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基于体感疗法的治疗小组,用于照料和治疗对性别多元身份的生物心理社会影响

Somatic Experiencing Informed Therapeutic Group for the Care and Treatment of Biopsychosocial Effects upon a Gender Diverse Identity.

作者信息

Briggs Paul C, Hayes Sage, Changaris Michael

机构信息

Healing Concepts, LLC, Hollywood, FL, United States.

Embodied Liberation, South Portland, ME, United States.

出版信息

Front Psychiatry. 2018 Feb 27;9:53. doi: 10.3389/fpsyt.2018.00053. eCollection 2018.

Abstract

BACKGROUND

Somatic Experiencing (SE™) is a resiliency-based treatment for autonomic nervous systems dysregulation syndromes, such as posttraumatic stress disorder, anxiety, depression, and physical syndromes like chronic pain, migraines, and fibromyalgia. "Transgender/gender non-conforming/gender variant" describes people whose gender identity/expression is different, at least part of the time, from the sex assigned at birth. Research indicates transgender individuals have a higher incidence of depression, anxiety, victimization, and discrimination. SE™ tools may support transgender/gender non-conforming individuals to increase resilience in the face of discrimination and social injustice.

METHODS

This study is a pretest posttest within group ( = 7) pilot study assessing the impact of a 10 session SE™ based group treatment on depression (PHQ-9), anxiety (GAD-7), somatic symptoms (PHQ-15), quality of life (QoL) (WHOQoL-BREF), and coping with discrimination (CDS) for a cohort of seven individuals identifying as transgender/gender non-conforming. Materials were created in collaboration with members of the LGBTQIA community. Care was taken to be inclusive of gender non-conforming identities and culturally responsive in design.

RESULTS

Participants described their gender identities as: non-binary, female to male, male to female, and gender fluid. Participants had significant increase in psychological QoL (psychological well-being) (WHOQoL-BREF)  = 0.004, SD = 2.31, with a modest effect size of  = 0.71. Some likely impacts of historical effect discussed. No other clinical or QoL outcomes were statistically significant. However, one outlier was identified in the dataset. When this outlier was excluded there was a trend toward significant reduction in depression symptoms (PhQ-9)  = 0.097, SD = 3.31 and a modest effect size of  = 0.68; somatic symptoms (PhQ-15)  = 0.093, SD = 3.52 and a modest effect size of  = 0.72.

CONCLUSION

These data indicate that a brief 10 session intervention of SE™ could have a meaningful impact on symptoms of depression, somatization, and QoL for gender non-conforming individuals. Further research is warranted.

LIMITATIONS

First, this study has a small sample size limiting statistical power and generalizability. Second is a history effect. Less than 1 week prior to final data collection, there was a significant hate-motivated act in Florida targeting the LGBTQIA community.

摘要

背景

体感疗法(SE™)是一种基于恢复力的治疗方法,用于治疗自主神经系统调节障碍综合征,如创伤后应激障碍、焦虑症、抑郁症以及慢性疼痛、偏头痛和纤维肌痛等身体综合征。“跨性别者/性别不一致者/性别变异者”指的是那些性别认同/表达至少在部分时间与出生时被指定的性别不同的人。研究表明,跨性别者患抑郁症、焦虑症、受侵害和受歧视的发生率更高。SE™工具可能有助于跨性别者/性别不一致者在面对歧视和社会不公时增强恢复力。

方法

本研究是一项组内前测后测(n = 7)的试点研究,评估为期10节的基于SE™的团体治疗对7名自我认定为跨性别者/性别不一致者的队列在抑郁(PHQ - 9)、焦虑(GAD - 7)、躯体症状(PHQ - 15)、生活质量(QoL)(WHOQoL - BREF)以及应对歧视(CDS)方面的影响。材料是与LGBTQIA群体成员合作创建的。在设计过程中注意包容性别不一致的身份,并具有文化适应性。

结果

参与者将他们的性别认同描述为:非二元性别、女变男、男变女和性别流动。参与者的心理生活质量(心理健康)(WHOQoL - BREF)有显著提高(p = 0.004,标准差 = 2.31,效应量适中,为0.71)。讨论了历史效应的一些可能影响。没有其他临床或生活质量结果具有统计学意义。然而,数据集中发现了一个异常值。排除这个异常值后,抑郁症状(PhQ - 9)有显著减轻的趋势(p = 0.097,标准差 = 3.31,效应量适中,为0.68);躯体症状(PhQ - 15)(p = 0.093,标准差 = 3.52,效应量适中,为0.72)。

结论

这些数据表明,为期10节的简短SE™干预可能对性别不一致者的抑郁、躯体化症状和生活质量产生有意义的影响。有必要进行进一步的研究。

局限性

首先,本研究样本量小,限制了统计效力和普遍性。其次是历史效应。在最终数据收集前不到1周,佛罗里达州发生了一起针对LGBTQIA群体的重大仇恨动机行为。

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