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A new treatment approach for PTSD: High-Intensive Narrative Exposure Therapy (HI-NET)
Journal Title: MALTRATTAMENTO E ABUSO ALL’INFANZIA 
Author/s: Patricia Strijk, Viyan Bedawi, Ruud A. Jongedijk 
Year:  2020 Issue: Language: English 
Pages:  12 Pg. 51-62 FullText PDF:  195 KB
DOI:  10.3280/MAL2020-003005
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Current international guidelines recommend Trauma-Focused Therapies (TFT) to treat Post-Traumatic Stress Disorder (PTSD). However, non-response and dropout rates have shown to be substantial. TFT, delivered in a highly intensive dose may lead to a more efficacious symptom reduction and lower dropout rates. This article describes an inpatient treatment program with Narrative Exposure Therapy (NET), called High-Intensive NET (HI-NET). The program consists of sixteen NET sessions during two weeks, combined with art therapy and yoga. After describing the treatment program, we present two case reports of patients who received HI-NET. We measured amongst others symptoms of PTSD and depression, sleep quality and general psychopathology at pre-treatment, post-treatment and at four months’ follow-up. The two patients showed that applying HI-NET is a promising approach to append to the existing way of conducting NET. One patient reported a slight increase in symptoms at post-treatment, but was fully recovered of PTSD at follow-up. The other patient recovered gradually, with full recovery at follow-up. The other measures also showed important improvements at the end of treatment and at follow-up. Concluding: NET in a high intensive form is applicable and feasible. Our two cases showed an important improvement in PTSD symptoms and in general psychopathology. More research is needed with larger patient groups to determine efficacy and efficiency more properly.
Keywords: Intensive; inpatient; treatment; trauma; PTSD.

