Adapting narrative exposure therapy for Chinese earthquake survivors: a pilot randomised controlled feasibility study.

Yinyin Zang,Yinyin Zang,Tom Cox,Tom Cox,Nigel Hunt

doi:10.1186/s12888-014-0262-3

Yinyin Zang, Yinyin Zang + Show 3 more

Open Access

https://doi.org/10.1186/s12888-014-0262-3

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Abstract

BackgroundNarrative exposure therapy (NET) is a brief, manualised treatment for Posttraumatic Stress Disorder (PTSD). It has been shown to have therapeutic benefits for a wide range of individuals and settings. This study, following our previous work applying the original NET in earthquake survivors, aimed to revise NET to be adaptable for treating PTSD after a natural disaster.MethodsA randomised waiting-list controlled study was conducted with 30 adult participants with PTSD who were randomly allocated to NET (n = 10), revised NET (NET-R; n = 10) or a waiting list condition (WL; n = 10). Participants in NET and NET-R received treatment immediately; those in the WL condition received NET-R treatment after a waiting period. All groups were assessed on PTSD, general distress, anxiety, depression, social support, coping and posttraumatic change before and after treatment and three-month follow-up.ResultsCompared with WL, both NET and NET-R groups showed significant reductions in PTSD and related symptoms. Significant increases were found in posttraumatic growth, active coping and perceived social support. The WL group showed similar improvements after treatment. Further reductions on PTSD symptoms were found at three months, showing that NET-R is as effective as the original NET in treating post-earthquake traumatic symptoms in adult Chinese earthquake survivors.ConclusionsNET-R is a feasible and cost-effective intervention for Chinese earthquake survivors. Further studies are needed to replicate these findings in other survivor populations, and with larger samples and over longer periods. This study highlighted the value of oral narrative approach, which is well-accepted and useful in the context of single natural disaster and lower- income area.Trial registrationChinese Clinical Trial Registry: ChiCTR-TRC-12002931

Highlights

Narrative exposure therapy (NET) is a brief, manualised treatment for Posttraumatic Stress Disorder (PTSD)
Cognitive processing models (e.g. [3]) suggest that PTSD symptoms are maintained through a distortion of explicit autobiographic memory about traumatic events and its detachment from the contents of implicit memory, which produces a fragmented narrative of the traumatic memories
We reported issues in the process of therapy which suggest that NET could be further adapted and shortened for use after a single traumatic event

Summary

Introduction

Narrative exposure therapy (NET) is a brief, manualised treatment for Posttraumatic Stress Disorder (PTSD). NET is a standardized short-term trauma-focused treatment approach developed to meet the needs of traumatised survivors of war and torture [9,10]. It is based on exposure therapy, cognitive behaviour therapy (CBT) and testimony therapy. Emotional processing theory [13,14] states that the habituation of emotional responses through exposure leads to a decrease in post-traumatic symptoms. NET stresses the importance of both approaches: the habituation of emotional responding to reminders of the traumatic event and the construction of a detailed narrative of the event and its consequences

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