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Assignment 2: Qualitative Journal Article Review

Said, G., Alqadri, Y., & King, D. (2021). Unaccompanied minors’ experiences of narrative

exposure therapy. The Cognitive Behaviour Therapist, 14(11).

https://doi.org/10.1017/s1754470x21000088

Statement of Problem

Within the current literature, there is a shortage of research on the experiences of

unaccompanied asylum-seeking minors (UAM) who have been receiving narrative exposure

therapy (NET) or other trauma-focused therapies. The researchers in this study desire to better

understand the experiences of UAM undergoing NET for post-traumatic stress disorder (PTSD).

Literature Review

UAM are at a high risk of developing mental health conditions, including PTSD, due to

numerous traumatic events (Fezel et al., 2012). Youth are more vulnerable to trauma as it

disrupts their ongoing emotional, neurobiological, and social development, resulting in chronic

PTSD and other mental health concerns. NET is designed to respond to multiple, complex

traumas, making it a promising treatment for PTSD in displaced populations (Schauer et al.,

2020). Despite the vulnerability of unaccompanied asylum-seeking minors, there is a sore lack of

literature on the efficacy of NET in UAM. The few studies that have been completed on this

topic have revealed promising results, suggesting NET as a viable intervention for PTSD.

Research Questions Being Investigated

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The researchers aim to recognize the motivations and fears of UAM when considering

NET and how UAM experience NET for PTSD. In addition, the researchers intend to identify

how the experiences of UAM relate to the existing literature and theoretical frameworks.

Method

Participants

The participants in this study were four unaccompanied asylum-seeking minors (UAM)

ages 16-17 who, through the National Health Service (NHS) in the United Kingdom, participated

in narrative exposure therapy (NET) for post-traumatic stress disorder (PTSD). Two participants

were refugees from Sudan, while the other two arrived from Vietnam and Albania.

Materials

Participants were assessed through clinical interviews and standardized psychometric

measures, including the 13-item version of the Child Revised Impact of Event Scale (CRIES-13)

and the Child PTSD Symptom Scale for DSM-5. Audio recording tools and translators were used

during interviews to allow for verbatim transcription.

Procedure

Semi-structured interviews, lasting 40 to 70 minutes, were conducted by a researcher who

did not deliver the intervention. Interviews were conducted in the participant’s preferred

language and designed to analyze specific elements of NET rather than therapy in general.

Data Analysis

Transcripts of the interviews were analyzed using interpretative phenomenological

analysis (IPA). After investigation, the data is structured and organized into themes and validated

by an unrelated researcher before final joint validation.

Results
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Five master themes and 14 subsections were identified in the data. The five master

themes were contemplating NET, experiencing NET, the perceived outcomes of NET, contextual

challenges, and individual preferences. Some of the subthemes included motivators, concerns,

constructing and narrating a lifeline, social and environmental factors, and cultural and religious

considerations. Results indicated that participants felt that treatment did not always reflect all

aspects of their unique experiences. Specific NET elements were highlighted as valuable, such as

the emphasis on viewing memories in an autobiographical context, placing them firmly in the

past. The use of lifelines is found to support identity formation for the UAM. Ultimately, the

findings in previous qualitative studies on NET treatment were echoed, with participants

emphasizing the recovery benefits that strengthened their ability to cope with traumatic

memories and some symptoms of PTSD.

Implications

Implications for Counselors, Clients, and Counselling

The research suggests how NET and other trauma-focused therapies were valued by

UAM experiencing PTSD. It emphasizes the necessity of interventions during adolescence.

Furthermore, this qualitative study highlights the importance of cultural awareness and

responsivity, leading to open and honest relationships between the interviewers and participants.

Discussion

Summary

This qualitative study set out to understand the experiences, concerns, and motivators of

unaccompanied asylum-seeking minors (UAM) receiving narrative exposure therapy (NET) for

symptoms of post-traumatic stress disorder (PTSD), as well as how these experiences relate to

the theoretical frameworks and existing literature on the topic. The analysis of the five main
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themes determined that NET is an acceptable and well-received intervention for UAM, both in

perceived outcomes and therapy experience. In addition, the study provided insights into how

participants felt pre-treatment and experienced the intervention. Therefore, it is determined that

the results echo those of previous research, emphasizing the value of NET as a therapeutic

intervention for PTSD in refugee populations.

Interpretation

Interpretative phenomenological analysis (IPA) was used for data analysis. The

researchers collected their data through semi-structured interviews conducted with UAM with

diagnosed PTSD and had recently participated in NET. IPA is an appropriate analytical method,

as phenomenological research aims to “identify the essence of the phenomenon and … and

explore concepts” (Richards & Morse, 2013, p. 52) by emphasizing the lived experience and

exploring it through dialogue. The conclusions reached by the authors were sound and supported

by the analysis provided. The study demonstrated thoughtful construction and implementation.

The researchers considered ethical concerns and ensured that participants knew they could

withdraw from the interviews at any point (Goodwin & Goodwin, 2017, p. 241). The emphasis

and incorporation of cultural responsivity is a strength of the study. Participants cited how they

valued the use of translators from similar cultural backgrounds, helping them feel supported

during the interview. One weakness is the small and heterogeneous sample size, suggesting that

the findings may not represent the larger UAM population. However, as a qualitative study, this

paper is not considered generalizable at a population level.

For Further Study

Further research on the effect of NET as a treatment for PTSD in displaced persons,

asylum-seekers, and refugees is necessary for data saturation. It is also advised to perform
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longitudinal research investigating the long-term implications of NET interventions on

relationships, education, mental health, and other quality of life indicators in refugees who have

completed treatment. A longitudinal study would allow for a better understanding of the long-

term effects of NET, allowing researchers, in turn to better prepare for future care needs.

References

Fazel, M., Reed, R. V., Panter-Brick, C., & Stein, A. (2012). The mental health of displaced and

refugee children resettled in high-income countries: risk and protective

factors. Lancet, 379(9812), 266–282. https://doi.org/10.1016/S0140-6736(11)60051-2

Goodwin, K. A. & Goodwin, C. J. (2017). Research in psychology: Methods and designs (8th

ed.). Hoboken, NJ: John Wiley & Sons.

 Richards, L., & Morse, J. M. (2013). Readme first for a user's guide to qualitative methods (3rd

ed.). Los Angeles, CA: Sage Publications.

Said, G., Alqadri, Y., & King, D. (2021). Unaccompanied minors’ experiences of narrative

exposure therapy. The Cognitive Behaviour Therapist, 14(11).

https://doi.org/10.1017/s1754470x21000088

Schauer, M., Robjant, K., Elbert, T., & Neuner, F. (2020). Narrative exposure therapy. In J. D.

Ford & C.A. Courtois (Eds.), Treating Complex Traumatic Stress Disorders in Adults:

Scientific Foundations and Therapeutic Models (pp. 309–331). Guilford Press.