"We Really Need This": Trauma-Informed Yoga for Veteran Women with a history of Military Sexual Trauma

Author: Tosca D Braun1, Lisa A Uebelacker2, Mariana Ward3, Cathryn Glanton Holzhauer4, Kelly McCallister5, Ana Abrantes6
Affiliation:
1 VA Central Western Massachusetts, 421 N. Main St., Leeds, MA, 01053, United States; West Springfield, MA Vet Center, 95 Ashley Ave., West Springfield, MA, 01089-1352, United States; Centers for Behavioral and Preventive Medicine, The Miriam Hospital, 196 Richmond St., Providence, RI, 02903, United States(1); Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Box G-BH, 700 Butler Drive, Providence, RI, 02906, United States(1). Electronic address: tosca_braun@brown.edu.
2 Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Box G-BH, 700 Butler Drive, Providence, RI, 02906, United States(1); Psychosocial Research, Butler Hospital, 345 Blackstone Blvd., Providence, RI, 02906, United States. Electronic address: LUebelacker@butler.org.
3 Memorial Sloan Kettering, Sloan Kettering Institute, 1275 York Ave., New York, NY, 10065, United States. Electronic address: mariana.ward@uconn.edu.
4 VA Central Western Massachusetts, 421 N. Main St., Leeds, MA, 01053, United States; Department of Psychiatry, University of Massachusetts Medical School, 55 Lake Ave., North Worcester, MA, 01655, United States. Electronic address: cathryn.holzhauer@va.gov.
5 West Springfield, MA Vet Center, 95 Ashley Ave., West Springfield, MA, 01089-1352, United States. Electronic address: Kelly.McAllister@va.gov.
6 Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Box G-BH, 700 Butler Drive, Providence, RI, 02906, United States(1); Behavioral Medicine and Addictions Research, Butler Hospital, 345 Blackstone Blvd., Providence, RI, 02906, United States. Electronic address: ana_abrantes@brown.edu.
Conference/Journal: Complement Ther Med
Date published: 2021 May 6
Other: Special Notes: doi: 10.1016/j.ctim.2021.102729. , Word Count: 260

Objectives:
Up to 70% of women service members in the United States report military sexual trauma (MST); many develop post-traumatic stress disorder (PTSD) and co-occurring disorders. Trauma-informed yoga (TIY) is suggested to improve psychiatric symptoms and shown feasible and acceptable in emerging research, yet no work has evaluated TIY in MST survivors. The current quality improvement project aimed to examine TIY's feasibility, acceptability, and perceived effects in the context of MST.

Design:
Collective case series (N = 7) SETTING: New England Vet Center INTERVENTIONS: Extant TIY program (Mindful Yoga Therapy) adapted for Veteran women with MST in concurrent psychotherapy.

Main outcome measures:
Attrition and attendance; qualitative exit interview; validated self-report measure of negative affect pre/post each yoga class, and symptom severity assessments and surveys before (T1; Time 1) and after the yoga program (T2; Time 2).

Results:
Feasibility was demonstrated and women reported TIY was acceptable. In qualitative interviews, women reported improved symptom severity, diet, exercise, alcohol use, sleep, and pain; reduced medication use; and themes related to stress reduction, mindfulness, and self-compassion. Regarding quantitative change, results suggest acute reductions in negative affect following yoga sessions across participants, as well as improved affect dysregulation, shame, and mindfulness T1 to T2.

Conclusions:
TIY is both feasible and acceptable to Veteran women MST survivors in one specific Vet Center, with perceived behavioral health benefits. Results suggest TIY may target psychosocial mechanisms implicated in health behavior change (stress reduction, mindfulness, affect regulation, shame). Formal research should be conducted to confirm these QI project results.

Keywords: PTSD; Veterans; Women; military sexual trauma; mindfulness; yoga.

PMID: 33965560 DOI: 10.1016/j.ctim.2021.102729

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