Intervention – Journal of Mental Health and Psychological Support in Conflict Affected Areas
July 2014 – Volume 12 – Issue 2 pp: 168-318
http://journals.lww.com/interventionjnl/pages/currenttoc.aspx

From the editor… questions of evidence
Marian Tankink
Editor in chief, Intervention
Excerpt
These days, more and more programmes and therapies are being developed to improve psychological and (psycho)social wellbeing of people affected by (armed) conflict. Yet, there is still little evidence of the efficacy of these programmes and therapies. The search for evidence raises many basic questions, starting with: what is evidence? When do findings become evidence? What is the justification for claiming that something is evidence, and how are they socially constructed or expressed? Furthermore, what and where are the facts to be found, and what is the impact of observation or perception? What exactly are we measuring if, for instance, we are attempting to interpret mental health and wellbeing?
Throughout this issue of Intervention, these questions raise important, as well as problematic, issues that are not easy to resolve. This is especially true when the concept of ‘evidence’ relates to qualitative findings, which within the field of ‘evidence based medicine’ are not considered ‘real’ evidence. Data collected through use of qualitative research is, by its very nature, subjective, meaning data from a person or a group is used as evidence within the context of a time and place. This, in itself, poses the question: is it possible within the context of conflict, chaos, urgency, temporality and complexity that our research findings can claim to be ‘evidence’ at all?…
… The final part of this issue is a debate on Narrative Exposure Therapy (NET). NET aims to treat people who are unable to integrate their personal traumatic experiences into their personal memories and public history. As a result, they can be locked within their psychological circumstances, making it very difficult for them to experience appalling lived events as meaningful and therefore, ‘sufferable’ (Zur, 1998). NET aims to help the traumatised person through creating a life line that gives an overview of his/her life and includes not only traumatic experiences, but positive ones as well. A cord (the line of life) is spread out and the life of the patient is worked through chronologically; flowers are added to the cord to represent positive experiences and stones for negative and/or traumatic ones. The traumatic experiences are thereby reconstructed through the integration of autobiographic and context information of the traumatic memory (the hot spot). This is called narrative exposure. Next to the line of life and the exposure of the stones, a third aspect of NET is a written account made of lived experiences and that can be considered as a testimony (Jongedijk, 2014). This approach is currently being used in many low and middle income countries (LMIC), by trained lay therapists, but is not without controversy.