Background: Focusing on positive memories as a complement to trauma-focused interventions for intimate partner violence against women (IPVAW) could contribute to enhancing the recovery from trauma with the development of a more integrated and emotionally modulated autobiographical narrative.Objective: To test the effectiveness of a trauma-focused cognitive behavioural therapy (CBT) tailored for IPVAW that incorporates the evocation of positive memories.Methods: Female survivors of IPVAW entered a randomized controlled trial comparing trauma-focused CBT for IPVAW (CBT; n = 35) to a version that incorporates the evocation of positive memories (CBT-M+; n = 44) and to a waitlist (WL; n = 12) control group. Pre and post measures were obtained for: posttraumatic stress, meaning of trauma, affect, emotional regulation, associated symptoms, self-concept and overall functioning.Results: A total of 43.04% of women who entered treatment dropped out, without significant treatment differences. Pre-post changes were not significant for the WL; both treatments resulted in significant improvements, with good effect sizes, for posttraumatic stress (g = 0.78 and g = 1.00 for CBT and CBT-M+, respectively), meaning of trauma, affect, associated symptoms, self-concept and overall functioning, but not in emotional regulation. There were no significant differences between CBT and CBT-M+ in the direct comparisons; however, the effect sizes showed better effects of CBT for centrality of the IPVAW, whereas they favoured CBT-M+ for PTSD, depression, self-esteem and impairment measures. No clinically significant change was reached for the WL, while both treatments significantly reduced the percentage of women with PTSD and self-esteem problems; additionally, the percentage of women with depression and impairment problems in the CBT-M+ group was significantly decreased.Conclusions: Although there were few differences between both treatments, CBT-M+ seemed to have a greater effect, pointing to the potential of the inclusion of the evocation of positive memories that should be further researched.
Antecedentes: Centrarse en los recuerdos positivos como complemento de las intervenciones centradas en el trauma para la violencia contra la mujer en la pareja (VCMP) podría contribuir a mejorar la recuperación del trauma con el desarrollo de una narrativa autobiográfica más integrada y emocionalmente modulada.
Objetivo: Comprobar la eficacia de una terapia cognitivo-conductual (TCC) centrada en el trauma y adaptada para VCMP que incorpora la evocación de recuerdos positivos.
Métodos: Mujeres supervivientes de VCMP participaron en un ensayo controlado aleatorizado que comparaba una TCC centrada en el trauma para VCMP (TCC; n = 35) con una versión que incorpora la evocación de recuerdos positivos (TCC-M+; n = 44) y con un grupo de control en lista de espera (LE; n = 12). Se obtuvieron medidas pre y post para: estrés postraumático (TEPT), significado del trauma, afecto, regulación emocional, síntomas asociados, autoconcepto y funcionamiento global.
Resultados: Un 43,04% de las mujeres que entraron en tratamiento abandonaron, sin diferencias significativas entre tratamientos. Los cambios pre-post no fueron significativos para LE; ambos tratamientos tuvieron mejoras significativas con buenos tamaños del efecto en estrés postraumático (g = 0,78 y g = 1,00 para TCC y TCC-M+, respectivamente), significado del trauma, afecto, síntomas asociados, autoconcepto y funcionamiento global, pero no en regulación emocional. No hubo diferencias significativas entre TCC y TCC-M+ en las comparaciones directas; sin embargo, los tamaños del efecto mostraron mejores efectos de la TCC para la centralidad del trauma, mientras que favorecieron al TCC-M+ en TEPT, depresión, autoestima y deterioro. No se alcanzaron cambios clínicamente significativos para LE, mientras que ambos tratamientos obtuvieron reducciones significativas en el porcentaje de mujeres con problemas de TEPT y autoestima; además, TCC-M+ obtuvo una reducción significativa del porcentaje de mujeres con problemas de depresión y funcionamiento.
Conclusiones: Aunque hubo pocas diferencias entre ambas condiciones, TCC–M+ pareció tener un mayor efecto, señalando el potencial de la inclusión de la evocación de recuerdos positivos que debería ser investigado más a fondo.
Keywords: Ensayo clínico aleatorizado; Randomized clinical trial; adherence to treatment; intimate partner violence against women; positive memories; posttraumatic stress; recuerdos positivos; terapia centrada en el trauma; trastorno de estrés postraumático; trauma-focused therapy; violencia de pareja íntima contra las mujeres.
The study is the first in testing in a clinical setting the effect of adding the evocation of positive memories as a complement to a trauma-focused cognitive–behavioural therapy.We designed a trauma-focused cognitive–behavioural treatment tailored to women who have suffered intimate partner violence that incorporates the evocation of positive memories, and we examined its effectiveness.Although the effect of the incorporation of the evocation of positive memories seemed to be small, the data tended to favour it with respect to the version without such an evocation.These findings point to the potential of the evocation of positive memories in the treatment of trauma and to the need for further research.