AUTHOR=Dozio Elisabetta , Bizouerne Cécile , Wamba Valdes , Atienza Ninon 

TITLE=Comparing the effectiveness of narrative therapy and EMDR-GTEP protocols in the treatment of post-traumatic stress in children exposed to humanitarian crises

JOURNAL=Frontiers in Child and Adolescent Psychiatry

VOLUME=3

YEAR=2024

URL=https://www.frontiersin.org/journals/child-and-adolescent-psychiatry/articles/10.3389/frcha.2024.1320688

DOI=10.3389/frcha.2024.1320688

ISSN=2813-4540

ABSTRACT=<sec><title>Background</title><p>The mental health of children living in humanitarian crisis situations is a major issue. Post-traumatic stress disorder (PTSD) causes great psychological suffering and has negative consequences on children's development. The aim of the study was to analyze retrospective data collected in a mental health and psychosocial support program for children in the Central African Republic, and to compare results of two trauma-focused treatment interventions: the narrative protocol Action contre la Faim (ACF)/KONO; and the EMDR-based Group Trauma Episode Protocol (G-TEP). Both protocols are proposed in a group setting and led by paraprofessionals.</p></sec><sec><title>Methods</title><p>In the program, 884 children attended a psychoeducation session and after that, 661 children (290 for ACF/KONO and 371 for G-TEP) benefited from all treatment sessions. PTSD was measured by the Children's Revised Impact of Event Scale (CRIES-8). General distress was measured by the Child Psychosocial Distress Screener (CPDS). Data were collected before and after treatment, and measured 5 months after the end of treatment for 185 children.</p></sec><sec><title>Results</title><p>Participants in the ACF/KONO group show a significant reduction on CRIES-8 (<italic>t</italic> = 44.8; <italic>p</italic> &lt; 0.001, effect size = 2.63) and CPDS (<italic>t</italic> = 38.2; <italic>p</italic> &lt; 0.001, effect size = 2.24). Participants to the G-TEP protocol show a significant effect with reduced scores on the CRIES-8 (<italic>t</italic> = 49.2; <italic>p</italic> &lt; 0.001, effect size = 2.55) and CPDS (<italic>t</italic> = 57.2; <italic>p</italic> &lt; 0.001, effect size = 2.97). A Student's <italic>t</italic>-test comparing the ACF/KONO and G-TEP groups shows no significant difference between the two types of treatment between pre- and post-treatment CRIES-8 scores (<italic>t</italic> = 1.744; <italic>p</italic> = 0.514, effect size = 0.040) and CPDS scores (<italic>t</italic> = 1.688; <italic>p</italic> = 0.092, effect size = 0.323). An analysis of the follow-up data for the 185 children shows that the effects of both protocols are maintained over time with mean scores after treatment and follow-up below the clinical cut-off for both CPDS (&lt;8) and CRIES-8 (&lt;17).</p></sec><sec><title>Conclusions</title><p>Both protocols have been shown to be effective in reducing traumatic symptoms in children exposed to conflict; they can be conducted by paraprofessionals and used in humanitarian crisis situations.</p></sec>