What is NET (Narrative Exposure Therapy)? – A Professional Overview

What is NET (Narrative Exposure Therapy)?

What is NET (Narrative Exposure Therapy)? – A Professional Overview

If you have experienced trauma, you may find it difficult to talk about what happened. You may feel overwhelmed, anxious or ashamed, and struggle to put your experiences into words. This is where Narrative Exposure Therapy (NET) can help. NET is a type of therapy that can help you to tell your story in a safe and supportive environment.

What is NET (Narrative Exposure Therapy)?

NET is a relatively new form of therapy that has been developed to help people who have experienced trauma. It is based on the idea that talking about your experiences can help you to process them and move on. During NET, you will work with a trained therapist to create a timeline of your life, including any traumatic events that you have experienced. You will then tell your story in detail, with the support of your therapist. By doing this, you can begin to make sense of what happened and start to heal.

Historical Background

What is NET? (Narrative Exposure Therapy)

Origins of NET

Narrative Exposure Therapy (NET) is a relatively new form of psychotherapy that was developed in the 1990s by German psychologists Frank Neuner, Maggie Schauer, and Thomas Elbert. They created NET as a response to the needs of refugees and survivors of war and conflict who experienced post-traumatic stress disorder (PTSD).

Development and Evolution

Initially, NET was developed to treat PTSD in refugees and survivors of war and conflict. The therapy was designed to be culturally sensitive and effective in treating individuals from different cultural backgrounds. The therapy involves exposure to traumatic memories through the use of storytelling, which is a common cultural practice in many societies.

NET has evolved over time and has been adapted for use in other populations, including survivors of sexual abuse, domestic violence, and natural disasters. The therapy has also been modified to be used in group settings and with children.

NET has been shown to be an effective treatment for PTSD in various populations. Studies have shown that NET is as effective as other forms of therapy, such as Cognitive Behavioural Therapy (CBT), in reducing PTSD symptoms. Additionally, NET has been shown to be more effective than other forms of therapy in reducing symptoms of depression and anxiety.

Overall, the development of NET has been an important step in the treatment of PTSD and other trauma-related disorders. Its cultural sensitivity and effectiveness in treating various populations make it a valuable tool for mental health professionals to use in their practice.

Theoretical Framework

What is NET? (Narrative Exposure Therapy)
What is NET? (Narrative Exposure Therapy)

Underlying Principles

Narrative Exposure Therapy (NET) is based on the principles of exposure therapy, which involves confronting traumatic memories in a controlled and safe environment. NET uses a narrative approach to help individuals construct a coherent and chronological account of their traumatic experiences. This narrative is then used as a tool to process and integrate the traumatic memories.

NET is also based on the principles of cognitive theory, which suggests that the way we think about events can have a significant impact on our emotional and behavioural responses. NET aims to help individuals restructure their thoughts and beliefs about their traumatic experiences, which can lead to a reduction in symptoms of post-traumatic stress disorder (PTSD).

Cognitive Theory

Cognitive theory suggests that individuals with PTSD may have negative and distorted thoughts about themselves, others, and the world around them. These thoughts can lead to a range of symptoms, including anxiety, depression, and avoidance behaviours.

NET aims to help individuals identify and challenge these negative thoughts, and replace them with more adaptive and realistic beliefs. This process is known as cognitive restructuring, and it is a key component of NET.

Overall, the theoretical framework of NET is based on the principles of exposure therapy and cognitive theory. By using a narrative approach and cognitive restructuring techniques, NET aims to help individuals process and integrate their traumatic memories, and develop more adaptive beliefs about their experiences.

Methodology of NET

What is NET? (Narrative Exposure Therapy)
What is NET? (Narrative Exposure Therapy)

Treatment Structure

Narrative Exposure Therapy (NET) is a short-term psychotherapeutic intervention designed to treat post-traumatic stress disorder (PTSD). The treatment typically consists of 12-16 weekly sessions, each lasting approximately 90 minutes. NET is typically delivered in individual sessions, but it can also be delivered in a group format.

Session Phases

The treatment is divided into three main phases: the Stabilisation Phase, the Exposure Phase, and the Reintegration Phase.

Stabilisation Phase

The first phase of NET, the Stabilisation Phase, is focused on building trust and rapport between the therapist and the client. The therapist helps the client develop coping skills to manage their symptoms and teaches relaxation techniques that can be used during the Exposure Phase.

Exposure Phase

The second phase of NET, the Exposure Phase, involves the client recounting their traumatic experiences in detail. The therapist uses a variety of techniques to help the client process their memories, including guided imagery, cognitive restructuring, and exposure therapy.

Reintegration Phase

The final phase of NET, the Reintegration Phase, is focused on helping the client to integrate their traumatic experiences into their life story. The therapist helps the client develop a coherent narrative that includes the traumatic event but is not defined by it.

Narrative Techniques

NET uses a variety of narrative techniques to help clients process their traumatic experiences. These include:

  • Timeline: The therapist helps the client create a timeline of their life, including key events and milestones. This helps the client to contextualise their traumatic experience within the broader narrative of their life.
  • Trauma Narrative: The client is encouraged to recount their traumatic experience in detail, using sensory and emotional language to describe their thoughts and feelings at the time.
  • Future Narrative: The therapist helps the client to imagine a positive future for themselves, one that is not defined by their traumatic experience.

