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Psychological intervention helps women experiencing domestic abuse

Women experiencing domestic violence and abuse who received an eight-session psychological intervention delivered by trained domestic violence and abuse advocates showed greater reduction in symptoms of psychological distress, depression and post-traumatic stress than those who received advocacy alone, according to study findings published in PLOS One.

“Psychological interventions, such as counselling and cognitive behavioral therapy that are not adapted to the specific needs of domestic violence and abuse survivors often fail to meet their needs,” Giulia Ferrari, PhD, from Bristol Medical School, England, and colleagues wrote.

“In the United Kingdom, domestic violence advocacy or support is provided by a network of specialist [domestic violence and abuse] services,” they continued. “Given the contact that advocates have with women who have recently experienced [domestic violence and abuse] and their understanding of the context of abuse, they are a potential source of psychological support to survivors who seek help.”

Researchers compared normal domestic violence and abuse advocacy with advocacy plus psychological intervention in a parallel-group, individually randomized controlled trial to determine whether a psychological intervention delivered by advocates helped improve mental health outcomes in female survivors of domestic abuse.

Women aged 16 years and older accessing domestic violence and abuse services in the U.K. received eight sessions of specialist psychological advocacy with two follow-up sessions. Specialist psychological advocates were trained to work with common presenting problems including post-traumatic stress, depression, anxiety, low self-esteem, anger and managing loss, and received handouts and self-help resources to use with their clients. The investigators measured participants’ depression symptoms and psychological distress at 12 months.

Of 263 women recruited, 130 women received the intervention and 64% of participants made it to 12-month follow-up. At follow up, Ferrari and colleagues found that women who received the psychological intervention experienced greater improvement than those who received the advocacy alone.

On average, the results showed a 3.3-point lower Clinical Outcomes in Routine Evaluation–Outcome Measure score, which measured psychological distress, and a 2.2-point reduced Patient Health Questionnaire-9 score, which measured depressive symptoms, between the intervention and the control group at 12 months follow-up.

Overall, 35% of the intervention group vs. 55% of the advocacy alone group were above the clinical threshold for having psychological distress (OR = 0.32; 95% CI, 0.16-0.64) and 29% vs. 46% were above the clinical threshold for the depression symptoms (OR = 0.41; 95% CI, 0.21-0.81) at 12 months. In addition, participants receiving the psychological intervention had lower mean PTSD scores than those in the advocacy only group after 12 months.

“Our study provides the most rigorous evidence yet of the benefit to survivors of trauma-informed psychological support offered by domestic violence advocates,” Ferrari said in a press release. “We hope our findings will be used by policy makers and commissioners to invest in programs that make a real difference to women who experience domestic violence and abuse.” – by Savannah Demko

Disclosure: Ferrari reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.