La Terapia de Exposición Narrativa como alternativa terapéutica para el Trastorno de Estrés Postraumático Complejo

  1. Cáceres Rubio, M. José 1
  2. Crespo, María 1
  1. 1 Universidad Complutense de Madrid
    info

    Universidad Complutense de Madrid

    Madrid, España

    ROR 02p0gd045

Revista:
Revista de Victimología

ISSN: 2385-779X

Año de publicación: 2019

Título del ejemplar: Revista de Victimología / Journal of Victimology

Número: 9

Páginas: 5-29

Tipo: Artículo

Otras publicaciones en: Revista de Victimología

Resumen

En los últimos años se han planteado nuevos acercamientos terapéuticos para el tra-tamiento del trauma complejo en poblaciones como los refugiados y solicitantes de asilo, que intentan adaptarse a las características y circunstancias específicas de estas poblaciones, en particular a la dificultad de accesibilidad a un tratamiento psicológico y a la acumulación de acontecimientos traumáticos. Entre ellos figura la Terapia de Exposición Narrativa (TEN), así como sus versiones, STAIR para personas que han sufrido adversidades en la infancia, y FORNET para población militar con altos niveles de agresividad. El presente trabajo tiene como objetivo realizar una revisión sistemática de estudios que valoren la eficacia de la TEN y sus dos versiones para el tratamiento del Trastorno de Estrés Postraumático (TEPT) en adultos. La revisión recoge un total de 21 estudios publicados entre 2000 y 2018. Los resultados muestran que la TEN y sus diferentes modalidades son eficaces para disminuir la sintomato-logía postraumática en un conjunto breve de sesiones. Los resultados son menos concluyentes respecto a la disminución de la sintomatología depresiva. Además, las tasas de abandono del tratamiento son bajas. Se discuten las implicaciones clínicas de los resultados.

