The end of the trial: Perspectives on cognitive processing therapy from community-based providers in the Democratic Republic of Congo
Open accessAbstract
Despite calls forincreased mental health programming in low-resource and humanitarian contexts and effectiveness trials of psychotherapy in these settings, little research exists on the extent to which providers and recipients continue to practice skills learned during trials of these programs. To understand if and how providers continued to use mental health intervention skills without ongoing institutional support following the completion of randomized controlled trials (RCTs), we analyzed data from semistructured interviews with six of seven providers who participated in an RCT of cognitive processing therapy (CPT) in the Democratic Republic of Congo 7 years prior. Provider interviews revealed continued knowledge of and, in some cases, the practice of core CPT skills as well as efforts to keep meeting with women in the community and a strong desire to learn new skills. Although financial limitations sometimes prohibited providers from formally convening CPT groups with women in need, participants maintained knowledge and skill use. Providers also reported feeling more valued in their communities, and they continued providing services beyond the planned intervention period despite a lack of ongoing support. In addition, participants described a strong desire to continue psychosocial interventions for trauma and learn more about this type of intervention. Reframing the evaluation of psychological interventions as program development and maintaining a strong working relationship with community partners may allow for increased sustainability of mental health services beyond the end of academic research studies in low-resource contexts.
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In a qualitative investigation from the same four-year follow-up study, practitioners retained cognitive processing therapy skills and maintained cognitive processing therapy groups with new clients despite a lack of institutional support and clinical oversight.
“In a qualitative investigation from the same four-year follow-up study [27], practitioners retained CPT skills and maintained CPT groups with new clients despite a lack of institutional support and clinical oversight, indicating some degree of sustainability with limited resources.”
From Psychological Interventions for Survivors of Intimate Partner Violence in Humanitarian Settings: An Overview of the Evidence and Implementation Considerations (2022) · cites this paper as [27]
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“In a qualitative investigation from the same four-year follow-up study [27], practitioners retained CPT skills and maintained CPT groups with new clients despite a lack of institutional support and clinical oversight, indicating some degree of sustainability with limited resources.”
BackgroundSelf-citation
- Authors
- Lakin, D. P., Murray, S. M., Lasater, M. E., Kaysen, D., Mataboro, A., Annan, J., Bolton, P., & Bass, J. K.
- Affiliations
- Johns Hopkins University (US)
- Stanford Medicine (US)
- Action Kivu, Bukavu, South Kivu Democratic Republic of Congo
- International Rescue Committee (US)
- Corresponding author
- Lakin, Daniel P.
- ORCID
- Venue
- Journal of Traumatic Stress
- Publisher
- Wiley
- Published
- 2021-10-13
- Volume
- 35
- Issue
- 1
- Pages
- 269-277
- ISSN
- 0894-9867 (ISSN-L)
- 1573-6598
- PMC
- PMC9903302
- OpenAlex
- W3206950830
- Cited by
- 6
- References
- 45
- Citations by year
- 2026: 1 · 2025: 3 · 2022: 2
- FWCI
- 0.34
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Traumatic Stress (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- United States Agency for International Development
- National Institute of Mental Health
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
- Keywords
- cognitive processing therapy, post-traumatic stress disorder, resource-limited settings, humanitarian settings, trauma-focused psychotherapy, program development, community partnerships, provider motivation, Democratic Republic of the Congo
- MeSH terms
- Female, Humans, Mental Health, Psychotherapy, Stress Disorders, Post-Traumatic, Democratic Republic of the Congo, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic
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