Abstract

Objective: Narrative Exposure Therapy (NET) is a short-term trauma-focused intervention originally developed for treating survivors of war and torture. The neurobiological theoretical foundations of NET would suggest that the approach should have long term beneficial effects. We tested this assumption and also provided an extensive overview of all NET studies for adults, for children (KIDNET), and for perpetrators (Forensic Offender Rehabilitation NET; FORNET).

Method: Following a systematic literature review, we conducted meta-analyses with all studies that had control conditions, and with all Randomized Controlled Trials (RCTs). We assessed between-groups short- (< 6 months) and long-term (≥ 6 months) effect sizes for symptoms of posttraumatic stress disorder (PTSD) and depression.

Results: In a total of 56 studies from 30 countries comparing 1370 participants treated with NET to 1055 controls, we found large between group effect sizes regarding the reduction of PTSD symptoms in favor of NET. Analyses of RCTs with active controls yielded small to medium effect sizes in the short-term, and large effect sizes in the long-term.

Conclusions: NET, KIDNET, and FORNET yield beneficial and sustainable treatment results for severely traumatized individuals living in adverse circumstances. Studies in highly developed health care systems comparing NET with other evidence-based trauma-focused interventions are needed.

摘要

目的：叙事暴露疗法（NET）是一种针对创伤的短期干预措施，最初是为治疗战争和酷刑幸存者而开发的。NET的神经生物学理论基础表明，该方法应具有长期的有益效果。我们测试了这一假设，并提供了有关成人，儿童（KIDNET）和犯罪者（法医康复网； FORNET）的所有NET研究的广泛概述。

方法：经过系统的文献综述，我们对所有具有控制条件的研究以及所有随机对照试验（RCT）进行了荟萃分析。我们评估了创伤后应激障碍（PTSD）和抑郁症状的组间短期（<6个月）和长期（≥6个月）效应大小。

结果：在来自30个国家/地区的56项研究中，将1370名接受NET治疗的参与者与1055名对照进行了比较，我们发现，在减少PTSD症状以支持NET方面，各组之间的影响差异很大。带有有效对照的RCT的分析在短期内产生了中小型的效应，而在长期内产生了较大的效应。

结论： NET，KIDNET和FORNET为生活在不利环境中的严重创伤患者提供了有益且可持续的治疗结果。需要在高度发达的医疗保健系统中进行研究，将NET与其他基于证据的针对创伤的干预措施进行比较。