Mental Health Professionals' Perspectives on Group Intervention for Women Survivors Intimate Partner Violence: A Qualitative study

Mental Health Professionals' Perspectives on Group Intervention for Women Survivors Intimate Partner Violence: A Qualitative study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Mental Health Professionals' Perspectives on Group Intervention for Women Survivors Intimate Partner Violence: A Qualitative study Chinnadurai Periyasamy, Sinu Ezhumalai This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3831525/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 20 Jun, 2024 Read the published version in Journal of Psychiatry Spectrum → Version 1 posted You are reading this latest preprint version Abstract Background: To examine the perspectives of mental health professionals on providing group intervention for female spouses of men with alcohol dependence who experienced intimate partner violence. Method : Aqualitative research design was used, and purposive sample technique was used to select the participants. Nine experts with more thanfive years of experience in handling partner violence cases providedinsights through in-depth interviews. The sample size was nine; data was saturated with nine experts. The researcher prepared a semistructured interview guide and mental health experts validated it. The transcripts were carefully examined several times, coded and re-codeded . The codes were subsequently organized into thematic categories. Results: More than half (66.7%) of the experts were aged35-45 years. Most of the experts (77.8%) were females. More than half (55.6%) of the experts had more than five years of experience in mental health and intimate partner violence. Most of the experts (66.7%) were working in teaching institutions related to mental health and intimate partner violence. The remaining one-third (33.3%) of the experts were legal and women empowerment practitioners. The thematic analysis generated six main themes and 19 subthemes, with 189 codes. Conclusion : Experts emphasized the importance of a holistic approach to IPV intervention. Group interventionaddresses multiple issues that contribute to violence. Survivors need safe housing, counseling, legal help, and financial assistance. Social Work Psychology Psychiatry Women's studies Group work partner Abuse expert opinion qualitative study. Introduction Intimate partner violence is a global public health issue affecting mental health women worldwide.[1]The WHO defines intimate partner violence as physical violence, sexual intimidation, emotional abuse, and controlling behaviors.[2] Intimate partner violence and alcohol dependence are ongoing crisis for individuals and their families.[3]Female spouses are extremely affected by intimate partner violence and experience physical, verbal, or sexual abuse from their intimate partners[4]. Globally, one-third of women worldwide report that they have experienced physical and sexual violence from their partner.[5]Fifty percent of the clinical population has a co-occurrence rate of substance use and IPV.[6] In India, the prevalence of physical and sexual violence is 29%. Women experience significant physical and mental health consequences due to IPV.[7] Alcohol consumption is associated with IPV perpetration and victimization.[8] Women view husbands’ alcohol dependence as a significant factor contributing to IPV.[9]IPV significantly worsens the mental well-being of survivors. Strong associations were found between IPV and depression, posttraumatic stress disorder, and anxiety. The severity and duration of IPV, intensifies mental health issues, accentuating the significant psychological impact of violence.[10] Rationale for the study Group work plays a vital role in addressing intimate partner violence (IPV) among the women survivors.[11] Group interventions improve physical health, interpersonal connections, and re-engagement in various aspects of IPV survivors.[12] Group interventions create a supportive and empowering environment where women can share their experiences [13], receive validation, and combat feelings of isolation and shame. Learning from each other's stories and coping strategies, survivors gain insights, practical advice, and emotional support, fostering resilience and a sense of agency.[14] Group interventions provide insights into IPV dynamics[15], and available resources[16], empowering women to make informed decisions about their safety and well-being.[17] Skill-building activities within groups enhance survivors' ability to recognize abusive patterns, set boundaries, and develop problem-solving skills, enabling them to break free from the cycle of violence.[18]Moreover, group interventions foster social connections and community building, mitigating the social isolation often experienced by IPV survivors. Overall, Group interventions provide support, shared experiences, information, skills to handle IPV, and social connection, contributing to the healing and empowerment of survivors.[19] Therefeore the study aimed to examine mental health professionals' views on group intervention for women experiencing intimate partner violence. The study proposed potential intervention compnenets to improve the program, empowering professionals to aid survivors. Methods Participants This study used a qualitative research design. The participants having more than five years of work experience in the field of intimate partner violence were selected using purposive sampling. The sample size was nine; the data reached saturation with nine expert interviews. The interviews with the mental health professionals were conducted at their workplace. The first author collected the data from the participants through face-to-face interview. He is a PhD scholar in Psychiatric Social Work. He underwent training and certification in qualitative research methodlogy and qualitative data analysis.. Measurements The researcher prepared an in-depth interview guide and validated it with five mental health experts. Ethical approval was obtained from the institute. The Institutional Ethics Committee granted ethical approval for the study (Ref No: NIMH/DO/Beh.Sc.Div./2020-2021). Written informed consent was obtained from all the experts before the data were collected. Data collection procedure All the interviews were audio-recorded and transcribed from the vernacular language into English. The field notes were taken, the duration of the data collection was two months. The duration of the audio recording ranged from 27 to 40 minutes. The transcribed data were read and re-read multiple times by the researcher, and two other social work docotral research scholars reviewed the codes. The researcher gained insights from the interviews with subject experts that the IPV survivors need psychosocial interventions related to their safety, and addressing their mental health needs and their children’s needs as well. Data analysis The Braun and Clarke method was utilized for thematic analysis, incorporating both deductive and inductive approaches.[20] ATLAS.ti.9 software was used for qualitative data analysis. The themes were generated iteratively after repeated re-reading of the data, relevant and appropriate codes were identified. Results Table 1: Profile of Subject Experts Sl.No Variables Categories N (%) 1 Age 35-45 06 (66.7) 46-55 03 (33.3) 2 Gender Male 02 (22.2) Female 07 (77.8) 3 Years of work experience 10 years 04 (44.4) 4 Designation Professor 01 (11.1) Additional professor 02(22.2) Associate professor 01(11.1) Assistant professor 02(22.2) Practitioner 03 (33.3) 5 Field (Specialization practice area) IPV and Mental health 05 (55.6) Addiction 02(22.2) Legal 01 (11.1) Women empowerment 01 (11.1) Table 1 explains the profile of the experts with whom interviews were conducted to develop the intervention module. The majority (66.7%) of the experts with whom interviews were conducted were aged 35-45 years. The majority of the experts (77.8%) were females. More than half(55.6%) of the experts had five years of experience in mental health and intimate partner violence. Most of the experts (66.7%) were working as professors in teaching institutions related to mental health and intimate partner violence. The remaining participants (33.3%) were legal and women empowerment practitioners. Table 2: Qualitative findings S.l.No Themes Subthemes 1 Psychosocial Needs And Concerns 1.1: Address and identification of the violence 1.2: Need for mental health screening among survivors 1.3:Safety of the women and children 1.4: Empowerment of the Survivors/Economic 1.5: Enhancement of survivor knowledge/awareness 1.6:Social support systems 2. Psychosocial interventions 2.1: Mental health literacy 2.2: Ventilation 2.3: Understanding the intimate partner violence 2.4: Trauma focused intervention 2.5: Law literacy 2.6: Safety assessment for the victims and children and safety of the victims and children 3 Enhancing psychological wellbeing 3.1 Sharing their experience 3.2: Relaxation 3.3: Coping with stress. 