Focusing in on CPT

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.

Nearing the end of the implementation of Cognitive Processing Therapy (CPT), the IRC South Kivu Psychosocial Team sat down with four of South Kivu’s Provincial Mental Health Program Coordination’s CPT focal points to see how the programme was going.

IRC:  How is the project going?

Focal Points: The project is going very well in the health centres where it is being implemented. Most of the sites are in their seventh session, though one site, Hospital General de Reference (HGR) Mukongola, is in its fourth session because of a slight delay in relation to the other sites. The supervision by four Provincial Health Direction (DPS) supervisors from the mental health coordination, one IRC Health staff member, one IRC WPE staff member, and the supervisor of the Kabare, takes place weekly.

We have seen that the therapists have gained experience in completing the first phase of CPT and concluding one month of identifying new participants. They have also been very adept at completing all the different steps of the therapy and leading the sessions. In addition, the beneficiaries are very engaged by the therapy. They regularly attend CPT sessions, have shown regression of their symptoms since the beginning, and share testimony about the changes they have seen in their everyday lives.

IRC: What have been some successes?

 Focal points: Key successes to highlight:

• We have seen a regression in participants’ symptoms by approximately 65%.
• In the Cirunga health centre, 12 beneficiaries participate regularly in the CPT sessions, though it was originally planned to only have eight. Another group of five beneficiaries has already been identified for a potential next phase.
• Moreover, the therapy has helped women to come together and create a solidarity fund which helps them to solve certain problems as we have seen in Cibungu, Kalulu, and Kinjuba. They also work in their fields on a rotating basis.
• One woman in Cirunga has told us that, since she began CPT she feels more open and has become more cooperative with her family and neighbours and she no longer fears being stigmatised. She knows that what happened to her was not her fault and she now knows how to address her trauma herself.
• CPT is helping women to increase functionality in their everyday lives.  One woman who stopped teaching after she was raped, started teaching again. Others are able to cultivate their fields and begin small businesses once they have the startup costs. Others attend women’s group/CBO meetings more regularly.

IRC: What have been some challenges?

Focal Points:   Some of the challenges we have seen:

• Certain beneficiaries continue to ask for remuneration for their participation in the CPT sessions as an expectation of continuing assistance following the intervention.
• Due to the distance to get to the health centre, four of the 10 members in Hospital General de Reference (HGR) Mukongola have dropped out, leaving six remaining participants.

IRC: What is your perspective on the future of CPT?

Focal Points: Based on the results of the first phase of CPT, the therapists themselves have come to understand the benefits of this intervention and how the therapy can help survivors address their trauma and regain their dignity. However, for continuity, it is very important to train local personnel in order to increase the number of trained therapists. Moreover, CPT needs to be accompanied with awareness-raising, and we need to assess the strategy for identifying beneficiaries in sites where there are no mental health interventions. Finally, we must think of how to bring CPT to all health structures in the Kabare health zone, if not the whole province, and why not, eventually in all of DRC.