Group Therapy for Sexual Trauma

Overseen By Alison B Hamilton, PhD MPH

Age: Any Age

Sex: Male

Trial Phase: Academic

Sponsor: VA Office of Research and Development

Disqualifiers: Severe suicidal ideation, Uncontrolled substance abuse, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 12

Duration: 12 weeks

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to improve therapy for male veterans who have experienced military sexual trauma (MST). It will test a specialized group therapy, called Men's MST Group, designed to address feelings of shame and distress often overlooked in existing treatments. By comparing this therapy with a general PTSD-focused group therapy, known as Present-Centered Group Therapy, researchers aim to develop better strategies for supporting men with MST. Veterans who identify as cisgender men and have a history of MST might be a good fit for this study. As an unphased trial, this study offers veterans a unique opportunity to contribute to the development of more effective therapies for MST.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It is best to discuss this with the trial coordinators or your healthcare provider.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that both Men's MST Group therapy and Present-Centered Group Therapy (PCGT) are safe and well-tolerated by participants. Men's MST Group therapy assists men in addressing military sexual trauma (MST) by discussing topics such as masculinity, emotions, and social connections. Although specific safety data is unavailable, the therapy is based on the lead researcher's previous work, indicating a design focused on participant safety.

For Present-Centered Group Therapy, studies have demonstrated its safety and effectiveness in reducing PTSD symptoms by addressing current life challenges. This therapy has been compared to other treatments and found effective in lessening PTSD severity. It relies on general psychotherapy methods, which are typically safe and well-accepted by patients.

Both therapies aim to support mental health recovery with a focus on safety and participant well-being. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Men's MST Group (MMG) therapy because it offers a unique approach to treating sexual trauma by focusing on gender-specific experiences. Unlike standard PTSD treatments, such as trauma-focused cognitive behavioral therapy, MMG integrates exposure- and mindfulness-based interventions to help men manage distress and enhance their sense of agency. It also fosters social belongingness by encouraging discussions on masculinity and identity, which are often overlooked in traditional therapies. Additionally, by tailoring sessions to address hope and coping skills, MMG aims to reduce psychiatric distress and identity-based shame, offering a comprehensive path to recovery that current options don't typically provide.

What evidence suggests that this trial's treatments could be effective for military sexual trauma?

This trial will compare Men's MST Group therapy with Present-Centered Group Therapy (PCGT) for male veterans who have experienced military sexual trauma (MST). Research shows that Men's MST Group therapy helps male veterans address issues like masculinity, sexuality, and emotional management. Studies have found that this therapy, tailored specifically for men, can reduce mental distress, including feelings of shame related to identity. It improves stress management through mindfulness and exposure techniques, encourages social connections, and builds hope by teaching coping skills.

Present-Centered Group Therapy (PCGT), another treatment arm in this trial, aids people with PTSD by improving their response to trauma-related stress. While more effective than no treatment, it may not be as powerful as therapies focused specifically on trauma. However, PCGT can still be a helpful part of treatment for managing current life challenges. ^{5 6 7 8 9}

Who Is on the Research Team?

Jonathan Yahalom, PhD MA

Principal Investigator

VA Greater Los Angeles Healthcare System, West Los Angeles, CA

Are You a Good Fit for This Trial?

This trial is for male veterans who have experienced military sexual trauma (MST) and are dealing with issues like PTSD, depression, substance use, or difficulties in relationships and employment. To participate, they must be seeking help within the VA system.

Inclusion Criteria

Enrolled in the VAGLA

Comprehend and sign the informed consent form

Report a history of MST

Exclusion Criteria

Severe suicidal or homicidal ideation, as defined by the Columbia Suicide Severity Rating Scale (C-SSRS) and behavioral flags per chart review

Severe and uncontrolled substance abuse (identified through current treatment of a substance use disorder in chart)

I am unable to give consent for myself.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants engage in a 12-week, gender-tailored group therapy for men MST survivors, focusing on reducing psychiatric distress and promoting recovery through exposure- and mindfulness-based interventions.

12 weeks

12 visits (in-person, weekly)

Follow-up

Participants are monitored for recovery-oriented outcomes and psychological symptoms at pre-, immediate post-, and 6-month post-intervention.

6 months

What Are the Treatments Tested in This Trial?

Interventions

• Men's MST Group
• Present-Centered Group Therapy

Trial Overview The study is testing a specialized 12-session group therapy program tailored for men who have survived MST. It compares this new approach to Present-Centered Group Therapy to see which is more effective at addressing their unique challenges.

How Is the Trial Designed?

Group I: Men's MST Group (MMG) Experimental Treatment 1 Intervention

This is a 12-week long group that meets for 90 minutes weekly. This group will draw on interventions, developed in our pilot study, and also based on the PI's previous clinical experience designing and delivering a men's MST Group oriented to reduce psychiatric distress including identity-based shame by promoting group discussion among Veteran men about masculinity, sexuality, belongingness, and emotion regulation. The group is oriented around building core drivers of recovery: 1) agency through exposure- and mindfulness-based interventions to improve distress management; 2) social belongingness through group discussions on gender-specific themes; and 3) hope through coping skill training and treatment experienced as relevant. The protocol will be further revised based on research activity during Aims 1 and 2.

