Resilience and Recovery After Intimate Partner Violence - Evaluation of the EMBER-IPV Protocol (EMBER-3)

The EMBER-protocol is an intervention used at the NCK clinic at Uppsala University Hospital with the purpose of helping women utilize their resilience and strengths in order to recover after intimate partner violence. This study is conducted in order to explore how health and resilience changes during the course of the EMBER-intervention. The participants are asked to complete questionnaires before, during and after the intervention.

Study Overview

• Status: Not yet recruiting
• Conditions: Intimate Partner Violence; Resilience, Psychological; Shame; Intimate Partner Violence Against Women; Domestic Abuse
• Intervention / Treatment: Behavioral: Biopsychosocial Resilience Intervention for Women Subjected to IPV

Detailed Description

Intimate partner violence (IPV) is a complex problem with extensive consequences for the individual as well as on a societal scale. In Sweden, there is a lack of accessible, cohesive, evidence-based models for biopsychosocial healthcare of survivors of IPV. A resilience-based intervention, the EMBER-protocol, has been developed at National Center for Knowledge on Men's Violence against Women (NCK) in Uppsala, Sweden. Based on cognitive behavior therapy and resilience research, the EMBER-protocol targets factors that have been found relevant for posttraumatic recovery and reorientation after IPV. The aim is to increase well-being and recovery, i.e. increase healthy functioning and reduce mental health symptoms in women who have been subjected to IPV. The protocol is conceptually divided into a stabilizing (A), a processing (B) and a reorienting (C) phase. This study is part of the EMBER-IPV-project, which purpose is to evaluate the effectiveness of the EMBER-protocol, focusing on phases A and C, which are carried out by midwives and nurses. The research question in EMBER-3 is:

How do the subjects´ self-assessed levels of the following variables change during the course of the intervention: Well-being, Resilience, Health (general, somatic, mental, sexual and social), Stress and Shame? Data will be collected by self-assessment questionnaires at start and completion of phase A, at start, after completion of 0, 2 and 4 group sessions in phase B, as well as 6 weeks and 6 months post-group-intervention in phase C. Data will be analyzed with t-test and mixed effects models.

• Study Type: Observational
• Enrollment (Estimated): 150

Contacts and Locations

• Study Contact: Name: Tove Filén, PhD-student; Phone Number: +46186170785; Email: tove.filen@nck.uu.se

Study Locations

• Sweden
  • Uppsala County
    • Uppsala, Uppsala County, Sweden, S-75185
      • Uppsala University Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

All patients at the NCK Outpatient Clinic for Women Subjected to Intimate Partner Violence or Sexual Abuse, Uppsala University Hospital who meet the eligibility criteria during the enrollment period will be asked to participate in the study.

Description

Inclusion Criteria:

• Women taking part of the EMBER intervention (phase A or C)
• Subjected to IPV within the past 2 years prior to enrollment

Exclusion Criteria:

• Ongoing severe intimate partner violence
• Ongoing severe substance abuse
• Severe mental health problems such as psychosis, suicidality

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort

Intervention / Treatment

Women Subjected to Intimate Partner Violence; Women who are enrolled at the NCK Outpatient Clinic at Uppsala University Hospital due to having been subjected to Intimate Partner Violence and Abuse within the past 2 years, taking part of the standard intervention at the clinic. The target is to have 100 participants in two different phases of the intervention (phase A and C). Due to the fact that not all patients who take part of phase A will continue to phase C, additional participants will be recruited in order to reach the goal of n=100 in each of the two phases.

