Efficacy and cultural adaptations of narrative exposure therapy for trauma-related outcomes in refugees/asylum-seekers: a systematic review and meta-analysis

Wright, A., Reisig, A. and Cullen, B. (2020) Efficacy and cultural adaptations of narrative exposure therapy for trauma-related outcomes in refugees/asylum-seekers: a systematic review and meta-analysis. Journal of Behavioral and Cognitive Therapy, 30(4), pp. 301-314. (doi: 10.1016/j.jbct.2020.10.003)

Abstract

Refugees/asylum-seekers are more likely to have experienced traumatic events than the general population in high-income countries. Narrative Exposure Therapy (NET) was developed to treat trauma within this population. This review aimed to determine (1) the efficacy of NET and (2) if the interventions have been successfully culturally adapted. Databases were searched from January 2002 to September 2020, for peer-reviewed randomised controlled trials (RCT) of NET published in English, involving adult refugees/asylum-seekers with any trauma disorder, resettled in high-income countries. Data were extracted and risk of bias assessed using the Cochrane data collection forms, and meta-analyses were conducted for depression and trauma symptom change. Cultural adaptations were assessed using a structured framework. Six RCTs (total n = 272) met eligibility criteria. All reported significant reductions in trauma symptoms in the NET group but only two studies found a significant reduction in depression symptoms. Meta-analyses showed medium-large between-groups effect sizes in favour of NET (depression −0.59 [−1.07, −0.11]; trauma −0.75 [−1.19, −0.31]), with substantial heterogeneity. The most common cultural adaptations were in language and context. NET was shown to be a potentially beneficial intervention for treating trauma-related outcomes. However, studies should be more transparent regarding any attempts to make interventions more culturally appropriate.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Cullen, Dr Breda
• Authors: Wright, A., Reisig, A., and Cullen, B.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing
• Journal Name: Journal of Behavioral and Cognitive Therapy
• Publisher: Elsevier
• ISSN: 2666-3473
• ISSN (Online): 2589-9791
• Published Online: 06 November 2020
• Copyright Holders: Copyright © 2020 Association Française de Therapie Comportementale et Cognitive
• First Published: First published in Journal of Behavioral and Cognitive Therapy 30(4): 301-314
• Publisher Policy: Reproduced in accordance with the publisher copyright policy