Group II: Present-Centered Group Therapy (PCGT) Active Control 1 Intervention

PCGT is a time-limited treatment for PTSD that focuses on increasing adaptive responses to current life stressors and difficulties that are directly or indirectly related to trauma or PTSD symptoms. PCGT was initially developed as a nonspecific comparison condition to test the effectiveness of trauma-focused cognitive behavioral therapy. The number of PCGT sessions has ranged from 12 to 32 for the group format, and is thus appropriate to utilize for the nature of this study. To minimize possible confounds, PCGT will be delivered for a 12-week period. The basis of PCGT is to provide "common factors" of psychotherapy, demonstrating the effects of what is unique in therapies. In this instance, PCGT may help articulate whether the effect of MMG is due to being gender-specific (bringing men together in the same group therapy setting) or being gender-tailored (delivering treatment that is specifically oriented to men, such as MMG group discussions).

Who Is Running the Clinical Trial?

VA Office of Research and Development

Lead Sponsor

Trials

1,691

Recruited

3,759,000+

Published Research Related to This Trial

Group psychotherapy significantly reduced depression, anxiety, and PTSD symptoms in 47 women with a history of sexual abuse, with improvements noted as early as the 6th session and lasting up to six months after treatment.

Participants identified existential factors, group cohesiveness, and universalism as the most helpful aspects of therapy, while higher dissociative symptoms at baseline were linked to poorer treatment response but greater session attendance.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Group psychotherapy in women with a history of sexual abuse: what did they find helpful? Sayın, A., Candansayar, S., Welkin, L.[2014]

The Warrior Renew treatment protocol, designed for female veterans who are survivors of military sexual trauma, showed significant reductions in anxiety, depression, negative thinking, and PTSD symptoms among participants, with large effect sizes reported.

Out of 34 participants who completed the program, 75% experienced reliable clinical improvement, indicating that this treatment may effectively address the unique challenges faced by survivors of military sexual trauma.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Efficacy of Warrior Renew group therapy for female veterans who have experienced military sexual trauma. Katz, LS.[2019]

In a study of 86 adult women who experienced childhood sexual abuse, both group therapy and individual therapy were effective in reducing symptoms and improving psychosocial functioning after 10 sessions, with continued improvement noted at 6- and 12-month follow-ups.

Neither therapy type was found to be superior, indicating that both approaches can be beneficial, but about half of the participants still sought additional treatment, suggesting a need for more targeted or longer-term therapy for some individuals.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A comparison of short-term group and individual therapy for sexually abused women. Stalker, CA., Fry, R.[2017]

A study involving 32 women showed that a new group treatment model for sexual abuse survivors was significantly more effective in reducing depression and anxiety compared to individual therapy alone, with improvements measured after 10 to 12 weeks.

While both groups experienced decreases in depression and trauma symptoms, the treatment group demonstrated a statistically significant greater improvement in these areas, highlighting the potential benefits of group therapy in conjunction with individual therapy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The efficacy of group treatment for survivors of childhood abuse. Westbury, E., Tutty, LM.[2019]

Citations

1. clinicaltrials.gov clinicaltrials.gov/study/NCT06741202

Recovery-oriented Group Therapy for Veteran Men With ... VA has identified military sexual trauma (MST) as one of its highest priorities. MST is associated with increased prevalence of PTSD and depression, ...

2. hsrd.research.va.gov hsrd.research.va.gov/research/cda_abstracts.cfm?Project_ID=2141710244

CDA 23-054 – HSR Study - VA Health Systems Research Innovation: This study is the first known effort to refine and test an intervention tailored to men MST survivors, and to measure access, engagement, and mental ...

3. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/35332551/

Patient experiences and reported effectiveness of a ... Patient experiences and reported effectiveness of a multimodal short-term pilot therapy group for veteran men with military sexual trauma. J Clin Psychol ...

4. ctv.veeva.com ctv.veeva.com/study/recovery-oriented-group-therapy-for-veteran-men-with-military-sexual-trauma

Recovery-oriented Group Therapy for Veteran Men With ... VA has identified military sexual trauma (MST) as one of its highest priorities. MST is associated with increased prevalence of PTSD and ...

5. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12214050/

Military sexual trauma and mental health counseling A meta‐analysis found that nearly 16% of military personnel and veterans reported MST; the prevalence was 3.9% for men and 38.4% for women when sexual assault ...

6. publichealth.va.gov publichealth.va.gov/epidemiology/studies/new-generation/military-sexual-trauma-infographic.asp

Military Sexual Trauma in Recent Veterans Combat exposed men were 1.57 times more likely to experience MST than those not exposed to combat. Combat exposed women were 1.42 times more ...

7. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12527520/

Mental health outcomes associated with military sexual ... Posttraumatic stress disorder and depression symptoms were associated with further outcomes, such as suicidality, disordered eating, and substance use.

8. sciencedirect.com sciencedirect.com/science/article/abs/pii/S0165032722002555

Research paper Military sexual trauma in the United States The prevalence of MST among female and male veterans was 44.2% and 3.5%. History of MST was associated with elevated health burden and suicide risk.

9. bmjopen.bmj.com bmjopen.bmj.com/content/15/6/e096912

Cross-sectional study of the rates of military sexual trauma ... This study investigates the rates of military sexual trauma (MST) and its associations with adverse mental health among a sample of UK female ex-service ...