Psychological advocacy towards healing (PATH): A randomized controlled trial of a psychological intervention in a domestic violence service setting
Experience of domestic violence and abuse (DVA) is associated with mental illness. Advocacy has little effect on mental health outcomes of female DVA survivors and there is uncertainty about the effectiveness of psychological interventions for this population. To test effectiveness of a psychologica...
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| Veröffentlicht in: | PloS one 2018-11, Vol.13 (11), p.e0205485-e0205485 |
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| creator | Ferrari, Giulia Feder, Gene Agnew-Davies, Roxane Bailey, Jayne E Hollinghurst, Sandra Howard, Louise Howarth, Emma Sardinha, Lynnmarie Sharp, Debbie Peters, Tim J |
| description | Experience of domestic violence and abuse (DVA) is associated with mental illness. Advocacy has little effect on mental health outcomes of female DVA survivors and there is uncertainty about the effectiveness of psychological interventions for this population.
To test effectiveness of a psychological intervention delivered by advocates to DVA survivors.
Pragmatic parallel group individually randomized controlled trial of normal DVA advocacy vs. advocacy + psychological intervention. Statistician and researchers blinded to group assignment. Setting: specialist DVA agencies; two UK cities. Participants: Women aged 16 years and older accessing DVA services.
Eight specialist psychological advocacy (SPA) sessions with two follow up sessions.
Primary outcomes at 12 months: depression symptoms (PHQ-9) and psychological distress (CORE-OM). Primary analysis: intention to treat linear (logistic) regression model for continuous (binary) outcomes.
263 women recruited (78 in shelter/refuge, 185 in community), 2 withdrew (1 community, control group; 1 intervention, refuge group), 1 was excluded from the study for protocol violation (community, control group), 130 in intervention and 130 in control groups. Recruitment ended June 2013. 12-month follow up: 64%. At 12-month follow up greater improvement in mental health of women in the intervention group. Difference in average CORE-OM score between intervention and control groups: -3.3 points (95% CI -5.5 to -1.2). Difference in average PHQ-9 score between intervention and control group: -2.2 (95% CI -4.1 to -0.3). At 12 months, 35% of the intervention group and 55% of the control group were above the CORE-OM -2clinical threshold (OR 0.32, 95% CI 0.16 to 0.64); 29% of the intervention group and 46% of the control group were above the PHQ-9 clinical threshold (OR 0.41, 95% CI 0.21 to 0.81).
64% retention at 12 months.
An eight-session psychological intervention delivered by DVA advocates produced clinically relevant improvement in mental health outcomes compared with normal advocacy care.
ISRCTN registry ISRCTN58561170 Original Research 3675/3750. |
| doi_str_mv | 10.1371/journal.pone.0205485 |
| format | Article |
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To test effectiveness of a psychological intervention delivered by advocates to DVA survivors.
Pragmatic parallel group individually randomized controlled trial of normal DVA advocacy vs. advocacy + psychological intervention. Statistician and researchers blinded to group assignment. Setting: specialist DVA agencies; two UK cities. Participants: Women aged 16 years and older accessing DVA services.
Eight specialist psychological advocacy (SPA) sessions with two follow up sessions.
Primary outcomes at 12 months: depression symptoms (PHQ-9) and psychological distress (CORE-OM). Primary analysis: intention to treat linear (logistic) regression model for continuous (binary) outcomes.
263 women recruited (78 in shelter/refuge, 185 in community), 2 withdrew (1 community, control group; 1 intervention, refuge group), 1 was excluded from the study for protocol violation (community, control group), 130 in intervention and 130 in control groups. Recruitment ended June 2013. 12-month follow up: 64%. At 12-month follow up greater improvement in mental health of women in the intervention group. Difference in average CORE-OM score between intervention and control groups: -3.3 points (95% CI -5.5 to -1.2). Difference in average PHQ-9 score between intervention and control group: -2.2 (95% CI -4.1 to -0.3). At 12 months, 35% of the intervention group and 55% of the control group were above the CORE-OM -2clinical threshold (OR 0.32, 95% CI 0.16 to 0.64); 29% of the intervention group and 46% of the control group were above the PHQ-9 clinical threshold (OR 0.41, 95% CI 0.21 to 0.81).
64% retention at 12 months.
