Background
Exposure to rape, sexual assault and sexual abuse has lifelong impacts for mental health and well‐being. Prolonged Exposure (PE), Cognitive Processing Therapy (CPT) and Eye Movement Desensitisation and Reprocessing (EMDR) are among the most common interventions offered to survivors to alleviate post‐traumatic stress disorder (PTSD) and other psychological impacts. Beyond such trauma‐focused cognitive and behavioural approaches, there is a range of low‐intensity interventions along with new and emerging non‐exposure based approaches (trauma‐sensitive yoga, Reconsolidation of Traumatic Memories and Lifespan Integration). This review presents a timely assessment of international evidence on any type of psychosocial intervention offered to individuals who experienced rape, sexual assault or sexual abuse as adults.
Objectives
To assess the effects of psychosocial interventions on mental health and well‐being for survivors of rape, sexual assault or sexual abuse experienced during adulthood.
Search methods
In January 2022, we searched CENTRAL, MEDLINE, Embase, 12 other databases and three trials registers. We also checked reference lists of included studies, contacted authors and experts, and ran forward citation searches.
Selection criteria
Any study that allocated individuals or clusters of individuals by a random or quasi‐random method to a psychosocial intervention that promoted recovery and healing following exposure to rape, sexual assault or sexual abuse in those aged 18 years and above compared with no or minimal intervention, usual care, wait‐list, pharmacological only or active comparison(s). We classified psychosocial interventions according to Cochrane Common Mental Disorders Group’s psychological therapies list.
Data collection and analysis
We used the standard methodological procedures expected by Cochrane.
Main results
We included 36 studies (1991 to 2021) with 3992 participants randomly assigned to 60 experimental groups (3014; 76%) and 23 inactive comparator conditions (978, 24%).
The experimental groups consisted of: 32 Cognitive Behavioural Therapy (CBT); 10 behavioural interventions; three integrative therapies; three humanist; five other psychologically oriented interventions; and seven other psychosocial interventions. Delivery involved 1 to 20 (median 11) sessions of traditional face‐to‐face (41) or other individual formats (four); groups (nine); or involved computer‐only interaction (six). Most studies were conducted in the USA (n = 26); two were from South Africa; two from the Democratic Republic of the Congo; with single studies from Australia, Canada, the Netherlands, Spain, Sweden and the UK. Five studies did not disclose a funding source, and all disclosed sources were public funding.
Participants were invited from a range of settings: from the community, through the media, fr...