3.4: Handling the children's emotions 4 Enhancing the social support systems 4.1: Networking 4.2 Mapping the resources 4.3: Referral systems 5 Challenges 5.1: Confidentiality 5.2: Not ready to share the group 6 Therapeutic strategies 6.1: Maintain confidentiality and build trust 6.2: Maintain the group we feeling 6.3: Continue the session with short periods and less times 6.4: Case scenario 6.5: Female cotherapist Table 2: Expert thematic analysis findings: Nine experts participated in the study based on the thematic analysis, six main themes, and 26 subthemes, with 189 codes generated from the analysis. Theme 1: Psychosocial needs and concerns: Subtheme 1.1: Address and identification of violence "As facilitators in group therapy, it is crucial to identify and address the experiences of violence and the psychosocial concerns raised by participants. We must acknowledge and validate the presence of violence within the group" (Mental Health Expert, 2). Subtheme 1.2 : Need for mental health screening among survivors "The participants will not report voluntarily. As mental health professionals, we should screen their mental health concerns and psychological distress simultaneously and provide mental health services to those requiring them, ensuring comprehensive support" (MHE,1). Subtheme 1.3: Safety of the women and children "For children's safety purposes, call the children's helpline services 1098; whenever the children have safety problems, they can call 1098, and there is CWC. You should be able to give this resource list to the CWC at the district level, or she can go to the nearby PHC, Anganwadi, where people can support her. She can even go to the police station even if every police station has a special juvenile police unit (SJPU). Every police station has an SJPUunit; they do not appoint any special persons there. Nevertheless, they have an SJPU, so the mother should have access to them if they are concerned about the safety of the children. Childline 1098 is the best way to give them a list of the resources where they can get help and safety guidelines" (MHE,1). Subtheme 1.4: Empowerment of the victims/Economic " Survivors usually depend economically on their husbands because many women are not ready for the relationship. Women should learn and have the skills to financially empower themselves with support of the welfare schemes available in the community that information should be discussed through the group work" (MHE, 7). Subtheme 1.5:Enhancement of survivor knowledge/awareness "We should provide women with opportunities and resources to develop their abilities, including skill training, access to welfare schemes, and education on the alcohol treatment process. This will empower women, reduce violence, promote awareness of women's rights, and enhance their overall well-being" (MHE, 2). Subtheme 1.6:Social Support Systems "We need to empower the women when they are unaware of how to handle violence" (MHE, 3). Theme 2: Psychosocial interventions Subtheme 2.1:Mental health literacy " I mean, we need to improve their mental health literacy" (MHE, 9). Subtheme 2.2:Ventilation " Allow them to talk about the violence" (MHE, 3). Subtheme 2.3: Understanding Intimate Partner Violence " We should clearly describe the addiction to violence and the general context of the violence" (MHE, 1). Subtheme 2.4: Trauma -focused intervention " Psychoeducation where we need to discuss the trauma-related, and we need some cognitive principles is that they are misconception" (MHE, 5). Subtheme 2.5: Legal literacy "Legal literacy they truly need because they will feel there is no help out for the violence" (MHE, 5) Subtheme 2.6: Safety assessment for the victims and children and safety of the victims and children "So I think this is a very pertinent question, ensuring safety.How to make a safety plan and how to do it" (MHE, 9). Theme 3: Enhancing psychological wellbeing Subtheme 3.1: Sharing experiences "In group therapy, it helps them to open up easily; they will share their own experience because they get to speak to other women; it will help them a little better, feel more supported" (MHE, 6). Subtheme 3.2: Relaxation " Including the manual components, I can say solution-focused components, role play and relaxation components it is better for them" (MHE, 9). Subtheme 3.3: Coping with stress In a group, some people influence them, and some people are already doing something. This may be another way to cope. If they are stressed, they need to manage the stress and social skill model, coping skills and creative model to help them manage the stress" (MHE,6). Subtheme 3.4: Handling children's emotions "If you are making an intervention, I think one component you can think of is dealing with children's emotions and how they can save and protect the children. I think that also included one of the components" (MHE, 5). Theme 4: Enhancing Social Support Systems Subtheme 4.1: Networking "What resources are available in the community and networking system ? " (MHE, 3). Subtheme 4.2: Mapping the Resources "Therefore, I think, first and foremost, is that, and identifying support systems through resource mapping" (MHE, 9). "In our sessions, I suggest adding another session specifically for wives. We can discuss the available resources to help them in difficult situations. She can address financial resources, emotional support networks, and people who can assist with childcare. We should also cover where to go in case of domestic violence and inquire about nearby police stations. It is important to explore the resources available in the community, such as hospitals, schools, and NGOs. During the group session, we can emphasize the importance of utilizing these resources, as many women may have access to them but might not realize their potential benefits" (MHE, 8). Subtheme 4.3: Referral systems "We can link some NGOs and give them local resources that will help them and some of the women they will identify themselves" (MHE, 6). Theme 5: Challenges Subtheme 5.1: Confidentiality "I mean, I think one of the things is like sexual trauma, sexual abuse; these are some of the things that women might not bring up; they might just or even other violence; also, they might feel very, under confidence to you know, talk about it, they might feel embarrassed about discussing these things" (MHE,9). Subtheme 5.2: Not ready to share with the group : "Due to stigma and confidentiality, participants do not disclose the trauma in the group" (MHE, 3). Theme 6: Therapeutic strategies Subtheme 6.1: Maintaining confidentiality and building trust "Second thing would be, I do not think they might come up openly about all the forms of abuse that they are going through. So sometimes it is about telling them that, you know, keeping things confidential, and just limiting the discussions to the group is very, very important" (MHE, 9). Subtheme 6.2: Maintaining group feelings "Sometimes the people use to feel the problems everyone facing it is not only to me another person there is way to come out the problems in this context it is a cohesion of the group" (MHE, 1). Subtheme 6.3: Continue the session for short periods or fewer times "The sessions will be very short and informative; otherwise, the participants will not continue" (MHE, 5). Subtheme 6.4: Case scenario "Sometimes the participants know how to disclose and share. If you make the case scenario or mindful games, it will help them understand" (MHE, 7). Subtheme 6.5: Female cotherapyist "Best, the female therapist will help them disclose. Other things therapist, it is not about the gender; the therapist should have good empathizing skills; it will help" (MHE, 2). Discussion On the basis of our analysis of the key informant's interviews, we identified four themes contributing to the experts' opinions on psychosocial concerns and psychosocial intervention for women who experience intimate partner violence. The study's first theme is that identifying women with intimate partner abuse is extremely important, especially for spouses with alcohol dependence syndrome. A similar study also revealed that addressing and understanding the factors influencing IPV is important for helping further research on preventing violence. [11]The results of the present study showed that survivors need to be screened for mental health care; a similar study revealed that female survivors of IPV are more likely than women not exposed to IPV to report needing mental health services.[21]A similar study also revealed the need for programming and research to address this connection between alcohol and intimate partner violence.[8] In this study, the experts said that safety strategies are the main concern of survivors in preventing the risk of violence, and many studies have shown that survivors need safety plans. Similarly, many studies have investigated practitioner intervention, including safety planning for women and children.[17], [22], [15], [18] The study showed that economic empowerment helps participants reduce violence. Similarly, other studies have shown that protective aspects of economic empowerment support women in accessing wider social networks, information, and support, resulting in improved confidence and bargaining positions in their relationships.[23] The study identified several recommended intervention components, including mental health literacy, ventilation, IPV awareness, trauma-focused intervention, law literacy, and safety assessment for survivors and their children. Experts have also emphasized the importance of improving psychological well-being and social support to reduce violence.The study identified several key intervention components: mental health literacy, ventilation, IPV understanding, trauma-focused intervention, law literacy, and safety assessment for survivors and their children. Experts stressed that improving psychological well-being and social support effectively helps survivors handle violence.[24] This study revealed that enhancing psychological well-being through sharing experiences, coping skills, relaxing techniques, and handling children's emotions in group sessions was very important for survivors. One study showed that similar interventions help survivors reduce psychological distress; coping is an essential element of IPV intervention, but the mediating effect of coping responses on IPV has not been extensively studied.