Our Recommendation
Saprea measures the right things and has compared them against a group that did not receive the program. In a published study of 986 adult women survivors of child sexual abuse, the four-day retreat reduced post-traumatic stress symptoms and increased wellbeing, social support, and coping self-efficacy, while a wait-list group measured over the same weeks showed no significant change on any of the four. Among retreat participants, post-traumatic stress symptoms were 37 percent lower and wellbeing 45 percent higher one year later.
Those are ultimate outcomes, measured with validated instruments, against a comparison group. That combination is what earns this organization a score of 90.
The comparison is real and it is weak, and the study’s own authors say so. Participants chose whether to join the wait-list rather than being randomly assigned. Only about 80 of the 608 wait-list members provided both measurements. And the wait-list was measured only across the roughly three weeks around the retreat, so the effects at three, six, and twelve months have no comparison at all. The authors write plainly that causal conclusions should not be drawn from the study.
The study was also not independent. The organization hired two of the three authors as contractors to design and analyze the study, and the third was an organization employee who helped with design and data collection. The paper discloses this in full and states that all analysis and interpretation were handled by the contracted authors, with organization staff agreeing to stay out of it.
What recommends Saprea is the combination: an organization that measured its participants for a year, built a comparison group, published the weaknesses of that comparison in the same paper, and later hired an outside firm to check its own satisfaction surveys because it suspected they were too positive. Saprea has about 6,000 alumni and an annual intake of roughly 500.
Saprea's Fierce Certification score is 90/100 points based on our criteria:
✔ Has Ultimate Outcome Goals (20 pts)
✔ Measures Intermediate Outcomes (15 pts)
✔ Measures Ultimate Outcomes (20 pts)
◪ Measures Intermediate and/or Ultimate Counterfactual (10 pts)
✔ Shows Continual Learning & Adaptation (25 pts)
The counterfactual earns half credit because every outcome compared against the wait-list is an ultimate outcome under our framework. Post-traumatic stress symptoms, wellbeing, social support, and coping self-efficacy, the last of which is agency over one’s own trauma responses, are all valued in themselves. We score self-efficacy as ultimate here for consistency with our other reviews.
The Social Problem
At least one in four girls and one in 20 boys in the United States experience child sexual abuse. In 80 percent of reported cases the child knows the person who abused them, and over half of survivors were abused by another juvenile. In Utah, where Saprea is based and where its evidence is most localized, 15.5 percent of surveyed adults report having been sexually abused as a child, and 19 percent of reported child abuse cases include sexual abuse.
What distinguishes this problem is that the harm continues for decades after the event. Survivors carry post-traumatic stress symptoms into middle age. They are at least three times more likely to attempt suicide later in life, one in five develop alcohol or illicit drug dependence by age 30, they are five times more likely to be hospitalized for a mental or physical health issue, they report fourteen or more days of poor mental or physical health per month, and nearly half are sexually revictimized in adulthood. Youth who were sexually abused are up to 40 percent less likely to graduate high school.
The economic cost is measurable and almost certainly understated. Researchers at Johns Hopkins estimated that the cases substantiated in a single year, 2015, will carry a lifetime economic burden of approximately $9.3 billion in health care, lost productivity, child welfare, special education, crime, and suicide costs. Because the estimate relies only on reported cases, the authors describe it as likely an underestimate.
The second half of the problem is silence. Adults who could intervene often do not know what to look for. Communities do not believe it is happening near them: a 2023 statewide study found that 40.8 percent of Utahns disagree and 24.6 percent are unsure that child sexual abuse is a problem in their state, despite reported cases running above the national average, and fewer than half believe it is preventable at all. Survivors themselves often go decades without telling anyone.
The Solution
Saprea works on two arms, aimed at the two halves of the problem.
The healing arm is built as a continuum. The Saprea Retreat is the flagship: a four-day intensive workshop for adult women survivors, free of charge, hosted in Utah, Georgia, and New York. Participants learn how trauma affects the brain, practice coping strategies, and take part in experiential and community-building activities including yoga, mindfulness, art journaling, and Muay Thai. Around the retreat sit an online course, a healing webinar, online support groups, and a library of free online healing resources in four languages, for survivors who are not ready for or cannot attend a retreat.
The organization frames the retreat as education rather than conventional therapy, though it is led by licensed clinicians. In 2018, the year studied, retreat staff included seven licensed clinicians alongside case managers, and each retreat hosted about 24 participants. Before the retreat launched in 2015, most child sexual abuse treatment was delivered through weekly individual or group psychotherapy. Saprea’s founders hypothesized that an intensive four-day format could reach survivors those models were not reaching, and the peer-reviewed study describes itself as the first published examination of retreat interventions for this population.
The prevention arm is aimed at parents and communities. Free prevention resources, a community education program enabling volunteers to teach in their own communities, and a substantial published research brief collection covering prevention, digital safety, emotional regulation, trafficking, sexting, and technology-facilitated abuse.
