NET with older adults.
NOVO: NET Onderzoek Voor ouderen.

Rationale:

In mental health services older adults represent a growing, but under-investigated population. However, trauma-related psychopathology for older adults represent robust, but often hidden problems. In general, few psychotherapies are specially designed for older adults. This accounts all the more for traumatized older adults. Recently an exposure intervention with narrative elements is developed: Narrative Exposure Therapy or NET. In this research project NET will be evaluated to answer the question if NET is a feasible and effective trauma treatment for older adults.



Central question:

Has NET with older adults with PTSD an additional effect on 1. PTSD-symptoms and 2. comorbid depressive symptoms, quality of life and attribution of meaning, compared with an intervention which is focuesed on the present (Present Centered Therapy or PCT).



Objective:

With this study NET will be evaluated in its effects on older adults. The purpose is to show that NET is an effective evidence based individual intervention for older adults with trauma-related psychopathology. Based on this study a treatment protocol and specific out-patient trauma-services for elderly patients will be developed.



Study design:

The study will be a randomized controlled intervention study (RCT / Randomized Controlled Trial), repeated measures design, mixed methods.



Study population:

80 older adults from 55 years of age, with a diagnosis of PTSD, according to the DSM-IV classification (full criteria or sub threshold PTSD), patients of foundation Centrum '45. To be included as a subject, for him/her an individual outpatient trauma-focused psychotherapy has to be indicated and there is no need of assistance by an interpreter.



Intervention:

11 weekly session of 90 minutes consisting of NET. The control-group receives 11 weekly sessions of PCT : Present Centered Therapy (Schnurr e.a., 2005).



Main study parameters/endpoints:

The observed changes in PTSD-symptoms, measures with CAPS and HTQ-16. Secondary outcomes: the observes changes in comorbid depressive symptoms (BDI-II), quality of life (WHOQOL-bref and SES), attribution of meaning (MoW), general mental health (BSI-53), anger/agression (STAS), explanatory model and process-evaluation (short interview).

The participants will be enrolled in the Netherlands.

The treatment-effects of Narrative Exposure
Rationale: In mental health services older adults represent a growing, but under-investigated population. However, trauma-related psychopathology for older adults represent robust, but often hidden problems. In general, few psychotherapies are specially designed for older adults. This accounts all the more for traumatized older adults. Recently an exposure intervention with narrative elements is developed: Narrative Exposure Therapy or NET. In this research project NET will be evaluated to answer the question if NET is a feasible and effective trauma treatment for older adults.

Hypothesis: Treatment-effects of Narrative Exposure Therapy with older adults are higher in comparison to the treatment-effects of Present Centered Therapy on symptoms of PTSD, on comorbid depressive symptoms, Quality of Life and Attribution of Meaning.

1. Pretest;

2. Posttest;

3. Follow-up (4 months after completing the intervention);

4. Instruments: Mentioned under primary and secondary outcomes.

1. Narrative Exposure Therapy (NET);

2. Present Centered Therapy (PCT).



11 weekly session of 90 minutes consisting of NET. The control-group receives 11 weekly sessions of PCT : Present Centered Therapy (Schnurr e.a., 2005).