Department of Clinical Psychology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
Department of Clinical Psychology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda; Mental Health & Behaviour Research Group, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda.
J Behav Ther Exp Psychiatry. 2023 Mar;78:101802. doi: 10.1016/j.jbtep.2022.101802. Epub 2022 Nov 23.
Although narrative therapy (NT) is globally practiced for alleviating psychological disorders, studies of its efficacy for vulnerable children are still scarce, especially in African post-conflict settings. Thus, this study was aimed at assessing the efficacy of NT for Rwandan Orphans and abandoned children (OAC) with ADHD and anxiety disorders.
This study was a parallel randomized controlled trial in which participants (n = 72) were recruited from SOS Children's Villages. A half of participants (n = 36) were randomly allocated to either the NT group or the waitlist control group (WCG). Outcomes were collected at baseline before randomization and 10 weeks post-randomization.
ANOVA results indicated a significant main effect of time for anxiety disorders (p < .001, ηp2= 0.176), and the main effects of group were significant for anxiety disorders (p < .001, ηp2= 0.254) and ADHD disorders (p < .001, ηp2= 0.260). There was a significant time by group interaction effect for anxiety disorders (p < .001, ηp2= 0.328) and for ADHD (p < .001, ηp2= 0.193). Between group analyses showed that the difference in symptoms was significant for anxiety disorders (p < .001, Cohen's d = 1.28) and for ADHD (p < .001, Cohen's d = 1.6) during the posttest, and the effect sizes were large.
The long-term effects of the intervention for the current sample were not assessed in this study.
Despite its limitations, this study provides initial support for the safety, efficacy, and usefulness of NT among Rwandan OAC with ADHD and anxiety disorders. Health professionals must implement the new intervention as an everyday tool.
尽管叙事疗法（NT）在全球范围内被用于缓解心理障碍，但针对弱势儿童的疗效研究仍然很少，尤其是在非洲冲突后环境中。因此，本研究旨在评估 NT 对卢旺达孤儿和被遗弃儿童（OAC）注意力缺陷多动障碍和焦虑障碍的疗效。
这是一项平行随机对照试验，参与者（n=72）从 SOS 儿童村招募。参与者被随机分为 NT 组或等待名单对照组（WCG）。在随机分组前和随机分组后 10 周收集结局。
方差分析结果表明，焦虑障碍的时间主效应显著（p<0.001，ηp2=0.176），组的主效应也显著（p<0.001，ηp2=0.254 和 p<0.001，ηp2=0.260）。焦虑障碍（p<0.001，ηp2=0.328）和 ADHD 障碍（p<0.001，ηp2=0.193）的时间与组之间存在显著的交互效应。组间分析显示，在焦虑障碍（p<0.001，Cohen's d=1.28）和 ADHD（p<0.001，Cohen's d=1.6）的后测中，症状差异显著，效应量较大。
本研究未评估当前样本干预的长期效果。
尽管存在局限性，但本研究为 NT 在卢旺达 ADHD 和焦虑障碍的 OAC 中的安全性、疗效和实用性提供了初步支持。卫生专业人员必须将新的干预措施作为日常工具实施。
