Meta-Analysis of the Use of Narrative Exposure Therapy for the Effects of Trauma among Refugee Populations
Open accessAbstract
BACKGROUND: Narrative therapies, especially narrative exposure therapy, are used to treat the effects of trauma in refugees and to prevent psychiatric illness. These methods involve helping the person to tell the story of what happened to them until it no longer elicits anxiety. METHODS: We reviewed all quantitative studies related to narrative exposure methods for treating trauma or posttraumatic stress disorder in refugees. We focused on studies with sufficient information to calculate effect sizes and statistical power. RESULTS: We found 7 quantitative studies for which effect size and power could be calculated. The total average effect size for all interventions was 0.63 (medium). The average effect size for studies in which interventions were administered by physicians, adequately trained graduate students, or both was 0.53. The effect size for studies in which the counselors were themselves refugees was 1.02. The 95% confidence intervals for the effect sizes of narrative exposure therapy did not reach below 0. CONCLUSION: Studies demonstrating the effectiveness of narrative methods have adequate effect sizes and statistical power. Empowering lay counselors to treat their fellow refugees in future studies is warranted.
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Meta-analysis data from several studies assessing narrative exposure therapy administered by trained lay providers in refugee settings have shown moderate effect sizes for the treatment of post-traumatic stress.
“Meta-analysis data from several studies assessing NET administered by trained lay providers in refugee settings have shown moderate effect sizes for the treatment of PTS [72].”
From Psychological Interventions for Survivors of Intimate Partner Violence in Humanitarian Settings: An Overview of the Evidence and Implementation Considerations (2022) · cites this paper as [72]
The Methods describe a meta-analysis of seven NET studies in refugees that compared lay and professional counselors, and the Study Descriptions report that trained lay counselors could treat fellow refugees. The reported medium effect size (0.63) is for all interventions, however; the effect size for studies using refugees as counselors is 1.02, not a moderate subgroup effect. (LLM, conf=0.87)
Experimental — accuracy not yet measuredNarrative exposure therapy has been used effectively with children and adults across a variety of settings, including refugee and humanitarian contexts.
“NET has been used effectively with children and adults across a variety of settings, including refugee and humanitarian contexts [71,72,73].”
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Cites
Maslow, A. H. (1943) · Psychological Review · doi:10.1037/h0054346 · Cited by 21,563 · see citing works
Axford, N. (2017) · Routledge eBooks · doi:10.4324/9781315258324-16 · Cited by 11,329 · see citing works
Writing About Emotional Experiences as a Therapeutic Process
Pennebaker, J. W. (1997) · Psychological Science · doi:10.1111/j.1467-9280.1997.tb00403.x · Cited by 2,486 · see citing works
Lifetime Events and Posttraumatic Stress Disorder in 4 Postconflict Settings
de Jong, J. T. V. M. (2001) · JAMA · doi:10.1001/jama.286.5.555 · Cited by 807 · see citing works
How Our Lives Become Stories: Making Selves
Eakin, P. J. (1999) · doi:10.7591/9781501711831 · Cited by 739 · see citing works
Neuner, F., Schauer, M., Klaschik, C., Karunakara, U., & Elbert, T. (2004) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.72.4.579 · Cited by 644 · see citing works
Ehntholt, K. A., & Yule, W. (2006) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2006.01638.x · Cited by 497 · see citing works
Crazy Like US: The Globalization of the American Psyche
PRIDMORE, S. A. (2010) · Australasian Psychiatry · doi:10.3109/10398562.2010.525649 · Cited by 465 · see citing works
The emerging evidence for Narrative Exposure Therapy: A review
Robjant, K., & Fazel, M. (2010) · Clinical Psychology Review · doi:10.1016/j.cpr.2010.07.004 · Cited by 397 · see citing works
Neuner, F., Onyut, P. L., Ertl, V., Odenwald, M., Schauer, E., & Elbert, T. (2008) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.76.4.686 · Cited by 395 · cited 2× · see citing works
“Any treatments for this population should ideally be suitable for harsh conditions in war-affected refugee camps.(2,17-19) Treatment should be in tune with cultural norms, short, and cost effective, and people from the community with little or no mental health care knowledge should be able to administer it.”
