Treating post-traumatic stress disorder in survivors of community and domestic violence using narrative exposure therapy: a case series in two public health centers in Rio de Janeiro/Brazil /Terapia de exposicao narrativa para o tratamento do transtorno de estresse pos-traumatico com pessoas que passaram por violencia domestica e comunitaria: estudo de serie de casos em dois centros de saude no Rio de Janeiro, Brasil

• Published in: Ciência & saude coletiva 2023-06, Vol.28 (6), p.1619
• Main Authors: Serpeloni, Fernanda, Narrog, Jeanine Arabella, Pickler, Bianca, Avanci, Joviana Quintes, de Assis, Simone Goncalves, Koebach, Anke
• Format: Article
• Language: Portuguese
• ISSN: 1413-8123
• DOI: 10.1590/1413-81232023286.16532022

Prevalence of violence in Brazil is high, which contributes to an increasing number of trauma-related disorders, especially post-traumatic stress disorder (PTSD). This study aims to present a case series of PTSD patients treated with narrative exposure therapy (NET) in two public health centers in Rio de Janeiro (Brazil). Health professionals were trained in a two-week workshop to deliver NET. Exposure to violence and other potentially traumatic events, as well as PTSD were assessed by interviewers before treatment and six months later in follow-up interviews conducted by blind assessors. Multiple traumatic events, including different types of childhood and sexual abuse, intimate partner violence and community violence were reported. Five patients were exposed to community violence, and one to domestic violence, during or after NET treatment. Treatment delivery was integrated into the routine of health centers. Eight patients completed NET and presented a substantial reduction in PTSD severity at six-month follow-up. NET is a feasible and effective treatment for PTSD patients exposed to ongoing violence, and can be integrated into established public health services. Key words Post-traumatic stress disorder, Narrative exposure therapy, Violence, Trauma, Mental health A prevalencia de exposicao a violencia e alta no Brasil, contribuindo para o aumento do numero de transtornos relacionados a traumas, especialmente o transtorno de estresse pos-traumatico (TEPT). Este estudo tem por objetivo apresentar uma serie de casos de pacientes com TEPT que passaram pela terapia de exposicao narrativa (NET) em dois centros de saude do Rio de Janeiro. Os profissionais de saude receberam duas semanas de treinamento NET. A exposicao a violencia e a outros eventos potencialmente traumaticos, bem como o TEPT, foram avaliados por entrevistadores antes do tratamento e seis meses depois em entrevistas de acompanhamento conduzidas por avaliadores sob condicao cega. O tratamento foi integrado a rotina dos servicos. Oito pacientes completaram a NET e apresentaram reducao substancial na severidade do TEPT. Todos reportaram exposicao a eventos traumaticos multiplos, incluindo diferentes tipos de abuso infantil, sexual, violencia por parceiro intimo e comunitaria. Cinco pacientes foram expostos a violencia comunitaria e um a violencia domestica durante ou apos o tratamento. Esta serie de casos mostra que a NET e um tratamento eficaz para pacientes com TEPT expostos a violencias continu