What services and supports are needed to enable trauma survivors to rebuild their lives? Implications of a systematic case study of cognitive therapy with a township adolescent girl with PTSD following rape

This systematic clinical case study describes the psychological assessment and treatment with cognitive therapy of Zanele, a Xhosa-speaking adolescent rape survivor with major depressive disorder and posttraumatic stress disorder (PTSD). A case narrative was developed to document the main features of the therapy process and progress was monitored using scales measuring symptoms of depression and PTSD. The narrative documents the operation in a local context of factors that maintain PTSD that have been identified in the international literature and, with the self-report scales, provides evidence for Zanele’s recovery from PTSD and the transportability to this context of an evidence-based psychological treatment. The narrative also documents the lack of safety for young women and girls in a South African township as well as significant limitations in the professional services available: in this case, Zanele was infected with HIV and other sexually transmitted diseases but medical management had not been followed through, and criminal charges against the rapist were dropped, and dropped again even after he had committed another rape on a six-year-old girl. This provides a basis for examining the complementary roles that can be played by psychologists and other professionals in empowering trauma survivors to regain a sense of dignity and control over their lives.