Narrative Exposure Therapy: Expanding Virtual Treatment of Posttraumatic Stress Disorder to the Postpartum Period.

Abstract

Individuals in the perinatal period (pregnancy and first 12-24 months postpartum) are particularly vulnerable to experience new traumatic events or exacerbation of pre-existing posttraumatic stress disorder (PTSD) symptoms. PTSD during the perinatal period is associated with the poorest mental and physical health outcomes for both the birthing person and their child. Treatment options for PTSD during the perinatal period remain underexplored, yet Narrative Exposure Therapy (NET) may be particularly well-suited to reduce perinatal PTSD. The current study evaluates the feasibility, acceptability, and preliminary effectiveness of a brief NET protocol for pregnant and postpartum participants. Participants (N = 16, mean age = 28.9, 75% White, 75% multiparous, 62.5% postpartum) completed a six-session virtual protocol. Participants completed self-report measures assessing acceptance and credibility of program, as well as depressive and PTSD symptoms at baseline, 1 week-, 1 month-, and 3 months-post-intervention. Participants endorsed that the program was acceptable and feasible; most eligible participants consented to participate (74%) and completed treatment (81%). There were statistically significantly lower levels of PTSD symptoms (M _pre = 37.70; M _post = 23.50, p = <.001, d = 1.74) and depressive symptoms (M _pre = 14.17; M _post = 9.42, p = .002, d = 1.14;) at 1-week post-intervention with gains maintained. Mean dissociation symptoms and dysfunctional posttraumatic cognitions also decreased. This study provides preliminary data that brief NET is a feasible, acceptable, and effective PTSD treatment for pregnant and postpartum individuals. Future research should utilize large clinical trials with more diverse samples to determine efficacy and generalizability across perinatal populations.