Feasibility and Effectiveness of Narrative Exposure Therapy and Cognitive Behavioral Therapy in a Context of Ongoing Violence in South Africa

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2017
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Holtzhausen, Leon
Kaminer, Debra
Seedat, Soraya
Wilker, Sarah
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European Union (EU): 323977
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Memo TV - Epigenetic, neural and cognitive memories of traumatic stress and violence
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Psychological Trauma: Theory, Research, Practice, and Policy. 2017, 9(3), pp. 282-291. ISSN 1942-9681. eISSN 1942-969X. Available under: doi: 10.1037/tra0000197
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Objective: In an observer-blinded intervention trial, we tested the reduction of posttraumatic stress symptoms, aggressive attitude, and behavior in young males living in a context of ongoing community and gang violence by means of (a) forensic offender rehabilitation narrative exposure therapy (FORNET), and (b) the cognitive-behavioral intervention "Thinking for a Change" (TFAC). A waiting list served as the control condition. Method: A total of 39 young men were included in the data analysis: 15 completed FORNET, 11 underwent cognitive-behavioral therapy (CBT), and 13 were on a waiting list for later treatment. The primary efficacy endpoints were the PTSD Symptom Scale-Interview (PSS-I) severity score, the Appetitive Aggression Scale (AAS) score, and the number of perpetrated violent event types 8 months (on average) after treatment. Results: Only in the sample receiving FORNET were posttraumatic stress disorder (PTSD) scores significantly reduced at the first follow-up (Cohen's d = -0.97) and significantly different from those of the control group (Cohen's d = -1.03). The changes in scores for appetitive aggression and perpetrated events were not significant for any of the treatment conditions. Conclusions: The study shows that trauma-focused treatment can reduce the psychological symptoms of posttraumatic stress even for individuals living under unsafe conditions in low-income urban communities. However, achieving changes in violent behavior within a context of ongoing violence may require more than the treatment of trauma-related suffering, confrontation with one's offenses, or cognitive-behavioral interventions.

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ISO 690HINSBERGER, Martina, Leon HOLTZHAUSEN, Jessica SOMMER, Debra KAMINER, Thomas ELBERT, Soraya SEEDAT, Sarah WILKER, Anselm CROMBACH, Roland WEIERSTALL, 2017. Feasibility and Effectiveness of Narrative Exposure Therapy and Cognitive Behavioral Therapy in a Context of Ongoing Violence in South Africa. In: Psychological Trauma: Theory, Research, Practice, and Policy. 2017, 9(3), pp. 282-291. ISSN 1942-9681. eISSN 1942-969X. Available under: doi: 10.1037/tra0000197
BibTex
@article{Hinsberger2017Feasi-37562,
  year={2017},
  doi={10.1037/tra0000197},
  title={Feasibility and Effectiveness of Narrative Exposure Therapy and Cognitive Behavioral Therapy in a Context of Ongoing Violence in South Africa},
  number={3},
  volume={9},
  issn={1942-9681},
  journal={Psychological Trauma: Theory, Research, Practice, and Policy},
  pages={282--291},
  author={Hinsberger, Martina and Holtzhausen, Leon and Sommer, Jessica and Kaminer, Debra and Elbert, Thomas and Seedat, Soraya and Wilker, Sarah and Crombach, Anselm and Weierstall, Roland}
}
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