675226

research-article2016
SGRXXX10.1177/1046496416675226Small Group ResearchSantos et al.

Article
Small Group Research
1­–28
Effectiveness of a Group © The Author(s) 2016
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DOI: 10.1177/1046496416675226
for Female Victims sgr.sagepub.com

of Intimate Partner
Violence

Anita Santos1,2, Marlene Matos3, and

Andreia Machado3

Abstract
Group intervention has been widely used with female victims of intimate
partner violence (IPV). However, efficacy studies are scarce due to several
research limitations. This study evaluates the effectiveness of an 8-week
group intervention program, with a cognitive-behavioral orientation and
attended by 23 female victims of IPV. Self-report psychological assessment
was conducted at pre-test, post-test, and follow-up. Results revealed that the
group intervention had a positive impact on participants, showing a decrease
in re-victimization and in beliefs toward legitimizing IPV. A decrease in levels
of depression and a significant improvement in general clinical symptoms
were also evident. Self-esteem and social support were enhanced throughout
group intervention. The changes were confirmed through follow-up after
3 months, suggesting that this group intervention has important effects on
female victims. The implications of the findings for practice are also discussed.

Keywords
group intervention, effectiveness, intimate partner violence, women victims

1ISMAI—Maia University Institute, Portugal

2Center for Psychology at University of Porto, Portugal
3University of Minho, Braga, Portugal

Corresponding Author:
Anita Santos, Maia University Institute, Av. Carlos Oliveira Campos, Castelo da Maia
4475-690 Avioso S. Pedro, Portugal.
Email: anitasantos@ismai.pt

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2 Small Group Research 

Group intervention has been widely used with female victims of intimate
partner violence (IPV). However, in Portugal, no study on the efficacy of this
type of intervention has been performed. This study presents a group inter-
vention proposal with 23 female victims of IPV and its longitudinal assess-
ment via a pre-test, post-test, and follow-up test.
It was during the last century that IPV became recognized, and was
socially and judicially condemned, and studied (e.g., Eckhardt et al., 2013;
Gordon, 1996; McBride, 2001), acquiring the status of global and social
problem (e.g., Abel, 2000; Crespo & Arinero, 2010; Kim & Kim, 2001;
Matos, Santos, & Dias, 2013). In recent decades, worldwide, we saw several
changes in criminal law, a proliferation of information on the subject, an
upsurge of cases in the criminal justice system, and increased media exposure
on this issue.
However, despite the various approaches developed to stop and prevent
IPV, this social problem still endures. For instance, results from the recent
National Intimate Partner and Sexual Violence Survey reveal that, during
their lifetime, one in four women in the United States experience severe
physical violence, one in two are psychologically abused, and one in 10 are
raped, perpetrated by the intimate partner (Breiding, Chen, & Black, 2014).
In Europe, recent data reveal that victimization of women cannot also be
underestimated: one in three women have experienced physical and/or sexual
victimization after the age of 15 (European Union Agency for Fundamental
Rights, 2014). In Portugal, where this study took place, IPV is acknowledged
as a prominent issue since the 1990s (e.g., Commission for Citizenship and
Gender Equality—Presidency of the Council of Ministers, 2015); it has been
a public crime since 2000. Still, the Portuguese criminal statistics in 2015
indicated that IPV was the second most reported crime in the category of
crimes against people (N = 22,569), and 84% of the victims were women
(Ministério da Administração Interna, 2016). Moreover, a wide survey in
Europe revealed that there is a high level of women victimization, with 24%
reporting having experienced physical and/or sexual abuse perpetrated by a
partner and/or by another person (European Union Agency for Fundamental
Rights, 2014).
Psychological interventions with female victims have been considered
very important to reduce the high personal, interpersonal, and societal costs
that are usually associated with IPV (e.g., Pico-Alfonso et al., 2006; Sartin,
Hansen, & Huss, 2006; Stover, Meadows, & Kaufman, 2009). In particular,
female victims reported high levels of anxiety, depressive symptoms, disso-
ciation, substance abuse, sexual problems, cognitive disorders, low self-
esteem, and somatization (e.g., Briere & Jordan, 2004; Coker et al., 2002;
Constantino, Kim, & Crane, 2005; Iverson, Shenk, & Fruzzeti, 2009; Lundy