NET has been shown to be an effective treatment for PTSD, with several studies demonstrating its efficacy. However, it is important to note that not all clients will respond to NET, and it may not be appropriate for all types of trauma.

Application and Efficacy

What is NET? (Narrative Exposure Therapy)
What is NET? (Narrative Exposure Therapy)

Clinical Applications

Narrative Exposure Therapy (NET) has been used to treat a variety of mental health conditions, including post-traumatic stress disorder (PTSD), depression, anxiety, and other trauma-related disorders. NET is particularly effective for individuals who have experienced trauma, including refugees, war survivors, and victims of violence.

Research on Efficacy

Research studies have shown that NET is an effective treatment for PTSD and other trauma-related disorders. A systematic review and meta-analysis of randomized controlled trials found that NET was effective in reducing symptoms of PTSD, depression, and anxiety in adults, children, and perpetrators. The review also found that NET was more effective than non-active control groups and other treatments, such as cognitive-behavioral therapy (CBT) and eye movement desensitisation and reprocessing (EMDR) (source).

Case Studies

Case studies have shown that NET can be effective in treating individuals with PTSD and other trauma-related disorders. For example, a study of refugees in Germany found that NET was effective in reducing symptoms of PTSD and depression. Another study of survivors of sexual violence in the Democratic Republic of Congo found that NET was effective in reducing symptoms of PTSD and improving quality of life (source).

Overall, NET has been shown to be an effective treatment for PTSD and other trauma-related disorders. It can be used in a variety of clinical settings and has been particularly effective for individuals who have experienced trauma.

Challenges and Considerations

What is NET? (Narrative Exposure Therapy)
What is NET? (Narrative Exposure Therapy)

Ethical Concerns

As with any therapy, Narrative Exposure Therapy (NET) has ethical considerations that must be taken into account. One of the main concerns is obtaining informed consent from the client. It is important that the client fully understands the nature of the therapy, the potential risks and benefits, and their right to refuse or terminate treatment at any time. NET may also involve revisiting traumatic events, which can be distressing for the client. Therefore, it is important to ensure that the client is emotionally prepared and has adequate coping mechanisms in place before beginning the therapy.

Cultural Sensitivity

Cultural sensitivity is an important consideration in NET. The therapy was originally developed for use in war-torn countries, where trauma is often experienced on a large scale. However, the therapy has since been adapted for use in other contexts, and it is important to consider cultural differences when applying the therapy. For example, some cultures may view trauma differently, and the therapist must be aware of these differences to provide appropriate treatment. Additionally, language barriers may exist, and the therapist must ensure that the client fully understands the therapy and its goals.

Limitations of NET

While NET has been shown to be effective in treating post-traumatic stress disorder (PTSD), it is not suitable for everyone. The therapy may not be appropriate for individuals with severe mental health conditions or those who are unable to engage in therapy due to other factors. Additionally, NET may not be effective for all types of trauma or may require additional sessions or treatments for some individuals. It is important for the therapist to assess the suitability of NET for each client and to consider alternative treatments if necessary.

In summary, while NET can be an effective treatment for PTSD, it is important to consider the ethical implications, cultural differences, and limitations of the therapy. By taking these factors into account, therapists can provide appropriate treatment and ensure the best possible outcome for their clients.

Frequently Asked Questions

What is NET? (Narrative Exposure Therapy)
What is NET? (Narrative Exposure Therapy)

How is Narrative Exposure Therapy applied in a clinical setting?

Narrative Exposure Therapy (NET) is typically delivered in an individual, face-to-face format. During the sessions, the therapist will work with the client to create a detailed timeline of their life, with a focus on significant traumatic events. The client will then be guided through a process of recounting these events in detail, with the aim of integrating them into their personal narrative.

What techniques are integral to the practice of Narrative Exposure Therapy?

The key techniques used in NET include exposure therapy, cognitive restructuring, and psychoeducation. Exposure therapy involves gradually exposing the client to the traumatic memories in a safe and supportive environment. Cognitive restructuring helps the client to challenge and reframe unhelpful thoughts and beliefs related to the traumatic events. Psychoeducation involves providing the client with information about the nature of trauma and its effects on the brain and body.

Can you provide an example of a Narrative Exposure Therapy session?

In a typical NET session, the therapist may begin by asking the client to recount a traumatic event in detail, focusing on the sensory details and emotions associated with the experience. The therapist may then guide the client through a process of cognitive restructuring, helping them to challenge any negative thoughts or beliefs related to the event. Finally, the therapist may provide psychoeducation about the nature of trauma and its effects on the brain and body.

What is the typical timeline for treatment with Narrative Exposure Therapy?

The length of treatment with NET can vary depending on the severity of the client’s symptoms and their individual needs. However, it is typically a short-term treatment, lasting between 8 and 16 sessions.

Where can one find training and certification for Narrative Exposure Therapy?

Training and certification in NET are available through a number of organisations, including the European Society for Traumatic Stress Studies (ESTSS) and the International Society for Traumatic Stress Studies (ISTSS). It is recommended that therapists seek training and supervision from a qualified NET trainer before implementing the therapy in their practice.

What are the NICE guidelines regarding the use of Narrative Exposure Therapy?

The National Institute for Health and Care Excellence (NICE) recommends the use of NET as a first-line treatment for post-traumatic stress disorder (PTSD) in adults who have experienced multiple traumas or who are refugees or asylum seekers. NICE also recommends NET as a second-line treatment for PTSD in adults who have experienced a single trauma.