Individually tailored Internet-delivered cognitive-behavioral therapy for survivors of intimate partner violence: A randomized controlled pilot trial

Abstract

Intimate partner violence (IPV) is a serious public health concern worldwide and defined as behavior performed by spouses or other intimate partners that causes physical, sexual, or psychological harm. Internet-delivered cognitive-behavioral therapy (ICBT) may be particularly useful for survivors of IPV for several reasons, including barriers pertaining to limited community recourses and treatment availability, safety concerns, and issues of stigma, guilt and shame, which may prevent members of this population from seeking help via face-to-face interactions. However, Internet interventions are lacking. The primary aim of the present randomized controlled pilot trial was to explore the feasibility of ICBT as guided self-help individually tailored to the predominant symptomatology of PTSD or depression in survivors of IPV. A second aim was to conduct a preliminary evaluation exploring the short- and long-term effects of the treatment in comparison to a waitlist control condition. Results showed that the treatment was feasible. Attrition rate was low (9.4%), and participants were satisfied with treatment. However, treatment adherence was moderate in terms of completed modules (62.5%). Results of the preliminary evaluation of treatment effects showed large and statistically significant between-group effect sizes (Cohen's d = 0.86–1.08) on some measures of PTSD and depression at post assessment, favoring the treatment condition. However, there were no effects on other measures. At follow-up assessment, when the control condition had received delayed treatment, there were large and statistically significant within-group effect sizes ( d = 0.96–1.48) on measures of PTSD, depression and anxiety, and small effects ( d = 0.48) on a measure of quality of life. The results of the present pilot study are promising and warrant further research on ICBT for this population.

Cognitive-behavioral therapy for psychological harm in domestically abused women: systematic review and meta-analysis

“…A systematic review was conducted in which eight articles were selected to assess the current empirical evidence of CBT for the treatment of psychological harm in domestically abused women. To begin with, based on the articles selected according to the inclusion and exclusion criteria, the majority of publications have been conducted at the international level (87.5%) (Andersson et al, 2021;Graham-Bermann et al, 2019;Greene et al, 2019;Johnson et al, 2020;Latif et al, 2021;Orang et al, 2018;Osma et al, 2022), compared to the regional (12.5%) (Habigzang et al, 2018); however, at the national level, no studies addressing the proposed topic were found in the databases consulted up to the date of review. Possibly the absence of research in Ecuador on CBT in DV may be attributable to multiple factors such as the lack of funding (governmental or private) for intervention projects, the inexistence of a governing body that regulates the practice of psychotherapists (Guano & Costales, 2021) complete, or pay for a treatment, which will make it difficult to establish processes for research purposes.…”

“…Regarding psychotherapy, the selected research is based on CBT; in addition, each one presents particularities that differentiate them from each other. For example, the work conducted by Orang et al (2018) relies on narrative therapy and previous traumatic memories Indeed, all studies (Andersson et al, 2021;Graham-Bermann et al, 2019;Greene et al, 2019;Habigzang et al, 2018;Johnson et al, 2020;Latif et al, 2021;Orang et al, 2018), have focused on addressing PTSD, anxiety, or depression. This finding is similar with a recent systematic review in which all eleven selected studies identified and treated the mentioned pathologies using CBT (Petersen et al, 2019).…”

“…3, pp. 61 -83 , julioseptiembre 2022 cognitions to discuss and generate functional alternative thoughts (Andersson et al, 2021;Greene et al, 2019;Habigzang et al, 2018;Latif et al, 2021). Similarly, to treat the symptomatology of the associated pictures, one seeks to gradually expose traumatic memories for meaning reprocessing (Andersson et al, 2021;Habigzang et al, 2018;Latif et al, 2021;Orang et al, 2018); in addition, the aim is to train patients on cognitivebehavioral strategies for emotion regulation (Osma et al, 2022), conflict management and communication skills; finally, relapse prevention is sought through a maintenance plan or future project (reinforcement with community support services).…”

“…61 -83 , julioseptiembre 2022 cognitions to discuss and generate functional alternative thoughts (Andersson et al, 2021;Greene et al, 2019;Habigzang et al, 2018;Latif et al, 2021). Similarly, to treat the symptomatology of the associated pictures, one seeks to gradually expose traumatic memories for meaning reprocessing (Andersson et al, 2021;Habigzang et al, 2018;Latif et al, 2021;Orang et al, 2018); in addition, the aim is to train patients on cognitivebehavioral strategies for emotion regulation (Osma et al, 2022), conflict management and communication skills; finally, relapse prevention is sought through a maintenance plan or future project (reinforcement with community support services). The therapeutic techniques associated with the described objectives have been mentioned in greater detail in Table 1; however, it seems that the techniques of psychoeducation, cognitive restructuring, exposure (imaginary, narrative and invivo) and problem solving reinforce the existing evidence on their effectiveness in addressing the symptomatology associated with DV (Petersen et al, 2019).…”

“…), so culturally adapted CBT makes it possible for subjects from diverse cultures to benefit from a scientifically evidenced treatment (Rathod et al, 2019). Andersson et al (2021) proposed an individually tailored intervention to be delivered via the Internet. The results of the study showed a significant reduction in PTSD and depression symptomatology.…”