Cognitive behavioral treatment of PTSD in residents of battered women's shelters: results of a randomized clinical trial

Abstract

Objective: This study was designed to explore the acceptability, feasibility, and initial efficacy of a new shelter-based treatment for victims of intimate partner violence (IPV; i.e., Helping to Overcome PTSD through Empowerment [HOPE]).

Method: A Phase I randomized clinical trial comparing HOPE (n = 35) with standard shelter services (SSS) (n = 35) was conducted. Primary outcome measures included the Clinician-Administered PTSD Scale (CAPS; D. D. Blake et al., 1995) and the Conflict Tactic Scales-Revised (M. A. Straus, S. L. Hamby, S. Boney-McCoy, & D. B. Sugarman, 1996). Participants were followed at 1-week, 3- and 6-months postshelter.

Results: Participants reported HOPE to be credible and indicated a high degree of satisfaction with treatment. Only 2 women withdrew from treatment. Both intent to treat (ITT) and minimal attendance (MA) analyses found that HOPE treatment relative to SSS was significantly associated with a lower likelihood of reabuse over the 6-month follow-up period (OR = 5.1, RR = 1.75; OR = 12.6, RR = 3.12, respectively). Results of hierarchical linear model analyses found a significant treatment effect for emotional numbing symptom severity in the ITT sample, t(67) = -2.046, p < .05, and significant treatment effects for effortful avoidance symptom severity, t(49) = -2.506, p < .05, and arousal symptom severity, t(49) = -2.04, p < .05, in the MA sample. Significant effects were also found for depression severity, empowerment, and social support.

Conclusions: Results support the acceptability and feasibility of HOPE and suggest that HOPE may be a promising treatment for IPV victims in shelter. However, results also suggest that modifications to HOPE may be required to improve treatment outcomes.

Figures

Figure 1

CONSORT diagram of participant flow through the protocol. IPV= intimate partner violence; PTSD= posttraumatic stress disorder; wk = week; ps = post shelter.