Narrative Exposure Therapy for Trauma

Examining Narrative Exposure Therapy for PTSD And Trauma Disorders

Narrative Exposure Therapy (NET) is a trauma-focused, short-term intervention that provides symptom reduction in people who have experienced complex or repeated traumatic events. Narrative Exposure Therapy for trauma helps clients construct a detailed, chronological narrative of their entire life story, including both the good and bad experiences that have shaped them.

Retelling and processing these within psychological treatments can help clients process the memories and start living in the present.

Icarus Nevada can attest to the effectiveness of narrative exposure therapy, as we use it in our Joint Commission-accredited treatment center successfully as treatment for PTSD. It’s particularly helpful in treating complex PTSD symptoms, where multiple traumatic events have scarred the individual over a long period.

Narrative Exposure Therapy (NET) can be a tool that helps people with post-traumatic stress disorder make significant therapeutic gains, even when the benefits of other modalities have been short-lasting.

What Is Narrative Exposure Therapy (NET)?

NET sessions are evidence-based, short-term psychological treatments that help clients who have survived long-term or multiple traumatic events.

Instead of asking the client to pinpoint a single traumatic experience, Narrative Exposure Therapy challenges them to create a chronological narrative of their life story. They tell about their joyful moments and deep distress to reframe trauma memories and integrate them into their personal identity.

How NET Differs from Other Trauma-Focused Therapies

Unlike therapies that only treat a single traumatic event, NET challenges clients to search their broader autobiographic memory. They don’t avoid stressful moments but start regaining access to it through the storytelling process.

The process of this psychotherapy is structured and follows a step-by-step format to gain a fuller emotional picture and regain a sense of self-control.

Frank Neuner and Narrative Exposure Therapy for Treating PTSD

Frank Neuner co-developed NET in the 1990s to meet the needs of people impacted by war, displacement, and violence. He found the power of creating a documented autobiography to be a very effective treatment for these populations.

His work promotes healing by accessing traumatic or fragmented memories. The clinical research he conducted became the foundation for NET around the world.

Evidence from Clinical Trials and Real-world Case Studies

Clinical trials and randomized controlled trials of NET published by the National Institute of Health (NIH) and other leading authorities have shown consistent reductions in post-traumatic stress disorder (PTSD), anxiety, and depression symptoms.

Case studies support these results, suggesting NET’s effectiveness. Study participants expressed feeling more in control of their sensory memories and physiological responses to trauma. Each patient also felt more hopeful about the future.

Meta-Analysis of Treatment Outcomes

Regarding Narrative Exposure Therapy, a review of meta-analysis research supports its role as a frontline PTSD treatment. Meta-analytic data have shown how NET yields symptom reduction, with effects comparable to longer-established treatments like prolonged exposure.

The data cements NET’s place as a beneficial treatment for posttraumatic stress disorder.

Meta Regression Analysis and Effectiveness of Narrative Exposure

Meta regression analysis allows researchers to look at what factors influence the overall success of NET. These can include the total number of NET sessions, therapy setting, and trauma type.

These analyses indicate that NET is most beneficial for clients with complex trauma histories. The results with NET consistently good across all cultural backgrounds.

NET Sessions Compared to Prolonged Exposure Therapy or EMDR

What are some of the reasons that a therapist might select a certain treatment method over others? In the case of Narrative Exposure Therapy, it might be its flexibility. Other therapies may be helpful in reducing the negative emotions that come from traumatic episodes, but NET helps understand the context of the trauma, giving it added clarity.

Narrative Exposure Therapy is also a short-term intervention, which can be easier to implement in areas that have limited resources or trauma-trained staff.

Who Benefits From Narrative Exposure Therapy?

NET was intended to be used with survivors of war, torture, and displaced refugees. Although it has had great success in those who have suffered human rights violations, it’s also been adapted to a broader section of trauma survivors:

• Childhood abuse survivors
• Victims of domestic violence
• After human trafficking
• Post-natural disasters
• Other chronic trauma

NET is also suitable for older adults or people who have found it hard to connect the dots between traumatic events and their symptoms.

Narrative Exposure Therapy: A Review of a Typical Session

A Narrative Exposure Therapy session begins with grounding exercises that help clients feel present and aware of any physical responses or stress. Activities to accomplish this can include breathwork, mindfulness, or a sensory technique. Once grounded, the therapist and client turn to the client’s lifeline.

Working together, the client and therapist will work through part of the client’s life, focusing on traumatic memories. The trauma therapy coach will use active listening and challenge clients to recall sensory information, like sights, sounds, and smells they noticed in the moment the traumatic experience occurred.

As the client tells their story, the therapist takes it down using their own words. It takes several NET treatments to tell the story in segments, with the counselor reading back the story to the client for emotional processing and reflection.

Our Narrative Exposure Therapy Worksheets for Adult Survivors of Trauma

It’s your turn to share your life story. Use our Narrative Exposure Therapy sheets to explore the life events that have shaped you today. The pages you find are intended for use along with professional treatments and therapy for PTSD.

If you complete them on your own, it’s important to share them with your therapist at your next session. They’re suitable for adults and older adolescents presenting the symptoms pf posttraumatic stress syndrome.

As you read about how to complete each sheet, you’ll follow ‘Layla’s’ journey, as she writes about her traumatic experiences.

Worksheet 1: Life Story Timeline Mapping

The lifetime mapping exercise is the basis of Narrative Exposure Therapy. This worksheet allows you to visually map out your life story as a chronological narrative, from your first memories of early childhood until present day. You’ll also use colored pencils or highlighters to mark the most important traumatic events and moments of joy.

