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Evaluating narrative exposure therapy for post‐traumatic stress disorder and depression symptoms: A meta‐analysis of the evidence base

Raghuraman, Shruti; Stuttard, Nathan; Hunt, Nigel

Authors

Shruti Raghuraman

Nathan Stuttard

NIGEL HUNT NIGEL.HUNT@NOTTINGHAM.AC.UK
Associate Professor



Abstract

Narrative Exposure Therapy (NET) is an intervention for trauma-spectrum disorders. Originally developed to treat refugee populations, NET has since been tested for efficacy across different settings. In this review, the NET evidence-base is examined through a retrieval, synthesis, and appraisal of randomised-controlled trials (RCTs) published since 2002. Two independent reviewers (SR & NS) searched online databases including EMBASE, PsycINFO, and PubMed. Twenty-four RCTs were selected for a meta-analysis of three outcomes: PTSD diagnosis and PTSD and depression symptoms. All outcomes were analysed at short-term (3-4 months), mid-term (6-7 months), and long-term (≥ 12 months) data points. A random-effects model was applied to yield standardized mean differences (SMDs) and odds ratios (OR) as indicators of NET treatment effect. Subgroup analyses for type of trauma and type of control groups were conducted to examine potential heterogeneity. For the NET group, moderate effect sizes for PTSD symptom severity were observed at mid-and long-term, and at mid-term for depression symptom severity. The number of PTSD diagnoses decreased significantly in the short-term for the NET condition, but this was not sustained at the long-term. Caution must be exercised when interpreting these results due to high heterogeneity estimates and low quality of evidence across trials. Potential small-study effects further complicate the interpretation of the findings. Recommendations are made for augmenting statistical significance research with qualitative analysis of NET efficacy to better inform clinical practice.

Journal Article Type Article
Publication Date Jul 15, 2020
Journal Clinical Psychology & Psychotherapy
Print ISSN 1063-3995
Electronic ISSN 1099-0879
Publisher Wiley
Peer Reviewed Peer Reviewed
APA6 Citation Raghuraman, S., Stuttard, N., & Hunt, N. (2020). Evaluating narrative exposure therapy for post‐traumatic stress disorder and depression symptoms: A meta‐analysis of the evidence base. Clinical Psychology and Psychotherapy, https://doi.org/10.1002/cpp.2486
DOI https://doi.org/10.1002/cpp.2486
Keywords Narrative Exposure Therapy; NET; Narrative Therapy; PTSD; Posttraumatic Stress; Psychological Trauma
Publisher URL https://onlinelibrary.wiley.com/doi/full/10.1002/cpp.2486
Additional Information Received: 2020-02-13; Accepted: 2020-06-03; Published: 2020-07-15

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