Torture survivors are frequently survivors of sexual assault as well. In this trial in the Democratic Republic of Congo, 16 villages either received cognitive processing therapy (1 individual session and 11 group sessions) or individual support to female sexual-violence survivors with high levels of PTSD symptoms and combined depression and anxiety symptoms. Group psychotherapy reduced PTSD symptoms and combined depression and anxiety symptoms and improved functioning. The specific type of group therapy used, cognitive processing therapy, was adapted for "illiterate participants and those potentially exposed to ongoing violence. The adaptations included an initial individual psychoeducational session, oral completion of assignments during group sessions, and simplification of materials to facilitate understanding and memorization".