From Victim to Agent: CBT-Driven Behavioral Change and Reduction in psychological impact of Intimate Partner Violence among women in Pakistani shelter homes

Madeeha Latif; Sadia Awan; Zahoor Ahmed; Shumyla Khan; Zahra Wakif; Thrija Pushpanathan

Madeeha Latif Sindh Institute of Physical Medicine and Rehabilitation
Sadia Awan Dow University of Health Sciences
Zahoor Ahmed Kyber Medical University
Shumyla Khan Shalamar Hospital
Zahra Wakif York University
Thrija Pushpanathan University of Toronto

Keywords: Intrapersonal Violence, Cognitive Behavior Therapy, Shelter Homes, Women, Pakistan

Abstract

Introduction: Domestic violence is a prevalent public health and human rights concern that affects psychological functioning. The present study compared the effectiveness of Group CBT and CBT-based Self-Help interventions in reducing the severity of intimate partner violence (IPV) and enhancing psychological well-being of women living in shelter homes in Karachi.

Method: 200 women exposed to IPV with elevated anxiety and depression scores were randomly allocated to Group CBT (n = 100) or CBT-based Self-Help (n = 100). Assessment tools included the HITS and the AKUADS scales at baseline and post intervention. The Group CBT condition underwent 10 structured sessions over 5 weeks, inclusive of psychoeducation, cognitive restructuring, behavioral activation, problem-solving, assertiveness training and communication skills. The Self-Help group was given a structured manual on CBT.

Results: The results suggest that both interventions significantly reduced IPV severity and psychological distress. The reductions in IPV severity (d = 3.57) were larger for the Group CBT intervention than for the Self-Help intervention (d = 1.46). Between-group analysis results showed Group CBT to be superior for post-intervention results (p < .001). There was a moderate correlation between a decrease in IPV severity and anxiety and depression symptoms (r = .42, p < .001).

Conclusion: Results indicate that although both interventions are effective, Group CBT is more effective in decreasing IPV severity and psychological distress. The study underscores the importance of group-based culturally-adapted CBT interventions as a scalable and effective intervention to support IPV survivors in low resource settings.