An eight-session psychological intervention delivered by DVA advocates produced clinically relevant improvement in mental health outcomes compared with normal advocacy care.
ISRCTN registry ISRCTN58561170 Original Research 3675/3750.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0205485</identifier><identifier>PMID: 30481183</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Abuse ; Adolescent ; Adult ; Advocacy ; Aged ; Aggression ; Analysis ; Biology and Life Sciences ; Cities and towns ; Clinical trials ; Cognitive therapy ; Communities ; Counseling ; Depression (Mood disorder) ; Depression - physiopathology ; Depression - psychology ; Domestic violence ; Domestic Violence - psychology ; Effectiveness ; Epidemiology ; Female ; Health aspects ; Human rights ; Humans ; Intervention ; Intimate Partner Violence ; Longitudinal studies ; Male ; Masking ; Medical schools ; Medicine and Health Sciences ; Mental depression ; Mental disorders ; Mental Health ; Mental health care ; Mental health services ; Middle Aged ; Motivation ; Outcome and process assessment (Medical care) ; Post traumatic stress disorder ; Pragmatism ; Primary care ; Psychological aspects ; Psychological distress ; Psychological research ; Psychometrics ; Psychotherapy ; Public health ; Randomization ; Recruitment ; Regression analysis ; Regression models ; Research and Analysis Methods ; Sex crimes ; Social aspects ; Social Sciences ; Spouse Abuse - psychology ; Stress (Psychology) ; Stress Disorders, Post-Traumatic - physiopathology ; Stress Disorders, Post-Traumatic - psychology ; Survivor ; Systematic review ; Trauma ; Violence ; Women ; Young Adult</subject><ispartof>PloS one, 2018-11, Vol.13 (11), p.e0205485-e0205485</ispartof><rights>COPYRIGHT 2018 Public Library of Science</rights><rights>2018 Ferrari et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2018 Ferrari et al 2018 Ferrari et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c593t-21da10ca75f20f4de6cc98fd9a77653bcea5e1d4506feb77a2c6490c3d188e0c3</citedby><cites>FETCH-LOGICAL-c593t-21da10ca75f20f4de6cc98fd9a77653bcea5e1d4506feb77a2c6490c3d188e0c3</cites><orcidid>0000-0003-2881-4180 ; 0000-0002-7890-3926 ; 0000-0003-3071-9860 ; 0000-0002-2990-755X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6258512/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6258512/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27321,27901,27902,33751,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30481183$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ferrari, Giulia</creatorcontrib><creatorcontrib>Feder, Gene</creatorcontrib><creatorcontrib>Agnew-Davies, Roxane</creatorcontrib><creatorcontrib>Bailey, Jayne E</creatorcontrib><creatorcontrib>Hollinghurst, Sandra</creatorcontrib><creatorcontrib>Howard, Louise</creatorcontrib><creatorcontrib>Howarth, Emma</creatorcontrib><creatorcontrib>Sardinha, Lynnmarie</creatorcontrib><creatorcontrib>Sharp, Debbie</creatorcontrib><creatorcontrib>Peters, Tim J</creatorcontrib><title>Psychological advocacy towards healing (PATH): A randomized controlled trial of a psychological intervention in a domestic violence service setting</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Experience of domestic violence and abuse (DVA) is associated with mental illness. Advocacy has little effect on mental health outcomes of female DVA survivors and there is uncertainty about the effectiveness of psychological interventions for this population.
To test effectiveness of a psychological intervention delivered by advocates to DVA survivors.
Pragmatic parallel group individually randomized controlled trial of normal DVA advocacy vs. advocacy + psychological intervention. Statistician and researchers blinded to group assignment. Setting: specialist DVA agencies; two UK cities. Participants: Women aged 16 years and older accessing DVA services.
Eight specialist psychological advocacy (SPA) sessions with two follow up sessions.
Primary outcomes at 12 months: depression symptoms (PHQ-9) and psychological distress (CORE-OM). Primary analysis: intention to treat linear (logistic) regression model for continuous (binary) outcomes.
