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The goal of this naturalistic single case series design is to investigate if an adapted Narrative Exposure Therapy protocol can be effective, is feasible, and acceptable for adults with a mile learning disability.
Participants will be complete three baseline sessions before taking part in Narrative Exposure Therapy using a manual that has been adapted for people with a learning disability. Trauma symptoms will be measured weekly using the Impact of Events scale adapted for intellectual disabilities. The person's carer will also complete an informant scale related to these symptoms (LANTS-IV). The client will also complete the CORE-LD at pre, and post therapy. Six weeks after the end of the intervention, the client and their carer will be invited to a feedback session to talk about how they found the intervention.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Narrative Exposure Therapy treatment | Experimental | All participants within the trial will receive narrative exposure therapy and be within the treatment arm. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Narrative Exposure Therapy (NET) | Other | NET is a psychological talking therapy that has been designed for people who have experienced multiple and prolonged traumatic experiences. It is typically 12-sessions, involving first a psychoeducation session, then laying a lifeline where stones are lain to represent traumatic events, and flowers positive life events. The following sessions the person is asked to talk through their life, going into detail on the traumatic memories that they have experienced. |
| Measure | Description | Time Frame |
|---|---|---|
| Impact of Events Scale for intellectual disabilities (IES-ID) | The IES-ID (Hall et al., 2014) is a 22 item scale scored on a three-point Likert scale measuring trauma related symptoms. This is an adapted measure that has been validated for people with an intellectual disability. | Completed weekly through baseline and intervention stages, approximately 16 weeks. Then at 6-week follow up (approximately week 22). |
| Lancaster and Northgate Trauma Scale for Intellectual Disabilities - Informant Version (LANTS-IV; Wigham et al., 2011) | 47 scored on a six-point scale for frequency and three-point for severity. | Completed weekly through baseline and intervention stages, approximately 16 weeks. Then at 6-week follow up (approximately week 22). |
| Clinical Outcome Routine Evaluation-Learning Disabilities (CORE-LD; Brooks et al., 2013) | 14 scored on a three-point Likert scale measuring psychological distress across four domains: well-being, symptoms, functioning, and risk | At baseline week 1 and at 6-week follow-up (approximately week 22). |
| Change interview (Elliott et al., 2001) with clients and carers | A feedback session will be held with the client and their carer around 6-weeks after the therapy has come to an end. This will ask for feedback on how they found the intervention. | 6-weeks post-intervention. Sessions will be around 30-60 minutes. |
| Measure | Description | Time Frame |
|---|---|---|
| Heart rate | Heart rate will be taken using a fitness watch that can measure continuous heart rate. This will show whether any within and between session habituation has taken place. Subjective units of distress (Wolpe, 1969) will be used if clients do not wish to wear a heart rate device. | Weekly during the intervention sessions, for approximately 12-weeks. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Thomas Schroder | University of Nottingham | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Nottinghamshire Healthcare NHS Foundation Trust | Nottingham | NG3 6AA | United Kingdom |
| Type | Date | Date Unknown |
|---|---|---|
| Release | Jun 10, 2026 | |
| Reset | Jul 7, 2026 |
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| Release Date | Unrelease Date | Unrelease Date Unknown | Reset Date | MCP Release Number |
|---|---|---|---|---|
| Jun 10, 2026 | Jul 7, 2026 |
| ID | Term |
|---|---|
| D000067073 | Psychological Trauma |
| D007859 | Learning Disabilities |
| D013313 | Stress Disorders, Post-Traumatic |
| D008607 | Intellectual Disability |
| D008224 | Lymphoma, Follicular |
| ID | Term |
|---|---|
| D040921 | Stress Disorders, Traumatic |
| D000068099 | Trauma and Stressor Related Disorders |
| D001523 | Mental Disorders |
| D003147 | Communication Disorders |
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|
| Post-session therapist reflections | Therapist reflections will be collected to gather information about their thoughts relating to the manual and therapy. | Across the intervention phase, an average of a year |
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D065886 | Neurodevelopmental Disorders |
| D008228 | Lymphoma, Non-Hodgkin |
| D008223 | Lymphoma |
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
| D008232 | Lymphoproliferative Disorders |
| D008206 | Lymphatic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D007160 | Immunoproliferative Disorders |
| D007154 | Immune System Diseases |