Video NET With CYP Who Witnessed Domestic Violence
Condition: Post-Traumatic Stress Disorder in Children; Post-Traumatic Stress Disorder in Adolescence; Post-Traumatic Stress Disorder Complex; Domestic Violence; Trauma, Psychological; Narrative Exposure Therapy
MeSH terms: Stress Disorders, Traumatic; Stress Disorders, Post-Traumatic; Psychological Trauma
Study type: Interventional

Summary: 
      Research suggests that children and young people (CYP) who witness domestic violence are
      susceptible to develop Post-traumatic stress (PTS). As their traumatic experiences are often
      repeated and prolonged, these CYP are likely to present with 'complex trauma' presentations,
      which also include other difficulties such as depressive symptoms and problems in
      functioning.

      This study aims to investigate whether Narrative Exposure Therapy (NET) delivered via
      videoconferencing can be effective, feasible, and acceptable for CYP who witnessed domestic
      violence. NET is a brief, evidence-based intervention for complex trauma which has been
      adapted for CYP. The study will use a 'single case study series' design and look at whether
      NET can impact on PTS, psychological distress, and functioning. It will also look at the
      processes of change within NET and participants' experience of the therapy. Young people aged
      12-17 who are experiencing PTS after exposure to domestic violence will be recruited from the
      waiting lists of Child and Adolescent Mental Health Services in Lincolnshire Partnership NHS
      Foundation Trust and Nottinghamshire Healthcare NHS Foundation Trust.

      Up to six participants will receive six to ten weekly video sessions and the changes in the
      outcomes will be explored before, during and after NET. Finally, participants will be
      interviewed about their experiences.

      The study is part of a Doctorate in Clinical Psychology programme and funded by Health
      Education England. Potential benefits include investigating NET with a new group,
      contributing to the research on complex trauma interventions for CYP, and providing insights
      on the effectiveness and acceptability of therapies via video.
    

Detailed description: 
      The purpose of the study is to investigate the potential effectiveness, feasibility,
      acceptability and putative mechanisms of change of video NET with children and young people
      who witnessed domestic violence.

      The primary objective of the study is to evaluate whether video NET can reduce PTS in this
      group.

      The secondary objectives of the study are:

        -  To determine whether video NET can also impact on general psychological distress and
           functioning;

        -  To examine the putative mechanisms of change within NET, i.e. habituation and
           integration of trauma memories;

        -  To explore the feasibility and acceptability of video NET.
    

Intervention name(s): Narrative Exposure Therapy
Intervention type(s): Other
Intervention description(s): NET is a trauma-focused psychological treatment for people who experienced multiple traumas (Schaeur et al., 2011).
An adaptation named KIDNET was developed for use with children and young people (Neuner et al., 2008; Schauer et al., 2011, 2017).
Participants will be offered 6-10 weekly sessions of NET lasting approximately 90 minutes each. The sessions will be delivered by a Trainee Clinical Psychologist via videoconferencing, in line with the UK's Government guidelines around reducing face-to-face contacts during the Covid-19 pandemic.
Other intervention name(s): NET; KIDNET (protocol for children and adolescents)
Intervention model: Single Group Assignment
Intervention model description: The study will adopt a Single Case Design (SCD) methodology, and specifically a naturalistic, sequential measurement, mixed-method AB design.
SCDs are an idiographic method that allows for the analysis and interpretation of change at the level of the individual, rather the group. As such, SCDs typically aim to measure the change occurring in the individual's behaviour or symptoms by comparing the baseline, the intervention and the follow-up phases in terms of trends and variability (Parsonson & Baer, 1986). Furthermore, SCDs lend themselves to an in-depth exploration of process and outcome of therapy in applied settings, and, particularly when experimental, allows for drawing causal inferences about effectiveness. This is in line with the objectives of this study, which aims to answer questions about both outcomes and processes of change within NET.
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: post-traumatic stress; narrative exposure therapy; children and young people; domestic violence; case study series