Fostering Psychological Recovery in Informal Settlements: A Mixed-Methods Study of Cognitive Restructuring Therapy Among Women Survivors of Political Violence in Nairobi and Kisumu
DOI:
https://doi.org/10.53819/81018102t7094Abstract
Political violence leaves invisible yet enduring wounds, fracturing identity, eroding agency, and entrenching psychological suffering long after the guns fall silent. This study investigates the transformative potential of Cognitive Restructuring Therapy (CRT), as a foundational component of Cognitive Behavioral Therapy (CBT), in fostering psychological recovery among women survivors of political violence in the informal settlements of Nairobi and Kisumu, Kenya. Anchored in Ryff's multidimensional model of psychological well-being and theoretically situated within CBT and Narrative Exposure Theory frameworks, the study employed a convergent mixed-methods design to capture both the measurable and lived dimensions of healing. Two hundred women survivors participated in the quantitative component, complemented by in-depth qualitative interviews with ward administrators and directors of community-based organizations. Pearson correlation analyses revealed statistically significant and clinically meaningful negative associations between engagement in CRT-based interventions and psychological distress: CRT demonstrated moderate correlations with reductions in both PTSD symptoms (r = –0.42, p < .01) and anxiety symptoms (r = –0.37, p < .01), with group therapy yielding comparably significant effects. Chi-square analyses further confirmed that age, marital status, and employment status significantly moderated both intervention participation and recovery trajectories, underscoring the socially embedded nature of psychological healing. Qualitative findings illuminated the complex ecology of recovery within these communities. While structured cognitive interventions generated tangible emotional relief and measurably enhanced coping capacity, their reach remained constrained by pervasive stigma, inadequate professional infrastructure, and the episodic, donor-dependent character of service delivery. Faith-based networks, indigenous healing traditions, and peer-driven community solidarity emerged as vital pillars of emotional stabilization. Together, these formal and informal systems constitute a fractured recovery landscape in urgent need of cohesion. The study concludes that CRT exerts a significant and positive influence on the psychological well-being of women survivors of political violence; however, durable recovery demands more than clinical efficacy alone. Sustainable outcomes necessitate integrated, culturally responsive, and institutionally anchored frameworks that bridge formal cognitive therapy with community-based support, economic empowerment, and long-term professional engagement.
Keywords: Cognitive Restructuring Therapy, Psychological well-being, Political violence, Women survivors, CBT, Informal settlements, Kenya
References
Beck, A. T., & Haigh, E. A. P. (2014). Advances in cognitive theory and therapy: The generic cognitive model. Annual Review of Clinical Psychology, 10, 1–24. https://doi.org/10.1146/annurev-clinpsy-032813-153734
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101. https://doi.org/10.1191/1478088706qp063oa
Charlson, F., van Ommeren, M., Flaxman, A., Cornett, J., Whiteford, H., & Saxena, S. (2019). New WHO prevalence estimates of mental disorders in conflict settings: A systematic review and meta-analysis. The Lancet, 394(10194), 240–248. https://doi.org/10.1016/S0140-6736(19)30934-1
Creswell, J. W., & Clark, V. L. P. (2017). Designing and conducting mixed methods research (3rd ed.). SAGE Publications.
Cuijpers, P., Veen, S. C., Sijbrandij, M., Yoder, W., & Cristea, I. A. (2022). Eye movement desensitization and reprocessing for mental health problems: A systematic review and meta-analysis. Cognitive Behaviour Therapy, 51(1), 1–16.
Diener, E., Oishi, S., & Tay, L. (2018). Advances in subjective well-being research. Nature Human Behaviour, 2(4), 253–260. https://doi.org/10.1038/s41562-018-0307-6
Ehlers, A., Bisson, J. I., Clark, D. M., Creamer, M., Pilling, S., Richards, D., & Yule, W. (2010). Do all psychological treatments really work the same in posttraumatic stress disorder? Clinical Psychology Review, 30(2), 269–276. https://doi.org/10.1016/j.cpr.2009.12.001
Herman, J. L. (2015). Trauma and recovery: The aftermath of violence—from domestic abuse to political terror. Basic Books.
Hofmann, S. G., Asnaani, A., Vonk, I. J., Sawyer, A. T., & Fang, A. (2012). The efficacy of cognitive behavioral therapy: A review of meta-analyses. Cognitive Therapy and Research, 36(5), 427–440. https://doi.org/10.1007/s10608-012-9476-1
Hofmann, S. G., Curtiss, J., & McNally, R. J. (2021). A network perspective on clinical science. Perspectives on Psychological Science, 11(5), 597–605.
Kenya National Commission on Human Rights. (2008). On the brink of the precipice: A human rights account of Kenya’s post-2007 election violence. Kenya National Commission on Human Rights.
Makumi, J. (2015). Psychosocial consequences of post-election violence in Kenya: A community perspective. African Journal of Trauma, 4(1), 21–29.
Muchemi, A. W. (2018). Psychological impact of political violence on women in Kenya’s informal settlements. East African Medical Journal, 95(7), 312–320.
Neuner, F., Schauer, M., Karunakara, U., Klasen, F., & Elbert, T. (2008). Psychological trauma and PTSD in West Nile: An exploratory study. Journal of Clinical Psychology, 64(9), 853–862. https://doi.org/10.1002/jclp.20515
Onyango, M. A., & Ojara, S. (2021). Psychological effects of political violence on women in Kenya’s informal settlements. African Journal of Psychology, 11(3), 45–58.
Prati, G., & Pietrantoni, L. (2009). Optimism, social support, and coping strategies as factors contributing to posttraumatic growth: A meta-analysis. Journal of Loss and Trauma, 14(5), 364–388.
Ryff, C. D. (1989). Happiness is everything, or is it? Explorations on the meaning of psychological well-being. Journal of Personality and Social Psychology, 57(6), 1069–1081.
Ryff, C. D. (2014). Psychological well-being revisited: Advances in the science and practice of eudaimonia. Psychotherapy and Psychosomatics, 83(1), 10–28. https://doi.org/10.1159/000353263
Slattery, J. M., & Park, C. L. (2015). Spiritual coping and resilience: A review of the literature. Journal of Religion and Health, 54(1), 17–29.
Tol, W. A., Barbui, C., & Jordans, M. J. D. (2011). Resilience in children affected by armed conflict: A systematic review of protective factors. Journal of Child Psychology and Psychiatry, 52(3), 237–249.
Tol, W. A., Barbui, C., Galappatti, A., Silove, D., Betancourt, T. S., Souza, R., & van Ommeren, M. (2013). Mental health and psychosocial support in humanitarian settings. The Lancet, 378(9802), 1581–1591.
UN-Habitat. (2020). World cities report 2020: The value of sustainable urbanization. United Nations Human Settlements Programme.
United Nations. (2023). Report of the Secretary-General on the protection of civilians in armed conflict. United Nations Security Council.
Ventevogel, P., Jordans, M., Reis, R., & De Jong, J. (2019). Madness or sadness? Local concepts of mental illness in conflict-affected settings. Global Mental Health, 6, Article e30.
Weathers, F. W., Litz, B. T., Keane, T. M., Palmieri, P. A., Marx, B. P., & Schnurr, P. P. (2013). The PTSD Checklist for DSM-5 (PCL-5). National Center for PTSD. https://www.ptsd.va.gov
White, M., & Epston, D. (1990). Narrative means to therapeutic ends. W. W. Norton.
World Health Organization. (2018). Psychological first aid: Guide for field workers. WHO Press.
World Health Organization. (2022). World mental health report: Transforming mental health for all. World Health Organization.
