Prevention of Re-Experiencing Abusive Relationships: Development and Effectiveness of a Transdiagnostic Intervention Package—A Pilot Study
,
Abstract
Objective: Re-experiencing abusive relationships is a distressing phenomenon, particularly among individuals with a history of intimate partner violence (IPV). This study aimed to develop and evaluate the effectiveness of a factor-based transdiagnostic package to prevent the re-experiencing of abusive relationships in Iran during 2020.
Method: This study was conducted in two phases. The qualitative phase involved in-depth, semi-structured interviews with seven experts and twelve patients from psychological clinics in Rasht, analyzed through content analysis. The quantitative phase utilized a semi-experimental design incorporating pre-test and post-test assessments with a control group. The population consisted of individuals referred to ten psychological clinics and three university counseling centers from 2018 to 2020. Out of 36 volunteers, 24 met the inclusion criteria and were randomly assigned into two groups of twelve. The intervention consisted of individual therapy sessions conducted bi-weekly over 16 sessions. A researcher-developed questionnaire was used to assess tendencies to re-experience abusive relationships in the quantitative phase.
Results: Qualitative analysis of expert interviews identified five key components essential for effective treatment of abusive relationship survivors: (1) the content of the sessions, emphasizing contextual and cognitive approaches alongside psycho-education, values clarification, and commitment to change (2) process factors, including a strong therapeutic relationship, client motivation, and giving hope; (3) the structure of the sessions, highlighting flexible frequency, continuity, and follow-up; (4) the characteristics of the therapist, such as expertise, self-awareness, and persistence; and (5) client-related factors like education, environmental stressors, and abuse history. In the quantitative phase, analysis of covariance (ANCOVA) revealed that the transdiagnostic therapy effectively prevented the re-experiencing of abusive relationships (P < 0.001).
Conclusion: This finding highlights the effectiveness of therapeutic interventions in reducing the recurrence of abusive relationships, indicating that factor-based transdiagnostic therapy may offer a promising approach to mitigating the risk of re-experiencing such relationships.
2. Masci BS, Sanderson S. Perceptions of Psychological Abuse Versus Physical Abuse and Their Relationship With Mental Health Outcomes. Violence Vict. 2017;32(2):362-76.
3. Abusbaitan HA, Eyadat AM, Holt JM, Telfah RK, Zahra TFA, Zahra TFA, et al., editors. Emotional Abuse Against Women in the Context of Intimate Relationships: A Concept Analysis. Nurs Forum; 2025: Wiley Online Library.
4. Lloyd Bright K. Controlling or coercive behaviour in an intimate or family relationship: A new domestic abuse offence in England and Wales. Journal of Commonwealth Law and Legal Education. 2016;11(1):99-106.
5. Rana W, Mukhtar S, Mukhtar S. Countering Emotional and Psychological Manipulation Abuse by Cultivating Resilience, Meaning, and Well-Being Among Victims of Male Intimate Partner Violence-Working Frontline Health Care Workers During COVID-19 Lockdown: A Qualitative Study. Asia Pac J Public Health. 2022;34(6-7):671-4.
6. Pereira ME, Azeredo A, Moreira D, Brandão I, Almeida F. Personality characteristics of victims of intimate partner violence: A systematic review. Aggress Violent Behav. 2020;52:101423.
7. Hogue J. Developing an integrative group treatment program for adult female survivors of domestic violence incorporating narrative therapy and acceptance commitment therapy [PhD. dissertation]. Mississippi: University of Mississippi. 2018.
8. Landenburger KM. The dynamics of leaving and recovering from an abusive relationship. J Obstet Gynecol Neonatal Nurs. 1998;27(6):700-6.
9. Mirpour Z, Rahmani M, Ghorbanshiroodi S. Explaining the concept of re-experiencing abusive relationships. Journal of holistic nursing and midwifery. 2021;31(2):124-34.
10. Balaban JC. The relationship between abuse experienced as female adults and the retrospective self-reports of child abuse: Alliant International University; 2020.
11. Nejad KSR, sadat Mirpour Z. Predicting the Tendency to Re-Experience Abusive Relationships Based on Schema Modes and Self-Compassion: A Web-Based Cross-Sectional Study. Partner Abuse. 2024.
12. Nejad KSR, sadat Mirpour Z. Predicting the Tendency to Re-Experience Abusive Relationships Based on Schema Modes and Self-Compassion: A Web-Based Cross-Sectional Study. Partner Abuse. 2024.
13. Park S, Kim S-H. Who are the victims and who are the perpetrators in dating violence? Sharing the role of victim and perpetrator. Trauma, violence, & abuse. 2019;20(5):732-41.
14. BAGREZAEI P, ZANJANI H, SEIFOLLAHI S. A meta-analysis of the studies on the violence of husbands against wives in Iran. 2017.
15. afari Z, Parvin F. An overview of types of violence against women in iran between 2010 and 2021. Nursing and Midwifery Journal. 2022;20(4):269-79.
16. Engel B. Breaking the cycle of abuse: How to move beyond your past to create an abuse-free future: John Wiley & Sons; 2005.