263 women recruited (78 in shelter/refuge, 185 in community), 2 withdrew (1 community, control group; 1 intervention, refuge group), 1 was excluded from the study for protocol violation (community, control group), 130 in intervention and 130 in control groups. Recruitment ended June 2013. 12-month follow up: 64%. At 12-month follow up greater improvement in mental health of women in the intervention group. Difference in average CORE-OM score between intervention and control groups: -3.3 points (95% CI -5.5 to -1.2). Difference in average PHQ-9 score between intervention and control group: -2.2 (95% CI -4.1 to -0.3). At 12 months, 35% of the intervention group and 55% of the control group were above the CORE-OM -2clinical threshold (OR 0.32, 95% CI 0.16 to 0.64); 29% of the intervention group and 46% of the control group were above the PHQ-9 clinical threshold (OR 0.41, 95% CI 0.21 to 0.81).
64% retention at 12 months.
An eight-session psychological intervention delivered by DVA advocates produced clinically relevant improvement in mental health outcomes compared with normal advocacy care.
ISRCTN registry ISRCTN58561170 Original Research 3675/3750.</description><subject>Abuse</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Advocacy</subject><subject>Aged</subject><subject>Aggression</subject><subject>Analysis</subject><subject>Biology and Life Sciences</subject><subject>Cities and towns</subject><subject>Clinical trials</subject><subject>Cognitive therapy</subject><subject>Communities</subject><subject>Counseling</subject><subject>Depression (Mood disorder)</subject><subject>Depression - physiopathology</subject><subject>Depression - psychology</subject><subject>Domestic violence</subject><subject>Domestic Violence - psychology</subject><subject>Effectiveness</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Health aspects</subject><subject>Human rights</subject><subject>Humans</subject><subject>Intervention</subject><subject>Intimate Partner Violence</subject><subject>Longitudinal studies</subject><subject>Male</subject><subject>Masking</subject><subject>Medical schools</subject><subject>Medicine and Health Sciences</subject><subject>Mental depression</subject><subject>Mental disorders</subject><subject>Mental Health</subject><subject>Mental health care</subject><subject>Mental health services</subject><subject>Middle Aged</subject><subject>Motivation</subject><subject>Outcome and process assessment (Medical care)</subject><subject>Post traumatic stress disorder</subject><subject>Pragmatism</subject><subject>Primary care</subject><subject>Psychological aspects</subject><subject>Psychological distress</subject><subject>Psychological research</subject><subject>Psychometrics</subject><subject>Psychotherapy</subject><subject>Public health</subject><subject>Randomization</subject><subject>Recruitment</subject><subject>Regression analysis</subject><subject>Regression models</subject><subject>Research and Analysis Methods</subject><subject>Sex crimes</subject><subject>Social aspects</subject><subject>Social Sciences</subject><subject>Spouse Abuse - psychology</subject><subject>Stress (Psychology)</subject><subject>Stress Disorders, Post-Traumatic - physiopathology</subject><subject>Stress Disorders, Post-Traumatic - psychology</subject><subject>Survivor</subject><subject>Systematic review</subject><subject>Trauma</subject><subject>Violence</subject><subject>Women</subject><subject>Young Adult</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>BHHNA</sourceid><sourceid>DOA</sourceid><recordid>eNptUk1vEzEUXCEQLYF_gMASl3JI8PfuckCKKqCVKtFDOVuO7U0cOXawN0Hhb_CHeUm2VYOqPTyvPTPvvdFU1VuCJ4TV5NMybXLUYbJO0U0wxYI34ll1TlpGx5Ji9vzR-ax6VcoSY8EaKV9WZwzzhpCGnVd_b8vOLFJIc290QNpuk9Fmh_r0W2db0MLp4OMcXdxO764-fkZTlHW0aeX_OItMin1OIcCxzx7oqUMarU8Ufexd3rrY-xThB96B7UrvDdr6FFw0DhVA-EPte2j2unrR6VDcm6GOqp_fvt5dXo1vfny_vpzejI1oWT-mxGqCja5FR3HHrZPGtE1nW13XUrCZcVo4YrnAsnOzutbUSN5iwyxpGgd1VL0_6q5DKmrwsyhKwCXMKRGAuD4ibNJLtc5-pfNOJe3V4SLludIZVgluzxLUtLZtXcMx57ppamIsk5zLlsPAo-rL0G0zWzlrwJKsw4no6Uv0CzVPWyWpaAShIHAxCOT0awMWqpUvxoWgo0ubYW5O5KHXh_-gT283oOYaFvCxS9DX7EXVVEgmCAAxoCZPoOCzbuUhAa7zcH9C4EeCyamU7LqHHQlW--jeD6P20VVDdIH27rE_D6T7rLJ_zdvtSg</recordid><startdate>20181127</startdate><enddate>20181127</enddate><creator>Ferrari, Giulia</creator><creator>Feder, Gene</creator><creator>Agnew-Davies, Roxane</creator><creator>Bailey, Jayne E</creator><creator>Hollinghurst, Sandra</creator><creator>Howard, Louise</creator><creator>Howarth, Emma</creator><creator>Sardinha, Lynnmarie</creator><creator>Sharp, Debbie</creator><creator>Peters, Tim