  1. American Psychological Association Guideline Development Panel for theTreatment of PTSD in Adults (2017). Clinical practice guideline for thetreatment of posttraumatic stress disorder (PTSD) in adults. -- Retrieved from https://www.apa.org/ptsd-guideline/ptsd.pdf.
  2. Boeschoten, M. A., Bakker, A., Jongedijk, R. A., & Olff, M. (2014). PTSD Check List for DSM-5 (PCL-5) – Dutch version. Uitgave: ARQ National Psychotrauma Centre, Diemen. -- Retrieved from: www.psychotraumadiagnostics.centrum45.nl/nl/home.
  3. Boeschoten, M. A., Van der Aa, N., Bakker, A., Ter Heide, F. J. J., Hoofwijk, M. C., Jongedijk, R. A., Olff, M. (2018). Development and Evaluation of the Dutch Clinician-Administered PTSD Scale for DSM-5 (CAPS-5). European Journal of Psychotraumatology, 9(1), 1546085., DOI: 10.1080/20008198.2018.1546085
  4. Bongaerts, H., Van Minnen, A., & De Jongh, A. (2017). Intensive EMDR to treat PTSD patients with severe comorbidity: A case series. Journal of EMDR Practice and Research, 11(2), 86-95., DOI: 10.1891/1933-3196.11.2.84
  5. Bradley, R., Greene, J., Russ, E., Dutra, L., & Westen, D. (2005). A multidimensional meta-analysis of psychotherapy for PTSD. American Journal of Psychiatry, 162(2), 214-227.
  6. De Beurs, E. (2011). Brief Symptom Inventory BSI. Handleiding, herziene editie 2011. The Netherlands, Leiden: PITS B.V.
  7. Ehlers, A., Hackmann, A., Grey, N., Wild, J., Liness, S., Albert, I., (…) Clark, D. M. (2014). A randomized controlled trial of 7-day intensive and standard weekly cognitive therapy for PTSD and emotion-focused supportive therapy. American Journal of Psychiatry, 171(3), 294-304.
  8. Elbert, T., Schauer, M., & Neuner, F. (2015). Narrative exposure therapy (NET): Reorganizing memories of traumatic stress, fear, and violence. In Evidence based treatments for trauma-related psychological disorders (pp. 229-253). Springer, Cham.
  9. Gutner, C. A., Suvak, M. K., Sloan, D. M., & Resick, P. A. (2016). Does timing matter? Examining the impact of session timing on outcome. Journal of Consultant and Clinical Psychology, 84(12), 1108-1115.
  10. Hendriks, L., de Kleine, R. A., Broekman, T. G., Hendriks, G. J., & van Minnen, A. (2018). Intensive prolonged exposure therapy for chronic PTSD patients following multiple trauma and multiple treatment attempts. European Journal of Psychotraumatology, 9(1), 1425574., DOI: 10.1080/20008198.2018.1425574
  11. Hurley, E. C. (2018). Effective treatment of veterans with PTSD: Comparison between intensive daily and weekly EMDR approaches. Frontiers in Psychology, 9, 1458.
  12. Jongedijk, R. A. (2014a). Narrative exposure therapy: an evidence-based treatment for multiple and complex trauma. European Journal of Psychotraumatology, 5, 26522.
  13. Jongedijk, R. A. (2014b). Levensverhalen en psychotrauma. Narratieve Exposure Therapie in de praktijk [Life stories and psychotrauma. Narrative exposure therapy in practice]. Amsterdam: Boom.
  14. Kessler, R. C., Chiu, W. T., Demler, O., & Walters, E. E. (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of general psychiatry, 62(6), 617-627.
  15. Lely, J. C. G., Smid, G. E., Jongedijk, R. A., Knipscheer, J. W. & Kleber, R. J. (2019). The effectiveness of narrative exposure therapy: A review, meta-analysis and meta-regression analysis. European Journal of Psychotraumatology, 10(1), 1550344., DOI: 10.1080/20008198.2018.1550344
  16. Lewis, C., Roberts, N. P., Gibson, S., & Bisson, J. I. (2020). Dropout from psychological therapies for post-traumatic stress disorder (PTSD) in adults: Systematic review and meta-analysis. European Journal of Psychotraumatology, 11(1), 1709709., DOI: 10.1080/20008198.2019.1709709
  17. Lowe, S. R., Blachman-Forshay, J., & Koenen, K. C. (2015). Trauma as a public health issue: Epidemiology of trauma and trauma-related disorders. In: Evidence based treatments for trauma-related psychological disorders: A practical guide for clinicians. (pp. 11-40). Switzerland: Springer International Publishing., DOI: 10.1007/978-3-319-07109-1_2
  18. Mollayeva, T., Thurairajah, P., Burton, K., Mollayeva, S., Shapiro, C. M., & Colantonio, A. (2016). The Pittsburgh sleep quality index as a screening tool for sleep dysfunction in clinical and non-clinical samples: A systematic review and meta-analysis. Sleep Medicine Reviews, 25, 52-73.
  19. Murray, H., El-Leithy, S., & Billings, J. (2017). Intensive cognitive therapy for post-traumatic stress disorder in routine clinical practice: A matched comparison audit. British Journal of Clinical Psychology, 56(4), 474-478.
  20. Pacella, M.L., Hruska, B., & Delahanty, D.L. (2013). The physical health consequences of PTSD and PTSD symptoms: a meta-analytic review. Journal of Anxiety Disorders, 27(1), 33-46.
  21. Schauer, M., Neuner, F., & Elbert, T. (2011). Narrative exposure therapy: A short-term treatment for traumatic stress disorders, 2nd rev. and expanded ed. Cambridge, MA, US: Hogrefe Publishing.
  22. Schnyder, U., Ehlers, A., Elbert, T., Foa, E. B., Gersons, B. P. R., Resick, P. A., & Cloitre, M. (2015). Psychotherapies for PTSD: What do they have in common?. European Journal of Psychotraumatology, 6, 28186.
  23. Üstün, T. B., Chatterji, S., Kostanjsek, N., Rehm, J., Kennedy, C., Epping-Jordan, J., (...) & Pull, C. (2010). Developing the World Health Organization disability assessment schedule 2.0. Bulletin of the World Health Organization, 88, 815-823.
  24. Van der Does, A. J. W. (2002). De Nederlandse versie van de Beck depression inventory-Tweede Editie.[The Dutch version of the Beck depression inventory].
  25. Van Minnen, A., Voorendonk, E. M., Rozendaal, L., & de Jongh, A. (2020). Sequence matters: Combining Prolonged Exposure and EMDR therapy for PTSD. Psychiatry Research, 290, 113032.
  26. Van Woudenberg, C., Voorendonk, E. M., Bongaerts, H., Zoet, H. A., Verhagen, M., Lee, C. W., (...) De Jongh, A. (2018). Effectiveness of an intensive treatment programme combining prolonged exposure and eye movement desensitization and reprocessing for severe post-traumatic stress disorder. European Journal of Psychotraumatology, 9(1), 1487225., DOI: 10.1080/20008198.2018.1487225
  27. Zepeda Méndez, M., Nijdam, M. J., ter Heide, F. J. J., van der Aa, N., & Olff, M. (2018). A five-day inpatient EMDR treatment programme for PTSD: Pilot study. European Journal of Psychotraumatology, 9(1), 1425575., DOI: 10.1080/20008198.2018.1425575

Patricia Strijk, Viyan Bedawi, Ruud A. Jongedijk, in "MALTRATTAMENTO E ABUSO ALL’INFANZIA" 3/2020, pp. 51-62, DOI:10.3280/MAL2020-003005

   

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