Narrative Exposure Therapy (NET) is an evidence-based short-term, trauma-focused therapy developed for survivors of multiple, complex, and/or politically motivated trauma. It helps clients create a coherent, chronological autobiographical narrative that integrates traumatic memories into their life story while using prolonged imaginal exposure to reduce PTSD symptoms and associated distress (American Psychological Association, 2017). It was developed for refugees living in unsafe conditions to serve not only therapeutic but also social and political purposes by recording human rights violations (Schauer, Neuner, & Elbert, 2025). The presentation proposes adapting elements of NET as an individual-focused therapy to a more collective approach.

The presentation will introduce an adaptation of core NET intervention concepts to apply within the Palestinian context (PAL-NET). It draws from Bonanno’s (2021) conceptualisation of resilience and the application of his ‘flexibility sequence’ as a core component to his broader contextual model to illustrate the ranges of responses to violence. It positions ecological interconnectivity - the interdependence and interconnectedness of all things - as a frame to then expand from Bonanno’s concepts of resilience to incorporate the Palestinian practice of sumud. The introduction of sumud alongside Western concepts of resilience demonstrates that the cultural knowledge of Palestinians offers a path towards forging novel uses of NET within their specific contexts.

The paper presents PAL-NET as a culturally-adapted protocol developed for Palestine-based mental health workers as an example of real time, on the ground adaptive training that encapsulates their specific context. It draws from social ecological interconnectedness, collective and indigenous storytelling frames of identity, and the specific Palestinian concept of sumud to broaden NET from an intervention focused on the individual to a culturally grounded practice with both personal and collective meaning making.

The PAL-NET protocol is part of a broader pilot partnership with the Palestinian Counselling Centre (PCC) where recipients of the training will be completing the PAL-NET intervention within the Palestinian community. Preliminary qualitative data from the PCC workers will be presented to form emerging evidence for the applicability of NET within the cultural context of Palestine.

Mindfulness-based interventions are widely integrated into contemporary clinical psychology and are frequently applied across trauma, mood, and anxiety presentations. However, in clients presenting with psychotic symptoms in the context of trauma and severe affective disturbance, standard mindfulness instructions that emphasise non-judgemental observation directs the client's attention toward overwhelming internal experiences, which may be destablishing (Baer, Crane, Miller, & Kuyken, 2019).
Instead of standard mindfulness instructions, this presentation introduces the technique of wise attention from Buddhist Psychotherapy, a contemporary psychotherapy model based on the teachings of early Buddhist text. Within Buddhist Psychotherapy, therapeutic change is supported through the cultivation of wise attention (yoniso manasikāra), understood as an active, guided process of attending to experience that differentiates sensory contact, affective response, and mental fabrication. From a clinical formulation perspective, this approach provides a structured framework for working with complex trauma presentations, including those accompanied by psychotic symptoms.
The presentation is organised into three components. First, Dr Debra Kawahara will outline the clinical and ethical challenges associated with applying undifferentiated mindfulness practices in trauma therapy, particularly in the presence of psychotic features, including risks related to hypervigilance, self-blame, and confusion between perception and interpretation.
Second, Dr Liang Tien will present the theoretical foundations of Buddhist Psychotherapy, focusing on wise attention and the five aggregates as a clinically translated formulation model that supports discernment and de-identification from distressing mental events. These concepts will be explicated using contemporary clinical language to support safe application within psychotherapy.
Finally, Dr Pauline Hall will present a detailed case vignette of a 67-year-old woman diagnosed with Major Depressive Disorder with psychotic features, who developed auditory, visual, and tactile hallucinations following prolonged workplace bullying. The case illustrates the stepwise clinical application of wise attention through guided differentiation of sensory contact, affective response, and mental fabrication, including work with environmental sounds, critical internal voices, and intrusive bodily sensations.
The case demonstrates the clinical use of wise-attention from Buddhist Psychotherapy. The clinical case will demonstrate how noticing the moment immediately prior to being overwhelm enables the client to regain choice in attentional focus and reducing suffering. The emphasis is on clinically guided micro-interventions that support agency and safety, with acknowledgement of therapeutic gains and ongoing symptom vulnerability.
This presentation aims to support the clinical psychologist in refining their use of attention-based interventions through a formulation-driven, trauma-informed framework grounded in Buddhist Psychotherapy, prioritising client safety, clarity of perception, and ethical practice.