| Study characteristics |
| Methods |
Study design: randomised controlled trial
Study grouping: parallel group
Duration of study: recruitment May 2017 and September 2018
Location of study: UK
Randomisation method: after diagnostic assessment and completion of baseline outcome measures, a research assistant randomised participants to either trial condition using a virtual coin toss programme.
Ethics approvals: the study was approved by the ethics committee of University College London (813/002). |
| Participants |
Baseline characteristics
Behavioural (NET)
Participants: 15 Gender: 73% female participants, 4 male participants Age, M (SD): 26.73 years (9.35 years) Ethnicity: 47% African, 53% other Disability: not given Time since trauma: not given Income: not given Education: not given Employment: not given Sexual violence in adulthood: 53% Comorbid conditions: not given Baseline PTSD, M (SD): 43 (34) Partnered: not given Randomised (N): 15 Completed post‐treatment assessment (N): 13 Dropped out or removed prior to analysis (N): 2 Numbers analysed at final applicable time point (N): 13 Number of sessions, M (SD): 17 (4.07) Treatment completion: 13 (87%)
Minimal intervention (psychoeducation + wait‐list)
Participants: 10 Gender: 80% female participants, 2 male participants Age, M (SD): 32.8 years (10.96 years) Ethnicity: 20% African, 80% other Disability: not given Time since trauma: not given Income: not given Education: not given Employment: not given Sexual violence in adulthood: 70% Comorbid conditions: not given Baseline PTSD, M (SD): 46 (25) Partnered: not given Randomised (N): 10 Completed post‐treatment assessment (N): 7 Dropped out or removed prior to analysis (N): 3 Numbers analysed at final applicable time point (N): 7 Number of sessions: N/A Treatment completion: N/A
Overall
Participants: 25 Gender: 76% female participants, 24% male participants Age: not given Ethnicity: 36% African, 66% other Disability: not given Time since trauma: not given Income: not given Education: not given Employment: not given Sexual violence in adulthood: 60% Comorbid conditions: not given Baseline PTSD, M (SD): 43 (17) Partnered: 45.1% Approached (N): 55 Ineligible (N): 20 Declined (N): 9 Other (N): 1 Randomised (N): 25 Completed post‐treatment assessment (N): 20 Dropped out or removed prior to analysis (N): 5 Numbers analysed at final applicable time point (N): 20 Number of sessions: N/A Treatment completion: N/A
Inclusion criteria
Exclusion criteria
Recent suicide attempt or persistent severe self‐harm Significant and frequent substance misuse Severe preoccupation with social or legal issues that would interfere with engagement in regular therapy sessions Facing imminent removal from the UK Currently in a situation of abuse or exploitation
Pretreatment: randomisation did not yield equal allocation across the 2 groups. There were also some notable group differences in the distribution of other participant characteristics, including whether the participant was an English speaker, and in terms of country of origin. Those in the wait‐list group reported more dissociative symptoms. |
| Interventions |
Intervention characteristics
Behavioural (NET)
Intensity of intervention (sessions): 90 min to 120 min × 20 Mode of delivery (face‐to‐face, online, video, telephone, blend, with explanation): face‐to‐face Format (group, individual, blend): individual Therapist qualifications and training appropriate (yes, no, unclear, with explanation): yes, NET sessions were delivered by 7 female psychological therapists (6 clinical psychologists and 1 psychotherapist); all had training and prior experience in working with survivors of trafficking and in delivering NET (trained by FB, EW and KR and supervised by FB and EW). Research allegiance or conflict of interest (yes, no, unclear, with explanation): no, declaration of interest considered/made and does not appear to affect allegiance to the therapy Treatment fidelity (yes, no, unclear, with explanation): yes, treatment fidelity was monitored through the recording of therapy sessions and regular case supervision by clinical psychologists with extensive experience of NET. Intervention aim and theoretical basis: as directed by the NET manual, the majority of time in sessions was spent on facilitation of the participant’s detailed narration of traumatic experiences to ‘process’ the trauma memory, facilitate attachment repair and make meaning of traumatic and adverse experiences. Where time permitted, positive life events were also explored. A written narrative was created following the therapy sessions; this was read back and given to participants in the final therapy session. Through detailed narration, NET processes and contextualises traumatic memories and helps individuals to establish a coherent autobiographical narrative of their experiences. Duration of intervention: 20 weeks
Minimal intervention (psychoeducation + wait‐list)
Intensity of intervention (sessions): 3 Mode of delivery (face‐to‐face, online, video, telephone, blend, with explanation): face‐to‐face Format (group, individual, blend): individual Therapist qualifications and training appropriate (yes, no, unclear, with explanation): psychoeducation sessions were delivered by NET therapists and trained assistant psychologists. Research allegiance or conflict of interest: N/A Treatment fidelity (yes, no, unclear, with explanation): interpreters were used where required. The study used protocolised psychoeducation about PTSD symptoms and symptom management strategies. Intervention aim and theoretical basis: irrespective of group, each participant was initially offered 3 sessions of protocolised psychoeducation about PTSD symptoms and symptom management strategies. Duration of intervention: N/A
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| Outcomes |
PTSD
Outcome type: continuous outcome Scale used: Clinician‐Administered PTSD Scale Direction: lower is better Score range: 0 to 80 Data value: endpoint, post‐treatment, 6 months and 12 months (NET only)
PTSD
Outcome type: continuous outcome Scale used: PCL‐5 Direction: lower is better Score range: 0 to 80 Data value: endpoint, post‐treatment
Depression
Outcome type: continuous outcome Scale used: Patient Health Questionnaire Direction: lower is better Score range: 0 to 27 Data value: endpoint, post‐treatment
Anxiety
Outcome type: continuous outcome Scale used: Generalized Anxiety Disorder Scale Direction: lower is better Score range: 0 to 21 Data value: endpoint, post‐treatment
Dissociation
Outcome type: continuous outcome Scale used: Shutdown Dissociation Scale Direction: lower is better Score range: 0 to 39 Data value: endpoint, post‐treatment
Treatment dropout
|
| Identification |
Sponsorship source: this project was supported by a grant from the Oak Foundation (ref: OCAY‐15‐286).
Country: UK
Setting: people seeking care post‐trafficking at either a charity or other support services
Authors name: Francesca Brady
Institution: The Helen Bamber Foundation, London, UK; Woodfield Trauma Service, Central and North West London NHS Foundation Trust, London, UK; and Department of Clinical, Educational and Health Psychology, University College London, UK
Email: francesca@helenbamber.org
Year: 2021 |
| Notes |
Data obtained from author |
