Cultural development and validation of a group-based Somatic Experiencing® intervention for Indonesian women survivors of sexual assault with PTSD symptoms: a mixed-methods study

Background: Sexual assault affects approximately 35.6% of women globally. In Indonesia, one in three women aged 15-64 has experienced physical and/or sexual violence, often resulting in post-traumatic stress disorder (PTSD). While evidence-based PTSD treatments exist, they often face limitations in cultural relevance and applicability in low-resource settings. Somatic Experiencing®, a body-oriented trauma therapy, has shown promise across diverse populations, yet remains underexplored among Indonesian women survivors. Objective: This study aimed to develop a culturally adapted, group-based SE® intervention tailored for Indonesian women survivors of sexual assault. Method: A mixed-method, cross-sectional design was employed for this Phase 1: Development and Cultural Validation Study. The development process followed the Generalized Model for Program Planning, encompassing needs assessment, goal setting, intervention design, module creation, translation, and cultural validation using the Cultural Relevance Questionnaire (CRQ). Expert reviewers provided both quantitative and qualitative feedback to refine linguistic, conceptual, and cultural fit. Results: = 4.60; 90%). Expert reviewers supported that the intervention aligned with key Indonesian cultural values, including collectivism, emotional restraint, and indirect communication. Conclusion: This study represents Phase 1 of a three-phase research program to establish a culturally grounded, group-based Somatic Experiencing® intervention for Indonesian women survivors of sexual assault. This Phase 1 study focuses exclusively on intervention development and expert-based cultural validation. With Phase 2 (feasibility and pilot) successfully completed and the Phase 3 RCT protocol published, the program provides a rigorous, sequential foundation for evaluating the clinical effectiveness of SE in low-resource, collectivist contexts. Feasibility, participant acceptability, and clinical effectiveness are addressed in subsequent phases of the research program.