COMforT study

Intervention refinement and feasibility trial of a trauma-informed mindfulness intervention for survivors of domestic violence and abuse with post-traumatic stress disorder (PTSD)

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Why is this research important?

People who experienced interpersonal trauma often develop PTSD which includes reliving the traumatic events through nightmares and disturbing memories, feeling isolated, irritated and guilty, having difficulties with concentration and functioning. Most women who have experienced domestic violence and abuse have PTSD. Their children are at risk of developing mental health problems. Unlike a one-off traumatic event, repeated domestic violence results in post-traumatic stress that is harder to treat.

Standard treatment for post-traumatic stress is a past-focused talking therapy which teaches how to change negative thoughts and feelings into more positive ones through ‘reliving’ traumatic memories. Many survivors of domestic violence 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 talking therapy which teaches how to respond to one-self with acceptance and self-compassion. We know that mindfulness works well for depression.

In collaboration with a group of survivors of domestic violence with post-traumatic stress, we have started adapting a standard mindfulness course for depression to fit the special treatment preferences and needs of abused women. Now we propose to finalise the adaptations with help from women survivors and mental health professionals and then test the adapted mindfulness therapy for PTSD in a small study.

If successful, the trauma-informed mindfulness programme could be an alternative talking therapy for those patients with post-traumatic stress who cannot or do not want to take up standard past-focused talking therapy. The proposed mindfulness therapy has a potential to increase uptake and satisfaction of the treatment. The NHS benefit could include substantial cost savings due to the group format of the adapted mindfulness therapy.

The study

The aim of this study is to adapt the standard mindfulness programme for depression for the treatment of PTSD and then test in a small study.

We will consult women survivors of domestic violence and mental health professionals on how to adapt the standard mindfulness programme for depression for the treatment of PTSD. Next, we will implement the adaptations into a new trauma-informed mindfulness programme. Then, we will recruit 57 women with post-traumatic stress and randomly allocate them into two arms. Half of the women will attend eight group sessions of the trauma-informed mindfulness, while the other half will receive the standard talking therapy.

The two groups will be compared with respect to mental health status of women and their children before the allocation and six months later. We will also interview all patients about their treatment experiences. If we find that the trauma-informed mindfulness course is acceptable and that the study plan could work, we will design a full-size trial and apply for funding.

For further information about this study, please contact Dr Natalia Lewis.