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Earlier this summer, I had the pleasure of attending a seminar on Narrative Exposure Therapy (NET) through the University of Minnesota – Twin Cities, Family Social Science Department. Narrative Exposure Therapy is a relatively new, but very effective, intervention for Posttraumatic Stress Disorder (PTSD). It was developed and is being used in mass trauma situations, like refugee camps. Multiple experimental randomized, control studies demonstrate its effectiveness at eliminating PTSD for victims of multiple trauma events (Neuner, 2004; Onyut, 2005; van Minnen, 2002).
Narrative Exposure Therapy is conducted in a short series of structured sessions. In the first, individuals participate in a diagnostic interview partially to evaluate for the presence of PTSD. In the subsequent session, they asked to create their “lifeline” by laying out a length of rope and indicate positive events with flowers and negative events with rocks. Subsequent sessions consist of explaining their “lifeline” with the inclusion of both their flowers and rocks. They may also be asked to describe some of their hopes and dreams for the rest of their lives.
In each session, counselors record the individual’s life story and ask for corrections. When counseling is completed, a digital photograph of their lifeline is taken. Through the use of the lifeline, the traumatic event becomes integrated into the total narrative of the person’s life.
I ran into the literature for this approach earlier this year while I was working on a literature review with the U of M and was impressed by the elegance and effectiveness of the approach. Attending the seminar really highlighted the theoretical basis, need and again, effectiveness. I will probably be writing future posts about some of those other things from the seminar that really stood out to me.
Neuner, F., Schauer, M., Klaschik, C., Karunakara, U., & Elbert, T. (2004) A comparison of narrative exposure therapy, supportive counseling, and psychoeducation for treating Posttraumic Stress Disorder in an African refugee settlement. Journal of Consulting and Clinical Psychology, 72(4), 579-587
Onyut, L.P., Neuner, F., Schauer, E., Ertl, V., Odenwald, M., Schauer, M., & et. al. (2005) Narrative exposure therapy as a treatment for child war survivors with posttraumatic stress disorder: Two case reports and a pilot study in an African refugee settlement. BMC Psychiatry, 5(7).
van Minnen, A., Wessel, I., Dijkstra, T., & Roelofs, K. (2002) Changes in PTSD patients’ narratives during prolonged exposure therapy: A replication and extension. Journal of Traumatic Stress, 15(3), 255-258.
A study put out by Michigan State University found that some children who are victims of domestic violence are more resilient because they are by nature, more easy-going, and their mom’s don’t have mental health issues of their own. Four times as many children who witness domestic violence prior to age 4 end up developing emotional or behavioral issues. In spite of that, half of the children surveyed didn’t develop those issues because of their nature and mother’s mental health. Children who were chronically exposed to domestic violence on the other hand typically did develop emotional/behavioral issues.
A huge part of this research seems to be very common sense. That is the blessing and the curse of the research’s paramountcy. Everything is simply not proven false. Data rules. However, in that world you have to spend money and time to confirm what would seem to incredibly evident. At least now we have the data to help confirm the importance of taking care of the mental health needs of mothers. With that data, we can get the money to make sure that it actually happens.
Society for Research in Child Development (2009, April 29). Why Are Some Young Victims Of Domestic Violence Resilient?. ScienceDaily. Retrieved May 7, 2009, from http://www.sciencedaily.com /releases/2009/04/090429091626.htm
In spite of widely held stereotypes, individuals experiencing an increase in mental health symptoms actually more likely to be victims of violence than perpetrators. This may be due to their behaviors driving caretakers away and/or an increased focus on the internal mental state on the part of the the individual. When individuals are experiencing an increase in symptoms, it is recommended that they consider spending less time in public spaces, community treatment facilities or increases in guardianship.
Georgia State University (2009, April 14). Increased Symptoms Lead Mentally Disordered To Become Victims Of Violence. ScienceDaily. Retrieved April 16, 2009, from http://www.sciencedaily.com /releases/2009/04/090414120459.htm
A recent study put out by the University of Washington found that girls growing up with a parent dealing with heroin dependence, incarceration, mental illness, or violence were four times more resilient than boys growing up in similar circumstances. Resilience was defined as “working or being in school [until adulthood], avoiding substance abuse and staying out of trouble with the law in the past five years.” (Although that may seem like a very minimal expectation, only 30 of the 125 surveyed children demonstrated resilience of that quality.) The sample was taken from children of parents utilizing methadone clinics in Seattle metro areas. The major factor affecting that finding seemed to be that boys more often had criminal charges against them.
I wonder about the affect gender socialization has on that outcome. Are males socialized more to respond in violence to adverse circumstances? Are males actually doing more criminal activity, or are females doing more criminal activity under the supervision of pimps? If males are doing more criminal activity, are they doing it to provide for their families? (If you join a gang, there is an element of protection there, not to mention an opportunity to make some money.) Also, how would the data be different if it were taken from more upper to middle class constituents, or from a third world setting? What do you think?
University of Washington (2009, February 12). Girls Growing Up With Heroin-addicted Parent More Resilient Than Boys. ScienceDaily. Retrieved February 13, 2009, from http://www.sciencedaily.com /releases/2009/02/090211161859.htm