Efficacy of narrative therapy for orphan and abandoned children with anxiety and attention deficit and hyperactivity disorders in Rwanda: A randomized controlled trial

Abstract

Background and objective: 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.

Method: 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.

Results: 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.

Limitation: The long-term effects of the intervention for the current sample were not assessed in this study.

Conclusion: 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.

Keywords: ADHD; Anxiety disorders; Narrative therapy; Orphans and abandoned children.