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Santos et al. 3

& Grossman, 2001). Alongside are behavioral and relational difficulties, as

well as the destructive aspect (homicide and suicide) and highly disabling
consequences of maltreatment (e.g., Abel, 2000; Lundy & Grossman, 2001;
Pico-Alfonso et al., 2006).
Currently, there are different expert responses on this issue (e.g., Abel,
2000; Bennett, Riger, Schewe, Howard, & Wasco, 2004; Stover et al., 2009).
In Portugal, victims can be referred to support agencies and eventually admit-
ted to shelters. In terms of intervention, the most common is individual crisis
intervention. Some support agencies and shelters provide individual therapy,
while few provide group intervention; no standardized type of intervention
has been implemented. Female victims can seek help on their own, or can be
referred by public institutions or criminal police bodies. On the other hand,
group intervention for male perpetrators is usually court mandated, with
recent evidence of efficacy (e.g., Cunha & Gonçalves, 2015).
However, while literature has been accumulating knowledge on the sub-
ject, research about the effectiveness of the psychological interventions and
the processes involved in women’s positive changes remained philosophical
rather than empirical. Consequently, little is known about the effectiveness of
the interventions available (e.g., Eckhardt et al., 2013; Ramsay, Rivas, &
Feder, 2005; Stover et al., 2009).

Group Intervention With Female Victims of IPV

Group intervention has emerged internationally as the most common type of
intervention with female victims of intimate violence. This type of interven-
tion has been considered to have a positive impact on women (e.g., Abel,
2000; Gordon, 1996; Tutty, Bidgood, & Rothery, 1993). Participation in a
group intervention with victims of IPV often derives from the need, usually
expressed by women, to share their experience with other women with simi-
lar life journeys (Tutty & Rothery, 2002). Group therapy has shown great
pragmatism in addressing the problems brought by this population, and
allows significant efficacy in the consolidation of the results achieved at indi-
vidual level (e.g., Machado & Matos, 2001).
This type of intervention is innovative in Portugal and may provide sev-
eral potential gains, in addition to cost-effectiveness. On one hand, it may
allow participants to validate their experience of victimization, offering them
encouragement, support, and information (e.g., Fritch & Linch, 2008; Iverson
et al., 2009; Liu, Dore, & Amrani-Cohen, 2013). On the other hand, women
who participate in this form of intervention reduce their social isolation, a
problem common to this population, as it enables a new network of relation-
ships (e.g., Fritch & Linch, 2008; Iverson et al., 2009; Liu et al., 2013). It can

