Please select the eligibility criteria that correspond to the clinical trial below.
Title: Connecting Women to Care: Home-based Psychotherapy for Women With MST Living in Rural Areas
Brief Summary: Military sexual trauma (MST) is a common duty-related stressor which occurs among one in four female Veterans and is associated with substantial concerns about social isolation and high rates of PTSD. Women with MST also experience numerous person-level barriers to care including the desire to avoid male-dominated VA clinics, transportation difficulties and childcare responsibilities. Treatment programs that address the social and mental health needs of this population and acknowledge barriers to care that disproportionately affect women are lacking. The proposed study will use a hybrid effectiveness-implementation design to evaluate the in-home delivery of a gender-sensitive, evidence-based coping skills program to improve social and role functioning as well as reduce PTSD and will prioritize enrolling rural women in a representative manner. If the program is found to be successful at improving social functioning and PTSD, and in reducing barriers to care, it will provide a tremendous benefit to women Veterans with MST, particularly those in rural areas.


Options:
A: Inclusion Criteria:

* 18 years of age or older,
* willing to undertake the qigong intervention program,
* available for all testing points,
* receptive to random allocation, and
* assessed to be abused by an intimate partner in the preceding year or longer, based on the Chinese Abuse Assessment Screen.

Exclusion Criteria:

* had participated in qigong training or other mind body intervention within the previous 6 months, or
* have serious medical conditions that might limit their participation in qigong exercise (based on our previous experience, such conditions include cancer, severe obesity, narcolepsy, major depressive disorder, schizophrenia), or
* have psychiatric disorders, or
* use medication or other psychological intervention for stress, or
* are abused by someone who is not their intimate partner.
B: Inclusion Criteria:

* Veteran
* A positive screen for MST
* A positive PTSD screen defined as PC-PTSD cut-off of \> 3

Exclusion Criteria:

* Substance abuse not in remission for at least 3 months
* Current psychotic symptoms

  * unmedicated mania or bipolar disorder
  * prominent current suicidal or homicidal ideation
* Cognitive impairment indicated by chart diagnoses or observable cognitive difficulties
* Current involvement in a violent relationship defined as more than casual contact

  * e.g., dating or living with an abusive partner
C: Inclusion Criteria:

* Participants will be at least three months post-crime at the time of their participation and will have been diagnosed with PTSD. Participants will score at least a "3" on the CAPS symptom of sleep impairment. This score is indicative of clinically significant symptomatology on any PTSD symptom. There is no upper limit on time since the trauma for participation.

Exclusion Criteria:

* Exclusion criteria for participants include psychosis, mental retardation, active suicidality, parasuicidality, or current addiction to drugs or alcohol. In the case of apparent illiteracy, we will try to accommodate the individual as much as possible to maximize success in the program. In addition, participants cannot be in a currently abusive relationship or being stalked. For marital rape or domestic violence, the participant must have been out of the relationship for at least three months. Participants can have received any therapy in the past with the exception of CPT. They may be receiving concurrent therapy as long as it is not trauma-focused. Allowing subjects to continue with concurrent therapy offers them the option to continue with established supports and more closely mimics clinical practice and the generalizability of the results. Participants will be asked to monitor and adhere to several behaviors that significantly impact sleep and may introduce error into the study aims. Inability or unwillingness to comply the the following will constitute exclusion criteria: Participants will be asked not to increase sleep medications, but to continue usual practice. This usage will be monitored on a daily basis on the sleep diaries. Daytime sleeping or naps will be monitored on the daily diaries and used as an outcome measure as naps are utilized less and less frequently across time in a number of insomnia treatment studies. Participants will also be asked to keep alcohol consumption to no more than 14 servings per week with no more than 5 servings on any given day. We will also ask participants to consume no more than 500 mg of caffeine on a daily basis and to refrain from caffeine consumption after 6 pm. We will further ask participants to maintain their bedtime and rise time during the work week and to not vary these times by more than one hour on days off. Participants will record bedtime and rise time on their daily diaries. Participants will be asked to maintain these sleep-related behaviors for the duration of therapy - approximately 8-10 weeks.
D: Inclusion Criteria:

* Registered as an ED patient.
* Able to participate verbally in an English language interview.
* Able to participate cognitively in an English language interview.
* Heavy drinking as assessed by the AUDIT.
* Positive screen for Intimate Partner Violence in the past 3 months.

Exclusion Criteria:

* Intoxication at the time of screening.
* Cognitive impairment or psychosis identified on physical exam or chart review.
* Serious current medical illness or injury, defined as respiratory distress, hemodynamic instability, active vomiting, bleeding, labor, severe pain, or acute need for hospital admission.
* Suicidal or homicidal ideation by chart review or on the Danger Assessment Scale for all assessed patients.
* No identifiable residence or contact phone number.
* Under arrest at the time of ED visit.
* Non-English speaking.
* Previously enrolled in the study.

Answer: B