Exposing Narrative Exposure Therapy
Research type
Research Study
Full title
Exposing Narrative Exposure Therapy: A series of single case studies
IRAS ID
295623
Contact name
Thomas Schröder
Contact email
Sponsor organisation
University of Nottingham
Clinicaltrials.gov Identifier
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
Research Summary
Post-traumatic stress disorder (PTSD) can result from being involved or witnessing a traumatic event. Symptoms of PTSD include intrusive images, avoidance of reminders, hypervigilance, and negative thoughts. People who experience multiple traumatic events in their life are more likely to develop PTSD. If the traumatic events were prolonged, repeated and happened when they were young, they are more likely to experience complex PTSD (CPTSD). CPTSD has the same symptoms of PTSD, but also includes difficulty with emotions and relationships.Narrative Exposure Therapy (NET) is used to treat CPTSD; however, we do not fully understand how it works. The aim of the current study is to investigate why and how NET works. This is important as it allows us to develop/improve existing and future therapies. The study is funded via Health Education England.
Participants will have a course of trauma focused treatment and will complete questionnaires and interviews. People will regularly fill out questionnaires and wear a chest strap so we can examine the areas being tested. People will complete questionnaires before therapy, during, and after therapy. This first set of questionnaires will be completed sometime before therapy begins, and this gives three points of comparison to see if the therapy works. For some people treatment will start later than others and this is to see the effect therapy has.
People who have experienced multiple traumatic events, are between the ages of eighteen-sixty-five, speak English, have no intellectual disabilities and are not receiving other therapies will be recruited from therapy services across Nottinghamshire. Four-six participants will receive up to twelve weekly sixty-ninety-minute sessions of NET, and complete two questionnaires measuring symptoms of PTSD, depression, anxiety, and general stress every time we meet; they will also wear a chest strap to measure their heart rate. After completing NET, they will take part in an interview to gain their views/opinions.
Summary of Results
The study investigated the ways in which Narrative Exposure Therapy (NET) is reported to make changes. NET is reported to make its changes through the process of Autobiographical Memory Integration (ABMI) which means through speaking about the trauma it integrates aspects of memory and gives it a place in time and space. The other way NET reports to make a change is through exposure and habituation which means through speaking about the trauma it is not avoided, and the person learns their anxiety will reduce, allowing for changes in beliefs about their memory and trauma. The study investigated how NET makes it changes alongside its potential effectiveness in treating trauma, depression, anxiety, and stress, and how acceptable it is for participants who use it, and how it can be delivered in secondary care mental health services in the UK. A design that used both quantitative (numbers) and qualitative (language) methods of analysis was used, a baseline phase (where no intervention is completed) and treatment phase (where the intervention i.e., NET is introduced) was also used with three females. The researcher created a tool to assess how NET makes it changes. The tool measured changes in autobiographical memory (one’s memory of episodes of their life) and the researcher took therapy transcripts before and after therapy and scored the transcripts for changes in autobiographical memory. To assess exposure and habituation participants wore chest straps collecting heart data and were asked to rate how anxious they were when recalling trauma memories. Participants also completed questionnaires to assess how effective NET was in treating symptoms of trauma, depression, stress, and anxiety (i.e., general psychological distress). After completing the therapy participants took part in interviews to gather their views of it. After completing the therapy two participants experienced significant reductions in their symptoms of trauma. There were reductions in general psychological distress for two participants, with small reductions in depression, anxiety, and stress across all participants, and a significant reduction in anxiety for one. Two participants consistently experienced a reduction in their levels of fear when recalling their trauma during sessions. The results of the study do not support NET’s claims of integrating time and place details as a part of autobiographical memory as a way the therapy makes a change. NET seemed acceptable as the only adaption suggested was to include more sessions. Participants noted it was difficult to recall time and place details when discussing trauma memories. The study cannot make claims of NET’s effectiveness in treating trauma and general psychological distress due to the results only being replicated across two and not three participants. Future research to develop the coding tool is needed to allow the role of autobiographical memory in trauma to be better understood.REC name
East Midlands - Derby Research Ethics Committee
REC reference
21/EM/0172
Date of REC Opinion
1 Sep 2021
REC opinion
Further Information Favourable Opinion