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4 Small Group Research 

also provide an opportunity to learn from other women, identifying common

difficulties and sharing strategies for problem solving (e.g., Fritch & Linch,
2008; Iverson et al., 2009; Liu et al., 2013). The group context can help
women “to realize that she is not alone and that her feelings of confusion, fear
and despair are real and shared by other women” (Webb, 1992, p. 209). Thus,
clinical symptomatology, beliefs toward violence, personal and social skills,
social support, and self-esteem are important indicators of change in this type
of intervention.
Although scarce, international literature has highlighted the success of
group intervention, especially in reducing female victims’ tolerance toward
violence and abuse, as well as increasing their personal and social skills (e.g.,
Bennett et al., 2004; Gordon, 1996; Tutty et al., 1993). Efficacy studies have
found significant improvements in areas such as self-esteem (e.g., Crespo &
Arinero, 2010; Kubany et al., 2004; Tutty, Babins-Wagner, & Rothery, 2016),
attitudes comparable to those found in a healthy marriage and family (e.g.,
McWhirter, 2011; Ramsay et al., 2005; Schwartz, Magee, Griffin, & Dupuis,
2004), an increase in social support and coping (e.g., Crespo & Arinero,
2010; Iverson et al., 2009; McWhirter, 2011), and a decrease in violence,
anger, depression, and stress (e.g., Iverson, Gradus, Resick, Suvak, & Smith,
2011; McWhirter, 2011; Tutty et al., 2016). Other group interventions have
been used to assist with dating relationships, and risk factors have provided
positive evidence supporting group intervention (Constantino et al., 2005;
McBride, 2001; Schwartz et al., 2004). The available studies conducted about
group intervention reveal that most of the interventions are based in several
different theoretical frameworks: (a) psychoeducational (e.g., Cox &
Stoltenberg, 1991; Crespo & Arinero, 2010; Holiman & Schilit, 1991;
McBride, 2001; McWhirter, 2011; Schwartz et al., 2004), (b) cognitive-
behavioral (e.g., Cox & Stoltenberg, 1991; Crespo & Arinero, 2010; Holiman
& Schilit, 1991; Kubany et al., 2004; McBride, 2001; McWhirter, 2011,
Rinfret-Raynor, & Cantin, 1997), (c) feminist (e.g., Cox & Stoltenberg, 1991;
Holiman & Schilit, 1991; McBride, 2001; Rinfret-Raynor & Cantin, 1997),
and also (d) narrative approach (Tutty et al., 2016). Psychological interven-
tion with groups tend to last between eight and 12 sessions (e.g., Crespo &
Arinero, 2010; McBride, 2001; Constantino et al., 2005), as recommended in
the literature (e.g., Yalom, 1995). Nevertheless, there are studies that utilize
short-term therapy (Cox & Stoltenberg, 1991; McWhirter, 2011; Schwartz
et al., 2004) and others that adhere to alternative therapies, such as Dialectical
Behavior Therapy (cf. Iverson et al., 2009), achieving equally positive results.
In a psychoeducational intervention program of Cox and Stoltenberg
(1991), with 21 women, an experimental design was used, with both a pre-
and a post-test assessment and control groups, which lasted 2 weeks (3 times

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Santos et al. 5

a week, for a total of 12 hr). Holiman and Schilit (1991) assessed 12 victims,
in a psychoeducational and support group through 10 sessions, with a pre-
and a post-test. Rinfret-Raynor and Cantin (1997) compared three forms of
feminist intervention—group, individual, and treatment as usual—with 60
women, with pre- and post-test assessment, and follow-up after 6 and 12
months. Support groups of 12 weeks, were also assessed by Tutty and col-
leagues (1993) in a quasi-experimental design, with pre-test, post-test, and
follow-up assessment of 76 victims. McBride (2001) evaluated support group
intervention, over 24 sessions with a total of 189 women. Despite the large
sample size, there was no control group and no follow-up assessment was
implemented. Schwartz and colleagues (2004) used a similar approach with
28 women, without a follow-up assessment. A pilot study with an experimen-
tal design (Constantino et al., 2005) was conducted in which intervention
groups were implemented with 24 women to promote social support, over 8
weeks. Crespo and Arinero (2010) evaluated two types of group intervention
that lasted 8 weeks, with 53 women in an experimental design, with pre- and
post-test assessment, and follow-up after 1, 3, 6, and 12 months. Liu,
Morrison, and Amrani-Cohen (2013) compared two very different models of
group intervention: a support group and a self-defense group. The first lasted
12 weeks, and the second lasted 10 weeks. The researchers evaluated 69
women for depression and self-esteem. The design had a pre- and post-test
assessment. There were no differences between groups; however, women had
improved in self-esteem and decreased depressive symptoms. Group therapy
with a narrative approach was implemented during 14 weeks and was evalu-
ated through a pre- and a post-test (Tutty et al., 2016).
Regarding the aims of the intervention, the majority of these studies pre-
sented outlined the following as the most common goals: to validate the per-
sonal stories of victimization, to stimulate empowerment, to restore control
over daily life, to reduce social isolation, to develop problem solving and
decision making, and to promote personal and social skills (e.g., Matos &
Machado, 2011).
In the composition of such intervention groups, there is usually at least
one facilitator that leads the group discussion. Regarding participants, a cer-
tain degree of homogeneity among the group members is necessary in the
early recovery stages. This homogeneity allows the facilitator to structure
the program to the specific needs of each participant. In contrast, during the
later stages of group interventions, participants may even benefit from a
degree of heterogeneity in the composition of the groups (e.g., Fritch &
Linch, 2008).
In terms of the structure of the intervention programs and strategies, the
literature provides considerable variability of program guidelines. Fleming

