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Legal redress can play a critical role in interrupting the pattern of domination and control inherent in intimate partner violence (IPV), yet it remains an infrequent strategy among battered women. The current study employed a contextual framework for investigating the correlates for engagement in the criminal justice system for a sample of 227 sheltered battered women. Results indicated that individual, relational, and system-level factors were all associated with two legal help-seeking behaviors: having a civil protection order and criminal prosecution. In particular, posttraumatic stress disorder (PTSD) symptomatology, social support, and prior experience with police officers were significant correlates for legal help-seeking. Results highlight the need for a coordinated community response to IPV, addressing both legal needs and psychological needs simultaneously. Keywords: intimate partner violence; criminal justice system; PTSD DOI: 10.1891/0886-6708.24.6.771

Do you feel overwhelmed when attempting to treat battered women with ongoing safety concerns? Could battered women in shelters benefit from psychotherapy in addition to the case management they traditionally receive? What type of treatment would be most beneficial for battered women in shelters? Posttraumatic stress disorder (PTSD) is the most prevalent disorder associated with intimate partner violence (IPV). PTSD is associated with severe impairment and loss of resources, which can severely impact a sheltered battered woman's ability to establish long-term safety for herself and her children. Consequently, we have developed a new treatment for sheltered battered women with PTSD, Helping to Overcome PTSD through Empowerment (HOPE). HOPE is a short-term cognitive-behavioral treatment in a preliminary stage of development for battered women with PTSD in domestic violence shelters. It focuses on stabilization, safety, and empowerment and teaches women skills to manage their PTSD symptoms that may interfere with their ability to access important community resources and establish safety for themselves and their children. A case example utilizing HOPE is offered. Future directions and clinical applications are discussed. Keywords: battered women, intimate partner violence, posttraumatic stress disorder (PTSD), cognitive-behavioral treatment, trauma

This article describes a brief, 12-week dialectical behavior therapy program modified for female victims of domestic abuse and provides a preliminary examination of this intervention. Dialectical behavior therapy is a comprehensive cognitive--behavioral treatment, which was originally developed to treat multiproblem clients with severe and chronic emotion dysregulation, and was adapted for this study to treat female victims of domestic abuse. From pretreatment to posttreatment, participants (N = 31) showed significant reductions in depressive symptoms, hopelessness, and general psychiatric distress as well as increased social adjustment. Additionally, participants reported high levels of consumer satisfaction with the treatment. Findings support the possible utility of dialectical behavior therapy for enhancing psychological and social well-being in female victims of domestic abuse. Keywords: domestic abuse, women victims, dialectical behavior therapy, group therapy, emotion regulation

Health professionals from two different clinical settings were asked about their comfort level in dealing with intimate partner violence (IPV). Focus groups and semistructured interviews were used to gather information. Staff in an obstetrics and gynecology setting relatively rich in IPV resources described feeling capable dealing with IPV. The staff in a general medicine setting dedicated to women's health but without a focus on IPV and with fewer supports described discomfort and difficulty dealing with IPV. Presence of systemic prioritization of and resources for IPV were described as contributing to the confidence in addressing the issue. Other necessary elements identified included (a) on-site resources, (b) adequate time, (c) focused IPV training, and (d) a team or systemic approach. Keywords: intimate partner violence; screening; barriers to care; health care system; coordinated care

Health care providers are advised to refer abused women to needed community services. However, little is known about abused women's perceived need for services, particularly among Latina women. We examined the relationship between intimate partner violence (IPV) and perceived needs for legal, social, and job services among a prospective cohort of 210 pregnant Latinas. IPV was associated with needing social and legal services at most time points. Women with recent IPV experiences reported greater service needs than women with more remote IPV experiences, who in turn reported greater need than women without IPV experiences. We conclude that IPV may be associated with ongoing perceived needs for social and legal services among Latina perinatal patients. Keywords: intimate partner violence; Hispanic health; community services; pregnancy

Items from the Emotional Support Subscale of the Bosch Support Measure were administered in a small survey of 56 formerly abused rural women in the midwestern USA. Maximum likelihood factor analyses were performed on a total of 21 items. A 5-factor solution appeared to produce the best results, but only 3 factors suggested viable subscales with Cronbach alphas greater than .80. Informal support networks in the rural areas studied here appeared to provide survivors of domestic violence with general emotional support to a greater extent than guidance on accessing professional resources and help.