[14] The study showed that enhancing the social support system among survivors through networking, resource mapping, and a referral system are essential components of enhancing the social support system. A previous study revealed that social networks, resource mapping, and referral systems increase women's help-seeking behavior.[24] While implementing the intervention, the experts mentioned some challenges, such as confidentiality and unwillingness to disclose the trauma during the session. Similarly, another study found that creating trust and confidentiality is crucial in sessions.[25] Expert reported that specific therapeutic strategy skills are beneficial for facilitating effective group work. Experts recommended that therapists prioritize maintaining confidentiality, building trust [26], and fostering a sense of cohesion within the group.[27] The session should be short and informative and give some case scenario examples. Therapists should be female when handling women-related trauma. A previousstudyshowed that women survivors prefer female therapists.[28]The provider or group leader in group therapy sessions is constrained by the laws of secrecy about the participant's histories and other personal information. Therefore, participants' confidentiality can be challenging to maintain, particularly in larger groups, when group leaders have less control over the infomations disseminated within the group.[29] Limitations The study engaged a limited sample of nine mental health experts. Though the data was saturated with nine subject experts; a larger, more diverse sample could enhance generalizability, encompassing various target participants. The predominant female, 35-45 age group of participants working as professors might limit perspectives. A more balanced representation of age, gender, and professional backgrounds could have benefitted the study.The variable interview durations (27 to 40 minutes) from mental health experts warrant standardization for consistency in data collection. Potential biases of the study could be; out of nine experts, seven were teaching and practicing in the same institute. Most of the mental health experts were the teachers of the first author. Conclusion Experts agree that intimate partner violence (IPV) interventions are crucial for addressing and reducing this complex issue. Early intervention is essential to prevent the escalation of violence. Collaborative efforts among various stakeholders, such as law enforcement agencies, social services, healthcare providers, legal professionals, and community organizations, are key to enhancing the effectiveness of interventions. Long-term support, including ongoing counseling, access to resources, and progress monitoring, is crucial for survivors and perpetrators. Experts advocate for evidence-based programs, emphasizing rigorous research, evaluation, and monitoring to ensure effectiveness and inform policy decisions. Consulting professionals and organizations specializing in IPV intervention need up-to-date and accurate information. Declarations Funding: This work was supported by a grant from the Indian Council of Social Science Research. The first author received a doctoral fellowship from the ICSSR. File No. RFD/2021-22/GEN/SW/204. (ICSSR). Acknowledgments : The authors thank the study participants and the Center for Addiction Medicine staff for their support in the data collection. Conflict of Interest : None. References Patra P, Prakash J, Patra B, et al. Intimate partner violence: Wounds are deeper. Indian J Psychiatry 2018; 60: 494. Daher M. Public Health World Report on Violence and Health. Leban Med J 2017; 51: 59–63. Klostermann KC, Fals-Stewart W. Intimate partner violence and alcohol use: Exploring the role of drinking in partner violence and its implications for intervention. Aggress Violent Behav 2006; 11: 587–597. Eckermann E. "Domestic violence: A priority public health issue in the Western Pacific region. WHO 2001; 5: 195–228. World Health Organization (WHO). Violence against women prevalence estimates, 2018: global, regional and national prevalence estimates for intimate partner violence against women and global and regional prevalence estimates for nonpartner sexual violence against women. 2021. Thomas MD, Bennett LW, Stoops C. The Treatment Needs of Substance Abusing Batterers: A Comparison of Men Who Batter Their Female Partners. J Fam Violence 2013; 28: 121–129. Devries K, Watts C, Yoshihama M, et al. Violence against women is strongly associated with suicide attempts: Evidence from the WHO multicountry study on women’s health and domestic violence against women. Soc Sci Med 2011; 73: 79–86. Devries KM, Child JC, Bacchus LJ, Mak J, Falder G, Graham K, Watts C, Heise L. Intimate partner violence victimization and alcohol consumption in women: A systematic review and meta‐analysis. Addiction. 2014;3:379-391. Satyanarayana VA, Hebbani S, Hegde S, et al. Two sides of a coin: Perpetrators and survivors perspectives on the triad of alcohol, intimate partner violence and mental health in South India. Asian J Psychiatr 2015; 15: 38–43. Lagdon S, Armour C, Stringer M. Adult experience of mental health outcomes as a result of intimate partner violence victimization: a systematic review. European journal of psychotraumatology. 2014;5:10.3402/ejpt.v5.24794. Ranapurwala SI. Identifying and addressing confounding bias in violence prevention research. Current epidemiology reports. 2019;6:200-207. Brown SJ, Carter GJ, Halliwell G, Brown K, Caswell R, Howarth E, Feder G, O'Doherty L. Survivor, family and professional experiences of psychosocial interventions for sexual abuse and violence: a qualitative evidence synthesis. Cochrane database of systematic reviews. 2022;10(10):CD013648. Fellin LC, Callaghan JEM, Alexander JH, et al. Empowering young people who experienced domestic violence and abuse: The development of a group therapy intervention. Clin Child Psychol Psychiatry 2019; 24: 170–189. Mitchell MD, Hargrove GL, Collins MH, et al. Coping variables that mediate the relation between intimate partner violence and mental health outcomes among low-income, African American women. J Clin Psychol 2006; 62: 1503–1520. O’Campo P, McDonnell K, Gielen A, et al. Surviving physical and sexual abuse: what helps low-income women? Patient Educ Couns 2002; 46: 205–212. Davies K, Block CR, Campbell J. Seeking Help from the Police: Battered Women’s Decisions and Experiences. 2007; 20: 15–41. Waugh F, Bonner M. Domestic violence and child protection: issues in safety planning. Child Abus Rev 2002; 11: 282–295. Elliott DE, Bjelajac P, Fallot RD, Markoff LS, Reed BG. Trauma‐informed or trauma‐denied: Principles and implementation of trauma‐informed services for women. Journal of community psychology. 2005; 33:461-477. Kim J, Eun-Hye Grace Y, Macy RJ, et al. Interventions to Prevent Suicidality Among Survivors of Intimate Partner Violence: A Systematic Review. Partner Abuse 2022; 13: 345–365. Lipsky S, Caetano R. Impact of intimate partner violence on unmet need for mental health care: Results from the NSDUH. Psychiatr Serv 2007; 58: 822–829. Logan T, Shannon L, Cole J, et al. The Impact of Differential Patterns of Physical Violence and Stalking on Mental Health and Help-Seeking Among Women With Protective Orders. 2006; 12: 866–886. Borchers A, Lee RC, Martsolf DS, et al. Employment maintenance and intimate partner violence. Work Heal Saf 2016; 64: 469–478. Tiwari A, Fong DYT, Yuen KH, et al. Effect of an advocacy intervention on mental health in Chinese women survivors of intimate partner violence: A randomized controlled trial. Jama 2010; 304: 536–543. Du Mont J, Forte T, Cohen MM, et al. Changing Help-Seeking Rates for Intimate Partner Violence in Canada. 2008; 41: 1–19. Harris M, Fallot RD. Using Trauma Theory to Design Service Systems.Vol 89. San Francisco, CA: Josey-Bass; 2001. Metz A, Jensen T, Farley A, Boaz A, Bartley L, Villodas M. Building trusting relationships to support implementation: a proposed theoretical model. Frontiers in health services. 2022; 23:2-71. Thye SR, Yoon J, Lawler EJ. The theory of relational cohesion, The Theory of Relational Cohesion: Review of a Research Program. 