What are the health and wellbeing outcomes of peer-led group-based interventions for adult survivors of sexual abuse and assault, and what are the experiences of participants using these groups?

Problem

Sexual assault and abuse (SA) are widespread, and are associated with short- and long-term physical and mental health problems. Multiple barriers exist to survivors disclosing, and to health practitioners asking about SA, and exploring whether appropriate support and treatment are being provided. Support and treatment options for survivors include peer-led support groups and 12-step approaches. While many systematic reviews address psychotherapies, limited evidence exists about the effects of peer-led support groups. We aimed to explore the published evidence for peer-led, group-based interventions, including the 12-step method, in the care of adult survivors of SA.

Approach

We undertook a systematic literature review involving electronic searches of seven large online health and social care databases. The review question was “What are the health and wellbeing outcomes of peer-led group-based interventions in the care of adult survivors who have experienced SA, and what are the experiences of participants using these groups?” Title and abstract screening was followed by full-text screening of relevant published material. Quality appraisal was completed using the Mixed Methods Appraisal Tool (MMAT). Results were reported by using a descriptive approach and thematic analysis with methods of constant comparison.

Findings

Initial searches identified 13,941 potentially relevant articles. 126 full texts were assessed and of these, eight met our study inclusion criteria and were selected for data extraction. Authors identified positive impacts of the various interventions delivered, relating to inclusion of the peer-process – an individual supporting another individual on the basis of a shared experience. This is reflected by the five overarching themes and twenty-three sub themes identified. These include positive psychological and interpersonal impacts; experiences of being part of the survivor group; mutuality and interconnectedness of benefit, pain and healing arising from participation; and issues concerning different models of peer groups.

Consequences

Evidence to support the use of peer-led group-based approaches amongst adult survivors of SA is limited. Given the scale of the problem and the vulnerable nature of the population, further research in the third sector where these groups are mostly run, is needed. This should involve robust studies designed to investigate the effectiveness of various approaches providing survivor peer support.