Therapy for victims and survivors with PTSD

About this review

This preliminary Intervention Review is based on 0 systematic reviews and 8 primary studies.

The review draws on the best available impact evaluation evidence. The research was selected against set selection criteria and is based on a rigorous and comprehensive search and screening process. It does not necessarily reflect all evidence on the intervention, and further materials on this intervention are listed under References and Further Reading.

See the Recovery and Healing Evidence and Gap Map to explore similar interventions. For detail about the individual studies, see the Included Studies section. For further information about the methods informing this review, please see the Intervention Review Technical Report (forthcoming).

Suggested citation: ANROWS. (2023). Cognitive behavioural therapy for victims and survivors with PTSD. Evidence Portal Intervention Review. ANROWS.

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Date Created: 28 June, 2023
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At a glance

Intervention

Therapeutic approaches such as cognitive behavioural therapy (CBT) and cognitive processing therapy (CPT) delivered in groups or individually

Key populations

Adult victims and survivors of intimate partner violence or non-partner sexual abuse, who have post-traumatic stress disorder (PTSD) or trauma symptoms

Outcomes studied

Gender-based violence, health, social and material support, wellbeing and emotions

Impact of the intervention

Of the 6 studies, 3 outcomes received an effectiveness rating on our Effectiveness Estimate Tool

Australian Evidence

0 studies presented findings from Australia. 0 studies reported on the experiences of Aboriginal and Torres Strait Islander people

Risk of bias

Of the studies with available quantitative data, we rated 3 as low or very low, 5 as moderate and 3 as high or very high risk of bias via our Risk of Bias tool

Intervention description

Therapy for victims and survivors with PTSD aims to help this group to recover and heal from intimate partner violence and/or non-partner sexual violence.

Therapeutic approaches target participants who have been diagnosed with PTSD or PTSD symptoms, and generally follow a set program for a number of weeks that either uses cognitive behavioural therapy (CBT) or cognitive processing therapy (CPT) to change outcomes for victims and survivors.

This intervention is delivered by therapists and registered psychologists. Most interventions were delivered face-to-face in person, but some include online components.

Some studies combined therapy with standard services (e.g., usual shelter services) or other treatments (e.g., aerobic exercises).

Therapy sessions often cover: psychoeducation, normalising common reactions to trauma, cognitive restructuring, teaching skills to recognise and address symptoms (e.g., breathing techniques).



What does the intervention involve?
Where is the intervention set?

Commonly delivered in women's shelters, crisis centres, and community mental health services

How is the intervention delivered?

Most delivered the intervention in person. Some delivered it live online (video call/live chat)

How frequently is the intervention delivered?

Studies varied in frequency, but most offered weekly sessions. The number of weeks ranges from 4 to 17

What resources and costs are involved?

0 studies comment on costs associated with the intervention

Theory of change

How is the intervention designed or theorised to work?

Many of the studies argue that given the connection between intimate partner violence and PTSD, incorporating a trauma- and violence-informed lens for victims and survivors has the potential to enhance the efficacy of existing therapies (e.g., CBT).

Trauma-focused CBT treatments, for example, are hypothesised to produce change via altering negative trauma-related cognitions.

Impact

This section speaks to the effectiveness of the studies.

The outcomes measured by the included studies include gender-based violence (specifically intimate partner violence and non-partner sexual violence), mental health (general psychological distress, anxiety, depression, PTSD, and cognitive functioning), wellbeing (feelings of empowerment), and social support (presence of support and satisfaction with support).

Six studies with very low, low, or moderate risk of bias with appropriate outcome data were used for the effectiveness estimates. The outcomes that these studies measured are intimate partner violence, depression, and PTSD.

✅ = Most systematic reviews and studies show effectiveness
🟢 = Most studies show effectiveness
🟨= Most systematic reviews and studies show no effect
🟡 = Most studies show no effect
⛔= Potentially harmful
🔵 = Mixed evidence
✖ = Insufficient causal evidence
🕓 = Not yet rated

Effectiveness rating
Outcome
Description

PTSD

Most studies (n = 5) show reduced PTSD, and report that the intervention was effective for reducing PTSD at the six-month mark post-intervention.

