Distress of child war and sex abuse victims halved by new trauma intervention

A new psychological intervention has been shown to more than halve the trauma experienced by child victims of war, rape and sexual abuse.

Researchers at Queen’s University Belfast pioneered the intervention in conjunction with the international NGO, World Vision as part of a wider programme to treat psychological distress in child victims of war and sexual violence in the Democratic Republic of Congo (DRC).

Eastern Congo has the world’s highest rate of sexual violence. Known as ‘the rape capital of the world’, it is estimated that girls and women in the eastern DRC are 134 times more likely to be raped than their counterparts in the West.

After only 15 sessions of the new group-based Trauma-Focused Cognitive Behaviour Therapy (TF-CBT), Queen’s researchers found reductions of:

• 72 per cent in trauma symptoms in female victims of rape and sexual abuse
• 81 per cent in feelings of depression and anxiety
• 72 per cent decrease in conduct disorder
• 64 per cent decrease in anti-social behaviourIn war-affected countries, such as the DRC, victims of rape and sexual violence often do not receive any psychological or even medical help.

In the Queen’s study, the children received sessions of trauma psycho-education, relaxation techniques, mental imagery techniques, and tips on how to identify and change particular inaccurate or unhelpful cognitions. The girls also drew pictures of their most traumatic events and were encouraged to talk about these events in individual sessions with Queen’s psychologists and a team of Congolese counsellors who were trained by the University’s lead researchers, Paul O’Callaghan and John McMullen.

Speaking about the implications of the results for treating child victims of war and sexual abuse worldwide, Paul O’Callaghan, from Queen’s School of Psychology said: “In war-affected areas, victims will often not seek, or receive help of any kind. This is because wives fear that their husbands will reject them, and girls fear that they will be unable to marry if it is known that they have been violated. Stigma is also compounded by the fact that many of these rapes are carried out by undisciplined militias operating in remote and inaccessible parts of the country and the nearest hospital or clinic is many miles away.

“It is not surprising that studies show sexual abuse to have a profoundly detrimental effect on the mental health of girls in war-affected countries, but what is surprising was just how successful the intervention was in reducing psychological distress.

This is the first time that such a therapy has been used in this way. Although Trauma-Focused Cognitive Behaviour Therapy has the greatest evidence for its effectiveness in treating child victims of sexual violence in the West, to date no study has ever adapted it for use in developing countries affected by the twin evils of war and sexual violence.

“The dramatic reduction in trauma, depression and anxiety, conduct problems and anti-social behaviour shows that this kind of therapy is very effective in treating war-affected children who have been exposed to rape and sexual violence. In addition to the statistical results of the therapy many of the girls attested to how the intervention helped reduced their terrible nightmares, disturbing flashbacks and suicidal thinking. For me, that was the most rewarding part of our work in the DRC.”

The study, which took place over five weeks in 2011, also treated the psychological distress of 50 war affected boys between the ages of 12 and 17. It was shown to dramatically reduce levels of trauma, depression and anxiety, conduct disorder and anti-social behaviour in male child soldiers and street children.