Trauma-focused therapy retention among military sexual trauma survivors: relationship with veterans' sexual or gender minority identification

Cogn Behav Ther. 2024 Jul;53(4):351-363. doi: 10.1080/16506073.2024.2313740. Epub 2024 Feb 6.

Abstract

Military servicemembers identifying as sexual and gender minorities (SGM) are at increased risk for military sexual trauma (MST) exposure and Post-traumatic Stress Disorder (PTSD). Although evidence-based treatments can reduce symptoms of PTSD, treatment attrition is concerning. Unfortunately, evaluations of such approaches with veterans identifying as SGM are currently restricted to case studies offering limited information regarding treatment completion. Both historic and current contextual factors related to military and mental health practices may uniquely influence minority veterans' treatment engagement in veteran healthcare settings. We explored associations between SGM identification and treatment of MST-focused therapy completion patterns (finishing the full protocol [FP] or receiving minimally adequate care [MAC; defined as attending eight or more sessions]). Veterans (N = 271, 12.5% SGM) enrolled in individual Prolonged Exposure or Cognitive Processing Therapies at a Midwestern veterans hospital system. Those identifying as SGM were more likely than non-identifying peers to complete FP treatment and, even when attrition occurred, they were retained longer. For MAC, the SGM group was as likely as non-SGM peers to be retained. This research suggests SGM veterans represent a notable minority of those seeking treatment in association with MST and do not appear at greater risk for discontinuation from trauma-focused treatment.

Keywords: Military sexual trauma; posttraumatic stress disorder; sexual and gender minority; treatment retention.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Cognitive Behavioral Therapy
  • Female
  • Humans
  • Implosive Therapy
  • Male
  • Middle Aged
  • Military Personnel / psychology
  • Military Sexual Trauma
  • Sexual Trauma* / psychology
  • Sexual Trauma* / therapy
  • Sexual and Gender Minorities* / psychology
  • Stress Disorders, Post-Traumatic* / psychology
  • Stress Disorders, Post-Traumatic* / therapy
  • Survivors / psychology
  • Veterans* / psychology