Adapting narrative exposure therapy for Chinese earthquake survivors: a pilot randomised controlled feasibility study.
BACKGROUND
Narrative exposure therapy (NET) is a brief, manualised treatment for Posttraumatic Stress Disorder (PTSD). It has been shown to have therapeutic benefits for a wide range of individuals and settings. This study, following our previous work applying the original NET in earthquake survivors, aimed to revise NET to be adaptable for treating PTSD after a natural disaster.


METHODS
A randomised waiting-list controlled study was conducted with 30 adult participants with PTSD who were randomly allocated to NET (n = 10), revised NET (NET-R; n = 10) or a waiting list condition (WL; n = 10). Participants in NET and NET-R received treatment immediately; those in the WL condition received NET-R treatment after a waiting period. All groups were assessed on PTSD, general distress, anxiety, depression, social support, coping and posttraumatic change before and after treatment and three-month follow-up.


RESULTS
Compared with WL, both NET and NET-R groups showed significant reductions in PTSD and related symptoms. Significant increases were found in posttraumatic growth, active coping and perceived social support. The WL group showed similar improvements after treatment. Further reductions on PTSD symptoms were found at three months, showing that NET-R is as effective as the original NET in treating post-earthquake traumatic symptoms in adult Chinese earthquake survivors.


CONCLUSIONS
NET-R is a feasible and cost-effective intervention for Chinese earthquake survivors. Further studies are needed to replicate these findings in other survivor populations, and with larger samples and over longer periods. This study highlighted the value of oral narrative approach, which is well-accepted and useful in the context of single natural disaster and lower- income area.


BACKGROUND
Chinese Clinical Trial Registry: ChiCTR-TRC-12002931.
Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Jubilee Campus, Wollaton Road, Nottingham, NG8 1BB, UK. zangyinyin@gmail.com.|Center for the Treatment and Study of Anxiety, Department of Psychiatry School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA. zangyinyin@gmail.com.
Yinyin
Y
Zang
Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Jubilee Campus, Wollaton Road, Nottingham, NG8 1BB, UK. nigel.hunt@nottingham.ac.uk.
Nigel
N
Hunt
Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Jubilee Campus, Wollaton Road, Nottingham, NG8 1BB, UK. t.cox@bbk.ac.uk.|School of Business, Economics and Informatics, Birkbeck, University of London, Torrington Square, London, WC1, UK. t.cox@bbk.ac.uk.
Tom
T
Cox
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People / Q000523:psychology*; D002681:China / Q000453:epidemiology; D004190:Disasters; D055866:Earthquakes; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D062525:Narrative Therapy / Q000379:methods*; D010865:Pilot Projects; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*; D014850:Waiting Lists