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6 Small Group Research 

(1979) recommended the simultaneous use of didactic techniques (e.g., bib-

liotherapy), training skills (e.g., role-playing, relaxation), and less structured
intervention activities, such as group discussions or venting anger sessions.
Meanwhile, Cox and Stoltenberg (1991) propose a structure of five modules,
integrating several techniques: (a) cognitive therapy, oriented to improve
women’s self-concept about their relational skills and their preparation for
work; and (b) assertiveness and communication skills to recognize their
rights and practicing self-defense skills. Seeing that the victim’s assertive-
ness may increase the risk of aggression, this module can also include (a)
safety skills, such as identifying signs of abuse, developing escape plans and
training emotional self-control; (b) problem-solving involving questions
about the definition of the problem, the production of alternative answers,
decision making, and verifying the adequacy of those decisions; (c) voca-
tional counseling and job search training; and finally (d) awareness of self
and body, encouraging women to discuss issues related to self-image, par-
ticularly in terms of physical image. In the implementation of these programs
a variety of strategies are used, including group discussions, teaching strate-
gies, and techniques involving cognitive restructuring. However, despite
multiple recommendations regarding group intervention, this method is not
immune to criticism. In fact, research on the outcomes of group therapy with
women reveals some significant methodological limitations. Limitations and
controversies underlying group intervention include the scarcity of published
studies about intervention results, small sizes ranging from 12 (Holiman &
Schilit, 1991) to 21 participants (Cox & Stoltenberg, 1991), and a lack of
control groups and follow-up assessment. This study hopes to address some
of these limitations and highlights the benefits of group intervention.
Specifically, this study aims to provide initial evidence of the effectiveness of
group intervention with female victims of intimate violence (e.g., Tutty &
Rothery, 2002; Matos & Machado, 2011).

Study Context
In Portugal, community services and formal help-sources are available to
female victims of IPV. These include both professional services (e.g., judi-
cial, criminal, medical) and social support organizations, such as agencies for
victims’ support and shelters. However, these answers are predominantly
based on crisis intervention as a first response and an individual intervention
in the support agencies. Although shelters or support agencies sometimes
offer group intervention, it is often unsystematic and fail to assess the effec-
tiveness of the intervention. Taking into account the limited availability of
psychological interventions for female victims of IPV in Portugal, along with

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Santos et al. 7

lacking empirical evidence of intervention efficacy, a group intervention pro-

posal with female victims of IPV was designed, implemented, and evaluated
in Portuguese public institutions. Furthermore, the longitudinal assessment
allows the efficiency regarding each woman to be identified and to determine
whether the changes achieved are sustained over time.
This study has three primary research goals. First, this study will assess
the effectiveness of a group intervention with female victims of IPV. Second,
the study aims to understand the amplitude of change and its main domains
(e.g., clinical symptoms, level of social support, and personal and social
skills) throughout the intervention process. Finally, this study is unique in
that will evaluate whether the evidenced changes were maintained after the
end of group intervention by taking a longitudinal approach. Overall, we
hypothesize that women who participated in the treatment group would dem-
onstrate statistically significant differences on outcomes measured at post-
intervention when compared with their own pre-intervention scores and that
gains would be maintained in the follow-up.

