A dyadic telehealth intervention to prevent PTSD and promote recovery for sexual and gender minority survivors of bias-related victimization

PROJECT SUMMARY Research documents concerning rates of group-related violence among sexual minority (LGB) individuals. Further, group-related violence is associated with risk for development of a host of deleterious health outcomes, including posttraumatic stress disorder (PTSD), depression, anxiety, suicidality, and a number of physical health issues (e.g., poor perceived health, gastrointestinal complaints). To date, however, no intervention work has focused on preventing these deleterious health outcomes among LGB group-related violence survivors. We propose to refine a promising brief telehealth intervention for interpersonal trauma survivors (Community Enhancement and Recovery [CARE]) to be inclusive of the experiences of LGB group-related violence survivors and then evaluate its efficacy in preventing deleterious health outcomes (e.g., PTSD, depression) among LGB recent group-related violence survivors. CARE is a two-session intervention for violence survivors and their supporters (e.g., friends, family) that seeks to facilitate natural recovery by normalizing trauma reactions, encouraging survivors to utilize discussion of their trauma reactions with a trusted person as a coping strategy, discussing ways that supporters can initiate support conversations, and assisting supporters in providing helpful disclosure reactions to survivors. CARE also includes a workbook for survivors and supporters to facilitate helpful discussions of the survivor’s trauma reactions and to reinforce intervention skills. During the Adaptation and Planning Phase, we will refine the content of CARE for inclusivity of the experiences of LGB group-related violence survivors via ongoing feedback from a Community Advisory Board of LGB community advocates, individuals involved in advocacy for survivors of violence, and LGB group-related violence survivors involved in advocacy (Aim 1a) as well as conduct an open pilot trial of the CARE with 20 survivor-supporter dyads to further refine the CARE content and evaluate the feasibility and acceptability of research procedures and program implementation (Aim 1b). During the Evaluation phase, we will via a randomized controlled trial of LGB recent group-related violence survivors and their supporters (60 survivor-supporter dyads assigned to CARE and 60 survivor-supporter dyads to a waitlist), assess the acceptability and feasibility of CARE (Aim 2a) via program observations, post-session surveys (n = 120), and exit interviews (n = 20) with survivors and supporters. We will test CARE’s efficacy in improving survivor (e.g., PTSD, depression) and supporter (e.g., secondary trauma symptoms) outcomes (Aim 2b) via surveys completed at baseline, immediate post-test, and 6-month follow-up as well as a diagnostic interview. We also will evaluate mechanisms of change of CARE (e.g., supporter disclosure reactions, survivor coping self-efficacy) via evaluation of daily ecological momentary assessment (EMA) data collected from survivors and supporters during the intervention (Aim2c). We will recruit LGB recent group-related violence survivors from across the U.S. via social media advertisements, from LGB organizations, and from survivor advocacy offices.