Shame, Resilience and Well-being After Intimate Partner Violence: an Intervention Study With Replicated Single-Subject Design.

Intimate partner violence (IPV) is a global problem with complex consequences in society as well as for the victim/survivor. The EMBER-protocol was developed at National Center for Knowledge on Men´s violence against Women, Uppsala University, Sweden. The purpose of the protocol is to provide women who have been subjected to IPV with support and tools for empowerment and improving resilience, thereby improving health and well-being. In this study with replicated single-case design, 8 patients will complete questionnaires bi-weekly while taking part of the intervention, starting from their very first contact with the clinic. The questionnaires are completed using a mobile application. Data will be processed using a combination of visual and statistical analysis, in order to examine how interventions intended to improve resilience, changes in resilience measures and changes in well-being and health relate to each other temporally.

• Resilience enhancing intervention, individual format (Other), also known as EMBER Phase A: A 4-step, Resilience-focused intervention based on the Resilience Portfolio Model, administered in individual format.
• Resilience enhancing intervention, group format (Other), also known as EMBER phase C: A 4-step, Resilience-focused intervention based on the Resilience Portfolio Model, administered in group format.

Primary outcomes

• Resilience - Psychological Endurance [Bi-weekly from enrollment 2-6 weeks prior to start of intervention, to completion of the intervention (intervention phase A and/or C). Follow-up 6 weeks post-intervention.]: The self assessment questionnaire Psychological Endurance Scale (range 6-24, higher value indicates higher endurance) is completed bi-weekly using a mobile application. Data will be analyzed with a combination of visual and statistical analyses.
• Resilience - Subjective Social Support [Bi-weekly from enrollment 2-6 weeks prior to start of intervention to completion of the intervention (intervention phase A and/or C). Follow-up 6 weeks post-intervention.]: The Oslo Subjective Social Support Scale - 3 items (range 3-14, higher value indicates higher level of social support) is completed bi-weekly using a mobile application. Data will be processed using a combination of visual and statistical analyses.
• Resilience - Meaning Making [Bi-weekly from enrollment 2-6 weeks prior to start of the intervention, to completion of the intervention (intervention phase A and/or C). Follow-up 6 weeks post-intervention.]: The MAPS - Meaningfulness subscale (range 5-25, higher value indicating higher meaningfulness) is completed by the subjects bi-weekly. Data is processed using a combination of statistical and visual analyses.

Secondary outcomes

• Health [Bi-weekly from enrollment 2-6 weeks prior to the intervention, to completion of the intervention (intervention phase A and/or C). Follow-up 6 weeks post-intervention.]: General, Somatic, Mental, Social and Sexual health is measured by 5 questions regarding subjective health the past week which are administered to the subject using a mobile application. The subject grades ones health on a visuoanalogue scale ranging from -10 to +10. The range on the total scale is thus -50 to +50, subscales -10 to +10. Higher value indicates better health. Data is processed using a combination in visual and statistical analyses.
• Shame [Bi-weekly from enrollment 2-6 weeks prior to start of the intervention, to completion of the intervention (intervention phase A and/or C). Follow-up 6 at weeks post-intervention.]: Shame is measured using the External and Internal Shame Scale (EISS; range 0.00-4.00, higher value indicating higher levels of shame), administered to patients using a mobile application. Data is processed using a combination of statistical and visual analyses.
• Well-Being [Bi-weekly from enrollment 2-6 weeks prior to start of the intervention, to completion of the intervention (intervention phase A and/or C). Follow-up at 6 weeks post-intervention.]: Well-being is measured bi-weekly using the Questionnaire on Well-Being (QWB, range 0-72, higher value indicating more wellbeing). Data is processed using a combination of statistical and visual analyses.

Sex: Female, ages: 18 Years to any

Inclusion Criteria:

* subjected to IPV within 2 years prior to enrollment
* capable of completing questionnaires using a mobile phone
* intention to complete intervention
* identifies as female

Exclusion Criteria:

* ongoing severe IPV
* ongoing severe substance use
* psychosis
* moderate to severe suicidality
* ongoing psychological intervention in other facility

• Carolina Överlien, Professor, Principal investigator, The National Centre for Knowledge on Men's Violence Against Women, Uppsala university