the therapist.

Where do you get it?

Narrative exposure therapy for PTSD should only be administered by a specifically trained registered mental health professional

What are the evidence limitations?

The evidence base for the use of narrative exposure therapy in PTSD is poor. Narrative exposure therapy has only been described for use with war and torture survivors. Further research is required to determine the effectiveness of this therapy for PTSD.

Recommendations

Based on current limited evidence, narrative exposure therapy cannot be recommended as a first-line intervention for PTSD. More research is required to identify its effectiveness for PTSD.

Key References

Neuner, F, Schauer, M, Klaschik, C, Karunakara, U & Elbert, T 2004, ‘A comparison of narrative exposure therapy, supportive counselling, and psychoeducation for treating posttraumatic stress disorder in an African refugee settlement’, Journal of Consulting and Clinical Psychology, vol. 72. No. 4, pp. 579-587.

Neuner, F, Schauer, M, Elbert, T & Roth, W 2002, ‘A narrative exposure treatment as intervention in a refugee camp: A case report’, Journal of Behavioural and Cognitive Psychotherapy, vol. 30, pp. 205–209.

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