17. Khorasani E, Spencer C. A Latent Class Analysis of the Relationship Between Adverse Childhood Experiences and Intimate Partner Violence Victimization in Northeast Iran. Advers Resil Sci. 2024:1-12.
18. Nejad KSR, sadat Mirpour Z. Predicting the Tendency to Re-Experience Abusive Relationships Based on Schema Modes and Self-Compassion: A Web-Based Cross-Sectional Study. Partner Abuse. 2024.
19. Santos A, Matos M, Machado A. Effectiveness of a group intervention program for female victims of intimate partner violence. Small Group Research. 2017;48(1):34-61.
20. Rinfret-Raynor M, Cantin S. Feminist therapy for battered women: An assessment. Out of the darkness: Contemporary perspectives on family violence: SAGE Publications, Inc.; 1997. p. 219-34.
21. Naismith I, Ripoll K, Pardo VM. Group compassion-based therapy for female survivors of intimate-partner violence and gender-based violence: A pilot study. J Fam Violence. 2021;36(2):175-82.
22. Tutty L, Rothery M. Beyond shelters: Support groups and community-based advocacy for abused women. Handbook of domestic violence intervention strategies Policies, programs, and legal remedies. 2002:396-418.
23. Henderson AJ, Bartholomew K, Dutton DG. He loves me; he loves me not: Attachment and separation resolution of abused women. J Fam Violence. 1997;12:169-91.
24. Fernandez MC. Immigrant mothers in abusive relationships: Decisions and actions: University of Miami; 2015.
25. Dalgleish T, Black M, Johnston D, Bevan A. Transdiagnostic approaches to mental health problems: Current status and future directions. J Consult Clin Psychol. 2020;88(3):179-95.
26. Brierley G, Agnew-Davies R, Bailey J, Evans M, Fackrell M, Ferrari G, et al. Psychological advocacy toward healing (PATH): study protocol for a randomized controlled trial. Trials. 2013;14(1):1-9.
27. Poorhejazi M, Khalatbari J, Ghorban-Shiroudi S, Khodabakhshi-Koolaee A. The Effectiveness of the Education Package of Meta-diagnostic Treatment Based on the McMaster Model with Focus on Compassion, Awareness on Emotional Divorce and Marital Boredom among Women with Marital Conflict: A Pilot Study. Community Health. 2021;8(1):65-77.
28. Van der Kolk B. The body keeps the score: Brain, mind, and body in the healing of trauma. New York. 2014;3.
29. Meidlinger PC, Hope DA. The new transdiagnostic cognitive behavioral treatments: Commentary for clinicians and clinical researchers. J Anxiety Disord. 2017;46:101-9.
30. Thompson-Hollands J, Sauer-Zavala S, Barlow DH. CBT and the future of personalized treatment: a proposal. Depress Anxiety. 2014;31(11):909-11.
31. Morse JM, Barrett M, Mayan M, Olson K, Spiers J. Verification strategies for establishing reliability and validity in qualitative research. Int J Qual Method. 2002;1(2):13-22.
32. Sinuff T, Cook DJ, Giacomini M. How qualitative research can contribute to research in the intensive care unit. J Crit Care. 2007;22(2):104-11.
33. Mirpour ZS, Rahmani M, Ghorbanshiroodi S. Designing and Examining the Psychometric Properties of the Tendency to Re-Experiencing Abusive Relationships Scale. Journal of Health System Research. 2022;18(3):223-33.
34. Faul F, Erdfelder E, Buchner A, Lang AG. Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behav Res Methods. 2009;41(4):1149-60.
35. Borm GF, Fransen J, Lemmens WA. A simple sample size formula for analysis of covariance in randomized clinical trials. J Clin Epidemiol. 2007;60(12):1234-8.
36. Cohen J. Statistical power analysis for the behavioral sciences: routledge; 2013.
37. Daneshmandi S. The Effectiveness of emotional schema therapy (EST) on emotion regulation difficulties, communication skills and emotional schemas of women of child abuse and neglect. University of Isfahan. 2013.
38. Flasch P, Murray CE, Crowe A. Overcoming Abuse: A Phenomenological Investigation of the Journey to Recovery From Past Intimate Partner Violence. J Interpers Violence. 2017;32(22):3373-401.
39. Kolyaie L, Badri R, Bahrami M, Hosseini S. The effect of emotional schema therapy on reduction of depression in high school students. Int j humanit cult stud. 2016:680-9.
40. Caridade S, Pinheiro I, Dinis MAP. Stay or leave abusive dating relationships: Portuguese victims’ reasons and barriers. Social Sciences. 2020;9(5):84.
41.Larki T, Yousefi E, Khajehpour L. Comparison of the Impact of Mentalization-Based Therapy and Unified Transdiagnostic Treatment on Intimacy and Marital Satisfaction of Women with Experience of Marital Infidelity. International Journal of Education and Cognitive Sciences. 2025;6(1):137-47.
| Files | ||
| Issue | Articles in Press | |
| Section | Original Article(s) | |
| Keywords | ||
| Dating Violence Intimate Partner Abuse Domestic Violence Spouse Abuse Transdiagnostic Therapy | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
