Nicotera, N., Connolly, M. M., Jawdat, L., & Ostrow, L. (2024). A qualitative study examining the lived experiences of stress among female sexual assault survivors in an 8-week trauma-sensitive yoga intervention. Traumatology, 30(2), 153–163. https://doi.org/10.1037/trm0000411
Key Takeaways
- Focus: The study explored the lived experiences of stress among female sexual assault survivors participating in an 8-week trauma-sensitive yoga (TSY) intervention.
- Aims: The research aimed to examine how sexual assault survivors rated and described their experiences of stress during the TSY group.
- Findings: Participants’ experiences were categorized into three main themes: stress, sense of well-being, and group effects, with various subthemes. Participants described diverse stressors, including everyday challenges, emotions, and trauma-related triggers, while also reporting experiences of coping, relaxation, and connection to their body and mind.
- Implications: The findings suggest that TSY interventions can provide a supportive space for sexual assault survivors to process stress, connect with their bodies, and develop coping mechanisms.
Rationale
The study is justified by the high prevalence of sexual assault and the need for effective interventions to address its impact on survivors.
Research suggests that trauma can manifest physically in the body, highlighting the potential value of body-based therapies like trauma-sensitive yoga (TSY) intervention.
TSY has shown promise in mitigating trauma-related symptoms, but there is limited qualitative research on participants’ experiences, particularly regarding stress.
This study aimed to fill this gap by examining the lived stress experiences of sexual assault survivors in an 8-week TSY intervention.
The findings contribute to a deeper understanding of how TSY interventions can support survivors in managing stress and promoting well-being.
Method
Procedure
The study employed a qualitative approach using data collected as part of a larger mixed-methods study
Participants were 23 women enrolled in an 8-week TSY group called Being in Your Body: Yoga Therapy and Mindfulness Group (BIB).
The group was co-facilitated by a licensed clinician and a registered yoga teacher.
At the beginning and end of each session, participants completed a check-in/check-out worksheet, rating their stress level on a scale of 0 to 10 and providing a written rationale for their rating.
The study focused on analyzing these written rationales to understand participants’ stress experiences throughout the intervention.
The study employed a constant comparative approach to analyze the qualitative data. This method involves continuously comparing data units to identify patterns and develop themes.
The analysis was conducted in Atlas-ti, a qualitative data analysis software.
Sample
The sample consisted of 23 women who had experienced sexual assault.
The average age of participants was 29 years. The majority identified as White (78.6%), followed by multiracial (10.7%) and Latina (7.1%).
A small percentage (3.6%) did not report their ethnic-racial identities.
Participants were recruited from the community and enrolled in an 8-week TSY group called Being in Your Body: Yoga Therapy and Mindfulness Group (BIB).
Results
The analysis of participants’ written rationales revealed three main themes:
1. Stress
This theme captured the various stressors that participants reported experiencing before and after the yoga sessions. It encompasses four subthemes:
- Everyday Stressors: These were common stressors related to daily life, such as work, school, relationships, finances, and traffic. One participant shared, “I had a stressful day at work.”
- Emotional Stress: This subtheme included experiences of anxiety, sadness, anger, and overwhelm. A participant described feeling “stressed about my emotions.”
- Extraordinary Stressors: These were significant life events or challenges that caused stress, such as court hearings, medical appointments, and trauma-related triggers. One participant mentioned feeling “stressed about an upcoming court date.”
- Stress Pile-Up: This subtheme represented the accumulation of various stressors, creating a sense of being overwhelmed or burdened. A participant explained, “I have a lot of things going on right now, and it’s all piling up.”
2. Sense of Well-being
This theme reflected participants’ experiences of coping with stress, practicing self-care, and developing new awareness. It includes eight subthemes:
- Coping Mechanisms: This subtheme described participants’ strategies for managing stress, such as exercise, meditation, and spending time with loved ones. One participant stated, “I’m feeling stressed, but I’m handling it.”
- Self-Care Activities: This subtheme included activities that participants engaged in to nurture their well-being, such as taking baths, reading, and spending time in nature. A participant shared, “I took a long bath to relax.”
- Feeling Good: This subtheme captured experiences of positive emotions, such as happiness, contentment, and gratitude. A participant expressed feeling “happy and grateful for my life.”
- Taking Action: This subtheme described participants’ proactive efforts to manage stress and improve their well-being, such as using breathwork to regulate emotions or setting boundaries in relationships. One participant mentioned, “I used my breathwork to calm down when I felt triggered.”
