Video NET With CYP Who Witnessed Domestic Violence

NCT04866511 | Completed DMC

• 2 other identifiers: 21003291108
• Study Type: interventional
• Target: 5
• Locations: 1 country
• Sites: 2

Brief 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.

Conditions

Post-Traumatic Stress Disorder in Children; Post-Traumatic Stress Disorder in Adolescence; Post-Traumatic Stress Disorder Complex; Domestic Violence; Trauma, Psychological; Narrative Exposure Therapy

Keywords

post-traumatic stress; narrative exposure therapy; children and young people; domestic violence; case study series

Outcome Measures

Primary Outcomes (1)

• Change in PTS symptoms between the baseline, NET intervention, and 1-month follow-up phases - as assessed by the Children's Revised Impact of Event Scale (CRIES-13; Perrin et al., 2005)

  The CRIES is a brief self-report questionnaire assessing PTS in children and young people aged 8-18. The original version of the scale (CRIES-8) includes 8 items evaluating intrusion and avoidance symptoms; a longer version (CRIES-13) comprising 5 additional items was developed to include the assessment of hyperarousal symptoms. The young person completing the scale is asked to rate each item depending on how frequently they experienced the symptom in the past week on a four-point scale . Although the CRIES is not a diagnostic instrument, higher scores suggest higher levels of PTS and likely clinical caseness. The scale has demonstrated good face and construct validity and has been used to screen and capture symptom change in children exposed to a variety of traumatic events (Perrin et al., 2005; Smith et al., 2003).

  Throughout the study, for approximately 18 weeks

Secondary Outcomes (1)

• Change in pyschological distress and functioning between the baseline, NET intervention, and 1-month follow-up phases - as assessed by the Young Person's Clinical Outcomes in Routine Evaluation (YP-CORE; Twigg et al., 2009)

  Throughout the study, for approximately 18 weeks

Other Outcomes (3)

• Process measure of habituation: Heart Rate (HR) wristband monitor

  For approximately 10 weeks

• Process measure of integration of trauma memories: Trauma Memory Quality Questionnaire (TMQQ; Meiser-Stedman et al. 2007)

  Approximately 10 weeks

• Change interviews

  At 1-month follow-up

Study Arms (1)

NET intervention

EXPERIMENTAL

This study will follow a single case design and will involve delivering and evaluating the child-friendly protocol of NET. Therefore, there will only be one arm (NET intervention) and no comparators.

Other: Narrative Exposure Therapy

Interventions

Narrative Exposure Therapy OTHER

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.

Also known as: NET, KIDNET (protocol for children and adolescents)

NET intervention

Eligibility Criteria

• Age: 12 Years - 17 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17)

You may qualify if:

• Be aged 12- 17;
• Have witnessed domestic violence in the past;
• Be experiencing clinical levels of post-traumatic stress, as assessed by a member of the CAMHS team;
• Be on the waiting list to receive trauma-focused treatment;
• If 16 or over, be able to consent to take part, as assessed by a member of the CAMHS team;
• If under 16, have at least one person with parental authority who can consent for them. These young people will also be asked to provide their assent;
• Be able to communicate verbally and speak English;
• Have access to a device with a webcam and Internet broadband to enable participation in video sessions;
• Have access to a mobile device, e.g. a smartphone or a tablet. Can be the same as the device above.

You may not qualify if:

• They have a known diagnosis of Intellectual Disability;
• They have a current high level of risk including of self-harm, suicide or current exposure to domestic violence, as assessed by a member of the CAMHS team;
• They are substance dependent.

Sponsors & Collaborators

• University of Nottingham: lead
• Nottinghamshire Healthcare NHS Trust: collaborator
• Lincolnshire Partnership NHS Foundation Trust: collaborator

Study Sites (2)

Lincolnshire Partnership Foundation NHS Trust - Child and Adolescent Mental Health Services

Lincoln, Lincolnshire, LN5 7RZ, United Kingdom

Location

Nottinghmashire Healthcare NHS Foundation Trust - Community Child and Adolescent Mental Health Services

Nottingham, Nottinghamshire, NG5 3FL, United Kingdom

Location

Related Publications (13)

• Neuner F, Catani C, Ruf M, Schauer E, Schauer M, Elbert T. Narrative exposure therapy for the treatment of traumatized children and adolescents (KidNET): from neurocognitive theory to field intervention. Child Adolesc Psychiatr Clin N Am. 2008 Jul;17(3):641-64, x. doi: 10.1016/j.chc.2008.03.001.

  PMID: 18558317 BACKGROUND

• Schauer, M., Neuner, F., & Elbert, T. (2011). Narrative exposure therapy: A short-term treatment for traumatic stress disorders (2nd rev. and expanded ed.). Hogrefe Publishing.

