What is Restavek?

Restavek is a form of modern-day slavery that is estimated to affect 300,000 (approximately 1 in 10) children in Haiti. The word is derived from the French and Creole term reste avec, which translates to “one who stays with.” It typically involves a child—usually around five years old—from a poor rural family being sent to work as an indentured domestic servant for an affluent urban family. Though the practice began as families sending their children to slightly wealthier urban relatives who could better provide for them, it now more often involves recruiters who are paid to find child slaves for host families. The devastation caused by the 2010 earthquake exacerbated this practice, as families who had lost their homes could no longer afford to care for their children and felt their best option was to send them away. Restavek children are commonly subjected to physical, psychological, and sexual abuse, and experience a high rate of trauma, as well as other mental health concerns.

What is SO-TF-CBT for Restavek Children?

Spiritually Oriented Trauma Focused Cognitive Behavioral Therapy (SO-TF-CBT) is a culturally adapted, standardized 12-week mental health treatment for restavek children in Haiti. It was designed to help children and adolescents of various faith backgrounds work through potential spiritual issues that may arise and become intertwined with their trauma history. The intervention is designed to be implemented by an in-country lay counselor in a one-on-one format, with each session lasting approximately one hour. Sessions focus on topics like psychoeducation, relaxation, trauma narratives, and spiritual struggles.
Our study on the effects of this treatment for restavek children involved 20 control participants and 38 treatment participants.

What Were the Results?

“One of the most interesting findings of the study concerned the damaging effects of trauma on one’s spirituality,” explains Dave Wang, associate professor of psychology at Biola University and lead on the study. “There’s a good amount of literature that speaks to human resilience—how trauma symptoms tend to naturally decrease over time even among those who never received any kind of mental health treatment (this trend was observed even in the control group in our study). However, what was surprising was that the spiritual struggles of the control group actually increased over the timeframe of our study (even though trauma symptoms decreased during this same timeframe). Notably, spiritual struggles took an opposite trend—decreasing over the timeframe of the study—among those who received our spiritually-oriented trauma treatment. Together, this suggests that even though the natural recovery process may lead to reductions in PTSD symptoms, damage to spirituality as a result of trauma may tend to persist and even possibly worsen. All of this attests to the importance of developing and utilizing spiritually-integrated approaches to psychotherapy—especially those that are designed to treat trauma.”