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Feasibility and acceptability of Narrative Exposure Therapy to treat individuals with PTSD who are homeless or vulnerably housed: a pilot randomized controlled trial.
Edgar, Nicole E; Bennett, Alexandria; Dunn, Nicole Santos; MacLean, Sarah E; Hatcher, Simon.
  • Edgar NE; Clinical Epidemiology Program, Ottawa Hospital Research Institute, The Ottawa Hospital Riverside Campus, 1919 Riverside Drive, Suite 406, Ottawa, ON, K1H 7W9, Canada.
  • Bennett A; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
  • Dunn NS; Ontario Institute for Studies in Education, University of Toronto, Toronto, ON, Canada.
  • MacLean SE; Clinical Epidemiology Program, Ottawa Hospital Research Institute, The Ottawa Hospital Riverside Campus, 1919 Riverside Drive, Suite 406, Ottawa, ON, K1H 7W9, Canada.
  • Hatcher S; School of Journalism and Communication, Carleton University, Ottawa, ON, Canada.
Pilot Feasibility Stud ; 8(1): 83, 2022 Apr 15.
Article in English | MEDLINE | ID: covidwho-1928206
ABSTRACT

BACKGROUND:

Diagnosed PTSD rates in people who are homeless are more than double that of the general population, ranging between 21 and 53%. Complex PTSD (cPTSD) also appears to be more common than PTSD. One treatment option is Narrative Exposure Therapy (NET), a brief trauma-focused psychotherapy which attempts to place trauma within a narrative of the person's life. Our primary aim was to assess the feasibility and acceptability of recruiting people to a randomized controlled trial (RCT) of NET alone compared to NET augmented by a genealogical assessment. We hypothesized that incorporating a genealogical assessment may be more effective than NET alone in a population with predominately complex PTSD.

METHODS:

This pilot RCT enrolled participants who were 18 years of age or older, currently homeless or vulnerably housed, and with active symptoms of PTSD. Participants were randomized to NET alone or NET plus a genealogical assessment. Rates of referral, consent, and retention were examined as part of feasibility. Demographic and clinical data were collected at baseline. Symptoms of PTSD, drug use, and housing status were re-assessed at follow-up visits. We conducted a thematic analysis of qualitative interviews of service providers involved in the study which explored barriers and facilitators of study participation.

RESULTS:

Twenty-two potential participants were referred to the study, with 15 consenting to participate. Of these, one was a screen failure and 14 were randomized equally to the treatment arms. One randomized participant was withdrawn for safety. Attrition occurred primarily prior to starting therapy. Once therapy began, retention was high with 80% of participants completing all six sessions. Seven participants completed all follow-up sessions. Service providers identified a clear need for the treatment and emphasized the importance of trauma-informed care, a desire to know more about NET, and more communication about the process of referral.

CONCLUSION:

Recruiting participants who were vulnerably housed to an RCT of a trauma-based therapy was possible. Once therapy had started, participants were likely to stay engaged. We will incorporate the results of this trial into a conceptual model which we will test in a factorial study as part of the optimization phase of MOST. TRIAL REGISTRATION ClinicalTrials.gov NCT03781297 . Registered December 19, 2018.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Prognostic study / Qualitative research / Randomized controlled trials Language: English Journal: Pilot Feasibility Stud Year: 2022 Document Type: Article Affiliation country: S40814-022-01043-x

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Prognostic study / Qualitative research / Randomized controlled trials Language: English Journal: Pilot Feasibility Stud Year: 2022 Document Type: Article Affiliation country: S40814-022-01043-x