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Cited by 26Posttraumatic Stress Disorder ResearchMaternal Mental Health During Pregnancy and PostpartumPsychotherapy Techniques and Applications

Exposure therapy for PTSD during pregnancy: a feasibility, acceptability, and case series study of Narrative Exposure Therapy (NET)

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Stevens, Natalie R., Miller, Michelle L., Soibatian, Christina, Otwell, Caitlin, Rufa, Anne K., Meyer, Danie J., Shalowitz, Madeleine U.·2020·BMC Psychology
DOI 10.1186/s40359-020-00503-4PMC PMC7727253
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Abstract

Background: Prenatal posttraumatic stress disorder (PTSD) is a significant complication of pregnancy linked to increased risk of adverse perinatal outcomes. Although 1 in 5 pregnant trauma-exposed individuals have PTSD, most PTSD treatment trials exclude participants who are pregnant, and none focus on treatment specifically during pregnancy. Moreover, access to mental health treatment is particularly challenging in low-resource settings with high rates of trauma. This study examined implementation of Narrative Exposure Therapy (NET), a short-term evidence-based PTSD treatment, in an urban prenatal care setting. Partial telehealth delivery was used to increase accessibility. Study aims were to examine (a) feasibility, (b) acceptability, and (c) case-based treatment outcomes associated with NET participation. Method: Eight pregnant participants (median age = 27, median gestational week in pregnancy = 22.5) received up to six sessions of NET with partial telehealth delivery. PTSD and depression symptoms were assessed at pre-treatment intake (T1), at each session (T2), and 1-week post-treatment (T3). A multiple case study approach was used to examine recruitment and engagement, retention, treatment completion, treatment barriers, use of telehealth, participants’ experiences of treatment, and PTSD and depression symptoms. Results: Nine of the 16 participants (56%) who were invited to participate engaged in treatment, and one dropped out after the first session. Eight participants completed the minimum “dose” of 4 NET sessions (N = 8/9, 89%). Seven participants gave the highest ratings of treatment acceptability. The most frequently reported barriers to treatment were competing priorities of work and caring for other children. Pre-post treatment symptom measures revealed clinically meaningful change in PTSD severity for nearly all participants (7/8, 88%). Conclusions: Results suggest that a brief exposure therapy PTSD treatment can be successfully implemented during pregnancy, suggesting promising results for conducting a larger-scale investigation. Trial registration ClinicalTrials.gov, NCT04525469. Registered 20 August 2020–Retrospectively registered, https://register.clinicaltrials.gov/prs/app/template/EditRecord.vm?epmode=View&listmode=Edit&uid=U00058T2&ts=3&sid=S000A59A&cx=-w1vnvn

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  • A small treatment study of exposure for post-traumatic stress disorder in pregnant women (37% Latina) showed that post-treatment, seven of eight participants selected the highest available acceptability ratings.

    “In fact, a small treatment study of exposure for post-traumatic stress disorder in pregnant women (37% Latina) showed that post-treatment, seven of eight participants selected the highest available acceptability ratings (Stevens et al., 2020).”

    From Exposure Therapy Acceptability Among Pregnant Latinas With Anxiety: A Qualitative Content Analysis (2025) · cites this paper as Stevens et al., 2020

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Cited by

Sorted by citations

Authors
Stevens, N. R., Miller, M. L., Soibatian, C., Otwell, C., Rufa, A. K., Meyer, D. J., & Shalowitz, M. U.
Affiliations
  • Rush University Medical Center (US)
  • VA Greater Los Angeles Healthcare System (US)
Corresponding author
Stevens, Natalie R.
ORCID
Venue
BMC Psychology
Publisher
Springer Science and Business Media LLC
Published
2020-12
Volume
8
Issue
1
Pages
130-130
ISSN
2050-7283 (ISSN-L)
DOI
10.1186/s40359-020-00503-4
PMC
PMC7727253
OpenAlex
W3111138837
Cited by
26
References
12
Citations by year
2026: 4 · 2025: 4 · 2024: 7 · 2023: 3 · 2022: 5 · 2021: 3
FWCI
1.10
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Psychology (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Keywords
narrative exposure therapy, exposure therapy, pregnancy, telemedicine, treatment feasibility, treatment acceptability, depressive symptoms, prenatal care, resource-limited settings, barriers to treatment
MeSH terms
Adult, Feasibility Studies, Female, Humans, Implosive Therapy, Pilot Projects, Pregnancy, Stress Disorders, Post-Traumatic, Narrative Therapy

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