A 17-minute video shown during a forensic exam lowered acute stress. Fifty women took part.

Three-quarters of sexual assault survivors meet PTSD criteria a month later. A pilot trial tested a short video and a three-week text programme delivered at the forensic examination itself. Promising, and very small.

Three-quarters of sexual assault survivors meet criteria for PTSD one month afterwards, and the forensic medical examination is often the only moment the health system reliably has with them. Researchers led by Kate Walsh tested whether that moment could carry an intervention. In a pilot trial across four US sexual assault forensic examination programmes, women who had been assaulted within the past seven days were randomised at the examination either to a 17-minute video, teaching social support, mindfulness and gradual self-exposure to feared but safe situations, or to usual care. A week later, those still above threshold for acute stress or opioid misuse were randomised again, to a three-week daily text programme or not. Fifty women took part, average age 28.9. Those assigned the video had lower odds of acute stress, with an odds ratio of 0.13 and a confidence interval from 0.02 to 0.78. They also reported less pain at one week, 2.1 against 3.6. At four weeks the text programme was associated with lower pain scores and the video was not quite statistically so. The design is clever and the setting is the right one. The sample is fifty. A confidence interval running from 0.02 to 0.78 is consistent with an enormous effect or a small one, and in a trial this size the point estimate is the least reliable part of the result. Follow-up is four weeks, which cannot speak to PTSD at three months. This is what a pilot is for: it establishes that the thing can be delivered at all, and that a larger trial is worth running.