Method
Participants
The study was conducted with a convenience sample of 23 female victims of
IPV. Participants were gathered based on inclusion criteria, namely, being a
victim of IPV or having left an abusive relation recently (within the last 12
months). Exclusion criteria included clinical diagnosis of a personality disor-
der, severe depressive disorder with suicidal thoughts and/or attempts, psy-
chotic symptoms, and/or substance abuse. Prior to joining the intervention
group, women were individually interviewed and assessed to serve as a
screening process. An initial assessment of clinical symptoms was made with
the Structured Clinical Interview for DSM IV disorders–Axis I (SCID-I;
First, Spitzer, Gibbon, & Williams, 2002), which covers the disorders diag-
nosed by Diagnostic and Statistical Manual of Mental Disorders (4th ed.;
DSM-IV; American Psychiatric Association, 1994) and allows the diagnosis
to be identified. From a total of 36 female victims assessed, 10 were excluded
because they did not match the inclusion criteria (e.g., they had left the abu-
sive partner more than 12 months prior to intake assessment) and three were
redirected to an individual intervention because their primary turmoil was
due to issues that were unrelated to domestic violence (e.g., abusive behavior
of their children). When screening participants, an assessment was created to
assess whether group intervention was the best response for these women.
Only in this case were the women selected to enter the group. Moreover, if at

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8 Small Group Research 

the end of the group intervention any participant demonstrated clinical symp-
tomatology that required further psychological intervention, other help alter-
natives were discussed with them.
Twenty-three women participated in one of three intervention groups (first
group, n = 8; second group, n = 8; third group, n = 7). All participants com-
pleted the intervention program, and there were no dropouts. The women’s
age ranged between 26 and 52 years (M = 38.33, SD = 6.86), they were pre-
dominantly divorced from (34.8%) or married to (30.4%) the perpetrator, and
had between one and four children (M = 1.87, SD = 0.81). In terms of national-
ity, most participants were Portuguese (87%), one was Brazilian (4.3%), and
two were from African countries (8.7%), although all were native Portuguese
speakers. With regard to their academic qualifications, most had completed
primary education (fourth grade, 21.7%; sixth grade, 21.7%; ninth grade,
21.7%). Finally, 60.9% of the participants were unemployed while the remain-
der had a wide variety of jobs, ranging from unskilled to skilled occupations.
At intake and at the end of the intervention, the majority of women (82.6%)
were no longer in the abusive relationship. However, the duration of the abu-
sive relationships ranged from 2 to 35 years (M = 16.74, SD = 8.39). Twenty
(87%) participants were subjected to prolonged victimization (more than 5
years) and only three (13%) had ceased victimization sooner (less than 5
years). Six of the participants lived in shelters (26.1%), three (13%) were liv-
ing with the abusive partner/husband, two were living with their daughters
(8.7%), and the remaining participants (52.2%) lived alone. Psychological
violence was present in all cases. Four women were simultaneously victims
of physical, psychological, and sexual abuse (17.4%) and 15 participants
were victims of physical and psychological violence (65.2%). Table 1 dis-
plays a sociodemographic characterization of the participants. All partici-
pants had pressed charges for domestic violence.

Measures
Clinical symptoms.  The Beck Depression Inventory (BDI-II; Beck, Steer, &
Brown, 1996, adapted by Coelho, Martins, & Barros, 2002) and OQ-45 (Out-
come Questionnaire—Lambert et al., 1996, adapted by Machado & Klein,
2006) were used in the assessment of clinical psychological symptoms.
The BDI-II is a self-report instrument consisting of 21 items. Respondents
select from four or five evaluative statements ranked from neutral (0) to
severe (3) to describe how they felt in the prior week (e.g., mood, sense of
failure, social withdrawal). This instrument allowed the diagnosis of minimal
symptoms (score 0 to 13), mild depression (14 to19), moderate depression
(20 to 28), and severe depression (29 to 63). This appears to be a reliable test,

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Santos et al. 9

Table 1.  Sociodemographics of the participants.