The purpose of this experiment was to conduct a dismantling study of cognitive processing therapy in which the full protocol was compared with its constituent components--cognitive therapy only (CPT-C) and written accounts (WA)--for the treatment of posttraumatic stress disorder (PTSD) and comorbid symptoms. The intent-to-treat (ITT) sample included 150 adult women with PTSD who were randomized into 1 of the 3 conditions. Each condition consisted of 2 hr of therapy per week for 6 weeks; blind assessments were conducted before treatment, 2 weeks following the last session, and 6 months following treatment. Measures of PTSD and depression were collected weekly to examine the course of recovery during treatment as well as before and after treatment. Secondary measures assessed anxiety, anger, shame, guilt, and dysfunctional cognitions. Independent ratings of adherence and competence were also conducted. Analyses with the ITT sample and with study completers indicate that patients in all 3 treatments improved substantially on PTSD and depression, the primary measures, and improved on other indices of adjustment. However, there were significant group differences in symptom reduction during the course of treatment whereby the CPT-C condition reported greater improvement in PTSD than the WA condition. Keywords: cognitive processing therapy, posttraumatic stress disorder, interpersonal violence, cognitive behavioral therapy

Very little is known about what factors influence women's treatment preferences after a sexual assault. To learn more about these factors, data were collected from 273 women who read a standard 'if this happened to you, what would you do' scenario describing a sexual assault and subsequent trauma-related psychiatric symptoms. After reading standardized treatment options for a pharmacotherapy (sertraline) and a psychotherapy (cognitive behavioral treatment), participants made a hypothetical treatment choice and reported the main reasons for their choice. Women often cited reasons surrounding the effectiveness of a treatment as the primary reason for their treatment preference, suggesting potential masking of symptoms with the medication and more logical, long-lasting effects with the psychotherapy. Other common reasons underlying treatment preference were wariness of the medication and positive feelings about talking in psychotherapy. Better understanding factors that influence treatment preference may aid in refining psychoeducation materials regarding the psychological consequences of sexual assault and their treatment for the lay public and in helping clinicians further tailor their discussion of treatment alternatives for these women. Keywords: exploratory analysis; treatment; choice; PTSD; prolonged exposure; sertraline

The authors report on changes in cognitions related to posttraumatic stress disorder (PTSD) among 54 female survivors of sexual and nonsexual assault with chronic PTSD who completed either prolonged exposure alone or in combination with cognitive restructuring. Treatment included 9-12 weekly sessions, and assessment was conducted at pretreatment, posttreatment, and a modal 12-month follow-up. As hypothesized, treatment that included prolonged exposure resulted in clinically significant, reliable, and lasting reductions in negative cognitions about self, world, and self-blame as measured by the Posttraumatic Cognitions Inventory. The hypothesis that the addition of cognitive restructuring would augment cognitive changes was not supported. Reductions in these negative cognitions were significantly related to reductions in PTSD symptoms. The addition of cognitive restructuring did not significantly augment the cognitive changes. Theoretical implications of the results are discussed.

This study partially replicates and expands on a previous study that showed women's perceptions of risk to be a strong predictor of reassault among batterers. The current study employed a larger and multisite sample, a longer follow-up period of 15 months, and multiple outcomes including 'repeated reassault' (n = 499). According to the multinomial logistic regressions, women's perceptions of risk improved prediction with risk factors (ROC area under the curve improved by .04 and sensitivity of repeated reassault increased 12 percentage points). In comparison to simulated risk instruments, women's perceptions by themselves were better predictors than the K-SID, similar in predictive ability to the SARA, and almost as strong as the DAS. The best prediction of repeated reassault was obtained using risk markers, including women's perceptions (ROC AUC = .83; 70% sensitivity) or by using the DAS and women's perceptions together (ROC AUC =. 73; 64% sensitivity). Keywords: batterer; batterer programs; perceptions of risk; risk assessment; risk instruments

This article describes a second treatment-outcome study of cognitive trauma therapy for battered women with posttraumatic stress disorder (PTSD; CTT-BW). CTT-BW includes trauma history exploration; PTSD education; stress management; exposure to abuse and abuser reminders; self-monitoring of negative self-talk; cognitive therapy for guilt; and modules on self-advocacy, assertiveness, and how to identify perpetrators. One hundred twenty-five ethnically diverse women were randomly assigned to immediate or delayed CTT-BW. PTSD remitted in 87% of women who completed CTT-BW, with large reductions in depression and guilt and substantial increases in self-esteem. White and ethnic minority women benefited equally from CTT-BW. Similar treatment outcomes were obtained by male and female therapists and by therapists with different levels of education and training. Gains were maintained at 3- and 6-month follow-ups.

