Patient Care

Healing for Veteran Survivors of Sexual Trauma

Researchers find the Warrior Renew treatment program beneficial for veterans to improve their quality of life after sexual trauma.


According to a VA national screening program, about 1 in 4 female veterans has experienced a sexual assault of some type. Sexual trauma can lead to major depressive disorder (MDD) (some research suggests that 1 in 3 rape victims will have at least 1 period of MDD during their lives) and posttraumatic stress disorder (PTSD) with repeated thoughts of the assault, memories, nightmares, and increased arousal (eg, difficulty sleeping and concentrating).

Related: Update on Sexual Assault in the Military

The Warrior Renew treatment program can make a big difference to survivors of assault—particularly veterans, according to findings from recent studies. Warrior Renew, developed by Lori Katz, PhD, was designed specifically to address the “unique aspects” of military sexual trauma for both men and women. The program offers an integrated curriculum that helps participants develop coping skills for improving sleep; reducing anxiety, triggers, anger/resentment, and grief; resolving self-blame; and improving communication. By targeting trauma-related perceptions and feelings that may replicate themselves in relationships, the program also helps participants build a more positive self-perception and optimistic vision for the future, Katz says.

The program format consists of 90-minute “core” classes 4 days a week, adjunctive therapy classes (self-care, art therapy, yoga, relaxation), and recreational outings. Unlike other treatments for trauma, Warrior Renew does not have an exposure component. Instead, it’s grounded in the principles of holographic reprocessing (HR), an evidence-based treatment that helps participants identify emotional themes (such as feeling endangered) and interpersonal patterns. Participants also are taught skills for affect management and self-soothing, such as a technique of “cleansing breath, observation, positive self-talk, and explanation” (COPE) to calm the excitatory system.

Dr. Katz’s outcome studies have shown promising results, and most participants show “reliable” and sustained clinical change in anxiety, depression and posttraumatic negative cognitions, as well as significant increases in self-esteem, optimism, and satisfaction with life.

Related: Sexual Trauma in the Military

Katz also led a study to examine the change in “attachment style” in program graduates—that is, to find out whether they could learn to form healthier relationships. In this study, 62 veterans graduated the program over more than 2 years. Of those, 95% had been diagnosed with PTSD, 57% reported being in recovery from substance abuse, and 45% had considered suicide. Nearly all reported chronic medical conditions. The participants took the Relationship Scales Questionnaire and Brief Symptom Inventory pre- and posttreatment.

The graduates reported significant decreases in “fearful” and “dismissive” insecure attachment as perceived in relationships, with significant increases in “secure” attachment. Improved scores were significantly correlated with reported levels of symptoms of anxiety and depression.

A fourth study, still in review, evaluated the treatment protocol delivered in an outpatient therapy group for survivors of military sexual trauma at a VA medical center. Participants met twice a week to discuss topics such as coping with feelings, sleep and nightmares, and remembering trauma. Again, findings revealed significant reductions in symptoms of anxiety, depression, posttraumatic negative thinking, and PTSD.

Related: Recovering From Military Sexual Trauma

According to Dr. Katz, relating to others with less fear and avoidance while feeling more secure may translate into more engagement in activities and social interactions, supporting an “upward spiral” in healing.

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