D'Errico, Danila
(2023)
Investigating the application of Narrative Exposure Therapy (NET) to reduce symptoms of traumatic stress in cancer patients not in active treatment: a naturalistic single case study series.
DClinPsy thesis, University of Nottingham.
Abstract
Objective: This study aimed to evaluate the feasibility, acceptability, and effectiveness of Narrative Exposure Therapy (NET) in reducing symptoms of traumatic stress, anxiety and depression, and existential anxiety, and in improving quality of life and promoting post-traumatic growth in cancer patients not in active treatment.
Design: This research adopted a naturalistic, mixed-method, explanatory sequential measurement single case study design.
Methods: The design collected repeated weekly outcome measurements using the PTSD Checklist Civilian (PCL-C), the Hospital Anxiety and Depression Scale (HADS), and the Functional Assessment of Cancer Therapy – General 7 Items (FACT-G7). The feasibility and acceptability of NET was investigated through the use of a Change Interview. Effect sizes, Reliable Change Index, and Clinically Significant Change were also calculated on all measures.
Results: The findings demonstrated a reduction in symptoms of traumatic stress at post-intervention for three participants and no change for one participant. No change was found in symptoms of depression, whilst one participant experienced clinically significant change in symptoms of anxiety. Two participants experienced a reduction in symptoms of existential anxiety; however, this was not maintained at follow-up for one participant. Two participants experienced improvement in quality of life, and three participants demonstrated increased post-traumatic growth, but two maintained at follow-up. Effect sizes for traumatic stress, anxiety, and quality of life ranged between moderate to very large, whilst they ranged between moderate to large for depression. The Change Interview highlighted that NET is considered acceptable and feasible by this client group.
Conclusion: In conclusion, it appears that NET can be an effective intervention to reduce symptoms of traumatic stress in cancer patients not in active treatment as three repetitions of change were obtained on the PCL-C. As a time-limited and structured intervention, the benefits of NET are clear. Not only did participants find it feasible and acceptable, but its accessibility makes it easy to implement within services.
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