Mapped against a Theory of Change, the healing arm’s chain is short and tested: bring survivors together, teach them how trauma works and how to manage it, and trauma symptoms fall while wellbeing, social support, and confidence in coping rise. The short-term change is measured against a wait-list. The one-year persistence is measured without one.
Key Outputs
- More than 6,000 survivors have attended the retreat since its launch in 2015.
- 516 survivors attended in 2024, across 31 retreats in Utah, 5 in Georgia, and 1 in New York.
- 33 retreats were held in 2018, the year studied, with about 24 participants each.
- All services free of charge; survivors pay only their own travel.
- Online healing and prevention resources available in English, Spanish, French, and German.
- A published research brief collection covering nine topic areas with several hundred academic citations, made available to other organizations and the public.
- Formerly The Younique Foundation and Defend Innocence, consolidated under the Saprea brand.
Key Intermediate Outcomes
Reach and access. More than 6,000 survivors served since 2015, 516 in 2024, all free. The tiered structure, with a webinar and support groups for those not ready for a retreat, is a deliberate response to the access barrier.
Retention. In the 2018 study cohort, no treatment participant chose to leave the retreat early, and fewer than 1 percent were sent home for substance use, conduct, or illness. The authors note this as possible evidence that the retreat format reduces treatment dropout.
Participant assessment. A Net Promoter Score of 98 from 60 Decibels, which that firm’s co-founder described as truly exceptional, with 91 percent having recommended the retreat to someone else.
Statewide attitudinal baselines. Saprea has established measurable public-opinion baselines in Utah: 42.4 percent believing child sexual abuse is preventable, 40.8 percent disagreeing that it is a problem in the state.
No counterfactual information was found for any intermediate outcome.
Key Ultimate Outcomes
Four outcomes were measured with validated instruments and compared against a wait-list group. All four improved significantly for retreat participants, and none changed significantly for the wait-list.
| Outcome | Instrument | Change at 12 months | Effect size (Cohen’s d) |
|---|---|---|---|
| Coping self-efficacy | Coping Self-Efficacy Scale-7 | Up 19% | 1.14 |
| Wellbeing | World Health Organization Well-Being Index | Up 45% | 0.98 |
| Post-traumatic stress symptoms | PTSD Checklist for DSM-5 | Down 37% | 0.69 |
| Social support | ENRICHD Social Support Instrument | Up 5% | 0.20 |
The study is Ward, Wood, and Young (2020) in Research on Social Work Practice. It analyzed all 986 women who engaged with the 2018 retreats: 378 who attended and 608 who chose to join a wait-list. Retreat participants were surveyed six times, from two weeks before the retreat through twelve months after. Wait-list members were surveyed twice, at the same points as the retreat group’s pretreatment and postretreat surveys. Before the retreat, the two groups did not differ significantly on any outcome, age, or race.
How to read the comparison. The between-group effect sizes are large for coping self-efficacy and wellbeing, between medium and large for post-traumatic stress, and small for social support. Three limits apply, all stated by the authors. Participants self-selected into the wait-list. Only about 80 of the 608 wait-list members completed both surveys. And the wait-list covers only the weeks around the retreat, so the effects at three, six, and twelve months are compared against each participant’s own baseline, not against anyone else.
How the result compares. The authors note that group psychotherapy for adult survivors of childhood abuse shows an uncontrolled post-traumatic stress effect size of 0.78 in a published meta-analysis. The retreat’s 0.69 is in the same range, delivered in four days rather than twelve to eighteen weeks. That is the most defensible claim the evidence supports: comparable symptom reduction to established group therapy, in a much shorter format.
What the online course did and did not show. In 2018 the retreat was followed by an optional twelve-week online course. Fewer than 10 percent of participants took it, and participation did not significantly change outcomes, which the authors attribute to too few participants to tell. The study’s evidence is therefore for the four-day retreat on its own.
Why these are ultimate outcomes. Mental health, wellbeing, belonging, and agency over one’s own life are each valued in themselves. Coping self-efficacy measures a survivor’s belief that she can manage the effects of her trauma, which the organization explains plainly: symptom reduction means she is triggered less often, and coping self-efficacy means she can manage the triggers that still come.
The social support result deserves attention, not embarrassment. At an effect size of 0.20 it is small, it is statistically significant, and the organization publishes it in the same list as the others. A four-day retreat changes what a survivor knows and how she copes much more than it changes who is in her life, which is what you would expect and what the data shows.
Who was studied. The 2018 sample averaged 38 years old and was about 84 percent White. The authors caution against assuming the results apply to every survivor, and note that women drawn to a retreat format may differ from those who prefer weekly outpatient care.
Perceived transformation. 60 Decibels separately found more than 91 percent of participants reported a transformation in their life ranging from positive to significant and lasting.
