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Objectives. We evaluated changes in social capital following group-based cognitive processing therapy (CPT) for female survivors of sexual violence.
Methods. We compared CPT with individual support in a cluster-randomized trial in villages in South Kivu province, Democratic Republic of the Congo. Local psychosocial assistants delivered the interventions from April through July 2011. We evaluated differences between CPT and individual support conditions for structural social capital (i.e., time spent with nonkin social network, group membership and participation, and the size of financial and instrumental support networks) and emotional support seeking. We analyzed intervention effects with longitudinal random effects models.
Results. We obtained small to medium effect size differences for 2 study outcomes. Women in the CPT villages increased group membership and participation at 6-month follow-up and emotional support seeking after the intervention compared with women in the individual support villages.
Conclusions. Results support the efficacy of group CPT to increase dimensions of social capital among survivors of sexual violence in a low-income conflict-affected context. (Am J Public Health. 2014;104:1680-1686. doi:10.2105/AJPH.2014.301981
Women who experience sexual violence have an increased risk of mental health problems,1 including posttraumatic stress disorder (PTSD), depression, anxiety, and social maladjustment.2 In the Democratic Republic of the Congo (DRC), studies show that upward of 40% of women experience sexual violence.3 Many of these women are rejected by their husbands and family, experience poor standing within their communities,4,5 and suffer what Kleinman6 refers to as social death-exclusion from social and community life. This community reaction is in part a product of existing dynamics of gender inequality and harmful gender attitudes that blame sexual violence survivors.7 In community contexts where interpersonal trauma rates are high, healing needs to involve social factors in addition to addressing psychological effects of these traumas. Studies show that losses to social resources occur following rape,8 but the literature has yet to focus on whether these resources can be restored or improved.
Within low-resource settings that lack adequate health infrastructure, people may rely on less-formal community social ties to meet their mental health needs. Within this context, the effects of sexual violence on the relationship between mental health and social resources can be partially explained by utilizing a social causation or social driftframework.9 Social causation suggests that losses to social resources...