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针对妇女遭受亲密伴侣暴力的创伤聚焦治疗中的退出情况。

Dropout From Trauma-Focused Treatment for Intimate Partner Violence Against Women.

作者信息

Crespo María, Antón Ana A, Hornillos Carlos

机构信息

Department of Personality, Assessment and Clinical Psychology, Universidad Complutense de Madrid, Spain.

出版信息

Clin Psychol Psychother. 2025 May-Jun;32(3):e70092. doi: 10.1002/cpp.70092.

Abstract

The current study aimed to analyze the characteristics, and the factors associated with dropout from a trauma-focused (TF) cognitive-behavioural therapy (CBT) tailored for intimate partner violence against women (IPVAW) that has been shown to be effective. Ninety-one female survivors of IPVAW entered a randomized controlled trial comparing two versions of the TF-CBT, both delivered in eight weekly sessions and group format. A total of 37.4% of women who entered treatment dropped out during treatment; an additional 7.1% dropped out after randomization and before starting treatment. There were no significant differences in dropout rate between conditions. Most of the dropouts occurred before session 4 (68.3%) and were related to practical/external difficulties (63.4%). Regarding sociodemographic features, dropping out significantly related to younger age, being migrant and being unemployed or active working. For characteristics of violence, dropouts significantly differed from completers in time elapsed since the last violence episode (lower in dropouts). Finally, regarding their clinical state, women that dropped out scored significantly higher in posttraumatic cognitions and anxiety. Comparisons between dropouts due to practical/external difficulties and due to treatment-related issues showed significant differences in origin (more dropouts related to practical difficulties in migrant women) and time since last episode of violence (lower in dropouts due to treatment-related issues). Data highlight the need for personalized retention strategies for younger and migrant women and measures to facilitate the attendance to sessions prior to entering a TF-therapy. This is an analysis of data collected as part of a clinical trial preregistered as ISRCTN73702156.

摘要

本研究旨在分析一种针对亲密伴侣暴力侵害妇女行为(IPVAW)量身定制的创伤聚焦(TF)认知行为疗法(CBT)的特点以及与退出治疗相关的因素,该疗法已被证明是有效的。91名IPVAW女性幸存者进入了一项随机对照试验,比较两种版本的TF-CBT,均以每周一次、共八次的小组形式进行。共有37.4%进入治疗的女性在治疗期间退出;另有7.1%在随机分组后但在开始治疗前退出。不同治疗条件下的退出率没有显著差异。大多数退出发生在第4次治疗前(68.3%),且与实际/外部困难有关(63.4%)。在社会人口学特征方面,退出与年龄较小、是移民以及失业或在职工作显著相关。关于暴力特征,退出者与完成治疗者在距上次暴力事件的时间上存在显著差异(退出者的时间较短)。最后,就她们的临床状态而言,退出治疗的女性在创伤后认知和焦虑方面得分显著更高。因实际/外部困难和因治疗相关问题而退出者之间的比较显示,在来源(移民女性中更多退出者与实际困难有关)和距上次暴力事件的时间(因治疗相关问题而退出者的时间较短)方面存在显著差异。数据凸显了针对年轻女性和移民女性制定个性化留存策略以及采取措施促进她们在进入TF治疗前参加治疗的必要性。这是对作为一项预先注册为ISRCTN73702156的临床试验一部分所收集数据的分析。

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