Women Tell All: A Comparative Thematic Analysis of Women’s Perspectives on Two Brief Counseling Interventions for Intimate Partner Violence

Abstract

Background: Intimate partner violence (IPV) is a significant public health problem that is commonly experienced by women and associated with psychosocial health issues. Recovering from IPV through Strengths and Empowerment (RISE) is a brief, clinician-administered, variable-length (1–6 sessions), modular, individualized psychosocial counseling intervention developed for women experiencing IPV. We present qualitative feedback and quantitative helpfulness ratings from women patients of the Veterans Health Administration who completed a randomized clinical trial (RCT) comparing RISE to a clinician-administered advocacy-based Enhanced Care as Usual (ECAU; a single structured session consisting of psychoeducation, safety-planning, resources, and referrals). Methods: 58 participants (Mage = 39.21) completed post-intervention semi-structured qualitative interviews, including helpfulness ratings, at two follow-up assessments (10- and 14-weeks post-enrollment) to assess the acceptability, usefulness, and perceived fit of the interventions for women’s needs. Interviews were transcribed and analyzed using a hybrid deductive-inductive analytic approach. Results: While both the RISE and ECAU interventions were deemed helpful (interventions were rated as ‘highly helpful’ by 77% of RISE and 52% of ECAU participants), differences were identified in perceived impacts of the intervention, application of content, approach to patient-centeredness, and implementation recommendations. Conclusions: Findings shed light on women Veterans’ experiences and preferences for IPV psychosocial counseling interventions. Such knowledge can inform evidence-based, trauma-informed, and individualized care for women Veterans who experience IPV and may have relevance to other populations of women who experience IPV.

Recovering from Intimate Partner Violence through Strengths and Empowerment (RISE): Initial Evaluation of the Clinical Effects of RISE Administered in Routine Care in the US Veterans Health Administration

“…Beyond traditional clinical outcomes, an important aspect of implementing evidence-based interventions into routine care is the acceptability of the treatment from the patient perspective [ 80 ]. The patients in this program evaluation reported high levels of satisfaction with RISE, extending prior research findings demonstrating the acceptability of RISE from the patient and provider perspectives [ 30 , 81 ]. Moreover, this program evaluation pilot included men, and although the content of the intervention manual and handouts were originally intended for women, men reported high levels of overall satisfaction with RISE suggesting that clinicians were able to effectively tailor the intervention to their needs.…”

“…Second, we increased the flexibility regarding how many sessions an individual could attend, to allow for greater individualization of needs and ensure all facility-level requirements (e.g., comprehensive suicide risk assessments) could be accomplished while still getting a full dose of RISE. Moreover, clinicians felt some patients would benefit from additional sessions to consolidate skills and plan for potential setbacks, consistent with IPV survivor preferences for IPV interventions [ 81 ]. This attention to increased flexibility and collaboration paralleled additional changes made to deliver the protocol during the COVID-19 pandemic, including how clinicians and patients must develop ‘work-arounds’ during COVID-19 [ 82 ].…”

PTSD and Depression Symptoms Increase Women’s Risk for Experiencing Future Intimate Partner Violence

“…This is an important line for future research, particularly among women veterans who experience high risk for both mental health concerns and IPV experience. Brief, motivational-interviewing-based interventions are acceptable and helpful to women veterans and hold promise as a means of increasing mental health treatment initiation and utilization among women veterans at risk for IPV and mental health concerns [75,[77][78][79].…”

Practical Implications of Research on Intimate Partner Violence Experiences for the Mental Health Clinician

“…Table 3 provides examples of common psychoeducation topics for mental health treatment addressing IPV. Psychoeducation is desired by individuals who experience IPV and may decrease isolation and shame, help clients gain perspective, aid in decreasing psychological entrapment, and offer a sense of hope and connection [73,110].…”