Referencias bibliográficas

  • Adenauer, H., Catani, C., Gola, H., Keil.J., Ruf, M., Schauer, M., & Neuner, F. (2011). Narrative exposure therapy for PTSD increases top-down processing of aversive stimuli-evidence from a randomized controlled treatment trial. BMC Neuroscience, 12, 127. doi: 10.1186/1471-2202-12-127
  • Alghamdi, M., Hunt, N., & Thomas, S. (2015). The effectiveness of Narrative Exposure Therapy with traumatised firefighters in Saudi Arabia: A randomized controlled study. Behaviour Research and Therapy, 66, 64-71. doi: 10.1016/j.brat.2015.01.008
  • Alto Comisionado de las Naciones Unidas para los Refugiado (ACNUR). (2017). Informe Anual 2017. Recuperado de: https://eacnur.org/files/ reports/file/memoria_anual_de_acnur_2017.pdf
  • Bichescu, D., Neuner. F., Schauer, M. & Elbert, T. (2007). Narrative exposure therapy for political imprisonment- related chronic posttraumatic stress disorder and depression. Behaviour Research and Therapy, 45, 2212-2220. doi: 10.1016/j.brat.2006.12.006
  • Cloitre, M., Koenen, K.C., Cohen, L.R., & Han, H. (2002). Skills training in affective and interpersonal regulation followed by exposure: A phase-based treatment for PTSD related to childhood abuse. Journal of Consulting and Clinical Psychology, 70, 1067-1074. doi: 10.1037/0022-006X.70.5.1067
  • Cloitre, M., & Schmidt. A. (2015). STAIR Narrative Therapy. En Cloitre, M. & Schnyder, U. (Eds.) (2015), Evidence Based Treatment for Trauma-Rela-ted Psychological Disorders: A Guide for Clinicians (pp. 277-291). Londres: Springer.
  • Cloitre, M., Stovall-McClought, K.C., Nooner, K., Zorbas, P., Cherry, S., Jackson, C.L., Gan, W., & Petkova, E. (2010). Treatment for PTSD related to childhood abuse: A randomized controlled trial. The American Journal of Psychiatry, 167, 915-924. doi: 10.1176/appi.ajp.2010.09081247
  • Crespo, M., Castro, S. y Gómez-Gutiérrez, M. (2017). Menores refugiados: psicopatología y factores relacionados. Revista de Victimología, 6, 9-32. doi: 10.12827/RVJV.6.01
  • Crombach, A., & Elbert, T. (2015). Controlling Offensive Behaviour Using Narrative Exposure Therapy: A Randomized Controlled Trial of Former Street Children. Clinical Psychological Science, 3, 270 –282. doi: 10.1177/2167702614534239
  • Elbert, T., Schauer, M. & Neuner, F. (2015). Narrative Exposure Therapy (NET): Reorganizing Memories of Traumatic Stress, Fear and Violence. En Cloitre, M. & Schnyder, U. (Eds.), Evidence Based Treatment for Trauma Related Psychological Disorders. A practical guide for clinicians (pp. 229-249). Londres: Springer.
  • Erbes, C.R., Stillman, J.R., Wieling, E. Bera, W., & Leskela, J. (2014). A Pilot Examination of the Use of Narrative Therapy with Individuals Diagnosed with PTSD. Journal of Traumatic Stress, 27, 730-733. doi: 10.1002/jts.21966
  • Gonçalves, F. (2002). Fundamentos de investigación. En Gonçalves, F. (2002). Psicoterapia cognitiva narrativa. Manual de terapia breve (pp. 46-47). Bilbao: Descleé de Brouwer.
  • Gwozdziewycz, N., & Mehls-Madrona, L. (2013). Meta-Analysis of the Use of Narrative Exposure Therapy for the Effects of Trauma Among Refugee Populations. The Permanent Journal, 17, 70-76. doi: 10.7812/FTPP/F12-058
  • Halvorsen, J. O., & Stenmark, H. (2010). Narrative exposure therapy for posttraumatic stress disorder in tortured refugees: A preliminary uncontrolled trial. Scandinavian Journal of Psychology, 51, 495-502. doi: 10.1111/j.1467-9450.2010.00821.x.
  • Hecker, T., Hermenau, K., Crombach, A. & Elbert, T. (2015). Treating traumatized offenders and veterans by means of Narrative Exposure Therapy. Frontiers in Psychiatry, 6, 80. doi: 10.3389/Ffpsyt.2015.00080
  • Hensel-Dittmann, D., Schauer, M., Ruf, M., Catani, C., Odenwald, M., Elbert, T., & Neuner, F. (2011). Treatment of Traumatized Victims of War and Torture: A Randomized Controlled Comparison of Narrative Exposure Therapy and Stress Inoculation Training. Psychotherapy and Psychosomatics, 80, 345-352. doi: 10.1159/000327253
  • Hermenau, K., Hecker, T., Schaal, S., Maedl, A., & Elbert, T. (2013). Addressing Post-traumatic Stress and Aggression by Means of Narrative Exposure: A Randomized Controlled Trial with Ex-Combatants in the Eastern DRC. Journal of Aggression, Maltreatment & Trauma, 22, 916–934. doi: 10.1080/10926771.2013.824057
  • Hijazi, A. M. (2013). Narrative Exposure Therapy to treat traumatic stress in Middle Eastern refugees: A clinical trial. Dissertation Abstracts International: Section B: The Sciences, and, Engineering, 74 (2-B(E)).
