Trauma-Informed Weight Lifting as an Adjunctive Intervention for Posttraumatic Stress Among Adolescents in Residential Treatment

Abstract

There is little research on the effects of weightlifting as an adjunctive embodiment-based intervention on posttraumatic stress symptoms among adolescents with complex trauma histories. Therefore, the present study sought to explore how a newly developed adjunctive embodiment-based intervention, Trauma-Informed Weight Lifting (TIWL), influenced participants’ self-reported posttraumatic stress and associated mental health symptoms. Twelve adolescents from two residential facilities participated in the current study. Seven participants engaged in a weekly, eight-week TIWL intervention. Following a participant preference approach, participants without a preference for engaging in TIWL were assigned to the treatment as usual (TAU) comparison condition (n = 5). Those who engaged in TIWL were compared to those in the TAU group. Posttraumatic stress and associated symptoms were measured with six validated self-report measures. Symptoms were assessed before participants started TIWL, mid-way through the intervention, at the end, at 4-week post-intervention follow-up. Posttraumatic stress symptoms and interoception were assessed weekly. Overall, TIWL appeared feasible and acceptable in an adolescent residential treatment setting based on participants’ attendance rate (87.5%) and ratings of helpfulness (Ms = 75.71–94.71). Although effects were not maintained at follow-up and demonstrated some mixed findings between the weekly and monthly outcomes, the present study provided overall evidence for the efficacy of TIWL in lowered posttraumatic stress (Mi-j = -3.39, t = -2.08, p = .04, dRM, pooled = 3.20), depression (F(4, 5.25) = 6.73, p = .03, dRM, pooled = 0.59), and stress symptoms (F(4, 5.04) = 9.76, p = .01, dRM, pooled = 0.05) and higher levels of interoception (Mi-j = 0.45, t = 0.73, p = .47, dRM, pooled = 0.18) at the last TIWL session compared to baseline. There was also a large difference (~1.32 SD) in arousal and reactivity symptom levels between the TIWL condition and the comparison condition, with greater differences in Week 1 to Week 8 scores for the TIWL condition. From baseline to the four-week post-intervention follow-up self-reported avoidance (Mi-j = 0.67, t = -0.50, p = .25, dRM, pooled = -0.39), arousal and reactivity (Mi-j = 3.21, t = 1.16, p = .15, dRM, pooled = -0.27) and derealization (Mi-j = 0.69, t = 1.01, p = .15, dRM, pooled = -0.30) posttraumatic stress symptoms were higher in the TIWL condition. Given that two of the seven TIWL participants dropped out after two sessions, posthoc exploratory analyses were conducted with them removed. These analyses showed lower posttraumatic stress (Mi-j = -11.28, t = -1.39, p = .11, dRM, pooled = 0.94), depression (Mi-j = -3.88, t = -1.27, p = .13, dRM, pooled = 0.64), anxiety (Mi-j = -2.24, t = -1.26, p = .12, dRM, pooled = 1.17) and stress (Mi-j = -4.45, t = -1.68, p = .08, dRM, pooled = 0.63) symptoms from baseline to follow-up. Therefore, the participants who received a minimum of seven sessions of TIWL reported improvements in their posttraumatic stress and associated mental health symptoms from baseline to follow-up with large effects. Researching the effects of TIWL and extending beyond the present pilot study (e.g., multiple trials starting at different time points, larger sample sizes, different doses, comparing TIWL to a standard weightlifting group) are warranted given the potential confounds that could not be controlled for here.