Sociodemographic characteristics M SD
Age 38.33 6.8
Number of children 1.87 0.8
Duration of the relationship (years) 16.74 8.4

  n %
Nationality
 Portugal 20 87.0
 Brazil 1 4.3
  African country 2 8.7
Marital Status
 Single 2 8.7
 Married 7 30.4
  Unmarried partner 2 8.7
 Divorced 8 34.8
 Separated 4 17.4
Educational level
  No literacy 1 4.3
  Fourth grade 5 21.7
  Sixth grade 5 21.7
  Ninth grade 5 21.7
  12th grade 3 13
 Graduation 4 17.4
Employment status
 Unemployed 14 60.9
 Employed 9 39.1
Relationship status
  Out of the relationship 19 82.6
  In the relationship 4 17.4
Type of violence suffered
 Psychological 3 13
  Psychological and physical 15 65.2
  Physical and sexual 1 4.3
  All types 4 17.4
Length of exposure to violence
  Continued (> 5 years) 20 87
  Non-continued (< 5 years) 3 13
Living conditions
 Shelters 6 26.1
  With abusive partner 3 13
  With children 2 8.7
 Alone 12 52.2

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10 Small Group Research 

revealing a high internal consistency (α = 0.89). In this sample, an internal

consistency score of .92 was found at pre-test for this scale.
In terms of the improvement of clinical symptoms, the Reliability Change
Index (RCI) was used to compute individual clinical significance, using the
outcomes of pre- and post-test assessment. A reliable change, as proposed by
Seggar, Lambert, and Hansen (2002) is achieved when there is a difference of
8.46 points between two assessment events.
Regarding OQ-45, this instrument is a general measure of wellness or
psychological discomfort. It has 45 items, from which a 5-point Likert-type
scale can be answered: never, rarely, sometimes, often, and always. It evalu-
ates the following subscales: Subjective Discomfort, Interpersonal
Relationships, and Social Role Performance. The total score can range from
0 to 180. Any individual whose total score lies between 0 and 62 reveals no
relevant clinical symptomatology. The questionnaire has high internal con-
sistency (α = .93) and good test–retest reliability (α = .84; Lambert et al.,
1996). The Portuguese version, adapted by Machado and Klein (2006), has
good internal consistency (α = .89; Machado & Fassnacht, 2014). A clinical
significant change from OQ-45 is achieved when there is a difference higher
than 15 points between two assessments. The internal consistency for this
sample was .87 for the pre-test.

Victimization perpetrated by the partner. The Marital Violence Inventory

(Inventário de Violência Conjugal [IVC]; Machado, Matos, & Gonçalves,
2007) aims to identify victimization and/or perpetration of abusive behavior
in marriage or similar relationships. It consists of 21 items, which involve
physically abusive behaviors (e.g., kicking, slapping), emotionally abusive
behaviors (e.g., insult or slur), and coercion/intimidation behaviors (e.g.,
avoiding contact with other people, breaking things to cause fear). For each
of the behaviors listed in Part A of the inventory, the subject is asked whether,
during the past year (a) he or she adopted those practices in the context of his
or her current affective relationship; and (b) their current partner adopted
those practices. If the answer to any of these questions is yes, the subject is
asked whether that behavior occurred just once or more than once. In this
sample, the internal consistency was .61 for victimizations and .98 for perpe-
tration of violence, at pre-test.

IPV beliefs.  The Scale of Beliefs About Marital Violence (Escala de Crenças
sobre a Violência Conjugal [ECVC]; Machado et al., 2007) was used to eval-
uate participants’ beliefs about IPV. This scale has 25 items, which consist in
statements that refer to marital violence legitimacy. Participants’ answer in a
Likert-type scale from 1 to 5 (totally disagree to totally agree). This range

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Santos et al. 11

reflects a high degree of internal consistency (α = 0.90), and previous studies

have demonstrated a strong positive association between acts of aggression
by the partner and the overall score on the scale. This scale also explains 56%
of the four-factor score. The factors are (a) legitimizing and trivialization of
minor violence, (b) legitimization of violence by the woman’s conduct, (c)
legitimization of violence by its attribution to external causes, and (d) legiti-
mization of violence by the preservation of family privacy. The total score is
obtained by calculating the sum of direct responses to each item. The score
for each factor can also be calculated by summing item responses. Total score
had an internal consistency of .954 for this sample at pre-test.