2002; 19: 139–166. Landes SJ, Burton JR, King KM, et al. Women’s Preference of Therapist Based on Sex of Therapist and Presenting Problem: An Analog Study. Couns Psychol Q 2013; 26: 330-342. Lasky GB, Riva MT. Confidentiality and privileged communication in group psychotherapy. Int J Group Psychother 2006; 56: 455–476. Additional Declarations The authors declare no competing interests. Supplementary Files Appendix.docx Cite Share Download PDF Status: Published Journal Publication published 20 Jun, 2024 Read the published version in Journal of Psychiatry Spectrum → Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-3831525","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":277720906,"identity":"d02c4ecc-203d-48d3-89fe-0f7fc0a402ab","order_by":0,"name":"Chinnadurai Periyasamy","email":"","orcid":"https://orcid.org/0000-0002-8250-2498","institution":"NIMHANS","correspondingAuthor":false,"prefix":"","firstName":"Chinnadurai","middleName":"","lastName":"Periyasamy","suffix":""},{"id":277720907,"identity":"4064bedd-b3b3-457c-8bf8-eb2e16ce6a6d","order_by":1,"name":"Sinu Ezhumalai","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAx0lEQVRIiWNgGAWjYFACxgYGhor/ciDmgQfEaznDbAzWkkC8RW3MiQ0gBlFa+PkPtz3mYWNLnx92+CHQFjs53QYCWiRnJLYb8/Dw5G68nWYA1JJsbHaAgBaDG4xt0jwSErkbZyeAtBxI3EZIi/35g0AtBgbphrPTPxCnxYAhEaglISFBXjqHSFskbiS2Sc45cMBwg3ROwYEEAyL8wt9//JnE238H5OVnp2/+8KHCTo6gFoQLD0DcSQKQbyBF9SgYBaNgFIwoAABBYEPzoJSlBgAAAABJRU5ErkJggg==","orcid":"https://orcid.org/0000-0001-6086-8133","institution":"NIMHANS","correspondingAuthor":true,"prefix":"","firstName":"Sinu","middleName":"","lastName":"Ezhumalai","suffix":""}],"badges":[],"createdAt":"2024-01-03 10:01:11","currentVersionCode":1,"declarations":{"humanSubjects":false,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":false,"humanSubjectConsent":false,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-3831525/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3831525/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.4103/jopsys.jopsys_47_23","type":"published","date":"2024-06-20T16:53:13+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":58825915,"identity":"8772ceca-62a4-4069-a9c4-6050854109bc","added_by":"auto","created_at":"2024-06-21 17:27:04","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":714427,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3831525/v1/740c20d8-4339-4c7a-a6ae-3dfaec857b5c.pdf"},{"id":52397963,"identity":"9e4e831c-878a-4e1f-9380-4ad4c02f976b","added_by":"auto","created_at":"2024-03-11 05:48:15","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":15724,"visible":true,"origin":"","legend":"","description":"","filename":"Appendix.docx","url":"https://assets-eu.researchsquare.com/files/rs-3831525/v1/3971f15b13b45a3209104610.docx"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003e\u003cstrong\u003eMental Health Professionals' Perspectives on Group Intervention for Women Survivors Intimate Partner Violence: A Qualitative study\u003c/strong\u003e\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eIntimate\u0026nbsp;partner violence\u0026nbsp;is a global public health issue affecting mental health women worldwide.[1]The\u0026nbsp;WHO defines intimate partner violence\u0026nbsp;as\u0026nbsp;physical violence, sexual intimidation, emotional abuse, and controlling behaviors.[2]\u0026nbsp;Intimate partner violence and alcohol dependence are ongoing crisis for individuals and their families.[3]Female spouses are extremely affected by intimate partner violence\u0026nbsp;and experience\u0026nbsp;physical, verbal, or sexual abuse from their intimate partners[4].\u003c/p\u003e\n\u003cp\u003eGlobally, one-third of women worldwide report that they have experienced physical and sexual violence\u0026nbsp;from\u0026nbsp;their partner.[5]Fifty percent\u0026nbsp;of the clinical population has a co-occurrence rate of substance use and IPV.[6]\u0026nbsp;In India, the prevalence of physical and sexual violence is 29%. Women experience significant physical and mental health consequences due to IPV.[7]\u0026nbsp;Alcohol consumption is associated with IPV perpetration and victimization.[8]\u0026nbsp;Women view\u0026nbsp;husbands’\u0026nbsp;alcohol\u0026nbsp;dependence\u0026nbsp;as a significant factor contributing to IPV.[9]IPV significantly worsens the mental well-being of survivors. Strong associations were found between IPV and depression, posttraumatic stress disorder, and anxiety. The severity and duration of IPV, intensifies mental health issues, accentuating the significant psychological impact of violence.[10]\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRationale for the study\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eGroup work plays a vital role in addressing intimate partner violence (IPV) among the women survivors.[11]\u0026nbsp;Group interventions improve physical health, interpersonal connections, and re-engagement in various aspects of IPV survivors.[12] Group\u0026nbsp;interventions create a supportive and empowering environment where women can share their experiences\u0026nbsp;[13], receive validation, and combat feelings of isolation and shame. Learning from each other's stories and coping strategies, survivors gain insights, practical advice, and emotional support, fostering resilience and a sense of agency.[14]\u0026nbsp;Group interventions provide insights into IPV dynamics[15], and available resources[16], empowering women to make informed decisions about their safety and well-being.[17]\u0026nbsp;Skill-building activities within groups enhance survivors' ability to recognize abusive patterns, set boundaries, and develop problem-solving skills, enabling them to break free from the cycle of violence.[18]Moreover, group interventions foster social\u0026nbsp;connections\u0026nbsp;and community building, mitigating the social isolation often experienced by IPV survivors. Overall, Group interventions provide support, shared experiences, information, skills\u0026nbsp;to handle IPV, and social connection, contributing to the healing and empowerment of survivors.[19]\u003c/p\u003e\n\u003cp\u003eTherefeore the study aimed to examine mental health professionals' views on group intervention for women experiencing intimate partner violence. The study proposed potential intervention compnenets to improve the program, empowering professionals to aid survivors.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cstrong\u003eParticipants\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study used a qualitative research design. The participants having more than five years of work experience in the field of intimate partner violence were selected using purposive sampling. The sample size was nine; the data reached saturation with nine expert interviews. The\u0026nbsp;interviews\u0026nbsp;with the mental health\u0026nbsp;professionals were\u0026nbsp;conducted at their workplace. The first author collected the data from the participants through face-to-face interview. He is a PhD scholar in Psychiatric Social Work. He underwent training and certification in qualitative research methodlogy and qualitative data analysis..\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMeasurements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe researcher prepared an in-depth interview guide and validated it with five mental health experts. Ethical approval was obtained from the institute. The Institutional Ethics Committee granted ethical approval for the study (Ref No: NIMH/DO/Beh.Sc.Div./2020-2021).\u0026nbsp;Written informed\u0026nbsp;consent was obtained from all the experts before\u0026nbsp;the\u0026nbsp;data\u0026nbsp;were collected.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData collection procedure\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll the interviews were audio-recorded and transcribed from the vernacular language into English. The field notes were taken, the duration of the data collection was two months. The\u0026nbsp;duration\u0026nbsp;of the audio recording\u0026nbsp;ranged from\u0026nbsp;27 to 40 minutes. The transcribed data\u0026nbsp;were\u0026nbsp;read and re-read multiple times by the researcher, and two other social work docotral research scholars \u0026nbsp;reviewed the codes. The researcher gained insights from the\u0026nbsp;interviews\u0026nbsp;with subject experts that the IPV survivors need psychosocial interventions related to their safety, and addressing their mental health needs and their children’s needs as well.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe Braun and Clarke method was utilized for thematic analysis, incorporating both deductive and inductive approaches.[20] ATLAS.ti.9 software was used for qualitative data analysis. The themes were generated iteratively after repeated re-reading of the data, relevant and appropriate codes were identified.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cstrong\u003eTable 1: Profile of Subject Experts\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"595\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.317803660565724%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSl.No\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"37.770382695507486%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.95341098169717%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eCategories\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.958402662229616%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eN (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.317803660565724%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"37.770382695507486%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.95341098169717%\" valign=\"top\"\u003e\n \u003cp\u003e35-45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.958402662229616%\" valign=\"top\"\u003e\n \u003cp\u003e06 (66.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"52.83018867924528%\" valign=\"top\"\u003e\n \u003cp\u003e46-55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"47.16981132075472%\" valign=\"top\"\u003e\n \u003cp\u003e03 (33.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.317803660565724%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"37.770382695507486%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.95341098169717%\" valign=\"top\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.958402662229616%\" valign=\"top\"\u003e\n \u003cp\u003e02 (22.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"52.83018867924528%\" valign=\"top\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"47.16981132075472%\" valign=\"top\"\u003e\n \u003cp\u003e07 (77.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.317803660565724%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"37.770382695507486%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eYears of work experience\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.95341098169717%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.958402662229616%\" valign=\"top\"\u003e\n \u003cp\u003e05 (55.