Assessment of effectiveness of narrative exposure therapy intervention in the management of traumatic stress among young people in Kakuma Division, Turkana County

Abstract

Studies have shown that individuals who experience traumatic stress are vulnerable to developing psychological disorders than any other population. Kakuma refugee camp is currently the home of 196,666 people who fled from their various countries due to civil war and organized violence. Young people form 20% of Kakuma refugee camp population. These individuals live with constant reminders of negative memories of their traumatic war experience. Their mental health worsens when effective evidence based trauma-focused interventions are not provided. Against this background, this study sought to assess the young people’s traumatic stress with the use of post-traumatic stress disorder checklist for DSM-5 (PCL-5) tool. The study adopted narrative exposure therapy framework and intervention for traumatic stress management. The study objectives were; to assess the effectiveness of narrative exposure therapy in management of memory intrusion symptoms, avoidance of stimuli symptoms, alterations in cognitions and mood symptoms and alterations in arousal and reactivity to external stimuli symptoms of traumatic stress. The study used quasi-experimental research design whereby the researcher adopted a non-equivalent groups design. This design involved one treatment group and one control group. The target population comprised of registered youth in Kakuma refugee camp who are 39,960 in number. The study sampled 104 participants through multistage cluster and proportionate sampling. While the treatment group received narrative exposure therapy intervention, the control group received normal counselling intervention. Descriptive and inferential statistics were used to analyse the data with the aid of statistical programme for social sciences (SPSS) version 23. Independent sample t-test was used to list the statistical significant differences between the means in the pre-test and post-test scores for the groups. From the results, memory intrusion symptoms were higher among young people who were exposed to normal counselling. The mean difference was -0.870 (95% CI = -1.156 to -0.585), t(102) = -6.045, p < 0.000. , avoidance of stimuli symptoms were higher among young people exposed to normal counselling. The mean difference was -0.496 (95% CI = -0.881 to -0.110), t(102) = -2.550, p = 0.12 < 0.05. In addition, negative alterations in cognitions and mood symptoms were higher among young people who were exposed to normal counselling. The mean difference was -1.306 (95% CI = -1.559 to -1.052), t(102) = -10.224, p = < 0.00, and alterations in arousal and reactivity to external stimuli symptoms were higher among young people who were exposed to normal counselling. The mean difference was -0.726 (95% CI = -0.968 to -0.484), t(102) = -5.953, p = < 0.00. The researcher established that narrative exposure therapy intervention is effective in the management of traumatic stress among young people in Kakuma division. The findings of this study were recommended as useful to counsellors, psychologists and other mental health practitioners working among refugees and traumatized populations in evidence based trauma counselling. Counselling students and counsellor trainers would refer to the study findings for guidance in their research work, counselling practice and training.