Cognitive Processing Therapy in Rape Crisis Centers: Does Race Congruency Matter?

Background/Purpose: Cognitive Processing Therapy (CPT) is a widely utilized therapeutic modality with a robust degree of support in the literature for the treatment of post-traumatic stress disorder (PTSD). However, no studies were found that have examined the significance of racial congruency between provider/client in the process of the manualized intervention among sexual violence survivors seeking support at non-profit violence prevention and intervention agencies.

Methods: This study is part of a multi-year randomized controlled trial examining the effectiveness of an implementation strategy for the adoption of CPT at 11 non-profit rape crisis centers (RCC) located in Texas. The quantitative data were collected from participants (N=73) prior to beginning treatment and at each treatment session utilizing the PTSD Checklist for DSM-5 (PCL-5). A standard multiple regression analysis was utilized to explore factors (baseline PCL-5 scores, number of treatment sessions, and racial congruency between provider/client) that impact final PCL-5 scores among the sample of 73 survivors of sexual violence. The assumptions of normality, linearity, homoscedasticity, and multicollinearity were conducted prior to running the standard multiple regression analysis. The data analysis was conducted using SPSS version 28.

Results: A standard multiple regression was conducted to determine how final PCL-5 scores were impacted by baseline PCL-5 scores, number of treatment sessions, and racial congruency between provider/client. The results revealed the overall model was significant (F = 7.410, p <.001) and explained 24.4% of the variance in the final PCL-5 scores. Of those factors, the baseline PCL-5 scores emerged as the strongest predictor of final PCL-5 scores, with a beta of .391 (p < .001) and accounting for 14.8% of the variance in final PCL-5 scores. The second strongest factor was number of treatment sessions (β = -.254, p = .021), accounting for 6.1% of the variance. The size and direction of the relationship suggest that as the number of treatment sessions increased, the final PCL-5 score decreased (for every unit of increase in the number of treatment sessions, final PCL-5 scores decrease 1.116); conversely, as baseline PCL-5 scores increase, the final PCL-5 scores increase (for every unit of increase in baseline scores, final scores increase .747). Importantly, results suggest racial congruency between provider/client is statistically insignificant in relation to final PCL-5 scores among survivors of sexual violence accessing support at 11 RCCs in Texas.

Conclusion/Implications: This study contributes to the literature and field by offering additional support for CPT use in RCC. Although additional research is needed to evaluate and identify additional variables explaining the remaining variance, the study results at hand support the use of CPT with diverse populations of survivors of sexual violence in RCCs where you have limited diversity in providers.