Intensive Narrative Exposure Therapy for Posttraumatic Stress Disorder: A 1-Week Intervention.

Abstract

Posttraumatic stress disorder (PTSD) is associated with some of the poorest mental and physical health outcomes. There is often high dropout from treatment for PTSD, especially among those who have experienced chronic or multiple traumatic events. One increasingly popular PTSD treatment delivery model targeting treatment retention is intensive treatment delivery. Narrative exposure therapy (NET) is an exposure-based PTSD treatment designed to address multiple trauma exposures, but NET has not been systematically delivered in an intensive brief format. The current study aimed to determine the feasibility, acceptability, and preliminary efficacy of intensively delivered NET to a highly traumatized sample (HI-NET). A trauma-exposed clinical sample (n = 8; range of lifetime traumatic events: 5-15; 100% endorsed history of interpersonal violence; mean age = 46; 87% White) participated in daily NET sessions for 1 week. Participants completed self-report measures assessing PTSD, depressive, and dissociation symptoms as well as trauma-related cognitions at baseline, 1 week posttreatment, and 1-, 3-, and 6-month follow-up timepoints. HI-NET was feasible, with all participants attending all sessions. Participants reported high levels of acceptability and satisfaction. Participants showed significant reductions in PTSD symptoms (≥12 points on the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders-5 [PCL-5]) from baseline (M = 49.00, SD = 16.34) through 6-month assessment (M = 24.29, SD = 16.89, g =1.88). Depressive symptoms, the frequency and intensity of dissociative symptoms, and dysfunctional trauma-related cognitions all significantly decreased alongside PTSD symptoms. This is the first investigation of an intensive delivery of NET, an evidence-based treatment for PTSD that can target multiple traumatic events. After only six sessions delivered to a highly traumatized sample, there was a significant decrease in PTSD symptoms that remained decreased over time. HI-NET is feasible, acceptable, and efficacious, yet larger clinical trials with more diverse samples are needed.