Impact of setting insecurity on Cognitive Processing Therapy implementation and outcomes in eastern Democratic Republic of the Congo.

Journal: European journal of psychotraumatology

Volume: 11

Issue: 1

Year of Publication: 

Affiliated Institutions:  Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, USA. Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA. International Rescue Committee, New York, NY, USA. Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. Research and Innovation Department, International Rescue Committee, New York, NY, USA.

Abstract summary 

: While evidence is growing for the efficacy of trauma-focused mental health interventions in low- and middle-income countries, concerns have been raised about whether these types of interventions can be effectively delivered in contexts with ongoing conflict and violence. Cognitive Processing Therapy (CPT) has been shown to be effective in reducing sexual violence survivors' psychological symptoms in eastern Democratic Republic of the Congo (DRC), a region with a history of chronic conflict. : The purpose of the present study is to assess the degree to which exposure to different levels of ongoing insecurity impacts effectiveness of an evidence-based trauma-focused psychotherapy for sexual violence survivors. : Participants were 158 female sexual violence survivors receiving CPT in seven communities in South Kivu. Participants completed weekly assessments of their symptoms of PTSD and depression as part of CPT. Degree of site insecurity was categorized as high or low levels of ongoing insecurity based on information collected from supervisors and clinicians. Hierarchical linear modelling was used to examine change over time moderated by level of insecurity at the site. : Overall, women reported a significant reduction in psychological symptoms over time ( = -2.04, <.001). Residing in a site of greater insecurity was associated with higher initial symptoms ( = 5.91, <.01), but similar improvement over time ( = -0.30, =.10) compared to women living in relatively more secure sites. High rates of attendance and treatment completion were observed. : These results support the effectiveness of trauma-focused therapies when provided in a well-structured and well-supervised program even in contexts of ongoing conflict and violence.

Authors & Co-authors:  Kaysen Debra D Stappenbeck Cynthia A CA Carroll Haley H Fukunaga Rena R Robinette Katie K Dworkin Emily R ER Murray Sarah M SM Tol Wietse A WA Annan Jeannie J Bolton Paul P Bass Judith J

Study Outcome 

Source Link: Visit source

Statistics
Citations :  Applied Mental Health Research Group . (2013a, December 1). Design, implementation monitoring, and evaluation of mental health and psychosocial assistance programs for trauma survivors in low resource countries: A user’s manual for researchers and program implementers (Adult version). Module 1: Qualitative assessment. Retrieved from https://www.jhsph.edu/research/%0D%0Acenters-and-institutes/global-mental-health/resource-materials/%0Ddesign-implementation-monitoring-and-evaluation-dime/%0D%0A
Authors :  11
Identifiers
Doi : 1735162
SSN : 2000-8066
Study Population
Women,Female
Mesh Terms
Other Terms
Sexual assault;cognitive processing therapy;psychological symptoms;randomized controlled trial;sexual violence
Study Design
Study Approach
Country of Study
Republic of the congo
Publication Country
United States