Video narrative exposure therapy (NET) with children and young people who witnessed domestic violence: A naturalistic single case study series

Abstract

This study investigated the potential effectiveness, feasibility, acceptability, and putative mechanisms of change of Narrative Exposure Therapy (NET) delivered via videoconferencing with young people who witnessed domestic violence. A naturalistic, mixed-method, AB, interventional single case design was used. Five female adolescents aged 13–17 years were recruited from a Child and Adolescent Mental Health Service in the United Kingdom and attended 4–10 video-sessions of the child-friendly NET protocol. Participants completed questionnaires assessing posttraumatic stress symptoms (PTSS), general psychological distress, and trauma memory quality, wore a heart rate (HR) monitor assessing habituation, and were offered a Change Interview. At post-intervention, three participants showed reliable improvement in PTSS, but only one showed clinically significant change. One participant also demonstrated reliable improvement in general psychological distress. Effect size estimates ranged from moderate to very large and indicated change in the desired direction for all but one participant; estimated effects for general psychological distress were more modest. Three participants showed reductions in trauma memory quality, indicating increased integration. Within-session habituation was observed for all participants with available HR data; between-session habituation was also recorded for two of them. The lifeline was mentioned as a helpful aspect of NET, the video delivery was considered both a barrier and a facilitator to engagement, and positive or mixed changes were reported by two participants. Future research with more control and larger samples is needed to answer questions on generality of findings and impact of online delivery; future studies may also include longer follow-up periods and investigate other outcomes.