J</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U3</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHHNA</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0003-2881-4180</orcidid><orcidid>https://orcid.org/0000-0002-7890-3926</orcidid><orcidid>https://orcid.org/0000-0003-3071-9860</orcidid><orcidid>https://orcid.org/0000-0002-2990-755X</orcidid></search><sort><creationdate>20181127</creationdate><title>Psychological advocacy towards healing (PATH): A randomized controlled trial of a psychological intervention in a domestic violence service setting</title><author>Ferrari, Giulia ; Feder, Gene ; Agnew-Davies, Roxane ; Bailey, Jayne E ; Hollinghurst, Sandra ; Howard, Louise ; Howarth, Emma ; Sardinha, Lynnmarie ; Sharp, Debbie ; Peters, Tim J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c593t-21da10ca75f20f4de6cc98fd9a77653bcea5e1d4506feb77a2c6490c3d188e0c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Abuse</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Advocacy</topic><topic>Aged</topic><topic>Aggression</topic><topic>Analysis</topic><topic>Biology and Life Sciences</topic><topic>Cities and towns</topic><topic>Clinical trials</topic><topic>Cognitive therapy</topic><topic>Communities</topic><topic>Counseling</topic><topic>Depression (Mood disorder)</topic><topic>Depression - physiopathology</topic><topic>Depression - psychology</topic><topic>Domestic violence</topic><topic>Domestic Violence - psychology</topic><topic>Effectiveness</topic><topic>Epidemiology</topic><topic>Female</topic><topic>Health aspects</topic><topic>Human rights</topic><topic>Humans</topic><topic>Intervention</topic><topic>Intimate Partner Violence</topic><topic>Longitudinal studies</topic><topic>Male</topic><topic>Masking</topic><topic>Medical schools</topic><topic>Medicine and Health Sciences</topic><topic>Mental depression</topic><topic>Mental disorders</topic><topic>Mental Health</topic><topic>Mental health care</topic><topic>Mental health services</topic><topic>Middle Aged</topic><topic>Motivation</topic><topic>Outcome and process assessment (Medical care)</topic><topic>Post traumatic stress disorder</topic><topic>Pragmatism</topic><topic>Primary care</topic><topic>Psychological aspects</topic><topic>Psychological distress</topic><topic>Psychological research</topic><topic>Psychometrics</topic><topic>Psychotherapy</topic><topic>Public health</topic><topic>Randomization</topic><topic>Recruitment</topic><topic>Regression analysis</topic><topic>Regression models</topic><topic>Research and Analysis Methods</topic><topic>Sex crimes</topic><topic>Social aspects</topic><topic>Social Sciences</topic><topic>Spouse Abuse - psychology</topic><topic>Stress (Psychology)</topic><topic>Stress Disorders, Post-Traumatic - physiopathology</topic><topic>Stress Disorders, Post-Traumatic - psychology</topic><topic>Survivor</topic><topic>Systematic review</topic><topic>Trauma</topic><topic>Violence</topic><topic>Women</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ferrari, Giulia</creatorcontrib><creatorcontrib>Feder, Gene</creatorcontrib><creatorcontrib>Agnew-Davies, Roxane</creatorcontrib><creatorcontrib>Bailey, Jayne E</creatorcontrib><creatorcontrib>Hollinghurst, Sandra</creatorcontrib><creatorcontrib>Howard, Louise</creatorcontrib><creatorcontrib>Howarth, Emma</creatorcontrib><creatorcontrib>Sardinha, Lynnmarie</creatorcontrib><creatorcontrib>Sharp, Debbie</creatorcontrib><creatorcontrib>Peters, Tim J</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Social Services Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Sociological Abstracts</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ferrari, Giulia</au><au>Feder, Gene</au><au>Agnew-Davies, Roxane</au><au>Bailey, Jayne E</au><au>Hollinghurst, Sandra</au><au>Howard, Louise</au><au>Howarth, Emma</au><au>Sardinha, Lynnmarie</au><au>Sharp, Debbie</au><au>Peters, Tim J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Psychological advocacy towards healing (PATH): A randomized controlled trial of a psychological intervention in a domestic violence service setting</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2018-11-27</date><risdate>2018</risdate><volume>13</volume><issue>11</issue><spage>e0205485</spage><epage>e0205485</epage><pages>e0205485-e0205485</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Experience of domestic violence and abuse (DVA) is associated with mental illness. Advocacy has little effect on mental health outcomes of female DVA survivors and there is uncertainty about the effectiveness of psychological interventions for this population.
