Adressing PTSD Symptoms and Aggressive Behavior in Vulnerable Children in Burundi

Study Overview
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Brief Summary
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Children either living in the streets of Bujumbara or that are similarly affected by extreme poverty or violence are regularly exposed to traumatic events. Additionally, they often find themselves in situations where engaging in violent behavior appears to be useful or even necessary for survival. The Narrative Exposure Therapy for violent offenders (FORNET) aims to reduce both PTSD symptoms and aggressive behavior. It helps the children to anchor fearful experiences and potential positive emotions linked to violent behaviour in the past. Additionally, visions for the future are developed in order to enable reintegration into the family. The investigators want to provide evidence, that FORNET effectively reduces PTSD symptoms and ongoing aggressive behavior which in change facilitates reintegration into society.

Official Title
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Treating Posttraumatic Stress Disorder and Reducing Aggressive Behavior in Street Children and Vulnerable Children in Burundi Using Narrative Exposure Therapy for Forensic Offender Rehabilitation.

Conditions
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Posttraumatic Stress Disorder, Aggressive Behavior

Intervention / Treatment
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* Behavioral: Narrative Exposure Therapy for Forensic Offender Rehabilitation (FORNET)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: High degree of symptoms of posttraumatic stress disorder according to UCLA PTSD Reaction Index Exclusion Criteria: Psychotic symptoms

Ages Eligible for Study
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Minimum Age: 8 Years
Maximum Age: 20 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: FORNET<br>During FORNET, the client, with the assistance of the therapist, constructs a chronological narrative of his or her entire life with a focus on exposure to traumatic stress and committed violence. Empathic understanding, active listening, congruency and unconditional positive regard are key components of the therapist's behavior. The therapist asks in detail for the client's emotions, cognitions, physiological reactions, and sensory informations during traumatic and aggressive events to link them to an autobiographical context, namely time and place. In total the individuals receive 8 sessions of FORNET, every session lasting between 1.5 and 2 hours depending on the needs of the participant. | Behavioral: Narrative Exposure Therapy for Forensic Offender Rehabilitation (FORNET)<br>* FORNET aims to reduce trauma-related symptoms and aggressive behavior via narrative exposure of traumatic and violent life events.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change of load of traumatic symptoms measured via the UCLA Adolescent PTSD Index (PTSD scale administered by Clinicians) |  | baseline; 5 months follow-up; 9 months follow-up | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change of number of aggressive acts measured via an adaption of the Domestic and Community Violence Checklist |  | baseline; 5 months follow-up; 9 months follow-up | 
| Change of experienced shame measured via the Shame Variability Questionnaire |  | baseline; 5 months follow-up; 9 months follow-up |