Social support.  The Scale of Satisfaction with Social Support (Escala de Sat-
isfação com o Suporte Social [ESSS], Ribeiro, 1999) consists of 15 items
over four dimensions or factors: satisfaction with friends (five items), inti-
macy (four items), family satisfaction (three items), and social activities
(three items). Items are organized in a Likert-type scale from 1 to 4 (totally
disagree to totally agree). Cronbach’s alpha of the total scale is .85, and the
overall load factor of items of ESSS is high (above 50%). The total score is
the sum of all items. The score for each dimension is the sum of items in each
scale or subscale. The result for the total scale can vary between 15 and 75,
and the highest scores correspond to a greater perception of social support. In
this sample, an internal consistency of .88 was found at pre-test.

Self-esteem. The Rosenberg Self-Esteem Scale (RSES; Rosenberg, 1965,

adapted by Santos & Maia, 2003) is a 10-item Likert-type self-rating measure
of global assessment of self-esteem. There are four alternative responses
from 1 to 4 (strongly disagree, disagree, agree, strongly agree). Five items
tend toward the positive and five toward the negative; total scores range from
10 to 40, with higher results showing higher levels of self-esteem. This scale
shows good levels of internal consistency, measured by Cronbach’s alpha,
with mean values situated, in most cases, above .80. In the current study,
internal consistency was .92, at the pre-test.

Procedures
Participants were recruited through several means of referral: social work
and health institutions, safety agencies, and all institutions that specialize in
providing support regarding this social issue in the northern region of Portugal
(e.g., non-governmental organizations). After requesting their collaboration,
the program was publicized through letters, flyers, public presentations, press
releases, and through the media. Those that participated in the study came

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12 Small Group Research 

from treatment referrals by a shelter (n = 6), or victim support agencies (n =

14); some came on their own initiative (n = 3). These last women were self-
identified victims, and were prescreened to evaluate victimization status and
type of violence experienced. The advertisement and recruitment process
took place during 3 months.
In the initial assessment, all of the procedures were explained to the par-
ticipants. Women were informed about the confidentiality of the data col-
lected, and all of them signed an informed consent statement, which contained
the study objectives and main rules of the intervention program. Participation
was voluntary and the intervention was implemented free of charge.
The research design was based on a psychological assessments protocol
that included a pre-test (at the beginning of the intervention), post-test (after
the end of the intervention), and follow-up (3 months after the end). Women
filled out questionnaires on their own for all of the assessment events. The
intervention took place in Portuguese public institutions in the cities of Braga
and Oporto (North of Portugal).

Data Analysis
Data analysis was conducted by means of inferential statistical testing, with
an intrasubject design to compare the three assessment events. Parametric
tests (one-way ANOVA) were computed when variables had a normal distri-
bution, and non-parametric tests (Friedman test and Wilcoxon’s test, with
Bonferroni correction) were used when variables did not meet the assump-
tion of normal distribution. The calculation of the effect sizes was made
through the η2 (eta square) for ANOVA, and the Kendall’s W (Kendall’s coef-
ficient of concordance) for Friedman. The p value assumed was .05, with the
exception of the Bonferroni correction used with p < .017. Statistical testing
was computed with SPSS-IBM® (Statistical Package for Social Sciences,
Version 21) statistical software.

Description of the Group Intervention Program

The group intervention program for female victims of IPV, with a cogni-
tive-behavioral orientation, was implemented in public institutions over
the course of eight weekly sessions of 90 min each, under the acronym
GAM (Grupos de Ajuda Mútua; Mutual Help Groups). The program aimed
to reduce re-victimization, reduce the clinical effects of victimization, and
promote social and personal skills. Two facilitators conducted the ses-
sions, with prior training in cognitive-behavioral therapy and experience