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"52.83018867924528%\" valign=\"top\"\u003e\n \u003cp\u003e\u0026gt;10 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"47.16981132075472%\" valign=\"top\"\u003e\n \u003cp\u003e04 (44.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.317803660565724%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"37.770382695507486%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003eDesignation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.95341098169717%\" valign=\"top\"\u003e\n \u003cp\u003eProfessor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.958402662229616%\" valign=\"top\"\u003e\n \u003cp\u003e01 (11.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"52.83018867924528%\" valign=\"top\"\u003e\n \u003cp\u003eAdditional professor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"47.16981132075472%\" valign=\"top\"\u003e\n \u003cp\u003e02(22.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"52.83018867924528%\" valign=\"top\"\u003e\n \u003cp\u003eAssociate professor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"47.16981132075472%\" valign=\"top\"\u003e\n \u003cp\u003e01(11.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"52.83018867924528%\" valign=\"top\"\u003e\n \u003cp\u003eAssistant professor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"47.16981132075472%\" valign=\"top\"\u003e\n \u003cp\u003e02(22.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"52.83018867924528%\" valign=\"top\"\u003e\n \u003cp\u003ePractitioner\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"47.16981132075472%\" valign=\"top\"\u003e\n \u003cp\u003e03 (33.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.317803660565724%\" rowspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"37.770382695507486%\" rowspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003eField (Specialization practice area)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.95341098169717%\" valign=\"top\"\u003e\n \u003cp\u003eIPV and Mental health\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.958402662229616%\" valign=\"top\"\u003e\n \u003cp\u003e05 (55.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"52.83018867924528%\" valign=\"top\"\u003e\n \u003cp\u003eAddiction\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"47.16981132075472%\" valign=\"top\"\u003e\n \u003cp\u003e02(22.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"52.83018867924528%\" valign=\"top\"\u003e\n \u003cp\u003eLegal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"47.16981132075472%\" valign=\"top\"\u003e\n \u003cp\u003e01 (11.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"52.83018867924528%\" valign=\"top\"\u003e\n \u003cp\u003eWomen empowerment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"47.16981132075472%\" valign=\"top\"\u003e\n \u003cp\u003e01 (11.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;Table 1 explains the profile of the experts with whom interviews were conducted to develop the intervention module. The majority (66.7%) of the experts with whom interviews were conducted were aged 35-45 years. The majority of the experts (77.8%) were females. More than half(55.6%) of the experts had five years of experience in mental health and intimate partner violence. Most of the experts (66.7%) were working as professors in teaching institutions related to mental health and intimate partner violence. The remaining participants (33.3%) were legal and women empowerment practitioners.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2:\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eQualitative\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;findings\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"595\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.588957055214724%\" valign=\"top\"\u003e\n \u003cp\u003eS.l.No\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.607361963190183%\" valign=\"top\"\u003e\n \u003cp\u003eThemes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"63.80368098159509%\" valign=\"top\"\u003e\n \u003cp\u003eSubthemes\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.588957055214724%\" rowspan=\"6\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.607361963190183%\" rowspan=\"6\" valign=\"top\"\u003e\n \u003cp\u003ePsychosocial Needs And Concerns\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"63.80368098159509%\" valign=\"top\"\u003e\n \u003cp\u003e1.1: Address and identification of the violence\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" valign=\"top\"\u003e\n \u003cp\u003e1.2: Need for mental health screening among survivors\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" valign=\"top\"\u003e\n \u003cp\u003e1.3:Safety of the women and children\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" valign=\"top\"\u003e\n \u003cp\u003e1.4: Empowerment of the Survivors/Economic\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" valign=\"top\"\u003e\n \u003cp\u003e1.5: Enhancement of survivor knowledge/awareness\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" valign=\"top\"\u003e\n \u003cp\u003e1.6:Social support systems\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.588957055214724%\" valign=\"top\"\u003e\n \u003cp\u003e2.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.607361963190183%\" valign=\"top\"\u003e\n \u003cp\u003ePsychosocial interventions\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"63.80368098159509%\" valign=\"top\"\u003e\n \u003cp\u003e2.1: Mental health literacy\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.588957055214724%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.607361963190183%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"63.80368098159509%\" valign=\"top\"\u003e\n \u003cp\u003e2.2: Ventilation\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" valign=\"top\"\u003e\n \u003cp\u003e2.3: Understanding the intimate partner violence\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" valign=\"top\"\u003e\n \u003cp\u003e2.4: Trauma focused intervention\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" valign=\"top\"\u003e\n \u003cp\u003e2.5: Law literacy\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" valign=\"top\"\u003e\n \u003cp\u003e2.6: Safety assessment for the victims and children and safety of the victims and children\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.588957055214724%\" rowspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.607361963190183%\" rowspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003eEnhancing psychological wellbeing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"63.80368098159509%\" valign=\"top\"\u003e\n \u003cp\u003e3.1 Sharing their experience\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" valign=\"top\"\u003e\n \u003cp\u003e3.2: Relaxation\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" valign=\"top\"\u003e\n \u003cp\u003e3.3: Coping with stress.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" valign=\"top\"\u003e\n \u003cp\u003e3.4: Handling the children\u0026apos;s emotions\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.588957055214724%\" rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.607361963190183%\" rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eEnhancing the social support systems\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"63.80368098159509%\" valign=\"top\"\u003e\n \u003cp\u003e4.1: Networking\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" valign=\"top\"\u003e\n \u003cp\u003e4.2 \u0026nbsp;Mapping the resources\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" valign=\"top\"\u003e\n \u003cp\u003e4.3: Referral systems\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.588957055214724%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.607361963190183%\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eChallenges\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"63.80368098159509%\" valign=\"top\"\u003e\n \u003cp\u003e5.1: Confidentiality\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" valign=\"top\"\u003e\n \u003cp\u003e5.2: Not ready to share the group\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.588957055214724%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"27.607361963190183%\" rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003eTherapeutic strategies\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"63.80368098159509%\" valign=\"top\"\u003e\n \u003cp\u003e6.1: Maintain confidentiality and build trust\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" valign=\"top\"\u003e\n \u003cp\u003e6.2: Maintain the group we feeling\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" valign=\"top\"\u003e\n \u003cp\u003e6.3: Continue the session with short periods and less times\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" valign=\"top\"\u003e\n \u003cp\u003e6.4: Case scenario\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" valign=\"top\"\u003e\n \u003cp\u003e6.5: Female cotherapist\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eTable 2: Expert thematic analysis findings: Nine experts participated in the study based on the thematic analysis, six main themes, and 26 subthemes, with 189 codes generated from the analysis.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTheme 1: Psychosocial needs and concerns:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eSubtheme 1.1: Address and identification of violence\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u0026quot;As facilitators in group therapy, it is crucial to identify and address the experiences of violence and the psychosocial concerns raised by participants. We must acknowledge and validate the presence of violence within the group\u0026quot; (Mental Health Expert, 2).