title: Feasibility and effectiveness of narrative exposure therapy and cognitive behavioral therapy in a context of ongoing violence in South Africa.
abstract: In an observer-blinded intervention trial, we tested the reduction of posttraumatic stress symptoms, aggressive attitude, and behavior in young males living in a context of ongoing community and gang violence by means of (a) forensic offender rehabilitation narrative exposure therapy (FORNET), and (b) the cognitive-behavioral intervention "Thinking for a Change" (TFAC). A waiting list served as the control condition.
  
  
  
  A total of 39 young men were included in the data analysis: 15 completed FORNET, 11 underwent cognitive-behavioral therapy (CBT), and 13 were on a waiting list for later treatment. The primary efficacy endpoints were the PTSD Symptom Scale-Interview (PSS-I) severity score, the Appetitive Aggression Scale (AAS) score, and the number of perpetrated violent event types 8 months (on average) after treatment.
  
  
  
  Only in the sample receiving FORNET were posttraumatic stress disorder (PTSD) scores significantly reduced at the first follow-up (Cohen's d = -0.97) and significantly different from those of the control group (Cohen's d = -1.03). The changes in scores for appetitive aggression and perpetrated events were not significant for any of the treatment conditions.
  
  
  
  The study shows that trauma-focused treatment can reduce the psychological symptoms of posttraumatic stress even for individuals living under unsafe conditions in low-income urban communities. However, achieving changes in violent behavior within a context of ongoing violence may require more than the treatment of trauma-related suffering, confrontation with one's offenses, or cognitive-behavioral interventions. (PsycINFO Database Record
authors.affiliation: Department of Psychology, University of Konstanz.
authors.forename: Martina
authors.initials: M
authors.lastname: Hinsberger
authors.affiliation: Department of Social Development, University of Cape Town.
authors.forename: Leon
authors.initials: L
authors.lastname: Holtzhausen
authors.affiliation: Department of Psychology, University of Konstanz.
authors.forename: Jessica
authors.initials: J
authors.lastname: Sommer
authors.affiliation: Department of Psychology, University of Cape Town.
authors.forename: Debra
authors.initials: D
authors.lastname: Kaminer
authors.affiliation: Department of Psychology, University of Konstanz.
authors.forename: Thomas
authors.initials: T
authors.lastname: Elbert
authors.affiliation: Department of Psychiatry, Stellenbosch University.
authors.forename: Soraya
authors.initials: S
authors.lastname: Seedat
authors.affiliation: Department of Clinical and Biological Psychology, University of Ulm.
authors.forename: Sarah
authors.initials: S
authors.lastname: Wilker
authors.affiliation: Department of Psychology, University of Konstanz.
authors.forename: Anselm
authors.initials: A
authors.lastname: Crombach
authors.affiliation: Department of Psychology, University of Konstanz.
authors.forename: Roland
authors.initials: R
authors.lastname: Weierstall
mesh_terms: D000293:Adolescent; D000328:Adult; D000374:Aggression / Q000523:psychology; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005240:Feasibility Studies; D006801:Humans; D007171:Implosive Therapy / Q000379:methods*; D008297:Male; D062525:Narrative Therapy / Q000379:methods*; D013019:South Africa; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome; D014754:Violence / Q000523:psychology; D055815:Young Adult