Mothers with special training can help family doctors provide at-home support to women with violent partners, a new study suggests.

Family doctors often see women in their practices who are suffering from intimate partner violence, but in the office, the physicians may not be equipped to give these women the help and support they need, say Dutch researchers.

Over a four-month period, “Mentor support had an important role for mothers in becoming aware of the negative effects of (partner violence) on their children and to accept professional support, preventing mental problems and intergenerational transmission of violent behavior,” the study authors write in the journal Family Practice.

Gert-Jan Prosman of the Radboud University Nijmegen Medical Center and his colleagues designed a program called Mentor Mothers for Support and Advice (MeMOSA) to train women to help other mothers in violent relationships.

The mentor mothers were recruited from welfare, healthcare and educational institutes in Rotterdam and had previous education in social work or healthcare.

The aim of the program, Prosman’s team writes, was to reduce the victims’ exposure to violence and also the symptoms of depression that usually go along with an abusive relationship. The intervention also sought to improve the women’s acceptance of outside help, like mental health care, and their participation in society.

According to the report, 50 to 60 percent of women in an abusive relationship suffer from depression and are commonly isolated by their abusive partners.

The World Health Organization sees domestic violence as a major health problem and defines it as violence caused by a partner or ex-partner from an intimate relationship, including physical, mental and sexual abuse.

Evidence-based programs designed to help victims of IPV are unusual in family practices, Prosman’s team writes. The authors were not available to comment on their study.

The seven mentor mothers they recruited received 10 days training in the new program for the study that lasted 16 weeks. Forty two family doctors agreed to participate by referring patients to the program.

The mentor mothers’ training included background on intimate partner violence, depression, children witnessing abuse, parenting support, practical skills and how to deal in emergency situations.

At the beginning of the study, 63 abused women were selected by their family doctors to receive visits from a mentor mother, and 43 of the women completed the program. All the participants had children under age 18 and women were recruited between 2007 and 2010.

At the beginning, each woman was interviewed and tested to determine how much violence she was exposed to, how depressed she was and her degree of participation in society.

At the end of 16 weeks of meetings with a mentor mother, the women were interviewed and tested again.

Among the women who completed the program, 25 no longer were exposed to partner violence after 4 months. Another 18 women were still victims, but the amount of violence they were exposed to had decreased.

On a standard scale, where higher numbers indicate greater depression, the women’s scores dropped from an average of 53.3 to 34.8 and scores measuring social support went up from 13.2 to 15.2.

Levels of participation in society also improved, with 9 women getting jobs and 13 women beginning new educational studies.

The study cannot show that the mentor mothers are what made a positive difference in the women’s lives. There was no comparison group of women who did not receive mentor mothers, and the program had a considerable dropout rate of 35 percent.

But the authors point out that abused women visit their family doctors more often than women who aren’t abused, so training doctors to recognize intimate partner violence and provide support through at-home visits by mentor mothers might help reduce suffering.

In the U.S., a number of home-based visiting programs exist and appear to be successful.

According to Samantha Miller at the U.S. Health Resources and Services Administration, “The Health Resources and Service Administration’s (HRSA) Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program implements 14 evidence-based home visiting models rigorously-approved by the U.S. Department of Health and Human Services across United States, its jurisdictions, and territories.”

An example is a toolkit called “A Comprehensive Approach for Community-Based Programs to Address Intimate Partner Violence and Perinatal Depression,” available on the agency’s website here: 1.usa.gov/19bwAnO.

Miller added, “One of the legislatively-mandated benchmark areas for the MIECHV program grantees to demonstrate improvement at the end of the program’s initial three years is in the reduction of IPV (domestic violence) among families participating in the program.”

SOURCE: Family Practice, online October 16, 2013.

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Support by trained mentor mothers for abused women: a promising intervention in primary care

Methods. A pre- post study of a 16-week mentoring intervention with identified abused women with children was conducted. After referral by a family doctor, a mentor mother visited the abused woman weekly. Primary outcomes are IPV assessed with the Composite Abuse Scale (CAS), depressive symptoms using the Symptom Checklist (SCL 90) and social support by the Utrecht Coping List. Secondary outcomes are analysed qualitatively: participation in society defined as employment and education and the acceptance of mental health care.

Results. At baseline, 63 out of 66 abused women were referred to mentor support. Forty-three participants completed the intervention programme. IPV decreased from CASt otal 46.7 (SD 24.7) to 9.0 (SD 9.1) (P ≤ 0.001) after the mentor mother support programme. Symptoms of depression decreased from 53.3 (SD 13.7) to 34.8 (SD 11.5) (P ≤ 0.001) and social support increased from 13.2 (SD 4.0) to 15.2 (SD 3.5) (P ≤ 0.001). Participation in society and the acceptance of mental health for mother and child improved.

Conclusions. Sixteen weekly visits by trained mentor mothers are a promising intervention to decrease exposure to IPV and symptoms of depression, as well as to improve social support, participation in society and the acceptance of professional help for abused women and their children.

  Gert-Jan Prosman,
  Sylvie H Lo Fo Wong and
  Antoine LM Lagro-Janssen