A review of the transportability of cognitive therapy for the treatment of PTSD among South African rape survivors

Anita Padmanabhanunni

doi:10.4102/hsag.v22i0.1014

Abstract

This study aimed to evaluate the transportability of cognitive therapy (CT) for rape survivors with PTSD to South African conditions. Ten local treatment outcome studies investigating the transportability of CT were identified and appraised. The common elements of CT for PTSD including psychoeducation, exposure therapy and cognitive restructuring oft rauma-related appraisals were found to be transportable to local contexts. Contextual factors that can complicate treatment delivery were also identified namely exposure to multiple traumatic events, HIV, absence of safety and support in the external environment and language barriers. The augmentations made to an existing evidence-based treatment protocol to address these contextual factors are described.

Highlights

Rape represents a serious societal crisis and major public health concern in South Africa
This study aims to evaluate the transportability of cognitive therapy (CT) in the treatment of rape-related posttraumatic stress disorder (PTSD) to local contexts by appraising the evidence from local treatment outcome studies
The intervention used in each case was ECCT, these studies provide an opportunity to examine the transportability of the core components of CT in the treatment of rape survivors to local contexts

Summary

Introduction

Rape represents a serious societal crisis and major public health concern in South Africa. Compared to other traumatic events, rape is associated with the highest frequency of posttraumatic stress disorder (PTSD) among survivors (Atwoli et al, 2013; Breslau, 2009; Ullman, Townsend, Filipas, & Starzynski, 2007). Several South African studies have confirmed the prevalence of PTSD following exposure to rape. Atwoli et al (2013), in a nationally representative survey of South African adults, found that rape was the traumatic event with one of the highest risks for PTSD. A comparative study of different types of traumatic events (Seedat Nyamai, Njenga, Vythilingum & Stein 2004) concluded that sexual assault, when compared to all other traumas, was associated with the greatest risk of PTSD. Studies conducted in community settings (Dinan, McCall, & Gibson, 2004) and university contexts (Padmanabhanunni & Edwards, 2015) have further corroborated these findings

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