Depression

Exercise caution! Potential for increased depressive symptoms. One study showed a statistically significant harmful effect for depression.

IPV

Most studies (n = 2) show reduced intimate partner violence, and report that the intervention was effective for reducing PTSD at the six-month mark post-intervention.

Key Populations

Has the impact of this intervention been tested with certain key populations?

This review assessed the impact of the evaluation on adult victims and survivors who had experienced intimate partner violence and/or non-partner sexual violence. It was a condition of eligibility that these participants had also experienced PTSD or trauma symptoms.

The interventions were not targeted towards any specific cultural or ethnic groups.

Some studies included participants who were studying at university, parents, and had other mental illness (e.g., depression symptoms).

The table below gives an overview of whether or not the intervention was examined with some key populations. The inclusion of these populations was guided by the National Plan to End Violence against Women and Children 2022-2032 and the Australian National Research Agenda to End Violence against Women and Children: 2023-2028.

🔴 = no studies
🟡 = at least 1 study mentions that population, but effectiveness wasn't tested with that population
🟢 = at least 1 study tests effectiveness with the population

Population What do we know about this group? Degree of knowledge
Aboriginal and Torres Strait Islander communities

0 studies. The appropriateness of this intervention with this population has not yet been established. Therefore, we cannot confirm the applicability of this intervention to this population

Sexuality and gender diverse / LGBTIQA+

0 studies. The appropriateness of this intervention with this population has not yet been established. Therefore, we cannot confirm the applicability of this intervention to this population

Specific age groups (including older people, children and young people)

0 studies. The appropriateness of this intervention with this population has not yet been established. Therefore, we cannot confirm the applicability of this intervention to this population

Culturally and racially marginalised (CARM) groups

0 studies. The appropriateness of this intervention with this population has not yet been established. Therefore, we cannot confirm the applicability of this intervention to this population

Migrants and refugees

0 studies. The appropriateness of this intervention with this population has not yet been established. Therefore, we cannot confirm the applicability of this intervention to this population

People with disability

0 studies. The appropriateness of this intervention with this population has not yet been established. Therefore, we cannot confirm the applicability of this intervention to this population

Key considerations

What do we know about the intervention in Australia?

What should Australian stakeholders consider?

Included studies

Characteristics of primary studies included in the Intervention Review
Study and location Design Intervention Sample Outcome categories
Smith et al. (2014), United States Quasi-experimental study with a control group
Qualitative data: No
Cognitive behavioural therapy plus group aerobic exercise sessions N=14 women who had experienced intimate partner violence Mental health, gender-based violence
Ferrari et al. (2018), United Kingdom Randomised controlled trial
Qualitative data: No
Specialist psychological advocate + usual care advocate support N=263 women who had experienced intimate partner violence Mental health, gender-based violence
Moreira et al. (2020), Portugal Randomised controlled trial
Qualitative data: No
Manualised cognitive-narrative program for IPV victims N=23 women who had experienced intimate partner violence Mental health, wellbeing and emotions, social and material support, gender-based violence
Johnson et al. (2011), United States Randomised controlled trial
Qualitative data: No
Helping to Overcome PTSD through Empowerment (HOPE) N=70 women who had experienced intimate partner violence Mental health, wellbeing and emotions, social and material support, gender-based violence
Johnson et al. (2016), United States Randomised controlled trial
Qualitative data: No
Helping to Overcome PTSD through Empowerment (HOPE) N=60 women who had experienced intimate partner violence Mental health
Jackson et al. (2020), Canada Qualitative study Trauma and Violence Informed CBT N=3 women who had experienced intimate partner violence Parenting, mental health, wellbeing and emotions, social and material support
Echeburúa et al. (2014), Spain Quasi-experimental study with a control group
Qualitative data: No
Combined individual and group cognitive behavioural therapy N=116 women who had experienced intimate partner violence Mental health, social and material support
Beck et al. (2016), United States Single group pre-post study
Qualitative data: No
Cognitive Trauma Therapy for Battered Women (CTT-BW) N=14 women aged 25-55. Mental health

References and further reading

id="opening"> Included Studies



Additional resources and further reading