Narrative exposure therapy for post-traumatic stress symptoms in women who are incarcerated: an open pilot study

Background: Women who are incarcerated (WI) face a disproportionately high prevalence of exposure to potentially traumatic events (PTEs) and related posttraumatic stress disorder (PTSD) symptoms. However, there remains a deficit of low-barrier, evidence-based, trauma-focused interventions for this highly vulnerable population.Aim: This study sought to determine the feasibility and preliminary effects of Narrative Exposure Therapy (NET) on PTSD and co-occurring mental health symptoms in WI across multiple correctional settings.Methods: We conducted a pilot study of NET across three women's correctional facilities. Feasibility was operationalized via protocol completion rates. We used linear effects modelling and Cohen's d to analyse pre- to post-NET changes and strength in effects in primary (PTSD, PCL-5) and secondary outcomes (depressive symptoms, PHQ-9; anxiety, GAD-7; somatization, SSS-8).Results: Thirty-eight women completed the intervention. Feasibility was demonstrated by an 86% NET intervention and assessment completion rate. Significant symptom reductions were observed in all measured symptom domains one-week post-NET. NET resulted in large effect size in reducing PTSD symptoms (PCL-5 = 21.8 points, d = 1.11) and depressive symptoms (PHQ-9 = 5.4 points, d = .92), and medium effect sizes in reducing anxiety (GAD-7 = 4.0 points, d = .68).Conclusion: NET appears to be a highly feasible and preliminarily beneficial intervention for reducing PTSD and co-occurring mental health symptoms in WI. These findings suggest the utility of NET in correctional contexts. A fully powered, randomized controlled trial is warranted to definitively determine long-term effects of NET in WI.