Narrative Exposure Therapy for the Treatment of Traumatized Children and Adolescents (KidNET): From Neurocognitive Theory to Field Intervention

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Many children in war-affected and refugee populations have experienced multiple traumatic experiences, and high rates of psychologic disorders, especially posttraumatic stress disorder (PTSD), are found. Intervention strategies require pragmatic and effective approaches to treatment. This article describes the rationale for and the use of narrative exposure therapy in children (KidNET). KidNET is a short-term treatment for PTSD based on a neurocognitive theory of traumatic memory. Early treatment trials, including randomized controlled studies, show promising results for the treatment of children and adolescents who have PTSD living in war-affected countries and refugee communities.

Section snippets

Current evidence and practice

Violence against children, including maltreatment at home, sexual abuse, and child labor, are common phenomena worldwide. In addition, many children are affected by violence caused by political conflicts, unrest, and war. Current wars are characterized by high levels of deliberate and systematic violence against the civilian population [1], including victimization of women and children. More than 30 countries are affected by current wars, and the populations of many now peaceful countries

Theoretical background: neurocognitive memory theory

The most prominent neurobiologic and cognitive theories of PTSD explain the development of PTSD on the basis of a pathologic distortion of the memory representations of the traumatic event [27], [28], [29], [30]. According to Tulving [31], there is a specific store of memories about past events called “episodic memory.” Episodic memory involves happenings in particular places at particular times and covers context information about “what,” “where,” and “when.” A unique feature that

The procedure of narrative exposure therapy

NET has been developed for application in crisis and postconflict regions. This context poses several challenges for a treatment approach. Because in these countries relatively few professionals are available for a high number of affected people, the treatment must be short and pragmatic. It should be easy to learn and be effective even when provided by trained laypersons or paraprofessionals with no or minimal medical or psychologic backgrounds. It should be applicable across cultures and fit

Outcome of narrative exposure therapy in children

So far, one case report and two randomized, controlled trials using NET with adults have been published [9], [82], [92]. In general, these studies with Sudanese refugees in Uganda and with survivors of political violence in Romania showed a clinically significant reduction in PTSD symptoms and greater effectiveness than supportive counseling and psychoeducation only. Treatment effects have been maintained for up to 1 year, and the data show that within the first year after treatment the

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    This work was supported by the Ministry of Science, Research and the Arts of Baden-Württemberg, the Deutsche Forschungsgemeinschaft, and the European Refugee Fund.

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