Utilizing the BEAR Therapeutic Group for Women with Interpersonal Violence to Reduce Suicidality and Enhance Self-Efficacy

In the United States, approximately 33% of women experience some type of sexual assault in their lifetime (Smith et al., 2017). Sexual violence can have a significant and lifelong impact on a women’s life. Women who experience sexual violence have high rates of mental health issues (e.g., depression, anxiety, substance abuse, PTSD), and sexual violence has been identified as a precipitating circumstance for suicide and a contributing factor to subsequent suicide and suicide attempts. Women who are victimized are at higher risk of subsequent victimizations, and with that, worsened well-being and an even higher suicide risk.

There are several empowerment programs that are effective in reducing the rates of sexual violence against women. Empowerment self-defense (ESD) training significantly reduces the risk of both attempted and completed sexual assault. Survivors of rape who participate in such training demonstrate decreases in PTSD symptoms and self-blame for past assaults. Increases in perceived self-efficacy is one of the positive outcomes of ESD work. Perceived self-efficacy is one’s beliefs about their competency and capabilities to perform and is a key factor of how people think, behave, feel, and motivate themselves and how they respond in various situations, including risky or traumatic situations. A positive assessment of one’s abilities (higher self-efficacy) appears to buffer individuals from posttraumatic distress, and separately, higher self-efficacy has been shown to be a proactive factor against suicidality in several populations.

In an effort to reduce the morbidity associate with sexual violence, the current study aims to test a novel therapeutic intervention for women who have a history of interpersonal trauma and currently endorse suicidal thinking or behavior. The Building Empowerment and Resilience (BEAR) Therapeutic program incorporates psychological skills, psychoeducation, and physical self-defense training, all within a therapeutic process. Our experience indicates that there will be a high level of interest from survivors of sexual violence who seek a more active intervention as they often continue to feel quite vulnerable with therapy alone. The program specifically addresses the effects of sexual assault and teaches skills for maintaining personal safety and for coping with unwanted thoughts, including suicidal thinking. All participants will enroll in the novel BEAR therapeutic group and are allowed to continue their current therapeutic interventions. The aims of this grant focus on whether we can demonstrate a reduction in suicidal ideation and an increase coping self-efficacy. Further, we will test the hypothesis that levels of coping self-efficacy partially mediates suicidality.

If the hypothesize relationship holds true, it will demonstrate a potential new avenue to address suicidality, that is by enhancing coping self-efficacy. This is important as higher self-efficacy is associated with a whole host of positive psychological outcomes and behaviors. Our longer-term goal is to more fully test our theoretical conceptualization of self-efficacy as a mediating factor of trauma symptoms and suicidality. In the future, we aim to examine the biological implications of our program on the stress response and threat detection systems.