BackgroundCrazy Like Us: The Globalization of the American Psyche
Watters, E. (2009) · Cited by 311 · see citing works
Catani, C., Kohiladevy, M., Ruf, M., Schauer, E., Elbert, T., & Neuner, F. (2009) · BMC Psychiatry · doi:10.1186/1471-244x-9-22 · Cited by 290 · see citing works
Ruf, M., Schauer, M., Neuner, F., Catani, C., Schauer, E., & Elbert, T. (2010) · Journal of Traumatic Stress · doi:10.1002/jts.20548 · Cited by 274 · see citing works
Smith, P. A., Perrin, S. G., Yule, W., & Rabe‐Hesketh, S. (2001) · Journal of Child Psychology and Psychiatry · doi:10.1111/1469-7610.00732 · Cited by 235 · see citing works
The Role of Interpreters in Psychotherapy With Refugees: An Exploratory Study.
Miller, K. E., Martell, Z. L., Pazdirek, L., Caruth, M., & López, D. C. C. (2005) · American Journal of Orthopsychiatry · doi:10.1037/0002-9432.75.1.27 · Cited by 219 · see citing works
Neuner, F., Kurreck, S., Ruf, M., Odenwald, M. G., Elbert, T. R., & Schauer, M. (2009) · Cognitive Behaviour Therapy · doi:10.1080/16506070903121042 · Cited by 191 · see citing works
How our lives become stories: making selves
(2000) · Choice Reviews Online · doi:10.5860/choice.37-6101 · Cited by 190 · see citing works
Onyut, L. P., Neuner, F., Schauer, E., Ertl, V., Odenwald, M., Schauer, M., & Elbert, T. (2005) · BMC Psychiatry · doi:10.1186/1471-244x-5-7 · Cited by 177 · see citing works
Psychological trauma: Burnt into memory
Elbert, T., & Schauer, M. (2002) · Nature · doi:10.1038/419883a · Cited by 172 · see citing works
Narrative Exposure Therapy versus Interpersonal Psychotherapy
Schaal, S., Elbert, T., & Neuner, F. (2009) · Psychotherapy and Psychosomatics · doi:10.1159/000229768 · Cited by 168 · see citing works
(2004) · PubMed Central · Cited by 163 · see citing works
Multiple Forms of Stress in Cambodian Adolescent Refugees
Sack, W. H., Clarke, G. N., & Seeley, J. R. (1996) · Child Development · doi:10.1111/j.1467-8624.1996.tb01722.x · Cited by 144 · see citing works
Psychologically Distressed Refugee Children in the United Kingdom
Hodes, M. (2000) · Child and Adolescent Mental Health · doi:10.1111/1475-3588.00286 · Cited by 140 · see citing works
Neuner, F., Catani, C., Ruf, M., Schauer, E., Schauer, M., & Elbert, T. (2008) · Child and Adolescent Psychiatric Clinics of North America · doi:10.1016/j.chc.2008.03.001 · Cited by 130 · see citing works
Walters, G. D. (2000) · The American Journal of Drug and Alcohol Abuse · doi:10.1081/ada-100100255 · Cited by 126 · see citing works
Psychologically Distressed Refugee Children in the United Kingdom
Hodes, M. (2000) · Child Psychology and Psychiatry Review · doi:10.1017/s136064170000215x · Cited by 112 · see citing works
A NARRATIVE EXPOSURE TREATMENT AS INTERVENTION IN A REFUGEE CAMP: A CASE REPORT
Neuner, F., Schauer, M., Roth, W. T., & Elbert, T. R. (2002) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465802002072 · Cited by 109 · see citing works
Multiple Forms of Stress in Cambodian Adolescent Refugees
Sack, W. H., Clarke, G. N., & Seeley, J. R. (1996) · Child Development · doi:10.2307/1131689 · Cited by 100 · see citing works
Meta-analysis: Methods, strengths, weaknesses, and political uses
Noble, J. H. (2006) · Journal of Laboratory and Clinical Medicine · doi:10.1016/j.lab.2005.08.006 · Cited by 91 · see citing works
Narrative exposure therapy in children : a case study
Schauer, E., Neuner, F., Elbert, T. R., Ertl, V., Onyut, L. P., Odenwald, M. G., & Schauer, M. (2004) · KOPS (University of Konstanz) · Cited by 65 · see citing works
Mothering During War and Postwar in Bosnia
Robertson, C., & Duckett, L. (2007) · Journal of Family Nursing · doi:10.1177/1074840707309350 · Cited by 43 · see citing works
Action Responses of Congolese Refugee Women
Pavlish, C. (2005) · Journal of Nursing Scholarship · doi:10.1111/j.1547-5069.2005.00010.x · Cited by 40 · see citing works
Healing the Mind through the Power of Story: The Promise of Narrative Psychiatry
Mehl‐Madrona, L. (2010) · Cited by 20 · see citing works
Self-citationHEALING THE MIND THROUGH THE POWER OF STORY: THE PROMISE OF NARRATIVE PSYCHIATRY.
