07/06/13 International Rescue Committee – Africa: Study in Congo Reveals Dramatic Impact of Group Therapy On Sexual Violence Survivors in War Zones

Published in the
New England Journal of Medicine (Thursday, June 6), the research is the first rigorous impact assessment of
psychological support to survivors of sexual violence in conflict affected
countries. The study found overall trauma symptoms decreased roughly twice as
much among survivors who received group therapy compared to those who only
received individual counseling.

"Sexual
violence against women and girls is a major threat in most of the conflict
zones where we work and it's a significant problem in Congo," says Catherine
Poulton, an IRC adviser for women's protection and empowerment programs. "While
most survivors show incredible resilience, others need more specialized
assistance."

For more than a
decade, the IRC has provided a range of services in Congo to help survivors of rape and
other forms of violence recover, including individual counseling, medical care
and economic and legal support. Over the past 12 months alone, the IRC has
provided assistance to more than 2,500 women and girls in eastern provinces.
But IRC-trained counselors have long recognized the need for better and more
targeted care for women with persistent symptoms of trauma and depression.

In 2011, the IRC
partnered with Johns Hopkins University
and the University
of Washington to
introduce group-based Cognitive Processing Therapy (CPT) to women who were
either raped or witnessed rape, had high symptoms of depression, anxiety and
PTSD, and were struggling to complete daily tasks, such as caring for children
or working. CPT is a structured treatment that helps people confront and cope
with memories and thoughts of traumatic events that trigger distress, fear,
shame and other debilitating feelings. The three groups then carried out a
rigorous evaluation to test CPT's effectiveness in this context.

The research
involved 405 women from 15 villages in North Kivu and South
Kivu Provinces
of eastern Congo.
The study found that after six months of treatment, only nine percent of women
who received CPT were still classified as having probable PTSD, depression or
anxiety compared to 42 percent of women who did not participate in the group sessions.

"Women who
were too afraid to work or were overcome by feelings of shame told us that
after the group therapy, they have been able to turn their lives around and
once again be part of the community," says Poulton.

"This is
critical, because if women feel marginalized and stigmatized because of the
devastating impact of sexual violence, they are unable to help their families
or communities recover from conflict."

One participant
described the impact of CPT this way: "Before, I felt ashamed when I passed
by others. I felt that they were judging me. I no longer feel ashamed, I feel
at ease. I can walk around without shame and without fear of being
judged."

The IRC has
continued to use CPT and individual counseling to aid women in Congo
and hopes to expand the use of CPT in other countries where the IRC assists
survivors of sexual violence.

The project and
evaluation were funded by the US Agency for International Development (USAID),
World Bank, Swedish International Development Cooperation Agency (SIDA), Open
Square Foundation and European Commission's Department of Humanitarian Aid and
Civil Protection (ECHO).