Saturday, 15 January 2005 - 4:00 PM

This presentation is part of: Intimate Partner Violence

Theoretical and Intervention Preferences of Service Providers Addressing Violence Against Women

Purpose: Domestic violence and sexual assault are traumatic events that often result in the development of Post Traumatic Stress Disorder (PTSD). Although rape crisis centers and domestic violence programs have been in existence for over 30 years, very little is known about their approaches to practice or the effectiveness of those methods in alleviating PTSD. This study identifies the theoretical and intervention preferences of direct service providers addressing violence against women. The data provides a mechanism for beginning to assess the extent to which these providers have the receptivity and capacity to adopt evidence-based interventions for the treatment of PTSD.

Methods: The 2003 National Directory of Rape Crisis Centers and the 1999-2000 National Directory of Domestic Violence Programs (most current) were used to develop the national sampling frame (n=2,510). A 28-item structured questionnaire was mailed to all members of the sampling frame and respondents were asked to provide one questionnaire per agency. Respondents could complete the questionnaire by hand and return it or complete the survey online through a web-based program. The majority preferred using the hard copy (n=696) rather than the web-based version (n=538), with the combination resulting in a 49% response rate. Descriptive statistics and correlations were used to analyze the results.

Findings: The top three theoretical perspectives used, based on a 4-point scale (0-3) ranging from never to always, were Empowerment (Response Ave=3.41), Strengths-Based (3.17), and Stress & Coping (3.08), followed by Feminist (2.40), Cognitive Behavioral (2.37) and Family Systems (2.36). The interventions with the highest response rate, based on a four point scale (0-3)ranging from never to always, were Client Centered Approach (2.97), followed by Cognitive Behavioral Therapy (2.09) and Psycho-Education (2.02). There was significant congruence (p=.01) between training in and use of theoretical perspectives and interventions among direct service providers addressing violence against women. The respondents used an average of 8.26 (SD=2.98) different theories and 6.16 (SD=3.28) different interventions in their practices. No significant differences in theoretical or intervention preferences based on type of agency were found. Although numerous studies have documented the prevalence of PTSD in both survivors of sexual assault and domestic violence, the interventions that have been found to be most efficacious in treating it were not endorsed with much frequency by this sample of service providers. Prolonged Exposure, which has the strongest evidence of effectiveness for treating PTSD, received an average response rate of .765, Stress Inoculation Training a .691 and Cognitive Processing Therapy a 1.48, on a four point scale(0-3).

Implications: Practitioners use the theoretical and intervention training that they receive to guide their practice. Considering the volume of empirical support for the beneficial effects of CBT, the degree to which it was endorsed in this survey is an encouraging indication of the providers' receptivity and capacity to adopt evidence-based practice. However, the infrequency with which specific evidence-based methods for treating PTSD are being used indicates the need for greater dissemination of evidence-based practice information and training.

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