Cochrane for Clinicians

Putting Evidence into Practice

Psychological Therapies for Women Who Experience Intimate Partner Violence

 

Am Fam Physician. 2021 Jun 1;103(11):661-662.

Author disclosure: No relevant financial affiliations.

Clinical Question

Are psychological therapies safe and effective for women who experience intimate partner violence (IPV)?

Evidence-Based Answer

Psychological therapies decrease depressive symptoms (standardized mean difference [SMD] = 0.24; 95% CI, 0.01 to 0.47) and anxiety symptoms (SMD = 0.96; 95% CI, 0.63 to 1.29). It is unclear if they improve self-efficacy (i.e., a belief in one's own ability to cope with challenging life situations), posttraumatic stress disorder symptoms, reexposure to IPV, or safety planning. No harmful effects were identified.1 (Strength of Recommendation: B, based on inconsistent or limited-quality patient-oriented evidence.)

Practice Pointers

IPV describes physical assault, sexual violence, psychological harm, or stalking by a current or former partner.2 One in three women reports having been a victim of IPV at some time.1 There is a higher incidence of depression, anxiety and phobias, posttraumatic stress disorder, and alcohol use disorder in women who have been abused by their partners.3

The authors of this analysis sought to determine whether psychological therapies benefit women who have experienced IPV.1 They included 33 randomized controlled trials (RCTs) and quasi-RCTs, with a total of 5,517 women 16 years and older; the average age of participants was 37 years. Most trials were conducted in high-income countries, including the United States (58%). The participants were recruited from health care, community, shelter, or refugee settings and had a wide range of education levels, relationship statuses, and ethnic backgrounds. An exception was socioeconomic status; 66% of participants were unemployed.

The psychological therapies in the study groups were mostly delivered face-to-face by staff with varied levels of training. The length of treatment ranged from two to 50 sessions. Control groups received usual care, which involved no treatment or delayed or minimal intervention. Depression was quantified using the Beck Depression Inventory, Center

Author disclosure: No relevant financial affiliations.

References

show all references

1. Hameed M, O'Doherty L, Gilchrist G, et al. Psychological therapies for women who experience intimate partner violence. Cochrane Database Syst Rev. 2020;(7):CD013017....

2. Centers for Disease Control and Prevention. Intimate partner violence. Accessed April 12, 2021. https://www.cdc.gov/violenceprevention/intimatepartnerviolence/index.html

3. World Health Organization; Pan American Health Organization. Understanding and addressing violence against women: intimate partner violence. 2012. Accessed April 12, 2021. https://apps.who.int/iris/bitstream/handle/10665/77432/WHO_RHR_12.36_eng.pdf?sequence=1

4. U.S. Preventive Services Task Force. Intimate partner violence, elder abuse, and abuse of vulnerable adults: screening. October 23, 2018. Accessed April 12, 2021. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/intimate-partner-violence-and-abuse-of-elderly-and-vulnerable-adults-screening

These are summaries of reviews from the Cochrane Library.

This series is coordinated by Corey D. Fogleman, MD, assistant medical editor.

A collection of Cochrane for Clinicians published in AFP is available at https://www.aafp.org/afp/cochrane.

 

 

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