Narrative exposure therapy

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The Narrative Exposure Therapy (NET) is a psychotherapeutic treatment for traumatized children and adults, the trauma focused cognitive behavioral therapies assigned and developed specifically for the treatment of heavy and Mehrfachtraumatisierung and organized violence.

The NET was developed by Maggie Schauer , Frank Neuner and Thomas Elbert at the University of Konstanz . The NET was originally created for precarious situations in which severely and multiply traumatized people can only receive a few treatment sessions (such as in war and crisis areas). It was created on the basis of Testimony Therapy, which was used to treat those persecuted by the Pinochet regime in Chile and combines psychotherapeutic treatment with aspects of human rights. There is now good evidence of the cross-cultural effectiveness of the NET in various types of trauma and after multiple and cumulative trauma (“building block”) and with the use of language mediators.

According to the effective understanding of the NET, the specific memory problems of the traumatized result in a lack of localization and history of the traumatic scene; so-called “cold” (logically structured) and “hot” (emotional, confused) memory contents remain unconnected. In order to achieve a spatiotemporal connection of the traumatic experiences, the patient positions himself together with the therapist in the narrative exposure therapy (NET) outside the trauma (exposure), in the present, and experiences his or her complete story, narrating in chronological order Life story again. The focus is on negative and traumatic events, with positive experiences being (re) discovered as a resource . Through the intensive re-experiencing, the past is actualized on all levels in the present (thoughts, feelings, meanings, sensations, posture, etc.). As far as possible all elements of the "fear network" are activated in the protection of "talking about", in the distance to "then", until the experience can be autobiographically classified, named, understood, located and relief occurs through habituation and integration . In the treatment sessions, the patient gradually creates a detailed and consistent, written narration of his life events in dialogical contact with the counterpart, supported by empathic verbalization.

This leads to an overall view of one's own life, an organic recognition of life patterns and contexts, an appreciation of the person and the biography of the survivor. In the tradition of Testimony Therapy , the NET is linked to human rights and child rights work; the survivors receive a testimony of their traumatic experiences with the written narration at the end of the therapy, which they could use for legal processing.

Based on the results of the NET in adults, a child-friendly form of narrative exposure therapy, KIDNET, was also developed.

Other approaches to narrative therapy

In addition to narrative exposure therapy (NET), there are other narrative approaches in psychotherapy, e.g. B. the narrative therapy according to Michael White , David Epston , as well as further narrative concepts in other psychodynamic therapy forms and other forms of therapeutic biography work , like the life review therapy according to Andreas Maercker ( psychodynamic , trauma therapeutic ), Verena Kast ( focal therapy ) or the structured life review therapy according to BK Haight and BS Haight.

