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Evaluating the impact of Narrative Exposure Therapy (NET) on the mental health and socioeconomic empowerment of survivors of sexual violence in Eastern DRC.
Last registered on April 08, 2020

Pre-Trial

Trial Information
General Information
Title
Evaluating the impact of Narrative Exposure Therapy (NET) on the mental health and socioeconomic empowerment of survivors of sexual violence in Eastern DRC.
RCT ID
AEARCTR-0002328
Initial registration date
July 14, 2017
Last updated
April 08, 2020 7:42 AM EDT
Location(s)
Primary Investigator
Affiliation
The World Bank
Other Primary Investigator(s)
PI Affiliation
The World Bank
Additional Trial Information
Status
Completed
Start date
2017-06-01
End date
2019-06-30
Secondary IDs
Abstract
The objective of the study is to evaluate the impact of Narrative Exposure Therapy (NET) delivered by local counselors, on the mental health and socio-economic empowerment of survivors of Sexual and Gender Based Violence (SGBV) who suffer Post-Traumatic Stress Disorder (PTSD), in North and South Kivu (DRC). The therapy is expected to reduce the symptoms of PTSD, depression, and anxiety in SGBV survivors. In the medium-term, the therapy is expected to improve beneficiaries’ economics empowerment, self-efficacy and social functioning and participation. The therapy will be delivered by local counselors only, but following a ‘training of trainers’ approach. A first generation of counselors will be trained and supervised by clinical experts from the NGO Vivo International. These trained counselors will deliver a subsequent training to a new generation of counselors, who after a period of time with train a third generation of counselors. This proposed impact evaluation will answer the following research questions: 1) What is the impact of NET on survivors’ psychosocial wellbeing, economic empowerment and social functioning and participation? 2) Does the intervention have the same impact when implemented by each generation of counselors, trained by international or local facilitators? Do counselors become better over time?
External Link(s)
Registration Citation
Citation
Rouanet, Léa and Julia Vaillant. 2020. "Evaluating the impact of Narrative Exposure Therapy (NET) on the mental health and socioeconomic empowerment of survivors of sexual violence in Eastern DRC.." AEA RCT Registry. April 08. https://doi.org/10.1257/rct.2328-2.0.
Former Citation
Rouanet, Léa, Julia Vaillant and Julia Vaillant. 2020. "Evaluating the impact of Narrative Exposure Therapy (NET) on the mental health and socioeconomic empowerment of survivors of sexual violence in Eastern DRC.." AEA RCT Registry. April 08. http://www.socialscienceregistry.org/trials/2328/history/65792.
Sponsors & Partners

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Experimental Details
Interventions
Intervention(s)
The Narrative Exposure Therapy (NET) was developed as a short-term intervention to reduce PTSD symptoms resulting from exposure to multiple traumatic events, including SGBV. NET treatment is relatively easy to deliver, and adaptable to different cultures and contexts. The therapy involves 8 to 12 individual sessions of about 90 minutes each. Focusing on the traumatic events, the patient constructs a chronological narrative of his/her life story and a coherent narrative is then structured with the assistance of the therapist. The Government of DRC (GoDRC) will be procuring the services of an international NGO (vivo) to deliver the NET training and support. In the first phase, counselors will be trained to deliver the NET and will be supervised by experts from the NGO. Among the trainees, a group will be selected to become teacher-counselors, then a sub-group of high-performers will be formed to supervise the teacher-counselors and counselors. The goal is that the knowledge and skills disseminated within the group of supervisors, teacher-counselors, and counselors can ensure that the administration and supervision of NET is self-sustaining after the project closes.
Intervention Start Date
2017-06-05
Intervention End Date
2018-12-31
Primary Outcomes
Primary Outcomes (end points)
Primary: 1. PTSD severity; 2. Depression; 3. Anxiety
Secondary: 1. Economic empowerment. This will include indicators on credit access, control over profits, economic decision-making, work-force participation, and other economic activities such as farming/cultivation, breeding animals, and other types of labor, trade or other ways of making money. 2. Individual self-efficacy. Specific indicators will include measures of self-esteem, aspirations, and feelings of acceptance and shame. 3. Social functioning and participation. Indicators will include the size of the survivor’s social networks, frequency of social contact, looking after children, exchanging ideas, socializing with others in the community, making important decisions about daily life, and taking part in family activities or events. (Babulal et al., 2015)
Primary Outcomes (explanation)
Secondary Outcomes
Secondary Outcomes (end points)
Secondary Outcomes (explanation)
Experimental Design
Experimental Design
The evaluation will adopt a randomized controlled trial design at the individual level. The evaluation will assess the causal impact of receiving NET by comparing individuals randomly selected to receive NET to a control group who will receive the therapy at a later date. The total sample size will be 1,500 individuals, or 750 each in North and South Kivu provinces.
In both provinces, around 20 health centers will be selected for inclusion in the impact evaluation. In each province, we will select six health centers where NET will be administered by the first generation of counselors, six centers where NET will be administered by the second generation of counselors, and seven centers where NET will be administered by the third generation.
Additionally, one urban hospital (center of excellence) in Goma, North Kivuis included in the impact evaluation. While NET counselors in health centers are mostly trained nurses, counselors in centers of excellence are trained psychologists. However, psychologists are also trained following the training of trainers approach, hence will be divided into 3 generations also.
The impact of NET will be assessed in these three groups of health centers and in center of excellence to determine whether this intervention has the same impact when implemented by different generations of counselors and different types of counselors (nurses or psychologists).
Experimental Design Details
Randomization Method
Randomization of individuals by cohorts, done in office by a computer.
Randomization Unit
Individuals
Was the treatment clustered?
No
Experiment Characteristics
Sample size: planned number of clusters
No clusters
Sample size: planned number of observations
1,500 individuals
Sample size (or number of clusters) by treatment arms
750 treatment, 750 control individuals
Minimum detectable effect size for main outcomes (accounting for sample design and clustering)
IRB
INSTITUTIONAL REVIEW BOARDS (IRBs)
IRB Name
Health Media Lab
IRB Approval Date
2017-02-21
IRB Approval Number
21-February-2017
Analysis Plan

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Post-Trial
Post Trial Information
Study Withdrawal
Intervention
Is the intervention completed?
No
Is data collection complete?
Data Publication
Data Publication
Is public data available?
No
Program Files
Program Files
Reports, Papers & Other Materials
Relevant Paper(s)
REPORTS & OTHER MATERIALS