Living Innovation: Cognitive Processing Therapy in the DRC

Piloted in April of 2014, cognitive processing therapy (CPT) is distinctively different from the traditional methods of treating survivors of gender-based violence (GBV) in the Democratic Republic of the Congo (DRC). Before the introduction of CPT in the DRC, psychosocial service providers helped survivors of GBV using case management, an individual therapy driven by the survivor expressing/presenting her problem to the psychosocial focal point which is then used as the starting point for treatment.

In the experience of the IRC’s Women’s Protection and Empowerment (WPE) program in DRC, most survivors of GBV improve using case management, yet some don’t, continuing to show high level of symptoms of trauma such as depression and anxiety even after numerous case management meetings. Before CPT was introduced, the psychosocial service providers did not know how to help those survivors as no specialized mental health services were available in their localities. CPT is designed to be used by trained paraprofessionals, which means that the specialized mental health services can be made available in rural areas as well as cities, reaching beneficiaries who had previously been unable to access these services.

In contrast to the individual nature of case management, CPT is a group focused, set methodology therapy, where beneficiaries and therapists work through five modules that include topics such as security, trust, control and power. During each session of CPT, the therapists pose questions to the beneficiaries regarding the specific topic enabling them to reflect on their feelings and perceptions, addressing a wide range of feelings resulting from the trauma they endured. During the initial pilot phase, IRC WPE staff and CPT focal points discovered that this line of questioning has proven very successful in helping participants to discover and address deeply hidden feelings themselves.

The individual versus group aspect of the therapies is a critical difference between case management and CPT. The group aspect of CPT allows a survivor to realize that there are others who have lived similar experiences and the participants are able to support one another. When asked about this, Viviane Maroy, the supervisor of the IRC’s South Kivu psychosocial team stated, “as a result of the group aspect of CPT, we have seen groups of solidarity and women’s groups pop up and have even seen the growth of community fields.”

Over the first pilot phase of cognitive processing therapy in the DRC, the IRC consistently monitored the impact of the therapy on beneficiaries using a functionality tool and continues to monitor the impact of CPT in the communities where it has been piloted. The IRC has repeatedly noted success through testimonies of the therapists, beneficiaries themselves, and the communities in which they live. CPT has proven effective in decreasing the symptoms and increasing survivors’ completion of daily activities and as such it has been found to serve best as a compliment to case management, ensuring that survivors’ needs are addressed both on an individual and group level.

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