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Hope for Restavek Children in Haiti

New HDI research finds that adapted intervention benefits traumatized children.

Photo courtesy of Humanitarian Disaster Institute
Source: Photo courtesy of Humanitarian Disaster Institute

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.”

Want to Learn More?

To get an in-depth overview of the study you can read more in the most recent issue of Spirituality in Clinical Practice. Stay connected with the work of HDI by signing up for our email newsletter, and follow us on Facebook and on Twitter for daily updates.

About HDI

HDI is the first social science research center in the United States devoted to the study of faith and disasters. The mission of HDI is to help the Church prepare and care in a disaster-filled world. Located at Wheaton College (Wheaton, IL), HDI conducts and translates research into theologically and scientifically informed best practices, resources, and trainings for navigating disasters and humanitarian crises.

Dr. Jamie Aten is a disaster psychologist and the founder and executive director of the Humanitarian Disaster Institute and Disaster Ministry Conference at Wheaton College (Wheaton, IL). His latest books include the Disaster Ministry Handbook and Spiritually Oriented Psychotherapy for Trauma. In 2016 he received the FEMA Community Preparedness Champion Award at the White House. Follow on Twitter at @drjamieaten or visit his website

© HDI, 2017


Wang, David C.; Aten, Jamie D.; Boan, David; Jean-Charles, Wismick; Griff, Kathylynn Pierre; Valcin, Viola C.; Davis, Edward B.; Hook, Joshua N.; Davis, Don E.; Van Tongeren, Daryl R.; Abouezzeddine, Tania; Sklar, Quyen; Wang, Anna (2016). "Culturally adapted spiritually oriented trauma-focused cognitive–behavioral therapy for child survivors of restavek." Spirituality in Clinical Practice, Vol 3(4), Dec 2016, 224-236.