Program Goals/Target Population
Narrative Exposure Therapy (NET) is a psychosocial treatment that aims to reduce posttraumatic stress disorder (PTSD) symptoms in traumatized refugee populations still living in dangerous situations (such as refugee camps). It attempts to reduce PTSD symptoms by habituating a patient to his or her emotional reactions to lived traumatic experiences and by creating a coherent narrative of his or her life’s experiences.
The program was developed to meet the need for psychosocial services in refugee camps. Refugee populations often demonstrate high rates of PTSD as a result of traumatic events experienced in war-affected areas. Populations in refugee camps are often impoverished and malnourished, and depend on the humanitarian aid.
Program Activities
The therapist works with a patient diagnosed with PTSD to construct a detailed chronological narrative of his or her biography. Over the course of four treatment sessions, the patient is asked to recall his or her life and include details of the traumatic events they had experienced. Frequently, this narrative initially includes fragmented reports of traumatic experience. It is the job of the therapist and patient to create a coherent narrative out of these reports. The process of construction also includes discussions to investigate current and past emotional, physiological, cognitive, and behavioral reactions to the narrative. The narrative is corrected during the course of treatment through multiple readings.
The process concludes when the patient shows evidence of habituation to the emotional reactions to these traumatic events. Patients receive a written biography at the end of treatment.
Program Theory
NET is a short-term therapeutic approach that is based on the principles of cognitive–behavioral exposure therapy and testimony therapy. In exposure therapy, the patient is asked to identify and talk repeatedly about his or her worst traumatic experience. During this conversation, the patient re-experiences the emotions experienced during the traumatic event. This can lead to the habituation of the emotional response, which, in turn, can lessen PTSD symptoms. Often, though, patients such as refugees cannot identify a single traumatic event that led to the development of testimony therapy. In testimony therapy, the patient generates a narrative of his or her life, but focuses on the details of the multiple traumatic events that he or she has experienced.
Key Personnel
Currently, the program is delivered by therapists who are doctoral-level psychologists or graduate students with experience in education and counseling. Therapists receive training in NET. To communicate with refugee populations, translators are used. In the future, developers hope that NET can be operationalized so that it can be delivered, at a lower cost, by local staff without any psychosocial educational background.