See also

literature

  • Maggie Schauer, Frank Neuner, Thomas Elbert: Narrative Exposure Therapy (NET). A Short-Term Intervention for Traumatic Stress Disorders. 2nd Edition. Hogrefe & Huber Publ. Cambridge, Mass. 2011, ISBN 978-0-88937-388-4 (NET Manual; EA 2005).
  • Martina Ruf, Maggie Schauer: Facing childhood trauma. Narrative Exposure Therapy within a Cascade Model of Care. In: Jennifer Murray (Ed.): Exposure Therapy. New Developments . Nova Science Publishers, New York 2012, ISBN 978-1-61942-504-0 , pp. 229-261.
  • Thomas Elbert, Katharin Hermenau, Tobias Hecker, Roland Weierstall, Maggis Schauer: FORNET. Treatment of traumatized and non-traumatized violent offenders using narrative exposure therapy. In: Jérôme Endrass, Astrid Rossegger, Frank Urbaniok , Bernd Borchard (eds.): Interventions with violent and sexual offenders. Risk management, methods and concepts of forensic therapy . Medizinisch Wissenschaftliche Verlagsgesellschaft, Berlin 2012, ISBN 978-3-941468-70-2 , pp. 255-276.
  • Martina Ruf, Maggie Schauer, Frank Neuner, Elisabeth Schauer, Claudia Catani, Thomas Elbert: KIDNET. Narrative exposure therapy for children. In: Markus Landolt, Thomas Hensel (eds.): Traumatherapy in children and adolescents . Hogrefe Verlag, Göttingen 2007, ISBN 978-3-8017-2332-3 .
  • Maggie Schauer, Thomas Elbert, Silke Gotthardt, Brigitte Rockstroh, Michael Odenwald, Frank Neuner: Re-experience through psychotherapy modifies mind and brain. In: behavior therapy. Practice, research, perspectives. Volume 16 (2006), pp. 96-103, ISSN  1016-6262 .
  • Maggie Schauer, Thomas Elbert, Frank Neuner: Interaction of neuroscientific knowledge and psycho-therapeutic insights using the example of fear and traumatic stress. In: Reinhold Becker, Hans-Peter Wunderlich (ed.): How does psychotherapy work. Research bases for practice . Thieme-Verlag, Stuttgart 2007, ISBN 978-3-13-145801-8 , pp. 87-108.
  • Frank Neuner, Maggie Schauer, Thomas Elbert: Narrative exposition and other narrative processes. In: Andreas Maercker (Ed.): Post-traumatic stress disorders . Springer, Heidelberg 2009, ISBN 978-3-540-88488-0 , pp. 302-318.
  • Katy Robjant, Mina Fazel: The Emerging Evidence for Narrative Exposure Therapy. A review. In: Clinical Psychology Review. Volume 30 (2010), Issue 8, pp. 1030-1039. PMID 20832922 .
  • Dorothea Hensel-Dittmann, Maggie Schauer, Martina Ruf, Claudia Catani, Michael Odenwald, Thomas Elbert, Frank Neuner: The treatment of traumatized victims of war and torture. A randomized controlled comparison of Narrative Exposure Therapy and Stress Inoculation Training. In: Psychotherapy and Psychosomatics. Volume 80 (2011), pp. 345-352, doi: 10.1159 / 000327253 .
  • Astrid Pabst, Josef Aldenhoff, Maggie Schauer, Rotraudt Rosentraeger, Martina Ruf, Thomas Elbert, Mareen Seeck-Hirschner: Treatment of borderline disorders with comorbid post- traumatic stress disorder using narrative exposure therapy (NET). In: Journal of Neurology. (2012) in press.
  • Astrid Pabst, Maggie Schauer, Kirsten Bernhardt, Martina Ruf, Robert Goder, Rotraudt Rosentraeger, Thomas Elbert, Josef Aldenhoff, Mareen Seeck-Hirschner: Treatment of patients with borderline personality disorder (BPD) and comorbid posttraumatic stress disorder (PTSD) using narrative exposure therapy (NET). A feasibility study. In: Psychotherapy and Psychosomatics. Volume 81 (2012), pp. 61-63, ISSN  0033-3190 .
  • Frank Neuner, Maggie Schauer, Thomas Elbert: Psychotherapy in War and Crisis Regions. Narrative Exposure Therapy and Beyond (PDF; 571 kB). In: International Society for Traumatic Stress Studies (ed.): ISTSS Traumatic Stresspoints , Volume 25 (2011), Issue 1, pp. 8–9.

Individual evidence

  1. ↑ Maggie Schauer, Frank Neuner, Thomas Elbert .: Narrative exposure therapy: a short-term treatment for traumatic stress disorders. 2nd rev. and expanded ed. Hogrefe, Cambridge, MA 2011, ISBN 978-0-88937-388-4 .
  2. ^ Frank Neuner, Maggie Schauer, Thomas Elbert :: Narrative exposition and other narrative methods. 3., completely rework. and exp. Springer, Heidelberg 2009, ISBN 978-3-540-88488-0 .
  3. ↑ Astrid Pabst, Josef Aldenhoff, Maggie Schauer, Rotraudt Rosentraeger, Martina Ruf, Thomas Elbert, Mareen Seeck-Hirschner: Treatment of borderline disorders with comorbid post- traumatic stress disorder using narrative exposure therapy (NET). In: Journal of Neurology. (2012) in press.
  4. ↑ D. Hensel-Dittmann, M. Schauer, M. Ruf, C. Catani, M. Odenwald: Treatment of Traumatized Victims of War and Torture: A Randomized Controlled Comparison of Narrative Exposure Therapy and Stress Inoculation Training . In: Psychotherapy and Psychosomatics . tape 80 , no. 6 , 2011, p. 345–352 , doi : 10.1159 / 000327253 ( karger.com [accessed September 9, 2017]).
  5. ↑ Martina Ruf, Maggie Schauer, Frank Neuner, Elisabeth Schauer, Claudia Catani, Thomas Elbert .: KIDNET. Narrative exposure therapy for children. In: Trauma therapy in children and adolescents. 2nd, updated and exp. Edition Hogrefe, Göttingen 2012, ISBN 978-3-8017-2332-3 .
  6. ↑ Michael White .: Maps of Narrative Therapy . 1st edition Carl Auer Verlag, Heidelberg 2010, ISBN 978-3-89670-741-3 .