Reflect on traumatic experiences, positive events that brought joy, and heartfelt losses. You’ll start organizing fragmented memories into a cohesive, clear structure before writing about life events as you progress with NET.

Layla’s Life Timeline

Layla’s timeline included her earliest happy memory, welcoming her little sister after birth. It also included her first time meeting her childhood best friend, Noor, at a park. But she recalled many hard times. She’d been born in a country where she frequently witnessed human rights abuses and recalled times of hunger, struggle, and persecution.

Then, she recalled a mix of happy and sad times upon arriving in the United States. She felt safe but sad knowing that her family had left her grandparents behind in her homeland. Layla put these things in order on her timeline, color-coded the entries, and trusted her trauma therapist to help her with taking the next steps.

Worksheet 2: Sharing Your Traumatic Event Details with the Therapist

The next worksheet helps focus on specific events from the lifeline, especially those highlighted as trauma. Writing an event narrative and providing sensory information about each trauma helps clients understand the event in concrete terms. What happened? Who was there? What made it so difficult or traumatizing?

Writing helps clients start externalizing the trauma in a supportive environment. NET transforms chaotic events into something a little more manageable by providing the proper context.

Layla’s Traumatic Event Details

Here’s what Layla wrote:

“I was only 10 the day soldiers came to our neighborhood. We had heard rumors about raids on citizens, but our worst fears came true that day. My mother hid us under the bed and covered our windows. The soldiers were outside shouting and stomping their boots on the ground. We stayed silent for what felt like an hour. When the soldiers left, we learned that they’d taken away one of our neighbors. I never understood why the took him, but I do remember fearing that they’d come take away my father next. I couldn’t move, the fear was so paralyzing. My mother told us never to speak of it again. Even now, I can recall the sound of their boots thudding against the concrete.”

Worksheet 3: Emotional Detail Prompt

Narrative Exposure Therapy (NET) helps you write a story and process your trauma. However, trauma is also stored in the body and emotions. This worksheet helps you describe the internal feelings associated with your trauma that interconnect with physical responses.

When you write about these feelings, you build emotional literacy. You will also discover how you can desensitize trauma responses by unpacking them under the safe watch of a mental health professional.

Layla’s Emotional Details

“I remember lying so quietly under the bed. My heart had started beating so hard I feared they might hear it. My hands were shaking. I was more scared than I’d ever been. I kept imagining what might happen if they found my family. I didn’t cry – I couldn’t – but I wanted to. My breathing felt wrong, like there was not enough air under the bed. Even now, the loud shouting and loud thuds make my stomach feel tied up in knots. I’m still angry, but mostly sad. I regret so much how we had to live like that. Our neighbor was a nice man; I often wonder what happened to him but also already know. Talking about this incident is still so hard and was the tipping point for us to pack up our belongings and leave behind our loved ones – my grandparents and my best friend Noor.”

Worksheet 4: Emotional Safety Check

The emotional safety check is a good idea at the final session and the end of every session with a therapist. Confronting PTSD is intense, hard work. The emotional safety check helps reflect on the needs of the inner self to ensure they’re met.

This tool takes a trauma-informed, patient-centered approach and recognizes that healing also means receiving appropriate support. The worksheet also helps the client look at their needs in a recovery context and express them to others.

Layla’s Emotional Safety Check Sheet

“Before I discuss my memories with my therapist, I need to make sure I’m present. Just thinking about my past can make my chest tighten or start feeling like I can’t breathe. I’ve learned to sit in a quiet room with my feet on the floor and something warm to hold – like a cup of hot, soothing tea. I also like to watch a flickering candle. It reminds me that I’m here in the present, not stuck in my past life.

When the process or writing about my lie triggers my PTSD, I pause and tell my therapist I need to take some deep breaths outside in the fresh air. I sometimes doodle on the margins of my worksheets, creating mantas: ‘I’m safe now,’ or, ‘I’m a survivor.’ Saying them aloud can bring me back to the present.

I’m usually tired at the end of each session with my therapist. I rest, drink lemon water, and call my mom. The therapist often reminds me that seeking support is brave, but the work of reclaiming my life from PTSD is hard work. After a therapy session, I often video chat with my Noor, who’s still my best friend. She’s been supportive of this process.”

About Icarus Nevada’s Las Vegas Trauma Treatment Facility

Icarus Nevada is here to help trauma survivors with treatment for PTSD. Our compassionate, understanding treatment professionals can help minimize the impact of post-traumatic stress disorder and any co-occurring mental disorders.

Whether your PTSD is the result of an upbringing in a home with child abuse or a single tragedy, the process of facing your trauma and learning coping tools to deal with it is essential to enjoying good mental health.

With the help of a licensed therapist, you can overcome mental health challenges and lead a fulfilling life. Each client who comes to our facility will work on building skills like active listening, setting goals, and creating boundaries to continue to protect their mental health in the future.

Our inpatient and outpatient treatment centers are beautifully appointed, providing a calm and supportive environment. We offer a setting that feels more like a luxurious retreat than a mental health facility.

Icarus Provides Narrative Exposure Therapy and PTSD Treatment

Are you ready to heal your PTSD? Our specialized therapists can provide NET and other trauma-informed treatment methods to support your recovery journey.

Give our admissions team a quick call today; contacting a team member is always free and confidential so please reach out for support now.