  • *Hijazi, A. M., Lumley, M.A., Ziadni, M. S., Haddad, L., Rapport, L.J., & Arnetz, B. B. (2014). Brief Narrative Exposure Therapy for Posttraumatic Stress in Iraqi Refugees: A Preliminary Randomized Clinical Trial. Journal of Traumatic Stress, 27, 314–32. doi: 10.1002/jts.21922
  • Hinsberger, M., Holtzhausen, L., Sommer, J., Kaminer, D., Elbert, T., Seedat, S., Wilker, S., Crombach, A., & Weierstall, R. (2017). Feasibility and Effectiveness of Narrative Exposure Therapy and Cognitive Behavioural Therapy in a Context of Ongoing Violence in South Africa. Psychological Trauma: Theory, Research, Practice and Policy, 9, 282-291. doi: 10.1037/tra0000197
  • *Köback, A., Schaal, S., Hecker, T., & Elbert, T., (2015). Psychotherapeutic Intervention in the Demobilization Process: Addressing Combat-related Mental Injuries with Narrative Exposure in a First and Second Dissemination Stage. Clinical Psychology and Psychotherapy, 24, 807-825. doi: 10.1002/cpp.1986.
  • *Levitt, J.T., Malta, L.S., Martin, A., Davis, L., & Cloitre, M. (2007). The flexible application of a manualized treatment for PTSD symptoms and functional impairment related to the 9/11 World Trade Centre Attack. Behaviour Research and Therapy, 45, 1419-1433. doi: 10.1016/j.brat.2007.01.004
  • McPherson, J. (2012). Does Narrative Exposure Therapy Reduce PTSD in Survivors of Mass Violence? Research on Social Work Practice, 22, 29-42. doi: 10.1177/1049731511414147
  • Morkved, N., Hartmann, K., Aarsheim, L.M., Holen, D., Milde, A.M., Bomyea, J., & Thorp, S.R. (2014). A comparison of Narrative Exposure Therapy and Prolonged Exposure Therapy for PTSD. Clinical Psychological Review, 34, 453-467. doi: 10.1016/j.cpr.2014.06.00
  • *Morkved, N., & Thorp, S. R. (2018). The treatment of PTSD in an older adult Norwegian using narrative exposure therapy: a case report. European Journal of Psychotraumatology, 9, 1414561. doi: 10.1080/20008198.2017.1414561
  • *Neuner, F., Kurreck, S., Ruf, M., Odenwald, M., Elbert, T., & Schauer, M. (2010). Can Asylum-Seekers with Posttraumatic Stress Disorder Be successfully treated? A randomized Controlled Pilot Study. Cognitive Behaviour, 38, 81-91. doi: 10.1080/16506070903121042.
  • *Neuner, F., Onyut, P.L., Ertl, V., Odenwal, M., Schauer, E. & Elbert, T. (2008). Treatment of Posttraumatic Stress Disorder by Trained Lay Counsellors in an African Refugee Settlement: A randomized Controlled Trial. Journal of Consulting and Clinical Psychology, 76, 686-694. doi: 10.1037/0022-006X.76.4.686.
  • *Neuner, F., Schauer, M., Klaschik, U., Karanuakara, U., & Elbert, T. (2004). A Comparison of Narrative Exposure Therapy, Supportive Counselling and Psychoeducation for Treating Posttraumatic Stress Disorder in an African Refugee Settlement. Journal of Consulting and Clinical Psychology, 72, 579-587. doi: 10.1037/0022-006X.72.4.579
  • National Institute for Health and Care Excellence (2019). Post-traumatic Stress Disorder: NICE Guideline. Londres: NICE. Accesible en: http://nice. org.uk/guidance/ng116
  • *Pabst, A., Schauer, M., Bernhardt, K., Ruf, M., Goder, R., Rosentraeger R., Elbert, T., Aldenhoff, J., & Seeck-Hirschner, M. (2012). Treatment of Patients with Borderline Personality Disorder and Comorbid Posttraumatic Stress Disorder Using Narrative Exposure Therapy: A feasibility Study. Psychotherapy and Psychosomatics, 81, 61-63. doi: 10.1159/000329548
  • Robjant, K., & Fazel, M. (2010). The emerging evidence for Narrative Exposure Therapy: A review. Clinical Psychological Review, 30, 1030-1039. doi: 10.1016/j.cpr.2010.07.004
  • *Robjant, K., Roberts, J., & Katona, C. (2017). Treating Posttraumatic Stress Disorder in Female Victims of Trafficking Using Narrative Exposure Therapy: A Retrospective Audit. Frontiers in Psychiatry, 8, 63. doi: 10.3389/fpsyt.2017.00063
  • Schauer, M., Neuner, F. & Elbert, T. (2011). Narrative Exposure Therapy. A shortterm treatment for traumatic stress disorders. Göttingen: Hogrefe.
  • *Stenmark, H., Catani, C., Neuner, F., Elbert, T., Holen, A. (2013). Treating PTSD in refugees and asylum seekers within the general health care system. A randomized controlled multicentre study. Behaviour Research and Therapy, 51, 641-647. doi: 10.1016/j.brat.2013.07.002
  • *Trappler, B. & Newville, H. (2007). Trauma healing via cognitive behaviour therapy in chronically hospitalized patients. Psychiatric Quarterly, 78, 317-325. doi: 10.1007/s11126-007-9049-8
  • *Zang, Y., Hunt, N., & Cox, T. (2013). A randomised controlled pilot study: the effectiveness of narrative exposure therapy with adult survivors of the Sichuan earthquake. BMC Psychiatric, 13, 41. doi: 10.1186/1471-244X13-41