A pilot study of the feasibility and preliminary outcomes of sequential TF-CBT and EMDR online group therapy for adult women with histories of childhood sexual abuse

Background: CSA is associated with post-traumatic stress disorder (PTSD), dissociation, emotion-regulation difficulties and psychopathology. Trauma-focused cognitive behavioral therapy (TF-CBT) and eye movement desensitization and reprocessing (EMDR) are evidence-based interventions, but their sequential delivery in online groups for women with CSA-related complex trauma remains underexplored. Objective: To examine feasibility and preliminary clinical outcomes of a 16-session online group intervention combining TF-CBT and EMDR Group Traumatic Episode Protocol (G-TEP), and to explore differences by sequence (EMDR → CBT vs. CBT → EMDR). Methods: = 4). Assessments at baseline (T1), T2, and T3 included PTSD (EGS-R), dissociation (DES), psychopathology (SCL-90-R), emotion regulation (DERS), self-esteem (RSES), life satisfaction (SWLS), and treatment satisfaction (CRES-4). Non-parametric tests and effect sizes were used. An illustrative case was included. Results: The intervention showed descriptive improvements across domains, including PTSD symptoms, dissociation, and psychopathology, with improved self-esteem and life satisfaction. However, most statistical tests were non-significant, consistent with the exploratory nature of the small sample. Effect sizes indicated variability across sequences: EMDR → CBT showed larger effects in phobic anxiety and self-esteem, whereas CBT → EMDR showed larger effects in dissociation. Findings indicate exploratory sequence-related patterns rather than definitive treatment effects. Conclusion: Sequential online delivery of TF-CBT and EMDR G-TEP appears feasible among completers, although substantial attrition limits feasibility. Findings are preliminary and require confirmation in future controlled studies.