Domestic violence: researchers pilot a trauma-informed mindfulness intervention for survivors with PTSD

Women who have experienced domestic violence and abuse (DVA) often develop post-traumatic stress disorder (PTSD), which includes reliving traumatic events through nightmares and disturbing memories. Researchers from the Centre for Academic Primary Care at the University of Bristol and the National Institute for Health Research (NIHR) Biomedical Research Centre (BRC) have adapted a standard mindfulness course for depression to address the special needs of DVA survivors with PTSD and are piloting it in a small-scale study.

Unlike a one-off traumatic event, DVA results in chronic PTSD that is harder to treat. Standard treatment for PTSD is a ‘past-focused’ talking therapy, which teaches people how to change their negative thoughts and feelings into more positive ones through ‘reliving’ traumatic memories. Many survivors of DVA drop out of the standard treatment because they find such an approach too upsetting or do not feel better.

In contrast, mindfulness is a ‘present-focused’ therapy that teaches people how to respond to thoughts and feelings arising from the past with acceptance and self-compassion. It is known to work well in the treatment of depression.

The coMforT (Mindfulness for Trauma) study is funded by the NIHR Bristol BRC at the University of Bristol. Women with PTSD taking part in the study have been randomly allocated into two groups: two thirds to attend eight group trauma-informed mindfulness sessions, and one third to receive the standard talking therapy available on the NHS. The mental health status of women from the two groups will be compared six months after allocation, and participants will be interviewed about their study experiences.

If the pilot is successful, the researchers will apply for funding to run a full-size trial, which will answer questions about effectiveness and value for money of the trauma-informed mindfulness course.

Dr Natalia Lewis, Research Fellow at the Centre for Academic Primary Care, who is leading the study said: “We have worked with DVA survivors and mental health professionals to adapt the standard mindfulness intervention for depression to meet DVA survivors’ needs and preferences. We are therefore optimistic that the pilot will be acceptable to those taking part and feasible to run. Our aim is to secure funding that will enable us to design a full-scale trial that will thoroughly test the effect of the mindfulness course on women’s health and its cost-effectiveness.

“DVA affects one in four women and has a serious impact on their mental health. For those who are mothers, it also affects the mental health of their children. Developing and evaluating interventions tailored to survivors’ needs is of vital importance to reduce the enormous individual and social harms resulting from DVA.”

For more information about the study, visit the study website.

Read the study protocol.

Further information

For help and support on domestic violence, these services provide free helplines:

• National Domestic Violence 24 hr Helpline for women experiencing abuse: 0808 2000 247
• Men’s Advice Line for men experiencing abuse: Monday-Friday 9am-5pm: 0808 801 0327
• National LGBT Domestic Abuse Helpline: 0800 999 5428
• RESPECT Phoneline: Confidential helpline offering advice, information and support to anyone concerned about their own or someone else’s violent or abusive behaviour. Monday-Friday 9am-5pm: 0808 802 4040

About the Centre for Academic Primary Care

The Centre for Academic Primary Care (CAPC) at the University of Bristol is a leading centre for primary care research in the UK, one of nine forming the NIHR School for Primary Care Research. It sits within Bristol Medical School, an internationally recognised centre of excellence for population health research and teaching.

About the NIHR

The National Institute for Health Research (NIHR) is the nation’s largest funder of health and care research. The NIHR:

• funds, supports and delivers high quality research that benefits the NHS, public health and social care
• engages and involves patients, carers and the public in order to improve the reach, quality and impact of research
• attracts, trains and supports the best researchers to tackle the complex health and care challenges of the future
• invests in world-class infrastructure and a skilled delivery workforce to translate discoveries into improved treatments and services
• partners with other public funders, charities and industry to maximise the value of research to patients and the economy.

The NIHR was established in 2006 to improve the health and wealth of the nation through research, and is funded by the Department of Health and Social Care. In addition to its national role, the NIHR supports applied health research for the direct and primary benefit of people in low- and middle-income countries, using UK aid from the UK government.