To test effectiveness of a psychological intervention delivered by advocates to DVA survivors.
Pragmatic parallel group individually randomized controlled trial of normal DVA advocacy vs. advocacy + psychological intervention. Statistician and researchers blinded to group assignment. Setting: specialist DVA agencies; two UK cities. Participants: Women aged 16 years and older accessing DVA services.
Eight specialist psychological advocacy (SPA) sessions with two follow up sessions.
Primary outcomes at 12 months: depression symptoms (PHQ-9) and psychological distress (CORE-OM). Primary analysis: intention to treat linear (logistic) regression model for continuous (binary) outcomes.
263 women recruited (78 in shelter/refuge, 185 in community), 2 withdrew (1 community, control group; 1 intervention, refuge group), 1 was excluded from the study for protocol violation (community, control group), 130 in intervention and 130 in control groups. Recruitment ended June 2013. 12-month follow up: 64%. At 12-month follow up greater improvement in mental health of women in the intervention group. Difference in average CORE-OM score between intervention and control groups: -3.3 points (95% CI -5.5 to -1.2). Difference in average PHQ-9 score between intervention and control group: -2.2 (95% CI -4.1 to -0.3). At 12 months, 35% of the intervention group and 55% of the control group were above the CORE-OM -2clinical threshold (OR 0.32, 95% CI 0.16 to 0.64); 29% of the intervention group and 46% of the control group were above the PHQ-9 clinical threshold (OR 0.41, 95% CI 0.21 to 0.81).
64% retention at 12 months.
An eight-session psychological intervention delivered by DVA advocates produced clinically relevant improvement in mental health outcomes compared with normal advocacy care.
ISRCTN registry ISRCTN58561170 Original Research 3675/3750.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>30481183</pmid><doi>10.1371/journal.pone.0205485</doi><orcidid>https://orcid.org/0000-0003-2881-4180</orcidid><orcidid>https://orcid.org/0000-0002-7890-3926</orcidid><orcidid>https://orcid.org/0000-0003-3071-9860</orcidid><orcidid>https://orcid.org/0000-0002-2990-755X</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2018-11, Vol.13 (11), p.e0205485-e0205485 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2138604215 |
| source | Public Library of Science (PLoS) Journals Open Access; MEDLINE; DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry; Sociological Abstracts |
| subjects | Abuse Adolescent Adult Advocacy Aged Aggression Analysis Biology and Life Sciences Cities and towns Clinical trials Cognitive therapy Communities Counseling Depression (Mood disorder) Depression - physiopathology Depression - psychology Domestic violence Domestic Violence - psychology Effectiveness Epidemiology Female Health aspects Human rights Humans Intervention Intimate Partner Violence Longitudinal studies Male Masking Medical schools Medicine and Health Sciences Mental depression Mental disorders Mental Health Mental health care Mental health services Middle Aged Motivation Outcome and process assessment (Medical care) Post traumatic stress disorder Pragmatism Primary care Psychological aspects Psychological distress Psychological research Psychometrics Psychotherapy Public health Randomization Recruitment Regression analysis Regression models Research and Analysis Methods Sex crimes Social aspects Social Sciences Spouse Abuse - psychology Stress (Psychology) Stress Disorders, Post-Traumatic - physiopathology Stress Disorders, Post-Traumatic - psychology Survivor Systematic review Trauma Violence Women Young Adult |
| title | Psychological advocacy towards healing (PATH): A randomized controlled trial of a psychological intervention in a domestic violence service setting |
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