Painful, but necessary: a qualitative process evaluation on patient experiences with modified prolonged exposure as early intervention after rape (the EIR study).

Background: Early trauma-focused cognitive behavioural therapy may help reduce post-traumatic stress symptoms in individuals recently exposed to sexual assault. In Norway, specialized Sexual Assault Centres (SACs) provide psychosocial support to survivors of sexual assault, yet the effectiveness of these services remains uncertain. The Early Intervention after Rape (EIR) study is a multisite randomized controlled trial evaluating the effectiveness of modified prolonged exposure therapy (mPE) compared to treatment as usual (TAU) in alleviating post-traumatic stress symptoms shortly after rape.Objective: This qualitative study explores patients' experiences with participating in the EIR study and receiving mPE as early psychosocial intervention at three SACs in Norway.Method: We interviewed 15 patients, 10 receiving mPE and five receiving TAU.Results: Thematic analysis revealed that patients found participation in the EIR study beneficial and meaningful, and that it was facilitated by a respectful and a trauma-competent research team. Patients favoured psychosocial support that directly addressed the traumatic event over non-specific focus on everyday concerns and recommended integrating mPE into the SAC's psychosocial support services.Conclusion: This study provides insights into the experiences of women receiving psychosocial support at SACs after recent sexual assault. It highlights clinical and practical challenges in implementing a novel intervention and conducting a multisite RCT, whilst at the same time identifying opportunities to enhance evidence-based support, ensuring alignment with survivors' preferences and recovery process.