Behavioral: Biopsychosocial Resilience Intervention for Women Subjected to IPV; A Resilience-Focused Intervention based on the Resilience Portfolio Model.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Well-Being	Participants complete the self assessment questionnaire Questionnaire of Wellbeing (scale 0-72 points, higher value indicates higher level of wellbeing) in connection to a visit at the NCK Outpatient Clinic. Change from pre to post is analyzed using t-test and mixed effects models.	Data collection intervention A at 0 weeks and at completion (approximately 12-20 weeks); intervention C at 2 weeks pre-group and at start, middle and end of group intervention (0, 2 and 4 weeks); follow-up 6 weeks and 6 months post-group-intervention.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Subjective General Health	Participants are asked to rate their general health on a thermometer-like scale with the same procedure as in EuroQuol5Dimensions (EQ5D; 0-100, higher value indicates better health). Change from pre to post is analyzed using t-test and mixed effect models.	Data collection intervention A at 0 weeks and at completion (approximately 12-20 weeks); intervention C at 2 weeks pre-group and at start, middle and end of group intervention (0, 2 and 4 weeks); follow-up 6 weeks and 6 months post-group-intervention.
Psychological Endurance	The self assessment questionnaire Psychological Endurance Scale (range 6-24, higher value indicates higher endurance) is administered to the participants in connection to their visit at the NCK Outpatient Clinic. Change from pre to post is analyzed with t-tests and mixed effect models.	Data collection intervention A at 0 weeks and at completion (approximately 12-20 weeks); intervention C at 2 weeks pre-group and at start, middle and end of group intervention (0, 2 and 4 weeks); follow-up 6 weeks and 6 months post-group-intervention.
Shame	Participants complete the self assessment questionnaire External and Internal Shame Scale (EISS; range 0.00-4.00, higher value indicates higher level of shame) in connection to a visit at the NCK Outpatient Clinic. Change from pre to post is analyzed using t-test and mixed effects models.	Data collection intervention A at 0 weeks and at completion (approximately 12-20 weeks); intervention C at 2 weeks pre-group and at start, middle and end of group intervention (0, 2 and 4 weeks); follow-up 6 weeks and 6 months post-group-intervention.
Depression	Participants complete the Patient Health Questionnaire-9 (PHQ-9; range 0-27, higher values indicate higher levels of depression) in connection to a visit at the NCK Outpatient Clinic. Change from pre to post is analyzed using t-test and mixed effects models.	Data collection intervention A at 0 weeks and at completion (approximately 12-20 weeks); intervention C at 2 weeks pre-group and at start, middle and end of group intervention (0, 2 and 4 weeks); follow-up 6 weeks and 6 months post-group-intervention.
Subjective Psychosocial Health	Participants are asked to rate their subjective psychosocial health on a visuoanalogue scale 100mm, in a composite measure with three items regarding how content the person has been with their mental, sexual and social health the past week. The Subjective Psychosocial Health measure has a range of 0-300 and three subscales of 0-100 each, higher value indicating better psychosocial health. Change from pre to post is analyzed using t-test and mixed effects models.	Data collection intervention A at 0 weeks and at completion (approximately 12-20 weeks); intervention C at 2 weeks pre-group and at start, middle and end of group intervention (0, 2 and 4 weeks); follow-up 6 weeks and 6 months post-group-intervention.
General Somatic Pain	Pain during past week is rated on a visuo-analogue scale 0-100mm . Higher value indicates higher pain. Change from pre to post is analyzed using t-test and mixed effects models.	Data collection intervention A at 0 weeks and at completion (approximately 12-20 weeks); intervention C at 2 weeks pre-group and at start, middle and end of group intervention (0, 2 and 4 weeks); follow-up 6 weeks and 6 months post-group-intervention.
Subjective General Health	Participants are asked to rate their general health on a thermometer-like scale with the same procedure as in EuroQuol5Dimensions (EQ5D; range 0-100, higher value indicates better health). Change from pre to post is analyzed using t-test and mixed effect models.	Data collection intervention A at 0 weeks and at completion (approximately 12-20 weeks); intervention C at 2 weeks pre-group and at start, middle and end of group intervention (0, 2 and 4 weeks); follow-up 6 weeks and 6 months post-group-intervention.
Social Support Seeking	The Social Support Seeking scale (range 6-24, higher value indicates higher level of social support seeking) is administered to patients in connection to their visit at the clinic. Change from pre to post is analyzed using t-test and mixed effects models.	Data collection phase A: at 0 weeks and at completion(approximately 12-20 weeks); phase C: 2 weeks pre-group and at start, middle and end of group intervention (0, 2 and 4 weeks); follow up: 6 weeks and 6 months post-group-intervention.
Subjective Social Support	The subject´s perception of social support available is measured by administering the Oslo Social Support Scale - 3 items (OSSS-3; range 3-14, higher value indicates higher level of perceived support) in connection to their visit at the clinic. Change from pre to post is analyzed using t-test and mixed effects models.	Data collection intervention A at 0 weeks and at completion (approximately 12-20 weeks); intervention C at 2 weeks pre-group and at start, middle and end of group intervention (0, 2 and 4 weeks); follow-up 6 weeks and 6 months post-group-intervention.
Meaningfulness	The subjects´ sense of meaningfulness is measured with the Meaningfulness Scale (range 0-20, higher value indicating higher levels of meaningfulness) in connection to their visit at the clinic. Change from pre to post is analyzed using t-test and mixed effects models.	Data collection intervention A at 0 weeks and at completion (approximately 12-20 weeks); intervention C at 2 weeks pre-group and at start, middle and end of group intervention (0, 2 and 4 weeks); follow-up 6 weeks and 6 months post-group-intervention.
Posttraumatic stress symptoms	Participants complete the National Stressful Events Survey PTSD Short Scale (NSESSS; range 0-36, higher values indicate higher levels of posttraumatic stress symptoms) in connection to a visit at the NCK Outpatient Clinic. Change from pre to post is analyzed using t-test and mixed effects models.	Data collection intervention A at 0 weeks and at completion (approximately 12-20 weeks); intervention C at 2 weeks pre-group and at start, middle and end of group intervention (0, 2 and 4 weeks); follow-up 6 weeks and 6 months post-group-intervention.
Subjective Stress	Subjective Stress is measured by the Single Item Stress Questionnaire (SISQ; range 1-5, higher value indicating more stress)	Data collection intervention A at 0 weeks and at completion (approximately 12-20 weeks); intervention C at 2 weeks pre-group and at start, middle and end of group intervention (0, 2 and 4 weeks); follow-up 6 weeks and 6 months post-group-intervention.

Collaborators and Investigators

• Sponsor: Uppsala University
• Investigators: Principal Investigator: Carolina Överlien, Professor, The National Centre for Knowledge on Men's Violence Against Women, Uppsala university

Study record dates

Study Major Dates

• Study Start (Estimated): May 1, 2026
• Primary Completion (Estimated): April 1, 2029
• Study Completion (Estimated): April 1, 2029

Study Registration Dates

• First Submitted: April 29, 2026
• First Submitted That Met QC Criteria: May 18, 2026
• First Posted (Actual): May 26, 2026

Study Record Updates

• Last Update Posted (Actual): May 26, 2026
• Last Update Submitted That Met QC Criteria: May 18, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: Intimate Partner Violence; Domestic Violence; gender-based violence; Shame; resilience intervention; Resilience, psychological; domestic violence exposure
• Other Study ID Numbers: EMBER-3

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No