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

32 Participants Needed

Trial Summary

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.

What data supports the effectiveness of the treatment Men's MST Group, Present-Centered Group Therapy?

Research on group therapy for sexual abuse survivors shows significant improvements in symptoms like anxiety, depression, and trauma-related distress. A study on the Warrior Renew group therapy for female veterans with military sexual trauma found large reductions in anxiety, depression, and PTSD symptoms, suggesting group therapy can be effective for similar issues in men. ^{1 2 3 4 5}

Is group therapy for sexual trauma safe for participants?

The research does not provide specific safety data for group therapy for sexual trauma, but it is generally based on best practices for PTSD treatment, which are considered safe for most people. ^{6 7 8 9 10}

How is the Men's MST Group treatment different from other treatments for military sexual trauma?

The Men's MST Group treatment is unique because it combines multiple approaches, including exposure therapy (facing fears in a safe environment), mindfulness (being present and aware), psychoeducation (learning about the condition), and psychodynamic group interventions (exploring emotions and relationships), specifically tailored for men with military sexual trauma, addressing gender-specific challenges that other PTSD treatments might overlook. ^{6 7 10 11 12}

What is the purpose of this trial?

VA has identified military sexual trauma (MST) as one of its highest priorities. MST is associated with increased prevalence of PTSD and depression, substance use disorders, suicide, difficulties maintaining relationships and employment, and homelessness. Yet important gender differences have been identified among MST survivors and many man may experience stigma and shame related to masculinity and sexuality. While gender-based shame appears central to MST-related distress and treatment underutilization, gender has often been overlooked in establishing evidence-based approaches, and no VA MST-related treatment has been developed specifically for men. To address this critical service gap, this study will collect data on improving treatment strategies and patient engagement for men with histories of MST. It will seek to develop strategies for enhancing a 12-session, gender-tailored group therapy for men MST survivors previously developed and implemented by the principal investigator. It will interview Veteran participants and mental health clinicians, conduct a pilot randomized trial, and evaluate feasibility within the VA, with the long-term goal of national implementation

Research Team

Jonathan Yahalom, PhD MA

Principal Investigator

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

Eligibility Criteria

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

Participants will not be excluded based on psychiatric diagnosis

Comprehend and sign the informed consent form

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

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

Treatment Details

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.

Participant Groups

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+

Findings from Research

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]

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]

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]

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]

References

1. England pubmed.ncbi.nlm.nih.gov

Factors affecting group therapy outcome for adult sexual abuse survivors. [2019]

2. United States pubmed.ncbi.nlm.nih.gov

A comparison of short-term group and individual therapy for sexually abused women. [2017]

3. England pubmed.ncbi.nlm.nih.gov

Group psychotherapy in women with a history of sexual abuse: what did they find helpful? [2014]

4. England pubmed.ncbi.nlm.nih.gov

The efficacy of group treatment for survivors of childhood abuse. [2019]

5. United States pubmed.ncbi.nlm.nih.gov

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

6. United States pubmed.ncbi.nlm.nih.gov

Unseen battles: the recognition, assessment, and treatment issues of men with military sexual trauma (MST). [2014]

7. England pubmed.ncbi.nlm.nih.gov

Military sexual trauma in men: a review of reported rates. [2011]

8. United States pubmed.ncbi.nlm.nih.gov

CE: Military Sexual Trauma in Male Service Members. [2021]

9. United States pubmed.ncbi.nlm.nih.gov

Military Sexual Trauma and Risky Behaviors: A Systematic Review. [2023]

10. United States pubmed.ncbi.nlm.nih.gov

Patient experiences and reported effectiveness of a multimodal short-term pilot therapy group for veteran men with military sexual trauma. [2023]

11. Netherlands pubmed.ncbi.nlm.nih.gov

Cognitive processing therapy for male veterans with military sexual trauma-related posttraumatic stress disorder. [2018]

12. United States pubmed.ncbi.nlm.nih.gov

Military sexual trauma among homeless veterans. [2022]