Intimate partner violence is a pervasive social problem with potentially severe mental health and functional consequences consistent with PTSD. Shelters provide an integral resource for battered women in that they provide emergency shelter, support, and access to community resources that can aid in their establishing long- term safety for themselves and their children. However, recent research suggests that symptoms of PTSD can compromise battered women's ability to access and effectively use these vital personal and social resources, emphasizing the importance of initiating PTSD treatment at this time. Despite the fact that annually 300,000 battered women and children access shelter services, and domestic violence shelters provide a prime time to initiate psychological treatment, virtually no research has systematically investigated the psychological treatment of PTSD in sheltered battered women. We have already developed a shelter-based treatment for battered women with PTSD or subthreshold PTSD, Helping to Overcome PTSD through Empowerment (HOPE). HOPE is a brief cognitive-behavioral treatment that emphasizes stabilization and empowerment, goals consistent with the theoretical and empirical literature on battered women and PTSD. Although preliminary research supports the initial feasibility and efficacy of the shelter version of HOPE, it also demonstrates that battered women continue to suffer from significant symptoms of PTSD, multiple safety concerns, continued deficits in access to and effective use of resources, and multiple ongoing secondary stressors immediately after they leave the shelter. These findings suggest that more extensive treatment and treatment that facilitates a successful transition from the shelter to the community is indicated. Thus, in this research plan we propose to modify and expand HOPE to include post-shelter sessions and to test the initial acceptability, feasibility, and efficacy of this expanded version of HOPE in battered women with PTSD or subthreshold PTSD. The proposed research plan will be divided into two major phases: 1) a development phase in which we will modify and expand HOPE and gain clinical experience with this expanded version of HOPE, and 2) a randomized pilot study phase in which we will test the feasibility and initial efficacy of the expanded HOPE in a group of sheltered battered women with PTSD or subthreshold PTSD (N = 60), and compare this group to women who receive standard care. Primary hypotheses are that women who receive the expanded HOPE will show greater reductions in symptoms of PTSD, greater effectiveness in obtaining community resources, and fewer losses of personal and social resources than will women who receive standard care. Secondary hypotheses are that women who receive the expanded HOPE will show greater reductions in symptoms of depression; greater improvement in psychological empowerment, social functioning, and social support; as well as less revictimization than women who receive standard care. To our knowledge our proposed research program represents the first attempt to develop and empirically evaluate a comprehensive treatment for sheltered battered women with PTSD. HOPE is designed to decrease battered women's emotional suffering and to help them to more effectively use the personal and social resources required to establish long-term safety for themselves and their children. HOPE is manualized and easily portable, and thus can potentially provide a national model of treatment for sheltered battered women with PTSD. ? ? ?
| Johnson, Dawn M; Johnson, Nicole L; Perez, Sara K et al. (2016) Comparison of Adding Treatment of PTSD During and After Shelter Stay to Standard Care in Residents of Battered Women's Shelters: Results of a Randomized Clinical Trial. J Trauma Stress 29:365-73 |
