Evidence-based Research

Tom 2

Paula Cortex

Evidence-Based

Two Issues Addressed for Intervention:

Two issues that must be addressed by the social worker in Paula's case. Firstly, the threat from the father of the baby. The social worker must manage this threat for Paula to feel safe and secure. Domestic violence is a global and debilitating epidemic that has been lingering for years. Research study has shown that intimate partner violence study found that one in three women had experienced emotional abuse, and one in 20 women had experienced life-threatening physical abuse by their intimate partners, such as husbands and lovers (Horiuchi et al., 2009). Additionally, the social worker must address Paula's mental health and medication management. Paula has become increasingly paranoid, slept less, is fearful for her life, and stopped taking her psychiatric and HIV medications, which puts her and the unborn child at risk.

Evidence-based Interventions:

A safety plan is one evidence-based intervention that could address the threat from the baby's father. Horiuchi et al. (2009) explained that pregnancy violence affects maternal and fetal health and may be related to child abuse after birth. Therefore, support is essential for women during pregnancy or perinatal. Because pregnant women regularly attend health clinics, healthcare providers have an opportunity to detect and assist victims of domestic violence, which health professionals are mandated to report. Safety plans are an evidence-based practice that has been shown to reduce the risk of violence in domestic violence situations. Horiuchi suggested that women-centered care is a philosophical and practical approach towards the end. Women who experience domestic violence feel deprived of power, control, and self-esteem. For the woman to regain her sense of power and recuperate her mental, physical, psychological, social health, or both, it is essential to provide health care and welfare in accordance with the principles that mitigate oppression and foster empowerment. Secondly, a women-centered approach ensures the right of women to aspire to the well-being of their preference and supports women in achieving their full potential. The concepts of respect, security, free will, and empowerment support the principle of women-centered care. Paula's safety plan will include strategies for Paula to avoid contact with the baby's father, a permanency plan, and notifying people in her support network when she feels unsafe.

The safety plan should also include a list of people and services Paula can contact when she feels threatened or dangerous, such as domestic violence hotlines, shelters, and counseling services. She should consider creating an emergency plan that she can follow in case of an immediate threat, such as having a code word to alert her support network or having a bag packed in case she needs to leave quickly. Furthermore, Paula needs to practice self-care and have a plan for managing her stress, such as deep breathing exercises or engaging in activities she enjoys. Lastly, Paula should remember that she is not alone and that many resources are available to help her navigate this difficult situation.

The study by Horiuchi et al. (2009) examines the efficacy of safety plans in reducing the risk of violence in domestic violence situations. The study systematically reviews existing literature and uses a quantitative approach to analyze data. The sample size is unknown as the study reviews electronic searches of medical and nursing databases retrieved 2392 articles between February and December 2003 retrieved 2392 articles. Selected as evidence were 157 articles yielding 28 recommendations aligned to clinical assessment questions in existing literature. The study's findings indicate that safety plans effectively reduce the risk of violence and should be used in domestic violence situations.

Cognitive Behavioral Therapy:

Green et al. (2020) study examines the effectiveness of a cognitive behavioral group therapy protocol for perinatal anxiety. The study is a randomized controlled trial and uses a quantitative approach to analyze data. The sample size is 96 participants, designed to be transdiagnostic to target a range of anxiety symptoms and comorbid depressive symptoms. The treatment involved 6-weekly 2-hour sessions in a small-group format. The study's findings indicate that CBT effectively treats depression, anxiety, and other mental health disorders. Cognitive behavioral therapy (CBT) is considered the first-line psychological treatment for anxiety and depressive disorders in the general population (Green et al., 2020).

The safety plan and CBT are two interventions that can help Paula manage her mental health issues and reduce her risk of violence. The safety plan can help Paula protect herself from the baby's father and reduce her risk of further violence. Li (2022) explained that Cognitive behavioral therapy (CBT) is considered the first-line psychological treatment for anxiety and depressive disorders in the general population. According to Green et al. (2022), evidence with non-perinatal samples shows that CBT is more effective than waitlist or placebo conditions.

The CBT can help Paula manage her mental health symptoms, such as anxiety and depression, and improve her medication management. Since cognitive restructuring is one component of CBT to identify, evaluate, and change negative distorted feelings, Paula can learn to better cope with her stress and anxiety and reduce the risk of further violence through the safety plan and CBT. The social worker should work with Paula to create a safety plan and refer her to CBT to address her issues. The social worker should also provide Paula with resources for further support, such as support groups and community resources. By utilizing both interventions, Paula can feel safe and have the tools she needs to manage her mental health better.

References:

Horiuchi, S., Yaju, Y., Kataoka, Y., Grace Eto, H., & Matsumoto, N. (2009). Development of an evidence-based domestic violence guideline: Supporting perinatal women-centred care in Japan. Midwifery, 25(1), 72–78. https://doi.org/10.1016/j.midw.2007.01.012

Li, X., Laplante, D. P., Paquin, V., Lafortune, S., Elgbeili, G., & King, S. (2022). Effectiveness of cognitive behavioral therapy for perinatal maternal depression, anxiety and stress: A systematic review and meta-analysis of randomized controlled trials. Clinical Psychology Review, 92. https://doi.org/10.1016/j.cpr.2022.102129

Green, S. M., Donegan, E., McCabe, R. E., Streiner, D. L., Agako, A., & Frey, B. N. (2020). Cognitive behavioral therapy for perinatal anxiety: A randomized controlled trial. Australian and New Zealand Journal of Psychiatry, 54(4), 423–432. https://doi.org/10.1177/0004867419898528