Introduction Interventions such as Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT) have demonstrated efficacy for the treatment of post-traumatic stress disorder (PTSD) following military sexual trauma (MST). However, MST survivors report a number of logistical and social barriers that impede treatment engagement. In an effort to address these barriers, the Veterans Health Administration offers remote delivery of services using clinical video technology (CVT). Evidence suggests PE and CPT can be delivered effectively via CVT. However, it is unclear whether rates of veteran retention in PTSD treatment for MST delivered remotely is comparable to in-person delivery in standard care. Methods Data were drawn from veterans ( N = 171, 18.1% CVT-enrolled) with PTSD following MST who were engaged in either PE or CPT delivered either via CVT or in person. Veterans chose their preferred treatment modality and delivery format in collaboration with providers. Data were analysed to evaluate full completion (FP) of the protocol and completion of a minimally adequate care (MAC) number of sessions. Results FP treatment completion rates did not differ significantly by treatment delivery format. When evaluating receipt of MAC care, CVT utilizers were significantly less likely to complete. Kaplan–Meier analyses of both survival periods detected significant differences in attrition speed, with the CVT group having higher per-session attrition earlier in treatment. Discussion Disengagement from CVT-delivered treatment generally coincided with early imaginal exposures and writing of trauma narratives. CVT providers may have to take special care to develop rapport and problem-solve anticipated barriers to completion to retain survivors in effective trauma-focused interventions.

This study seeks to explore the role of preference in provider gender for treatment-seeking, survivors of military sexual trauma (MST) in a Midwestern VHA hospital setting. The subjects were one hundred ninety-seven veterans enrolled in care who endorsed a history of MST and agreed to referral for follow-up care related to concerns associated with their experiences. Patients indicated their preference, if any, for provider gender. Overall, 47.2% of participants requested a female clinician, less than 1% requested a male clinician (this group not further analyzed), and the remainder had no gender preference. Among women, 53.5% requested a female provider in contrast with 29.4% of men. The patient gender difference in provider gender preference was significant with a small-to-medium effect. The rate of attendance at evaluation appointments was 73.6%. Attendance rates were 74.6% and 70.6% for women and men respectively. Requesting a female provider was associated with an 80.2% attendance rate while those indicating no gender preference demonstrated a 67.6% attendance rate. This comparison was statistically significant though the magnitude of the effect was small. Incorporation of a screener for posttraumatic stress disorder symptoms from a screener did not significantly improve the models or interact with gender and provider preferences.The findings of this study clarify gender preferences among those articulating a desire for MST-related care and that articulating a provider gender preference, rather than patient gender, is associated with improved chance of attending scheduled follow-up care. These findings have important policy and clinical implications for the potential role of veteran preference in augmenting liaison to care.

Despite the high rates of military sexual trauma (MST) experienced by service members and veterans, little is known about how contextual features of the MST event or concurrent histories of other interpersonal traumas are associated with diverse clinical presentations. This study examined contextual factors of MST events (number of perpetrators, location of MST, relationship to perpetrator, location of MST) and dual history of interpersonal traumas (including sexual abuse or assault throughout the lifespan, repeated MST, and intimate partner violence) in relation to total symptoms and symptom clusters of Posttraumatic Stress Disorder (PTSD). MST involving multiple perpetrators was related to higher avoidance and hyperarousal. MST while combat-deployed was associated with higher hyperarousal. Veterans endorsing a history of partner violence presented with higher reexperiencing and avoidance. Recognition of phenotypic differences may assist providers in treatment planning and optimizing outcomes.

Despite the high rates of military sexual trauma (MST) experienced by service members and veterans, little is known about how contextual features of the MST event or concurrent histories of other interpersonal traumas are associated with diverse clinical presentations. This study examined contextual factors of MST events (number of perpetrators, location of MST, relationship to perpetrator, location of MST) and dual history of interpersonal traumas (including sexual abuse or assault throughout the lifespan, repeated MST, and intimate partner violence) in relation to total symptoms and symptom clusters of Posttraumatic Stress Disorder (PTSD). MST involving multiple perpetrators was related to higher avoidance and hyperarousal. MST while combat-deployed was associated with higher hyperarousal. Veterans endorsing a history of partner violence presented with higher reexperiencing and avoidance. Recognition of phenotypic differences may assist providers in treatment planning and optimizing outcomes.