Integrating Cognitive Processing Therapy in the DRC Health System Pilot – Progress to Date

With support from the Humanitarian Innovation Fund, the International Rescue Committee is piloting Cognitive Processing Therapy in eastern DRC, a targeted mental health therapy that gives survivors of sexual violence a new way to manage distressing thoughts and overcome trauma.

Since the training of the service providers that took place in April, each of the seven health centres that are part of this pilot started a CPT group for survivors. The women who are taking part in the groups have been identified by IRC partners, local community-based organizations (CBOs) who previously provided basic psychosocial services to those women but who also noticed a high level of anxiety and depression even after completing case management.

To date, sixty-five women, who were divided into seven groups, have benefitted from CPT sessions. Each group has carried out five of the twelve sessions, which will continue until the end of July. Attendance has been almost 100% and the women have been making efforts to change their “stuck thoughts”. Some of the thoughts they identified at the beginning were:

-I will never have peace because of this rape.

-If I had run away, I would not have been raped.

- Because of rape I’ve become poor; I do not have any work anymore.

-If I had not cried out for help during the rape, my husband would not have been killed by my aggressors. I have become a widow because I was not quiet.

In the initial sessions of the therapy, the women were not very open about their experiences and thoughts, but, with time, during later sessions, they started feeling at ease and began to trust the therapist and the others in the group. They started showing lower levels of trauma symptoms, which were measured after each session. The survivors were asked if they experienced any of signs of trauma, including shame, fear, suicidal thoughts, and guilt, among other signs, and the women rate on a scale of zero the extent that they experienced these symptoms since the last session. Some of these signs decreased, including suicidal thoughts in some of the groups, and other signs continue to present themselves and will require more attention, such as feeling shame and fear.

The project is supervised jointly by an IRC expert from our Women Protection and Empowerment programme, and by supervisors from the DRC’s Ministry of Health. Regular meetings between the supervisors help them to address challenges as they arise. Supervisors are also in regular contact with the CPT trainers from University of Washington, who provide assistance to counsellors and training to prepare for the following sessions and answer any technical questions.