Single-session group CBT post sexual assault: an outcome study
Research type
Research Study
Full title
Single-session group Cognitive Behavioural Therapy (CBT) post-sexual assault: an outcome study
IRAS ID
226813
Contact name
Raquel Machado Correia
Contact email
Sponsor organisation
Teesside University
Duration of Study in the UK
2 years, 1 months, 1 days
Research summary
Research Summary
Single-session group cognitive-behavioural therapy post-sexual assault: an outcome study
The study aims to look at a psychological intervention designed for survivors of rape and/or serious sexual assault. Often, people who have been through this experience develop psychological symptoms, which may include, amongst others, anxiety, posttraumatic stress (PTSD) and low mood/depression. These symptoms may, in turn, negatively impact on people’s daily functioning. Although not everyone who has experienced a sexual assault will develop PTSD, people who do develop PTSD are not currently routinely offered psychological therapy until after at least one month after the traumatic event.
We aim to look at how this intervention, which will be delivered within 4 weeks post-assault, may impact on people’s symptoms of PTSD, low mood/depression and functioning and, how these symptoms may change over time. If we can show that this intervention helps prevent the development and/or severity of PTSD, low mood/depression and impaired functioning, we may be able to help people who experience a rape or serious sexual assault to get early symptom-relief and recover sooner. This study is also important because this is a research topic that is much under-researched and preventive psychological treatments for Posttraumatic stress are scarce.
Women aged 18 years and over who have experienced a rape and/or serious sexual assault and are attending the Havens (London Sexual Assault Referral Centre) within four weeks post-assault will be invited to participate.
Participants will be asked to attend an initial psychological assessment and to fill in some questionnaires. Following that participants will be offered the group intervention, which they are free to accept or decline, and then ask them to fill in questionnaires again 2 weeks after the intervention.
Summary of Results
Study aims The primary aim of the study was to test the effectiveness of a single-session group Cognitive Behavioural Therapy (CBT) intervention in preventing and/or reducing Post-Traumatic Stress (PTS) symptoms in the weeks following sexual assault. It further aimed to explore whether the intervention was effective at decreasing symptoms of depression and improving daily functioning. Secondary aims were to explore whether pre-existing mental health problems as well as sexual assaults involving multiple rather than single acts were linked to levels of post-traumatic stress symptoms and symptoms of depression.
Method
The intervention group attended the single-session group CBT within 4 weeks post-sexual assault and the control group did not. The single-session group CBT was a psychoeducational intervention, which provided information about stress and trauma; behavioural, psychological, and physiological reactions to trauma; and coping strategies. The intervention included two parts supported by a presentation and it was delivered in a two and a half hour-single-session with a 15-minute break. The session was limited to a maximum of 14 clients to allow group participation and a balance between taught and interactive aspects of the intervention.
Both the intervention and the control groups completed self-report outcome measures to assess levels of PTS, depression and daily functioning at baseline (pre-intervention, within four weeks post-sexual assault) and at 6 weeks following sexual assault. The sample consisted of 29 adult female participants referred by Havens staff members, with 13 participants in the intervention group and 16 in the control group. The study aimed to recruit a total of 82 participants but it proved difficult to recruit and retain participants.Key findings
Results from data analysis demonstrate that:
• There is evidence to suggest that the single-session group CBT post-sexual assault helped reduce symptoms of PTS when attended within a month post-sexual assault. The mean PCL-5 score (measure used to assess levels of PTS) for the intervention group at baseline was 47.54. The mean score reduced to 37.92 at follow-up assessment, indicating a significant reduction in levels of PTS.
• Findings suggest the intervention might help earlier symptom relief of PTS.
• No evidence was found to suggest that the single-session group CBT intervention helped reduce symptoms of depression or improve daily functioning.
• The results also suggested that neither pre-existing mental health problems or experiencing a sexual assault involving multiple rather than single acts were related to PTS symptoms or symptoms of depression at baseline/ pre-intervention.
• Several factors may have influenced the study results such as: the exclusion of clients with severe and enduring mental health problems from the study; reliance on self-report accounts for presence of pre-existing mental health problems; different patterns for improvement in PTS or depression symptoms and daily functioning; and lack of sufficient power due to the small sample size.Strengths of the study
Strengths of the present study included factors such as (i) the use of a clinical population (many studies have used student University populations); (ii) providing an intervention in line with the CPS guidelines on pre-trial therapy and; (iii) the offer of an intervention to those displaying clinically significant symptoms of PTS in the acute phase post-sexual assault. Moreover, this was a unique study in the field of preventive psychotherapeutic interventions for sexual assault-related PTSD as this was the first study where CBT was utilized in a group format with clients displaying clinically significant symptoms of PTS up to 4 weeks post-sexual assault.
The findings have promising clinical and theoretical implications for developing interventions for people who have experienced recent sexual assault, in particular, for clients who do not feel ready to talk about their assaults and/or are worried about the legal implications of doing so. This type of intervention could also allow quicker access to psychological support within busy and short staffed services with long wait lists for therapy.
Recommendations for future research include a larger sample size, the evaluation of mechanisms of change (e.g. impact of group, motivation, changes in shame and self-blame), longer follow-up periods, randomised allocation and, use of focus group feedback to complement the questionnaire data. The study has been presented at national and international conferences and the author also hopes to publish the study in a peer academic journal so that the findings can have a wider reach.REC name
North West - Preston Research Ethics Committee
REC reference
17/NW/0559
Date of REC Opinion
3 Oct 2017
REC opinion
Favourable Opinion