- Letting Go of Worries: This subtheme reflected participants’ ability to release worries and concerns, allowing them to feel more present and at ease. A participant stated, “I’m letting go of my worries and focusing on the present moment.”
- Relaxation: This subtheme captured experiences of physical and mental relaxation, such as feeling calm, grounded, and at peace. A participant described feeling “relaxed and rejuvenated.”
- Connection to Body: This subtheme described participants’ experiences of feeling more connected to their bodies, such as increased body awareness, acceptance, and appreciation. One participant shared, “I feel more connected to my body and its sensations.”
- New Awareness: This subtheme reflected participants’ development of new insights and understandings about themselves, their experiences, and their coping mechanisms. A participant expressed, “I’m becoming more aware of my emotions and how they affect my body.”
3. Group Effects
This theme emerged only in post-session data and described how the group experience influenced participants’ stress levels. It includes three subthemes:
- Processing Emotions and Experiences: This subtheme captured participants’ experiences of sharing their emotions and experiences with the group, receiving support and validation from others, and gaining new perspectives. A participant shared, “It was helpful to talk about my experiences with the group.”
- Integrating Skills and Concepts: This subtheme described participants’ ability to apply the skills and concepts learned in the group to their daily lives, such as using breathwork to manage stress or practicing self-compassion. One participant mentioned, “I’m using the skills I learned in the group to cope with stress.”
- Managing Trauma-Related Triggers: This subtheme reflected participants’ experiences of managing trauma-related triggers within the group setting, such as feeling safe and supported to process difficult emotions and experiences. A participant stated, “I felt safe to share my trauma with the group.”
Insight
This study provides valuable insights into the lived experiences of stress among sexual assault survivors participating in a TSY intervention.
The findings highlight the diverse stressors that survivors may face, including everyday challenges, emotional distress, and trauma-related triggers.
Importantly, the study also reveals that TSY can offer a supportive space for survivors to process stress, connect with their bodies, and develop coping mechanisms.
The study extends previous research by examining stress experiences throughout the TSY intervention, rather than just at the end.
This longitudinal perspective allows for a deeper understanding of how stress and coping mechanisms evolve over time within the context of TSY.
The findings suggest that TSY interventions can facilitate not only stress reduction but also personal growth and new awareness among survivors.
Future research could explore the long-term effects of TSY on stress and well-being in sexual assault survivors.
It would also be beneficial to investigate how different TSY program components and facilitator characteristics contribute to participant experiences.
Clincial Implications
The findings have implications for practitioners working with sexual assault survivors.
TSY can be a valuable addition to trauma-informed care, providing a body-based approach to address stress and promote well-being.
Practitioners should consider incorporating TSY or referring survivors to TSY programs.
It is essential to ensure that TSY interventions are trauma-sensitive and tailored to the unique needs of sexual assault survivors.
Policymakers can also use these findings to inform the development of trauma-informed services and policies.
Supporting the integration of TSY into existing healthcare and mental health systems can increase access to this beneficial intervention for sexual assault survivors.
Implementing TSY interventions may present challenges, such as the need for specialized training for facilitators and addressing potential financial barriers for participants.
However, the potential benefits of TSY in promoting stress management, coping skills, and overall well-being for sexual assault survivors make it a worthwhile investment.
Strengths
- Qualitative Approach: Allows for in-depth exploration of participants’ subjective experiences.
- Longitudinal Data Collection: Provides insights into the dynamic nature of stress experiences over time.
- Trauma-Sensitive Intervention: Ensures the safety and appropriateness of the intervention for sexual assault survivors.
Limitations
- Small Sample Size: May limit the generalizability of findings.
- Homogeneous Sample: The majority of participants were White, which may not reflect the experiences of diverse sexual assault survivors.
- Self-Reported Data: May be subject to recall bias or social desirability effects.
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Socratic Questions
- How might the qualitative approach of this study have influenced the findings compared to a quantitative approach?
- What are some potential alternative interpretations of the findings, and how might future research address them?
- How could the study’s findings be applied to develop more effective trauma-informed yoga interventions for diverse populations of sexual assault survivors?
- What ethical considerations should practitioners be aware of when implementing TSY interventions with sexual assault survivors?
- How might the findings inform the development of public health policies aimed at addressing the impact of sexual assault on individuals and communities?
