"We really need this": Trauma-informed yoga for Veteran women with a history of military sexual trauma

Abstract

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: Military sexual trauma; Mindfulness; PTSD; Veterans; Women; Yoga.

Figure 1.

Changes in PTSD and depressive symptoms from pre- to post-treatment (12 weeks), and changes in negative affect from pre- to post-yoga class (averaged across all classes attended), by participant. Note that Kathleen was in an 8-week cohort. * Kimberly was in exposure therapy for PTSD at T2, underlying her PTSD symptom increase and potentially contributing to her stable depressive symptoms. **Nicole is a daily yoga practitioner and this may have contributed to ceiling effects on symptom severity assessments.

Figure 2.

Changes in emotion dysregulation, internalized shame, and mindfulness from pre- to post-treatment (12 weeks), by participant. Note that Kathleen was in an eight-week cohort. **Nicole is a daily yoga practitioner and this may have contributed to ceiling effects on affect dysregulation.