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eSubtheme 1.2\u003c/em\u003e\u003c/strong\u003e: \u003cstrong\u003eNeed for mental health screening among survivors\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u0026quot;The participants will not report voluntarily. As mental health professionals, we should screen their mental health concerns and psychological distress simultaneously and provide mental health services to those requiring them, ensuring comprehensive support\u0026quot; (MHE,1).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eSubtheme 1.3: Safety of the women and children\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u0026quot;For children\u0026apos;s safety purposes, call the children\u0026apos;s helpline services 1098; whenever the children have safety problems, they can call 1098, and there is CWC. You should be able to give this resource list to the CWC at the district level, or she can go to the nearby PHC, Anganwadi, where people can support her.\u003c/p\u003e\n\u003cp\u003eShe can even go to the police station even\u0026nbsp;if\u0026nbsp;every police station has\u0026nbsp;a special juvenile police unit\u0026nbsp;(SJPU). Every police station has an SJPUunit; they do not appoint any special\u0026nbsp;persons\u0026nbsp;there. Nevertheless, they have an SJPU, so the mother should have access to them if they are concerned about the safety of the children. Childline 1098 is the best way to give them a list of the resources where they can get help and safety guidelines\u0026quot; (MHE,1).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eSubtheme 1.4: \u0026nbsp;Empowerment of the victims/Economic\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u0026quot;\u003c/strong\u003eSurvivors usually depend economically on their husbands because many women are not ready for the relationship. Women should learn and have the skills to financially empower themselves with support of the welfare schemes available in the community that information should be discussed through the group work\u0026quot; (MHE, 7).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eSubtheme 1.5:Enhancement of survivor knowledge/awareness\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u0026quot;We should provide women with opportunities and resources to develop their abilities, including skill training, access to welfare schemes, and education on the alcohol treatment process. This will empower women, reduce violence, promote awareness of women\u0026apos;s rights, and enhance their overall well-being\u0026quot; (MHE, 2).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eSubtheme 1.6:Social\u0026nbsp;\u003c/em\u003e\u003c/strong\u003eSupport Systems\u003c/p\u003e\n\u003cp\u003e\u0026quot;We need to empower the women when they are unaware of how to handle violence\u0026quot; (MHE, 3).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTheme 2: Psychosocial interventions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eSubtheme 2.1:Mental health literacy\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u0026quot;\u003c/em\u003e\u003c/strong\u003eI mean, we need to improve their mental health literacy\u0026quot; (MHE, 9).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eSubtheme 2.2:Ventilation\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u0026quot;\u003c/strong\u003eAllow them to talk about the violence\u0026quot; (MHE, 3).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eSubtheme 2.3: Understanding Intimate Partner Violence\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026quot;\u003c/strong\u003eWe should clearly describe the addiction\u0026nbsp;to\u0026nbsp;violence and\u0026nbsp;the\u0026nbsp;general context of the violence\u0026quot; (MHE, 1).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eSubtheme 2.4: Trauma\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003e-focused\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;intervention\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026quot;\u003c/strong\u003ePsychoeducation where we need to discuss the trauma-related, and we need some cognitive principles is that they are misconception\u0026quot; \u003cem\u003e(MHE, 5).\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eSubtheme 2.5: Legal literacy\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026quot;Legal literacy they truly need because they will feel there is no help out for the violence\u0026quot; (MHE, 5)\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eSubtheme 2.6: Safety assessment for the victims and children and safety of the victims and children\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026quot;So I think this is a very pertinent question, ensuring safety.How to make a safety plan and how to do it\u0026quot; (MHE, 9).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTheme 3: Enhancing psychological wellbeing\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eSubtheme 3.1: Sharing\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003eexperiences\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u0026quot;In group therapy, it helps them to open up easily; they will share their own experience because they get to speak to other women; it will help them a little better, feel more supported\u0026quot; (MHE, 6).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eSubtheme 3.2: Relaxation\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026nbsp;\u0026quot;\u003c/em\u003eIncluding the manual components, I can say solution-focused components, role play and relaxation components it is better for them\u0026quot; (MHE, 9).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eSubtheme 3.3: Coping with stress\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn a group, some people influence them, and some people are already doing something. This may be another\u0026nbsp;way to cope. If they are stressed, they need to manage the stress and social skill model, coping skills and creative model to help them manage the stress\u0026quot; (MHE,6).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eSubtheme\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e3.4:\u003cem\u003e\u0026nbsp;Handling children\u0026apos;s emotions\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u0026quot;If you are making an intervention, I think one component you can think of is dealing with children\u0026apos;s emotions and how they can save and protect the children. I think that also included one of the components\u0026quot; (MHE, 5).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTheme 4: Enhancing Social Support Systems\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eSubtheme 4.1: Networking\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u0026quot;What resources are available in the community and networking system\u003c/em\u003e\u003cem\u003e?\u003c/em\u003e\u003cem\u003e\u0026quot; (MHE, 3).\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eSubtheme 4.2: Mapping the\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003eResources\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026quot;Therefore, I think, first and foremost, is that, and identifying support systems through resource mapping\u0026quot; (MHE, 9).\u003c/p\u003e\n\u003cp\u003e\u0026quot;In our sessions, I suggest adding another session specifically for wives. We can discuss the available resources to help them in difficult situations. She can address financial resources, emotional support networks, and people who can assist with childcare. We should also cover where to go in case of domestic violence and inquire about nearby police stations.\u0026nbsp;It is\u0026nbsp;important to explore the resources available in the community, such as hospitals, schools, and NGOs. During the group session, we can emphasize the importance of utilizing these resources, as many women may have access to them but might not realize their potential benefits\u0026quot; (MHE, 8).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eSubtheme 4.3: Referral systems\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u0026quot;We can link some NGOs and give them local resources that will help them and some of the women they will identify themselves\u0026quot; (MHE, 6).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTheme 5: Challenges\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eSubtheme 5.1: Confidentiality\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u0026quot;I mean, I think one of the things is like sexual trauma, sexual abuse;\u0026nbsp;these are some of the things that women might not bring up;\u0026nbsp;they might just or even other violence;\u0026nbsp;also, they might feel very, under\u0026nbsp;confidence\u0026nbsp;to you know, talk about it, they might feel embarrassed\u0026nbsp;about discussing\u0026nbsp;these things\u0026quot; (MHE,9).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eSubtheme 5.2: Not ready to share\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003ewith\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003ethe group\u003c/em\u003e\u003c/strong\u003e: \u0026quot;Due to stigma and confidentiality, participants do not disclose the trauma in the group\u0026quot; (MHE, 3).