Psychological therapies for women who experience intimate partner violence

摘要: Background Intimate partner violence (IPV) against women is prevalent and strongly associated with mental health problems. Women experiencing IPV attend services frequently for The World Health Organization recommends that who have experienced a diagnosis should receive evidence-based treatments. However, it not known if psychological therapies work in the context of whether they cause harm. Objectives To assess effectiveness experience on primary outcomes depression, self-efficacy an indicator harm (dropouts) at six- to 12-months' follow-up, secondary other symptoms, anxiety, quality life, re-exposure IPV, safety planning behaviours, use healthcare services, social support. Search methods We searched Cochrane Common Mental Disorders Controlled Trials Register (CCMDCTR), CENTRAL, MEDLINE, Embase, CINAHL, PsycINFO, three databases, end October 2019. also international trials registries identify unpublished or ongoing handsearched selected journals, reference lists included grey literature. Selection criteria randomised controlled (RCTs), quasi-RCTs, cluster-RCTs cross-over aged 16 years older self-reported recent lifetime IPV. co-existing diagnoses substance abuse issues, both. Psychological wide range interventions targeted cognition, motivation behaviour compared usual care, no treatment, delayed minimal interventions. classified according Disorders's list. Data collection analysis Two review authors extracted data undertook 'Risk Bias' assessment. Treatment effects were between experimental comparator short-term (up six months post-baseline), medium-term (six under 12 months, outcome time point), long-term follow-up (12 above). used standardised mean difference (SMD) continuous odds ratio (OR) dichotomous outcomes, random-effects meta-analysis, due high heterogeneity across trials. Main results 33 involving 5517 randomly assigned (2798 women, 51%) (2719 49%). 11 integrative therapies, nine humanistic cognitive behavioural therapy, four third-wave psychologically-orientated There as psychodynamic therapies. Most from high-income countries (19 USA, Iran, two each Australia Greece, one trial China, India, Kenya, Nigeria, Pakistan, Spain UK), among recruited healthcare, community, shelter refuge settings, combination any all these. mostly delivered face-to-face (28 trials), but varied by length treatment (two 50 sessions) staff delivering (social workers, nurses, psychologists, community family doctors, researchers). average sample size was 82 (14 479), 37 average, 66% unemployed. Half married living just over half participants had last (17 6% past trials) 42% during their trials). Whilst 20 (61%) described reliable low-risk random-sampling strategies, only (36%) procedures conceal allocation participant status. While 19 measured women's depression follow-up. These showed probable beneficial effect reducing (SMD -0.24, 95% CI -0.47 -0.01; trials, 600 women; moderate-certainty evidence). self-efficacy, there may be evidence groups -0.12, -0.33 0.09; data, 346 low-certainty Further, number dropped out intervention groups, (OR 1.04, 0.75 1.44; five 840 Although reported adverse events participation trial, using validated scale. For anxiety showing reduce symptoms -0.96, -1.29 -0.63; 158 within revealed 0.04, -0.18 0.25; 337 women), post-traumatic stress disorder -0.54 0.06; 484 women) form 0.03, -0.14 0.2; 547 women). Authors' conclusions probably anxiety. we are uncertain improve (self-efficacy, disorder, planning) limited Thus, while emotional health, unclear needs safety, support holistic healing complex trauma addressed this approach. need more focused approaches rigorous (with consistent similar points), unable synthesise much research.