Therapy using storytelling may be key to fighting adolescent trauma

For teenagers from low-income households, trauma from bullying, parental abuse and dating violence often goes untreated since many families can’t afford traditional therapy.

In search of a less-expensive, yet effective, form of therapy, a new study led by UB behavioral health researcher Ellen Volpe will investigate the effectiveness of narrative exposure therapy (NET) in treating post-traumatic stress disorder (PTSD) and substance abuse among adolescents who have experienced multiple traumas.

The pilot study, “The Effectiveness of Narrative Exposure Therapy (NET) for Diverse Populations Experiencing Multiple Traumas,” is funded by the Mentored Career Development Award from the National Institutes of Health’s Clinical and Translational Science Awards Program.

“Trauma is like a book on a shelf full of memories that a person has no control over in terms of when or how it is experienced,” says Volpe, assistant professor in the School of Nursing. “Narrative exposure therapy helps re-establish the link between memories that were destroyed by trauma, allowing people to have more control over the book.”

These links, Volpe says, are what hold together cold, or contextual, memory, such as people, places and events, and hot, or sensory, memory, which includes smells, images, sounds and more. The destruction of this link can cause people to relive a traumatic experience that is triggered by a specific sense, such as a war veteran experiencing PTSD symptoms after hearing exploding fireworks.

NET is a cognitive behavioral therapy that helps participants reconstruct fragmented, traumatic memories into a clear, personalized story. The brief therapy, which can be completed in 12-16 sessions, helps rebuild the memory by asking participants to recall details such as their age during the experience, the timeline of events, their hopes or fears and notable sounds, smells or other senses.

The therapy has proven effective in treating trauma in foreign countries affected by natural disasters or war. Volpe will work with Buffalo and Rochester community agencies to lead the first investigation testing the therapy with American adolescents ages 16-21 who are affected by interpersonal violence.

“Across the board, the big difference between recoveries from trauma among adolescents is access to care, whether due to cost, transportation or competing demands,” says Volpe. “Often, these kids are victims of multiple forms or episodes of violence, creating a snowball effect on their mental health.”

Nearly 70 percent of urban, low-income, minority youth reported undergoing violent trauma in some form, whether it be bullying or abuse, says Volpe. And although not every person who experiences trauma develops PTSD, the experiences place teenagers at risk for depression, substance abuse, high-risk sexual behavior, abuse in future relationships and involvement in the criminal justice system.

If proven effective, Volpe believes NET will provide a cost-effective therapy to offer in low-income, community settings.

Volpe will complete her research under the mentorship of Margarita Dubocovich, SUNY Distinguished Professor and chair of the Department of Pharmacology and Toxicology in the Jacobs School of Medicine and Biomedical Sciences.

Additional investigators include Jennifer Read, professor, Department of Psychology, UB College of Arts and Sciences; Kevin Fiscella, professor of family medicine, University of Rochester; Catherine Cerulli, associate professor of psychiatry, University of Rochester; and Marilyn Sommers, Lillian S. Brunner Professor of Medical-Surgical Nursing, University of Pennsylvania.

Editor's note: The research reported in this publication was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Number KL2TR001413. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.