Narrative Exposure Therapy for Depression

Narrative exposure therapy (NET) is a relatively new form of psychotherapy for treatment of individuals with traumatic pasts. In NET, the patient is asked to repeatedly talk about the most traumatic and painful events from their past, dwelling on the pain and ideally re-experiencing every emotion associated with the event. NET—while new—has been demonstrated to be an effective short-term treatment for post-traumatic stress disorders and is best-suited for depression sufferers who've experienced extremely painful pasts and whose mood disorders directly result from those events.

The Treatment

• NET is meant to be a short-term treatment, compromised of a few sessions a week for about four to six weeks. NET is most effective when the patient repeatedly relates and re-experiences the most painful events from their past, the ones causing them the most pain. However, according to a study published in BMC Psychiatry in 2005, most people suffering from mood disorders are unsure of which events these are before beginning treatment. Consequently, NET requires that patients construct a narrative of their life, focusing primarily on the most painful events from their past. Once this has been established, the patient talks about the past painful events, focusing more and more on those that elicit the strongest responses. The effect is that patients undergo habituation of the emotional response to the traumatic memory, and this habituation leads to a remission of PTSD (post-traumatic stress disorder) symptoms. PTSD suppressed, the patient can undergo other treatments such as behavioral-cognitive therapy for other mood disorders.

Use and Effectiveness

• NET is most well-adapted for patients who've undergone extremely traumatic experiences, such as war or torture, that have left bold marks on their personalities. According to a study published in Psychotherapy and Psychosomatics in 2009, NET has undergone multiple small-group trials to compare the efficacy of the therapy to other, well-established treatments like interpersonal psychotherapy. In the study conducted by Susanne Schaala, Thomas Elberta and Frank Neunerin, orphans of the Rwandan genocide who had been diagnosed with PTSD were exposed to NET. The researchers showed that NET is an effective treatment when combined with group-based mourning. Another study published in Behaviour Research and Therapy in 2007 showed similar results for adult victims of political imprisonment.