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTheme 6: Therapeutic strategies\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eSubtheme 6.1:\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003eMaintaining\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;confidentiality and\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003ebuilding\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;trust\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026quot;Second thing would be, I do not think they might come up openly about all the forms of abuse that they are going through. So sometimes it is about telling them that, you know, keeping things confidential, and just limiting the discussions to the group is very, very important\u0026quot; (MHE, 9).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eSubtheme 6.2:\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003eMaintaining\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;group\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003efeelings\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u0026quot;Sometimes the\u0026nbsp;people\u0026nbsp;use to feel the problems everyone facing it is not only to me another person there is way to come out the problems in this context it is a cohesion of the group\u0026quot; (MHE, 1).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eSubtheme 6.3: Continue the session\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003efor\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;short periods\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003eor fewer\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003e\u0026nbsp;times\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u0026quot;The sessions will be very short and informative; otherwise, the participants will not continue\u0026quot; (MHE, 5).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eSubtheme 6.4: Case scenario\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026quot;Sometimes the participants know how to disclose and share. If you make the case scenario or mindful games, it will help them understand\u0026quot; (MHE, 7).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eSubtheme 6.5: Female\u0026nbsp;\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003ecotherapyist\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026quot;Best, the female therapist will help them disclose. Other things therapist, it is not about the gender; the therapist should have good empathizing skills; it will help\u0026quot; (MHE, 2).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eOn the basis of\u0026nbsp;our analysis of the key informant's interviews, we identified four themes contributing to the experts' opinions on psychosocial concerns and psychosocial intervention for women who experience intimate partner violence. The study's first theme is that identifying women with intimate partner abuse is extremely important, especially\u0026nbsp;for\u0026nbsp;spouses with alcohol dependence syndrome. A similar study also\u0026nbsp;revealed\u0026nbsp;that addressing and understanding the factors\u0026nbsp;influencing\u0026nbsp;IPV\u0026nbsp;is\u0026nbsp;important\u0026nbsp;for\u0026nbsp;helping further research\u0026nbsp;on preventing\u0026nbsp;violence.\u0026nbsp;[11]The\u0026nbsp;results\u0026nbsp;of the present study showed that\u0026nbsp;survivors need to be screened for mental health care; a similar study\u0026nbsp;revealed\u0026nbsp;that female survivors of IPV are more likely than women not exposed to IPV to report needing mental health services.[21]A similar study also\u0026nbsp;revealed the\u0026nbsp;need for programming and research to address this connection between alcohol and intimate partner violence.[8]\u0026nbsp;In this study,\u0026nbsp;the\u0026nbsp;experts\u0026nbsp;said\u0026nbsp;that\u0026nbsp;safety\u0026nbsp;strategies are the main\u0026nbsp;concern\u0026nbsp;of survivors\u0026nbsp;in preventing\u0026nbsp;the risk of violence, and many studies\u0026nbsp;have shown\u0026nbsp;that survivors need safety plans. Similarly, many studies\u0026nbsp;have investigated\u0026nbsp;practitioner intervention, including safety planning for women and children.[17],\u0026nbsp;[22],\u0026nbsp;[15],\u0026nbsp;[18]\u003c/p\u003e\n\u003cp\u003eThe study\u0026nbsp;showed\u0026nbsp;that economic empowerment\u0026nbsp;helps\u0026nbsp;participants reduce violence. Similarly, other studies\u0026nbsp;have shown\u0026nbsp;that protective aspects of economic empowerment support women\u0026nbsp;in accessing\u0026nbsp;wider social networks, information, and support, resulting in improved confidence and bargaining\u0026nbsp;positions\u0026nbsp;in their relationships.[23]\u0026nbsp;The study identified several recommended intervention components, including mental health literacy, ventilation, IPV awareness, trauma-focused intervention, law literacy, and safety assessment for survivors and their children. Experts\u0026nbsp;have\u0026nbsp;also emphasized the importance of improving psychological well-being and social support\u0026nbsp;to reduce\u0026nbsp;violence.The study identified several key intervention components: mental health literacy, ventilation, IPV understanding, trauma-focused intervention, law literacy, and safety assessment for survivors and their children. Experts stressed that improving psychological well-being and social support effectively\u0026nbsp;helps\u0026nbsp;survivors handle violence.[24]\u003c/p\u003e\n\u003cp\u003eThis study\u0026nbsp;revealed\u0026nbsp;that enhancing psychological well-being through sharing experiences, coping skills,\u0026nbsp;relaxing\u0026nbsp;techniques, and handling children's emotions in group sessions was very important for survivors.\u0026nbsp;One\u0026nbsp;study\u0026nbsp;showed\u0026nbsp;that similar interventions help survivors reduce psychological distress; coping is an essential element\u0026nbsp;of\u0026nbsp;IPV intervention, but the\u0026nbsp;mediating\u0026nbsp;effect of coping responses on IPV has not been extensively studied.[14]\u003c/p\u003e\n\u003cp\u003eThe study\u0026nbsp;showed\u0026nbsp;that enhancing the social support system among survivors through networking, resource mapping, and a referral system are essential components\u0026nbsp;of enhancing\u0026nbsp;the social support system.\u0026nbsp;A\u0026nbsp;previous study\u0026nbsp;revealed\u0026nbsp;that social\u0026nbsp;networks, resource mapping, and referral systems increase women's help-seeking behavior.[24]\u0026nbsp;While implementing the intervention, the experts mentioned some challenges,\u0026nbsp;such as\u0026nbsp;confidentiality and unwillingness to disclose the trauma\u0026nbsp;during the\u0026nbsp;session. Similarly, another study found that creating trust and confidentiality is crucial in\u0026nbsp;sessions.[25]\u003c/p\u003e\n\u003cp\u003eExpert reported that specific therapeutic strategy skills are beneficial for\u0026nbsp;facilitating\u0026nbsp;effective group work. Experts recommended that therapists prioritize maintaining confidentiality, building trust\u0026nbsp;[26], and fostering a sense of cohesion within the group.[27]\u0026nbsp;The session should be short and informative and give some case scenario examples. Therapists should be female\u0026nbsp;when\u0026nbsp;handling women-related trauma.\u0026nbsp;A previousstudyshowed\u0026nbsp;that women survivors prefer female therapists.[28]The provider or group leader in group therapy sessions is constrained by the laws of secrecy about the participant's histories and other personal information. Therefore, participants' confidentiality can be challenging to\u0026nbsp;maintain, particularly in\u0026nbsp;larger\u0026nbsp;groups,\u0026nbsp;when group leaders have less control over the infomations disseminated within the group.[29]\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eLimitations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study engaged a limited sample of nine mental health experts. Though the data was saturated with nine subject experts; a larger, more diverse sample could enhance generalizability, encompassing various target participants. The predominant female, 35-45 age group of participants working as professors might limit perspectives. A more balanced representation of age, gender, and professional backgrounds could have benefitted the study.The variable interview durations (27 to 40 minutes) from mental health experts warrant standardization for consistency in \u0026nbsp;data collection. Potential biases of the study could be; out of nine experts, seven were teaching and practicing in the same institute. Most of the mental health experts were the teachers of the first author.\u0026nbsp;\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eExperts agree that intimate partner violence (IPV) interventions are crucial for addressing and reducing this complex issue. Early intervention is essential to prevent the escalation of violence. Collaborative efforts among various stakeholders, such as law enforcement agencies, social services, healthcare providers, legal professionals, and community organizations, are key to enhancing the effectiveness of interventions. Long-term support, including ongoing counseling, access to resources, and progress monitoring, is crucial for survivors and perpetrators. Experts advocate for evidence-based programs, emphasizing rigorous research, evaluation, and monitoring to ensure effectiveness and inform policy decisions. Consulting professionals and organizations specializing in IPV intervention need up-to-date and accurate information.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e This work was supported by a grant from the Indian Council of Social Science Research. The first author received a doctoral fellowship from the ICSSR. File No. RFD/2021-22/GEN/SW/204. (ICSSR).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003cstrong\u003e:\u003c/strong\u003e The authors thank the study participants and the Center for Addiction Medicine staff for their support in the data collection.