  BACKGROUND

• Schauer, M., Neuner, F., & Elbert, T. (2017). Narrative Exposure Therapy for Children and Adolescents (KIDNET). In M. A. Landolt, M. Cloitre, & U. Schnyder (Eds.), Evidence-Based Treatments for Trauma Related Disorders in Children and Adolescents (pp. 227-250). Springer.

  BACKGROUND

• Parsonson, B. S., & Baer, D. M. (1986). The graphic analysis of data. In J. S. Bailey & M. R. Burch (Eds.), Research methods in applied behavior analysis (pp. 157-186). Springer.

  BACKGROUND

• Perrin, S., Meiser-Stedman, R., & Smith, P. (2005). The Children's Revised Impact of Event Scale (CRIES): Validity as a screening instrument for PTSD. Behavioural and Cognitive Psychotherapy, 33(4), 487-498.

  BACKGROUND

• Twigg, E., Barkham, M., Bewick, B. M., Mulhern, B., Connell, J., & Cooper, M. (2009). The Young Person's CORE: Development of a brief outcome measure for young people. Counselling and Psychotherapy Research, 9(3), 160-168.

  BACKGROUND

• Twigg E, Cooper M, Evans C, Freire E, Mellor-Clark J, McInnes B, Barkham M. Acceptability, reliability, referential distributions and sensitivity to change in the Young Person's Clinical Outcomes in Routine Evaluation (YP-CORE) outcome measure: replication and refinement. Child Adolesc Ment Health. 2016 May;21(2):115-123. doi: 10.1111/camh.12128. Epub 2015 Nov 3.

  PMID: 32680371 BACKGROUND

• Schafer SK, Ihmig FR, Lara H KA, Neurohr F, Kiefer S, Staginnus M, Lass-Hennemann J, Michael T. Effects of heart rate variability biofeedback during exposure to fear-provoking stimuli within spider-fearful individuals: study protocol for a randomized controlled trial. Trials. 2018 Mar 16;19(1):184. doi: 10.1186/s13063-018-2554-2.

  PMID: 29548298 BACKGROUND

• Meiser-Stedman R, Smith P, Yule W, Dalgleish T. The Trauma Memory Quality Questionnaire: preliminary development and validation of a measure of trauma memory characteristics for children and adolescents. Memory. 2007 Apr;15(3):271-9. doi: 10.1080/09658210701256498.

  PMID: 17454664 BACKGROUND

• Peltonen K, Kangaslampi S. Treating children and adolescents with multiple traumas: a randomized clinical trial of narrative exposure therapy. Eur J Psychotraumatol. 2019 Jan 17;10(1):1558708. doi: 10.1080/20008198.2018.1558708. eCollection 2019.

  PMID: 30693077 BACKGROUND

• Isoaho, P., Kangaslampi, S., & Peltonen, K. (2015). Narratiivisen altistusterapian (NET) vaikutus kognitiivisiin prosesseihin ja mielenterveyteen: Tapaustutkimus = The effect of Narrative Exposure Therapy (NET) on cognitive processes and mental health: A case study. Psykologia, 50(5), 355-372. https://proxy.library.lincoln.ac.uk/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2015-52491-003&site=ehost-live

  BACKGROUND

• Elliott, R., Slatick, E., & Urman, M. (2001). Qualitative Change Process Research on Psychotherapy: Alternative Strategies. Psychologische Beitrage, 43(3), 69-111.

  BACKGROUND

• Rocca F, Schroder T, Golijani-Moghaddam N, Wilde S. Video Narrative Exposure Therapy (NET) with Children and Young People who Witnessed Domestic Violence: A Naturalistic Single Case Study Series. J Child Adolesc Trauma. 2025 Jan 10;18(2):447-465. doi: 10.1007/s40653-024-00681-y. eCollection 2025 Jun.

  PMID: 40469793 DERIVED

MeSH Terms

Conditions

Psychological Trauma

Interventions

Clinical Protocols

Condition Hierarchy (Ancestors)

Stress Disorders, Traumatic; Trauma and Stressor Related Disorders; Mental Disorders

Intervention Hierarchy (Ancestors)

Therapeutics; Epidemiologic Study Characteristics; Health Care Evaluation Mechanisms; Quality of Health Care; Health Care Quality, Access, and Evaluation

Study Officials

• Thomas Schröder, PhD

  University of Nottingham

  STUDY DIRECTOR

• Sarah Wilde, DClinPsy

  University of Lincoln

  STUDY DIRECTOR

• Fiammetta Rocca, Trainee Clinical Psychologist, MSc

  University of Nottingham

  PRINCIPAL INVESTIGATOR

• Nima Moghaddam, PhD, DClinPsy

  University of Lincoln

  STUDY DIRECTOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: 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.

Study Record Dates

• First Submitted: April 22, 2021
• First Posted: April 29, 2021
• Study Start: April 13, 2021
• Primary Completion: March 11, 2022
• Study Completion: April 11, 2022
• Last Updated: January 19, 2023

Record last verified: 2023-01

Data Sharing

• IPD Sharing: Will not share

Locations

GB (2)