A Stage Ia Behavioral Treatment Development Trial of Recovering Safety: A Women’s Empowerment Group for Survivors of Intimate Partner Violence with Substance Use Disorders

Amanda Sedgewick, DO

McLean Hospital – Faculty
SEDGEWICK_AMANDA poster

Scientific Abstract

Background Recent studies estimate intimate partner violence (IPV) in women receiving substance use treatment to be 31-90%.Women experiencing IPV are more likely to develop substance use disorders (SUDs), PTSD, and other mental health issues and have decreased odds of completing substance use treatment. Despite these high rates, there are few treatments that have been developed for women with IPV/SUDs. The “Recovering Safety” group is an 8-session empowerment group for IPV survivors with SUDs.

Methods The goals of this Stage 1 behavioral treatment development trial are to a) refine the treatment manual for the “Recovering Safety” group (based on review of 3 experts), and b) enroll participants (N=8) in a study of this group intervention. Participants completed surveys at baseline, mid-group and post-group to evaluate 1) satisfaction and feasibility and 2) pre- and post-assessment of symptoms of PTSD, substance use, and measures of safety and empowerment.

Results All participants were White and non-Hispanic; average age 44 years (SD=16). Seven of 8 women met criteria for PTSD, 8/8 for SUD, with an average Danger Assessment score= 11.6 (SD=8.4), indicating a high level of safety risk. Participants who completed post-group surveys (N=8) reported high satisfaction with the group. From baseline to post-group, 6/8 participants reported a reduction in PTSD symptoms, and 6/8 increased in empowerment and defining safety goals.

Conclusions Results of this study support initial feasibility and satisfaction of the group intervention “Recovering Safety.” Participants reported high satisfaction with treatment and improvement in many areas of empowerment. Most participants noted improved outcomes in PTSD symptoms.  Though results must be interpreted with caution given the small sample size, this initial data is promising. Given the number of women in SUD treatment affected by IPV, further study of treatments such as these are needed in order to provide options to treat women struggling at the intersection of IPV and substance use disorders. A larger study is warranted to show further feasibility and efficacy for this group intervention. 

SoundCloud Transcript

This poster is entitled A Stage Ia Behavioral Treatment Development Trial of “Recovering Safety: A Women’s Empowerment Group for Survivors of Intimate Partner Violence with Substance Use Disorders”       

The Recovering Safety group is an 8-session, weekly outpatient group run in the McLean Hospital outpatient clinic for women with substance use disorders who have experienced or are experiencing IPV.  It has been run since 2019, the study began in 2020. 

The aims of this study were twofold, 1) to develop the intervention manual, and 2) examine patient satisfaction and pre/post changes in PTSD symptoms and perception of safety and empowerment.

The manual was revised based on review and feedback from 3 experts in the field.  We enrolled 8 Women who completed surveys at baseline, mid-group and post-group.  The average number of groups attended was 6.3, and we found that the satisfaction of the group was high.   

We found that from baseline to post-group 6/8 participants:

  • reported an increase in empowerment and defining safety goals
  • reported a reduction in PTSD symptoms

The middle section shows the graphical representation of the increase in average empowerment scores over time from baseline to midgroup to post group.  The most significant change was seen from baseline to midgroup.  This was measured with the MOVERS scale, which stands for (Measure of Victim Empowerment Related to Safety (MOVERS).

The lower graph shows participants PCL-5 scores measuring their PTSD symptoms, which on average, decreased over the course of the group treatment.

The table on the right characterizes our sample, which was small, an N of 8.   There was an age range, 22-65, and 8/8 were white, non-hispanic and heterosexual with high educational attainment.

The Danger assessment score shown in the last row of the demographics table, is a clinician administered measure that each participant is given by the clinician prior to starting the group.  The Danger Assessment helps to determine the level of danger an abused woman has of being killed by her intimate partner.  In our study population, on average, participants were in the “increased danger” category, and some participants in the “extreme danger” category. 

The lower right corner shows a graphic in the first session of Recovering Safety.  The graphic  shows a woman thinking of questions that are often asked during the group discussion, such as “What if my partner’s behaviors aren’t all bad?”  or “What would I tell a friend whose partner treats them the way mine treats me?”  These are effective in highlighting common experiences of group members with a goal of generating initial insight into a past or current abusive relationship.  The manual provides psychoeducation on IPV, SUDs, PTSD and co-occurring disorders and helps to identify ways how these intersect

Live Zoom Session – March 9th

research Areas

Authors

Amanda E. Sedgewick, DO, Callie L. Wang, BA, Shelly F. Greenfield, MD, MPH, Dawn E. Sugarman, PhD

Principal Investigator

Amanda Sedgewick, DO