In first world countries, criminals are often reprimanded as soon as they commit their crime. Their victim reports them, and they are almost immediately caught and appropriated by cops. In cases of rape, this process can speed recovery of victims, as they can know that their assailant can no longer harm them as they articulate their worries to a therapist.

Victims of sexual violence face immediate and long-term psychological consequences. They may become fearful, anxious, and mistrusting, develop post-traumatic stress disorder (PTSD), become depressed, and attempt suicide. In high-income countries, effective treatments for the psychological effects of rape are useful; the victim can easily articulate his or her feelings and fears to a therapist, either alone or in a group setting.

However, lower-income countries and their social structure may not allow for similar aid to rape victims.

In low-income countries like the Eastern Democratic Republic of Congo where 40 percent of women have experienced sexual violence, researchers have not known the efficacy of therapy and treatments for rape victims because few studies have been performed, and because their social structures are so different from higher income countries. In the Eastern Democratic Republic of Congo, rape victims are made to feel ashamed and embarrassed. So while they experience similar aftereffects as the rape victims in higher income countries, the stigma created by abandonment and rejection by family and friends as well as lack of law enforcement could potentially cause proven treatments to fail.

In a new study, 402 female survivors of sexual violence across 16 villages in the Eastern Democratic Republic of Congo were evaluated. They were first tested for the psychological effects of rape and were then given one of two treatments — either individual support, where they chose whether or not they would attend therapy sessions, or cognitive processing therapy. Cognitive processing therapy, or mandatory therapy, went on for 11 sessions with small groups of survivors that talked about the management of their psychological states and were given tasks to facilitate the treatment of their depression, anxiety, or PTSD. This is similar to what is done in higher income countries.

The study intended to find whether treatments used could cross cultural and cognitive circumstances, as many of these women were below the poverty line as well as illiterate.

Both therapy groups in the study indicated significant improvements during treatment for psychological disorders. Among the women receiving cognitive processing,  there were fewer incidences of probable depression in comparison to their condition before therapy. Only 10 of the original 71 women with depression still had probable depression or anxiety. Similarly, only eight of the original 60 women with PTSD still had likely cases of PTSD. Improvement in the individual support group was not as pronounced, as 53 percent of participants still had probable cases of PTSD or anxiety at the end of treatment.

The efficacy of therapy as a mental health intervention after the experience of sexual violence is clear. More of those who received therapy got better and returned to their normal lives. It seems that these traditional therapy methods could mean improved mental health within war and conflict-torn countries like Eastern Democratic Republic of Congo and many others, where rape statistics are high and mental health is difficult to achieve.

 

Source: Bass JK, Annan J, Murray SM. Controlled Trail of Psychotherapy for Congolese Survivors of Sexual Violence. The New England Journal of Medicine. 2013.