Exposure therapy for PTSD during pregnancy: a feasibility, acceptability, and case series study of Narrative Exposure Therapy (NET).

BACKGROUND: Prenatal posttraumatic stress disorder (PTSD) is a significant complication of pregnancy linked to increased risk of adverse perinatal outcomes. Although 1 in 5 pregnant trauma-exposed individuals have PTSD, most PTSD treatment trials exclude participants who are pregnant, and none focus on treatment specifically during pregnancy. Moreover, access to mental health treatment is particularly challenging in low-resource settings with high rates of trauma. This study examined implementation of Narrative Exposure Therapy (NET), a short-term evidence-based PTSD treatment, in an urban prenatal care setting. Partial telehealth delivery was used to increase accessibility. Study aims were to examine (a) feasibility, (b) acceptability, and (c) case-based treatment outcomes associated with NET participation. METHOD: Eight pregnant participants (median age = 27, median gestational week in pregnancy = 22.5) received up to six sessions of NET with partial telehealth delivery. PTSD and depression symptoms were assessed at pre-treatment intake (T1), at each session (T2), and 1-week post-treatment (T3). A multiple case study approach was used to examine recruitment and engagement, retention, treatment completion, treatment barriers, use of telehealth, participants' experiences of treatment, and PTSD and depression symptoms. RESULTS: Nine of the 16 participants (56%) who were invited to participate engaged in treatment, and one dropped out after the first session. Eight participants completed the minimum "dose" of 4 NET sessions (N = 8/9, 89%). Seven participants gave the highest ratings of treatment acceptability. The most frequently reported barriers to treatment were competing priorities of work and caring for other children. Pre-post treatment symptom measures revealed clinically meaningful change in PTSD severity for nearly all participants (7/8, 88%). CONCLUSIONS: Results suggest that a brief exposure therapy PTSD treatment can be successfully implemented during pregnancy, suggesting promising results for conducting a larger-scale investigation. Trial registration ClinicalTrials.gov, NCT04525469. Registered 20 August 2020-Retrospectively registered, https://register.clinicaltrials.gov/prs/app/template/EditRecord.vm?epmode=View&listmode=Edit&uid=U00058T2&ts=3&sid=S000A59A&cx=-w1vnvn.

Advocates' Experiences With Media and the Impact of Media on Human Trafficking Advocacy.

The present qualitative study explores advocates' opinions of misinformation about human trafficking in the media and describes advocates' strategies to counter the misinformation presented by the media. Thus, 15 advocates who work against human trafficking in Chicago-based nonprofit organizations participated in semistructured interviews about their opinions and strategies. Data were analyzed using thematic content analysis. The present study identifies specific misperceptions of human trafficking in the media, highlights advocates' opinions of this misinformation, and discusses advocates' strategies to counteract inaccurate media, adding support to the role of media advocacy. Advocates note how media images shape and perpetuate stereotypes of trafficking through glamorizing sex work and sensationalizing stories that are most often international depictions of trafficking. Advocates report media generally shares only a piece of the story, simplifying the stories of survivors and the issue of human trafficking. Advocates critique media perpetuating these misperceptions for how they may contribute to policies and programs which fail to address structural factors that create vulnerabilities to be trafficked and the multisystem needs of survivors. However, advocates also note misperceptions can be counteracted by producing sensitive, informed media through social platforms. Advocates share their strategies counteracting misinformation through engaging in informative conversations, utilizing social media to educate, and promoting media messages of survivor agency. Research, clinical, and policy implications are also discussed. The present study emphasizes the importance of decision makers and service providers being critical consumers of media and to assess how media portrayals may (or may not) inform their understanding and response to the issue.