As members of an international nongovernmental organisation that operates across a variety of income contexts, and works with local counsellors to co-create local capacity in contexts ravaged by atrocities and deprivation, the authors offer their experiences with Narrative Exposure Therapy. The authors have found Narrative Exposure Therapy to be an effective clinical and training tool where practical considerations allow it. These considerations, including the high level of counsellor skill and the individual modality the therapy requires, should not be underestimated

Among Mundt and colleagues’ (2014) criticisms of NET is that testing a particular intervention implies that it is meant to be delivered irrespective of systems of care. But trauma-focused treatments should be judged based on the specific problems they target; larger sets of problems are the purview of health systems research.

While agreeing that there are very few studies on Narrative Exposure Therapy, the author responds to the critique of Mundt et al. (elsewhere in this issue), by arguing that psychological interventions should not only, nor primarily, be evaluated by outcomes immediately after the end of the intervention. This is because psychological interventions, such as Narrative Exposure Therapy, aim to start a process of recovery that may continue long after treatment and eventually result in stronger change.

This invited commentary reflects on utilising Narrative Exposure Therapy protocols in very different cultural setting than those they were originally developed for, and is a response to Mundt et al. (this issue) and Neuner, Schauer & Elbert (this issue). The author discusses several key issues that should be considered, including: the allegiance effect, demand characteristics, clinical efficacy, and ecological validity.

Despite an influx of agencies conducting psychiatric and psychosocial interventions worldwide, there is scarce agreement regarding treatment goals and best practice to deal with trauma related mental disorders. A systematic review of posttraumaticc stress disorder treatments concluded that scientific evidence on treatment modalities did not reach the level of certainty that would be desired. This commentary ends by outlining the kind of evidence that would be required.

In their review article, Mundt et al. (2014), ‘Evaluating interventions for posttraumatic stress disorder in low and middle income countries: Narrative Exposure Therapy’, (Intervention, this issue) evaluated Narrative Exposure Therapy (NET) as an example of a short-term treatment for posttraumatic stress disorder that is applied in low and middle income, post conflict settings. They concluded that it is premature to recommend NET as a treatment approach. In this response, the clinicians and researchers who developed NET argue that the paper by Mundt et al.

This article provides a framework for evaluating randomised controlled efficacy trials for the treatment of posttraumatic stress disorder, in low and middle income countries, applied to Narrative Exposure Therapy. A list of methodological and conceptual indicators to evaluate trial data was developed and utilised to assess six trials. The efficacy of this therapy to reduce symptoms is mainly deduced from effects that were measured at long term follow-up points, and that had not been seen at relatively early follow-up points.

Minister Edith Schippers van Volksgezondheid wil dat de mogelijkheden van e-health beter worden benut. De minister ziet nieuwe technologieën waardoor zorg op afstand geboden kan worden en waar mensen veel baat bij kunnen hebben. Toch signaleert Schippers dat brede implementatie nog vaak achterblijft. Hoe zit dit bij een specialistische GGZ-instelling als Stichting Centrum ’45? Ziet deze instelling de voordelen van het gebruik van e-health? En, als dat zo is, maakt Centrum ’45 er ook al gebruik van? Cogiscope sprak met Tim Wind, klinisch psycholoog i.o.

E-health speelt een steeds belangrijker rol in de GGZ. Maar zijn e-health interventies wel effectief in het reduceren van gezondheidsklachten of het verbeteren van de kwaliteit van leven? En, zo ja: is e-health dan ook net zo effectief als een face-to-face interventie? De app-ontwikkelingen volgen elkaar in razend tempo op, maar de wetenschap is traag, zo is vaak de kritiek. Niettemin zal een ieder beamen dat uiteindelijk alleen bewezen effectieve e-health producten op de markt zouden moeten komen.