Two-year treatment effects of the common elements treatment approach (CETA) for reducing intimate partner violence and unhealthy alcohol use in Zambia

Abstract

Background Intimate partner violence (IPV) and unhealthy alcohol use are common yet often unaddressed public health problems in low- and middle-income countries. In a randomized trial, we found that the common elements treatment approach (CETA), a multi-problem, flexible, transdiagnostic intervention, was effective in reducing IPV and unhealthy alcohol use among couples in Zambia at a 12-month post-baseline assessment. In this follow-up study, we investigated whether treatment effects were sustained among CETA participants at 24-months post-baseline. Methods Participants were heterosexual couples in Zambia in which the woman reported IPV perpetrated by the male partner and in which the male had hazardous alcohol use. Couples were randomized to CETA or treatment as usual plus safety checks. Measures were the Severity of Violence Against Women Scale (SVAWS) and the Alcohol Use Disorders Identification Test (AUDIT). The trial was stopped early upon recommendation by the trial's DSMB due to CETA's effectiveness following the 12-month assessment. Control participants exited the study and were offered CETA. This brief report presents data from an additional follow-up assessment conducted among original CETA participants at a 24-month visit. Results There were no meaningful changes in SVAWS or AUDIT scores between 12- and 24-months. The within-group treatment effect for SVAWS from baseline to 24-months was d = 1.37 (p < 0.0001) and AUDIT was d = 0.85 (p < 0.0001). Conclusions The lack of change in levels of IPV and unhealthy alcohol use between the 12- and 24-month post-baseline timepoints suggests that treatment gains were sustained among participants who received CETA for at least two years from intervention commencement.

Programme responses for men who perpetrate intimate partner violence in the context of alcohol or other drugs: a scoping review

“…Men’s voluntary participation in couple-based programmes reflects a desire to improve their relationship functioning. A RCT in Zambia compared counselling sessions separately for men and their spouses to no treatment (Kane et al , 2021; Murray et al , 2020; Murray et al , 2021). Couples ( n = 123) were randomised into the combined programme finding men’s alcohol use and IPV perpetration significantly reduced after treatment completion (Murray et al , 2021).…”

“…Couples (n = 123) were randomised into the combined programme finding men's alcohol use and IPV perpetration significantly reduced after treatment completion (Murray et al, 2021). Follow-up at 24 months postbaseline showed no significant changes in AOD or IPV outcomes with authors suggesting that treatment gains were sustained for two years (Kane et al, 2021). A sub-set of couples reported that skills learnt in the programme included strategies to avoid conflict, anger management, reduce alcohol use and improved empathy for their partner (Murray et al, 2021).…”

Psychometric performance of the Mental Health Implementation Science Tools (mhIST) across six low- and middle-income countries

“…The trial was ended early based on recommendation of the data and safety monitoring board due to an interim data analysis indicating a clear benefit of CETA at 12 months; participants in the control arm were then offered CETA [ 37 ]. Study investigators followed the original CETA participants for an additional 12 months for a 24-month post-baseline assessment [ 42 ]. Family members, including adolescents, in the CETA arm completed Consumer mhIST following their 12-month post-baseline assessment.…”

Violencia íntima de pareja: experiencias de hombres perpetradores

“…De la misma manera, Bauch et al (2022) encontraron que la negligencia infantil y el estrés de los padres disminuyó significativamente después de su participación en un programa de terapia multisistémica. Con respecto a intervenciones dirigidas a hombres perpetradores de violencia íntima de pareja, Kane et al (2021) evaluaron la eficacia a mediano plazo del tratamiento de elementos comunes (CETA), intervención flexible y multiproblemática, donde se consideran las particularidades de los participantes, y las diferentes problemáticas que presentan. Los autores evidenciaron que el tratamiento de elementos comunes (CETA) fue un tratamiento eficaz para reducir la violencia de pareja y el consumo nocivo de alcohol, resultados que se mantuvieron durante al menos dos años desde el comienzo de la intervención.…”