Continual Learning & Adaptation
It built a comparison group into its first evaluation. Saprea’s 2018 study did not stop at measuring participants before and after. It also measured a wait-list over the same period, which is the step most program evaluations skip.
It published the weaknesses alongside the findings. The study states that participants self-selected, that only age and race were controlled for, that the sample was mostly White, and that causal conclusions should not be drawn. It calls for randomized trials and for direct comparisons with individual and group therapy.
It disclosed its role in the research in full. The paper’s conflict-of-interest statement names the organization as the employer of one author and the contractor of the other two, and describes the firewall placed between organization staff and the analysis.
It checked its own favorable data because it suspected the data was too favorable. Saprea’s education coordinator stated that the organization had fielded Net Promoter Score surveys with retreat participants before but suspected the responses were skewed because they were so overwhelmingly positive. So it commissioned 60 Decibels, an independent global measurement firm, to ask the same questions. The external result came back higher than the internal one.
It publishes the modest result next to the impressive one. Five percent social support beside 45 percent wellbeing, in the same list, in the annual report and the newsroom.
Research-informed practice was a stated commitment from the start. The research briefs collection opens by stating that the work began in 2015 with a goal of creating research-informed services, resources, and messaging, and invites readers to send information that would update the summaries.
Research changed the organization’s own language. The brief on minors who sexually harm others states that Saprea intentionally avoids the phrase “child-on-child sexual abuse” and the label “abusers,” because research shows labeling can increase harm and keep at-risk children from receiving help.
The service model expanded into a continuum. From a single retreat in 2015 to a retreat plus online course, a healing webinar, online support groups, and a resource library in four languages, each reaching survivors the retreat alone could not. Geographic expansion followed from Utah to Georgia to New York.
It rebranded to consolidate. The Younique Foundation and Defend Innocence became Saprea, with the Haven Retreat becoming the Saprea Retreat, and the organization published an explanatory piece for participants who would otherwise have lost track of it.
It evaluated prevention at population scale. Saprea conducted a statewide evaluation of sexual abuse prevention education in Utah kindergarten through sixth grade schools and shared the findings.
Further Reading
Organization Sources
- Saprea homepage - Mission framing and the problem statistics drawn from the literature.
- Saprea Retreat - Current program description and the 6,000-plus cumulative figure.
- Saprea, 2024 Annual Report - Source of the 516 survivors and the 31 Utah, 5 Georgia, and 1 New York retreat counts.
- Saprea, “Research on Selected Topics Revolving Around Child Sexual Abuse,” November 2024 - Nine research briefs with several hundred citations, source of the prevalence and impact statistics and of the terminology commitments.
- Saprea, Heal, Prevent, Community Education, and Understand the Issue
- Saprea, Annual Reports archive and Newsroom
- Saprea, “What Happened to The Haven Retreat?” - Source of the rebrand account and the 60 Decibels transformation finding.
Peer-Reviewed and Third-Party Evidence
- Ward, K. P., Wood, D. S., and Young, T. M. (2020), “Retreat Intervention Effectiveness for Female Survivors of Child Sexual Abuse,” Research on Social Work Practice 30(7): 760-769 - DOI 10.1177/1049731520921936. Quasi-experimental study of 986 adult female survivors, 378 in treatment and 608 in a self-selected wait-list, with treatment outcomes followed for twelve months. Source of all four outcome findings and effect sizes, the wait-list comparison and its limits, the 2018 retreat structure and online course uptake, the sample demographics, the group psychotherapy benchmark, and the conflict-of-interest disclosure.
- Saprea, “Saprea Retreat Featured in Third-Party Peer-Reviewed Study” - The organization’s announcement of the study and source of the percentage figures.
- Saprea, “Third-Party Research Validates Retreat Services Have Deep Impact” - Source of the 60 Decibels Net Promoter Score of 98, the 91 percent recommendation rate, and the organization’s account of why it commissioned the external survey.
- Utah Women and Leadership Project (2024), “Research Summary: Child Sexual Abuse.” Source of the 42.4 percent preventability figure and the 40.8 percent and 24.6 percent public perception findings.
- Saprea, statewide evaluation of sexual abuse prevention education in Utah kindergarten through sixth grade schools, referenced in the newsroom.
Field Context
- Letourneau, E. J., Brown, D. S., Fang, X., Hassan, A., and Mercy, J. A. (2018), “The economic burden of child sexual abuse in the United States,” Child Abuse & Neglect 79: 413-422 - DOI 10.1016/j.chiabu.2018.02.020. Source of the $9.3 billion lifetime economic burden of cases substantiated in 2015 and the authors’ note that it is likely an underestimate.
- Centers for Disease Control and Prevention, “About Child Sexual Abuse” - Source of the at least one in four girls and one in 20 boys prevalence figure.
Ratings and Background
- Stand Together, “Defying Taboo: Saprea Tackles the Unspoken Trauma of Childhood Sexual Abuse” - Source of the chief officer’s interpretation of the 37 percent figure.
Written by