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eInterest\u003c/strong\u003e: None.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003ePatra P, Prakash J, Patra B, et al. Intimate partner violence: Wounds are deeper. Indian J Psychiatry 2018; 60: 494.\u003c/li\u003e\n \u003cli\u003eDaher M. Public Health World Report on Violence and Health. Leban Med J 2017; 51: 59\u0026ndash;63.\u003c/li\u003e\n \u003cli\u003eKlostermann KC, Fals-Stewart W. Intimate partner violence and alcohol use: Exploring the role of drinking in partner violence and its implications for intervention. Aggress Violent Behav 2006; 11: 587\u0026ndash;597.\u003c/li\u003e\n \u003cli\u003eEckermann E. \u0026quot;Domestic violence: A priority public health issue in the Western Pacific region. WHO 2001; 5: 195\u0026ndash;228.\u003c/li\u003e\n \u003cli\u003eWorld Health Organization (WHO). Violence against women prevalence estimates, 2018: global, regional and national prevalence estimates for intimate partner violence against women and global and regional prevalence estimates for nonpartner sexual violence against women. 2021.\u003c/li\u003e\n \u003cli\u003eThomas MD, Bennett LW, Stoops C. The Treatment Needs of Substance Abusing Batterers: A Comparison of Men Who Batter Their Female Partners. J Fam Violence 2013; 28: 121\u0026ndash;129.\u003c/li\u003e\n \u003cli\u003eDevries K, Watts C, Yoshihama M, et al. Violence against women is strongly associated with suicide attempts: Evidence from the WHO multicountry study on women\u0026rsquo;s health and domestic violence against women. Soc Sci Med 2011; 73: 79\u0026ndash;86.\u003c/li\u003e\n \u003cli\u003eDevries KM, Child JC, Bacchus LJ, Mak J, Falder G, Graham K, Watts C, Heise L. Intimate partner violence victimization and alcohol consumption in women: A systematic review and meta‐analysis. Addiction. 2014;3:379-391.\u003c/li\u003e\n \u003cli\u003eSatyanarayana VA, Hebbani S, Hegde S, et al.\u0026nbsp;Two sides of a coin: Perpetrators and survivors perspectives on the triad of alcohol, intimate partner violence and mental health in South India. Asian J Psychiatr 2015; 15: 38\u0026ndash;43.\u003c/li\u003e\n \u003cli\u003eLagdon S, Armour C, Stringer M. Adult experience of mental health outcomes as a result of intimate partner violence victimization: a systematic review. European journal of psychotraumatology. 2014;5:10.3402/ejpt.v5.24794.\u003c/li\u003e\n \u003cli\u003eRanapurwala SI. Identifying and addressing confounding bias in violence prevention research. Current epidemiology reports. 2019;6:200-207.\u003c/li\u003e\n \u003cli\u003eBrown SJ, Carter GJ, Halliwell G, Brown K, Caswell R, Howarth E, Feder G, O\u0026apos;Doherty L. Survivor, family and professional experiences of psychosocial interventions for sexual abuse and violence: a qualitative evidence synthesis. Cochrane database of systematic reviews.\u0026nbsp;2022;10(10):CD013648.\u003c/li\u003e\n \u003cli\u003eFellin LC, Callaghan JEM, Alexander JH, et al. Empowering young people who experienced domestic violence and abuse: The development of a group therapy intervention. Clin Child Psychol Psychiatry 2019; 24: 170\u0026ndash;189.\u003c/li\u003e\n \u003cli\u003eMitchell MD, Hargrove GL, Collins MH, et al. Coping variables that mediate the relation between intimate partner violence and mental health outcomes among low-income, African American women. J Clin Psychol 2006; 62: 1503\u0026ndash;1520.\u003c/li\u003e\n \u003cli\u003eO\u0026rsquo;Campo P, McDonnell K, Gielen A, et al. Surviving physical and sexual abuse: what helps low-income women? Patient Educ Couns 2002; 46: 205\u0026ndash;212.\u003c/li\u003e\n \u003cli\u003eDavies K, Block CR, Campbell J. Seeking Help from the Police: Battered Women\u0026rsquo;s Decisions and Experiences. 2007; 20: 15\u0026ndash;41.\u003c/li\u003e\n \u003cli\u003eWaugh F, Bonner M. Domestic violence and child protection: issues in safety planning. Child Abus Rev 2002; 11: 282\u0026ndash;295.\u003c/li\u003e\n \u003cli\u003eElliott DE, Bjelajac P, Fallot RD, Markoff LS, Reed BG. Trauma‐informed or trauma‐denied: Principles and implementation of trauma‐informed services for women. Journal of community psychology. 2005; 33:461-477.\u003c/li\u003e\n \u003cli\u003eKim J, Eun-Hye Grace Y, Macy RJ, et al. Interventions to Prevent Suicidality Among Survivors of Intimate Partner Violence: A Systematic Review. Partner Abuse 2022; 13: 345\u0026ndash;365.\u003c/li\u003e\n \u003cli\u003eLipsky S, Caetano R. Impact of intimate partner violence on unmet need for mental health care: Results from the NSDUH. Psychiatr Serv 2007; 58: 822\u0026ndash;829.\u003c/li\u003e\n \u003cli\u003eLogan T, Shannon L, Cole J, et al. The Impact of Differential Patterns of Physical Violence and Stalking on Mental Health and Help-Seeking Among Women With Protective Orders. 2006; 12: 866\u0026ndash;886.\u003c/li\u003e\n \u003cli\u003eBorchers A, Lee RC, Martsolf DS, et al. Employment maintenance and intimate partner violence. Work Heal Saf 2016; 64: 469\u0026ndash;478.\u003c/li\u003e\n \u003cli\u003eTiwari A, Fong DYT, Yuen KH, et al. Effect of an advocacy intervention on mental health in Chinese women survivors of intimate partner violence: A randomized controlled trial. Jama 2010; 304: 536\u0026ndash;543.\u003c/li\u003e\n \u003cli\u003eDu Mont J, Forte T, Cohen MM, et al. Changing Help-Seeking Rates for Intimate Partner Violence in Canada. 2008; 41: 1\u0026ndash;19.\u003c/li\u003e\n \u003cli\u003eHarris \u0026nbsp;M, Fallot \u0026nbsp; RD. \u0026nbsp;Using Trauma Theory to Design Service Systems.Vol 89. San Francisco, CA: Josey-Bass; 2001.\u003c/li\u003e\n \u003cli\u003eMetz A, Jensen T, Farley A, Boaz A, Bartley L, Villodas M. Building trusting relationships to support implementation: a proposed theoretical model. Frontiers in health services. 2022; 23:2-71.\u003c/li\u003e\n \u003cli\u003eThye SR, Yoon J, Lawler EJ. The theory of relational cohesion, The Theory of Relational Cohesion: Review of a Research Program. 2002; 19: 139\u0026ndash;166.\u003c/li\u003e\n \u003cli\u003eLandes SJ, Burton JR, King KM, et al. Women\u0026rsquo;s Preference of Therapist Based on Sex of Therapist and Presenting Problem: An Analog Study. Couns Psychol Q 2013; 26: 330-342.\u003c/li\u003e\n \u003cli\u003eLasky GB, Riva MT. Confidentiality and privileged communication in group psychotherapy. Int J Group Psychother 2006; 56: 455\u0026ndash;476.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Group work, partner Abuse, expert opinion, qualitative study.","lastPublishedDoi":"10.21203/rs.3.rs-3831525/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3831525/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground: \u003c/strong\u003eTo examine the perspectives of mental health professionals on providing group intervention for female spouses of men with alcohol dependence who experienced intimate partner violence.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethod\u003c/strong\u003e: Aqualitative research design was used, and purposive sample technique was used to select the participants. Nine experts with more thanfive years of experience in handling partner violence cases providedinsights through in-depth interviews. The sample size was nine; data was saturated with nine experts. The researcher prepared a semistructured interview guide and mental health experts validated it. The transcripts were carefully examined several times, coded and re-codeded . The codes were subsequently organized into thematic categories.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eMore than half (66.7%) of the experts were aged35-45 years. Most of the experts (77.8%) were females. More than half (55.6%) of the experts had more than five years of experience in mental health and intimate partner violence. Most of the experts (66.7%) were working in teaching institutions related to mental health and intimate partner violence. The remaining one-third (33.3%) of the experts were legal and women empowerment practitioners. The thematic analysis generated six main themes and 19 subthemes, with 189 codes.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e: Experts emphasized the importance of a holistic approach to IPV intervention. Group interventionaddresses multiple issues that contribute to violence. Survivors need safe housing, counseling, legal help, and financial assistance.\u003c/p\u003e","manuscriptTitle":"Mental Health Professionals' Perspectives on Group Intervention for Women Survivors Intimate Partner Violence: A Qualitative study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-03-11 05:48:10","doi":"10.21203/rs.3.rs-3831525/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"602d51bf-fe57-4576-af34-145867421c19","owner":[],"postedDate":"March 11th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[{"id":29262309,"name":"Social Work"},{"id":29262310,"name":"Psychology"},{"id":29262311,"name":"Psychiatry"},{"id":29262312,"name":"Women's studies"}],"tags":[],"updatedAt":"2024-06-21T16:53:13+00:00","versionOfRecord":{"articleIdentity":"rs-3831525","link":"https://doi.org/10.4103/jopsys.jopsys_47_23","journal":{"identity":"journal-of-psychiatry-spectrum","isVorOnly":true,"title":"Journal of Psychiatry Spectrum"},"publishedOn":"2024-06-20 16:53:13","publishedOnDateReadable":"June 20th, 2024"},"versionCreatedAt":"2024-03-11 05:48:10","video":"","vorDoi":"10.4103/jopsys.jopsys_47_23","vorDoiUrl":"https://doi.org/10.4103/jopsys.jopsys_47_23","workflowStages":[]},"version":"v1","identity":"rs-3831525","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3831525","identity":"rs-3831525","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}