Hanlon, K. (2010) · Journal of Religion and Health · doi:10.1007/s10943-010-9426-8 · Cited by 18 · see citing works
A Psychotherapy Model for Treating Refugee Children Caught in the Midst of Catastrophic Situations
Rothe, E. M. (2008) · Journal of the American Academy of Psychoanalysis and Dynamic Psychiatry · doi:10.1521/jaap.2008.36.4.625 · Cited by 15 · see citing works
INTERNALIZED OTHER INTERVIEWING OF CHILDREN EXPOSED TO VIOLENCE
Hurley, D. (2006) · Journal of Systemic Therapies · doi:10.1521/jsyt.2006.25.2.50 · Cited by 15 · see citing works
Awareness and authoring: the idea of self in mindfulness and narrative therapy
Percy, I. (2008) · European Journal of Psychotherapy & Counselling · doi:10.1080/13642530802577109 · Cited by 13 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- [1]1. REVIEW ARTICLE Meta-Analysis of the Use of Narrative Exposure Therapy for the Effects of Trauma Among Refugee Populations References
Cited by
Sorted by citations
Lund, C., Brooke-Sumner, C., Baingana, F., Baron, E. C., Breuer, E., Chandra, P., Haushofer, J., Herrman, H., Jordans, M., Kieling, C., et al. (2018) · The Lancet Psychiatry · doi:10.1016/s2215-0366(18)30060-9 · Cited by 1,147 · see citing works
Nosè, M., Ballette, F., Bighelli, I., Turrini, G., Purgato, M., Tol, W., Priebe, S., & Barbui, C. (2017) · PLOS ONE · doi:10.1371/journal.pone.0171030 · Cited by 276 · see citing works
Trauma-focused therapy for refugees: Meta-analytic findings.
Lambert, J. E., & Alhassoon, O. M. (2015) · Journal of Counseling Psychology · doi:10.1037/cou0000048 · Cited by 199 · see citing works
Wright, A., Reisig, A., & Cullen, B. (2020) · Journal of Behavioral and Cognitive Therapy · doi:10.1016/j.jbct.2020.10.003 · Cited by 47 · see citing works
Kira, I. A., Ashby, J. S., Omidy, A. Z., & Lewandowski, L. (2015) · Journal of Mental Health Counseling · doi:10.17744/mehc.37.4.04 · Cited by 42 · see citing works
Bangpan, M., Lambert, F., Chiumento, A., & Dickson, K. (2016) · doi:10.21201/2016.605150 · Cited by 30 · see citing works
Lakin, D. P., García-Moreno, C., & Roesch, E. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19052916 · Cited by 18 · see citing works
“Meta-analysis data from several studies assessing NET administered by trained lay providers in refugee settings have shown moderate effect sizes for the treatment of PTS [72].”
MethodBehler, J., Daniels, A., Scott, J., & Mehl-Madrona, L. (2017) · The Qualitative Report · doi:10.46743/2160-3715/2017.2964 · Cited by 6 · see citing works
Self-citation
- Authors
- Gwozdziewycz, N., & Mehl-Madrona, L.
- Affiliations
- Argosy University (US)
- Core Faculty at the Union Institute and University in Brattleboro, VT..
- Venue
- The Permanente Journal
- Publisher
- The Permanente Federation
- Published
- 2013-03
- Volume
- 17
- Issue
- 1
- Pages
- 70-76
- ISSN
- 1552-5767 (ISSN-L)
- 1552-5775
- PMC
- PMC3627789
- OpenAlex
- W2152786206
- Semantic Scholar
- 5c8ecc7f2e2ce5c1cdc320ac85400f85272ea0cd
- Cited by
- 149
- References
- 37
- Citations by year
- 2026: 5 · 2025: 11 · 2024: 16 · 2023: 16 · 2022: 14 · 2021: 8 · 2020: 14 · 2019: 14 · 2018: 14 · 2017: 13 · 2016: 9 · 2015: 11 · 2014: 4
- FWCI
- 1.17
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- other-oa
- Locations
- The Permanente Journal (publishedVersion, other-oa)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- narrative exposure therapy, narrative therapy, refugee trauma, post-traumatic stress disorder, refugees, trauma treatment, lay counselors, effect size, statistical power
- MeSH terms
- Humans, Refugees, Stress Disorders, Post-Traumatic, Narrative Therapy
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