Two personalized substance abuse assessment and feedback interventions were tested for effectiveness in engaging female domestic violence shelter residents in substance abuse treatment. One hundred forty-seven residents were assessed for quantity and frequency of substance use, negative consequences due to use, motivation to change substance use behavior, and psychopathological symptoms related to substance abuse. Assessment identified (33) 22% of participants as heavy substance users. Twenty of the 33 heavy-using residents received one of two personalized substance use feedback interventions: face-to-face feedback or written feedback placed in shelter mailboxes. Treatment engagement was defined as attending at least one substance abuse treatment session within 30 days after the intervention. Results showed a significant difference in treatment engagement rates in favor of the face-to-face feedback group (60% vs. 0%). The results provide preliminary data suggesting that substance abuse assessment can be effectively accomplished in the shelter environment and that the face-to-face feedback procedure may be an effective intervention to bridge the service linkage problem between domestic violence services and substance abase treatment. Keywords: domestic violence; substance abuse; treatment engagement; motivational interviewing

Approximately 15% of married or cohabiting women and as many as 60% of battered women are raped at least once by their partners. This study compared community-based counseling outcomes of battered women with outcomes of women who were both raped and battered by their partners. Over time, both groups improved in well-being and coping. Although those both battered and raped progressed more in counseling, they had lower scores before and after counseling compared to women who were battered only. Implications for research and intervention are discussed. Keywords: domestic violence; evaluation; marital rape: counseling

A prior experimental evaluation of a community-based advocacy program for women with abusive partners demonstrated positive change in the lives of women even 2 years postintervention (C. M. Sullivan & D. I. Bybee, 1999). The current study explored the complex mediational process through which this change occurred, using longitudinal structural equation modeling and formal tests of mediation. As hypothesized, the advocacy intervention first resulted in women successfully obtaining desired community resources and increasing their social support, which enhanced their overall quality of life. This improvement in well-being appeared to serve as a protective factor from subsequent abuse, as women who received the intervention were significantly less likely to be abused at 2-year follow-up compared with women in the control condition. Increased quality of life completely mediated the impact of the advocacy intervention on later reabuse. Discussion places advocacy for women in the context of other efforts that are ne eded to build an effective community response to preventing intimate violence against women. KEY WORDS: domestic violence; battered women; longitudinal structural equation modeling; tests of mediation.

This article is based on the findings from a study in which nurses from two different countries and a variety of clinical settings explained their approach to the nursing care of abused women and described their understanding of issues of abuse. These conclusions constitute one aspect of a larger study titled 'Nurses' Social Construction of Self: Implications for Work With Abused Women' (Henderson, 1999). Following a description of the nurses' practice, the author discusses some of the important contextual, factors that influence nurses' ability to act effectively in the care of abused women. Although the participants in this study were nurses, and therefore much of the information presented derives from their accounts, many of the issues raised might equally have implications for other community practitioners or healthcare professionals encountering abused women in the course of their practice. These implications are discussed.

Ann D. Carden's study of wife abuse was praised for admitting that few definitive conclusions may be drawn from studies of the issue due to its complexity. However, Carden's version of systems theory is dated and has been rejected by most modern family therapists. Specifically, Carden's version of systems theory is too narrow and simplistic, attributing causality and responsibility for wife abuse in a way that would be repudiated by many family therapists.

Ann D. Carden's integrative model for the treatment of male batterers was analyzed. Carden urged clinicians to examine their values as a way of increasing their self-awareness of the increasing epidemic of violence in domestic relations. However, she does not express a specific preference for any approach among various approaches to solve the problem of wife abuse. This weakens her call for greater commitment to fight wife abuse via more sophisticated clinical work and research.

Ann D. Carden's study of wife abuse and proposals for treatment of wife abusers was praised as a scholarly and important work which will help in the understanding of the rising incidence of domestic violence in the US. Carden has presented a comprehensive and theoretically based treatment intervention programs for wife abusers. However, she failed to address other crucial issues such as who will pay for the intervention programs and how to evaluate the outcomes of the proposed intervention programs.

Experimentally tested the hypotheses that (1) battered women are in need of numerous community resources upon exit from a domestic violence shelter, (2) working with advocates increases women's effectiveness in obtaining needed resources and social support, and (3) success in obtaining resources and social support increases women's levels of life satisfaction and decreases their risk of further abuse. The initial findings of a short-term intervention project designed to provide postshelter advocacy services to women with abusive partners are presented. One-hundred forty-one battered women were interviewed immediately upon their exit from a domestic violence shelter as well as 10 weeks thereafter. Half the sample was randomly assigned to receive the services of trained advocates who assisted them in accessing needed community resources. Women who worked with advocates reported being more effective in accessing resources and had higher levels of social support and overall quality of life postintervention. Although all women reported some decrease in postshelter abuse, there were no differences between those with and those without advocates, and abuse continued to be a problem for many women.

Abstract Domestic violence hurts, maims and kills between two and eight million women annually; children in homes where the adults are abusive are more likely to be victims themselves -- [...]

A report published by a national inter-agency working party on battered wives called 'Domestic Violence' shows that services foe battered women are inadequate. Refuges and funding is limited. Social workers need more training on how to deal with victims. Many social workers fail to cater for the needs of battered wives as they focus on the needs of the child trying to keep the family together. This risks further violence which the child will witness. A national policy needs to be established to encourage cooperation between statutory and voluntary groups.