A Hybrid Effectiveness-Implementation Randomised Control Trial of the 'Left Write Hook' program for Adult Survivors of Child Sexual Abuse

The Left Write Hook intervention combines expressive writing and trauma-informed boxing. Left Write Hook is delivered via 8 x weekly 2-hour group-based sessions in a local sports centre or community room. Sessions are led by a Lead facilitator, and is assisted by an Assistant Facilitator, both of whom are survivors themselves Each session has two components; expressive writing and trauma-informed boxing. Peer-trainers guide participants to locate an empowered state, through stance, focus on punch, direction, and movement. Week 1 explains the program, introduces participants and establishes group safety. For Weeks 2-8, the first hour involves participants writing to prompts designed to reclaim their life narrative, with the option of sharing with the group. Prompts include ‘body’, ‘power’, ‘mind’, ‘healing is...’, ‘recovery’, ‘fighting back means...’ For the second hour, participants complete a trauma-informed group boxing session. This involves a warmup, technique session, drills, cool down and stretch. Each session ends with reflections. To monitor treatment adherence, session attendance will be recorded each week, Fidelity checklists which index all intervention components will also be completed by at the end of each intervention session by the Lead Facilitator, Assistant Facilitator and/or Boxing Coach, and two Participants (who will volunteer at the end of each session). Facilitators for the trial are recruited from those currently delivering Left Write Hook in the community (outside of the trial context, with Left Write Hook being a pre-existing community program). Past Left Write Hook participants, including those who have participated during the present trial, are invited to enrol in a 6-week, self-directed online training course to receive a certification in Trauma Informed Writing and Boxing Facilitation (also referred to as champion training). The training course involves six online modules that guide prospective champions through the essential components of facilitating a Left Write Hook program. Each module takes 3-4 hours to complete. Modules are comprised of a mix of multimedia resources, educational videos, group discussion boards, and assessments. Assessments include knowledge check-ins after each module, a digital portfolio to document skill development and learning (i.e. reflections on the benefits peer support, trauma-informed care, etc), a statement of practice as a trainer/coach, and a full day experiential class at the conclusion of the online training (approx 6 hours), where champions participate in a Left Write Hook session themselves then demonstrate practical skills learnt in the training (i.e. writing facilitation, warm ups, boxing combinations, etc). Training within the trial context is overseen by the research team. At the completion of the training program, collaborative discussion between the Head Trainer (an existing, experienced Left Write Hook facilitator) and trainee champions evaluates readiness to act as a Lead facilitator, or whether beginning as an Assistant Facilitator is preferable. Upon completion of the course, new facilitators can commence immediately and are shadowed by the Head Trainer for 1-2 sessions of their first Left Write Hook group. The Head Trainer supports confidence in delivering the intervention and provides personalised feedback on intervention delivery.