Våld och Trauma. Klientfokuserad utvärdering av behandling för våldsutsatta mammor och deras barn

Sammanfattning: The general purpose of this thesis was to evaluate a community-based treatment program targeted for mothers subjected to intimate partner violence (IPV) and their children. In an open study the treatment program was evaluated with a repeated measure design. With a patient focused approach the program was analyzed according to its statistical-, practical- and clinical significance. Study I included 42 mothers. At the start of treatment the mothers displayed trauma symptoms and psychiatric symptoms in the clinical range. Furthermore, the mothers had a low sense of coherence and the measure of parental locus of control indicated a high level of resignation concerning child issues. Results based on group means indicated that the mothers showed significantly reduced trauma and psychiatric symptoms and improved their sense of coherence after participating in the program. Surprisingly, no improvement regarding perceived parental locus of control was found. When the results were analyzed with the reliable change index (RCI) at the individual level the treatment gains were more uncertain. Far from the majority of mothers within the clinical symptom range were improved or recovered. Study II examined the mother´s perceived effectiveness of the group treatment for their 46 children (5-14 years old) exposed to IPV. Initially, about half of the children displayed behavioral problems in the clinical range and the majority of children showed posttraumatic stress symptoms. Children´s behavioral problems were reduced significantly following the program and the higher the mother´s initial trauma symptoms the greater were the reduction in child behavioral problems. However, results analyzed at the individual level presented a more complex picture. The majority of children did not show individual changes beyond chance levels on the outcome measure used. The conclusions drawn from the studies concerned the importance of monitoring the treatment progress for each individual and to report results at the group as well as the individual level.