Technology
Initial examination of DAHLIA: A fully-automated internet intervention for women survivors of sexual assault
Danielle R. Goodmann, Ph.D.
Postdoc
Palo Alto University
Palo Alto, California
Lisa M. Brown, Ph.D.
Professor
Palo Alto University
Palo Alto, California
Eduardo L. Bunge, Ph.D.
Professor
Palo Alto University
Palo Alto, California
Yan Leykin, Ph.D.
Professor
Palo Alto University
Palo Alto, California
Background: Worldwide, sexual assault is one of the most significant events that women can experience. Mental health syndromes that result following sexual assault are often pervasive and cause long-standing effects that adversely impact life functioning. Numerous barriers prevent women from accessing effective mental health treatment or resources. The internet serves as a confidential platform that increases the accessibility of mental health resources. This pilot study evaluates utilization, perceived helpfulness, and initial efficacy of Digital Aid to Help Life Improve after Assault (DAHLIA), a fully automated internet-based microinterventions website developed to help women improve mood, reduce distress, and improve functioning.
Methods: Participants were recruited via sexual violence support groups, online forums, and social media. Participants had to be 18 years of age and have experienced sexual assault in adulthood. Men were excluded from the study. To prioritize anonymity, only an email address was required to sign up. After completing brief demographic information and symptom screening, participants advanced to a menu where they could select from 8 microinterventions targeted at reducing psychological distress that follows sexual violence: Learning More (psychoeducation), Sleeping Better, Breathing Deeply, Finding Relaxation, Grounding Down (grounding exercise), Pleasant Activities, Goal Setting, and Creating Positivity (gratitude exercise). Emails were sent to encourage follow up completion and return visits.
Results: Sixty-eight individuals provided consent to participate in the study. Most participants visited the website only once, and the eight modules of DAHLIA were used 117 times. The number of modules used was not related to demographic or clinical variables. Participants rated modules as moderately useful; depression and age were inversely related to the perception of usefulness (p < .05). Modules designed to provide immediate relief (BD, FR, GD, CP) improved mood more than modules requiring activities outside of the intervention (LM, SB, PA, GS; F(1, 74) = 5.72, p</span> = .02, ƞ2 = 0.07).
Conclusion: Overall results indicate that DAHLIA is effective in improving mood, reducing distress, and is of interest to participants. Feedback indicated moderate satisfaction with modules. Both types of modules were similarly effective for reducing distress. Improvements in mood and distress were similar to those reported in prior research (Elefant et al., 2017). DAHLIA shows promise as an accessible online intervention to provide short-term symptom relief. The findings from this study can be utilized to inform the development and improvement of resources for those who have experienced sexual violence.