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Santos et al. 13

in psychotherapy with victims. Each session was divided into four parts,
starting with a brief review of the content of the previous session, proceed-
ing to questions and concerns of the subjects, objectives for the current
session, and ending with a summary of the session. In general, the inter-
vention goals were to (a) decrease victimization and to reduce tolerance
toward IPV; (b) reduce clinical symptoms; (c) help reduce social isolation;
(d) promote empowerment and social abilities; (e) promote alternative
ways of communication with the partner; and (f) develop new life projects.
To achieve the objectives, different strategies were implemented, such as
psychoeducation, relaxation techniques, cognitive restructuring, self-instruc-
tions, decision-making, problem-solving, assertiveness, and communication
skills training. Participants trained new abilities by role-play, case study visual-
ization, debate from videos and educational games, and brainstorming. Table 2
summarizes each session name, objectives, and key achievements for partici-
pants. The group intervention program had three main phases. The first
phase focused on the identification and comprehension of the phenomenon
and comprised three sessions. There were three primary goals during phase
one. First, participants were taught to understand the concept of IPV and its
impact (e.g., fear, sadness). The second aim of Phase 1 was to teach the
women how to understand the individual characteristics of the victim and
the abusive partner who supports the abuse, with the ultimate goal of clari-
fying that the only person responsible for the violence was the perpetrator.
Phase 1 concluded by working to identify cultural and social requirements
that legitimize violence against women (e.g., patriarchy, criticism of women
who leave relationships). The second phase included Sessions 4, 5, and 6
and relied on developing personal and social skills (e.g., self-esteem, asser-
tiveness, decision making). The final sessions (7 and 8) were, respectively,
about the prevention of violence in future relationships and the consolida-
tion of the gains achieved. Intervention was performed by four psycholo-
gists who constituted the team of facilitators; each had expertise in IPV and
master’s and/or PhD in psychology. Throughout all the stages of treatment,
individual needs of participants were addressed, as the group leaders were
looking for signs that other types of intervention could be needed.
The development and the dynamics of group intervention were evaluated
by means of a qualitative survey of the participants after the end of the inter-
vention. The main results (Matos, Santos, & Cunha, 2016) indicated the
women’s positive experience in the appropriate environment, satisfaction
with the activities, the facilitators, and the peers. They also pinpointed the
achievement of well-being and social support, as well as increased knowl-
edge about IPV dynamics. They also reported attitudinal change, specifically

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14 Small Group Research 

Table 2.  Structure and Goals of Group Intervention Program.

Session name Session goals Key achievements

1. Participants Create a warm and safe The group as a space to share
and facilitators environment common experiences
presentation Promote a sense of The group as space of help and
belonging and group mutual learning
cohesion The group as a space with rights
Define rules and and duties
objectives of the group
Evaluate the expectations
of the participants with
the group
2. Grasp of the Define the different forms The definition of domestic
dynamics of of violence violence and the identification
violence Know the dynamics of of its forms
maintenance of victims The identification of the
in abusive relationships difficulties, challenges and
Identify the consequences meanings of IPV
of violence in women The identification of the
and their children, in the consequences of IPV to the
short and long term victims and their children
The recognition of the
strategies of power and
control used by the abusive
partner to keep the woman in
a relationship
To define that the origin and
maintenance of the violence
are of the sole responsibility
of the aggressor
3. News about Deconstruct the myths Deconstruction of the current
violence about violence cultural and social discourse
Identify and analyze the about the women’s role in
cultural discourses various areas of life and the
relating to marriage and impact that this discourse
the role of men and has in maintaining women in
women in the family violent relationships
and society Construction of alternative
Build alternative discourses and positions
discourses compared to be taken by women
to traditional to change the current
performances of mainstreaming
gender

(continued)

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Santos et al. 15
Table 2. (Continued)
Session name Session goals
4. Emotional Promote emotional
coping differentiation (e.g.,
learned discouragement,
guilt, anger)
Modify maladaptive
emotions
Learn how to deal
adaptively with negative
emotions
5. Communication Recognize the assertive
skills style of interpersonal
communication as the
most appropriate and
effective
Promote assertive
communication
6. Self-esteem Develop self and hetero
knowledge
Raise awareness of the
role of self-esteem
Promote self-esteem
7. Prevention of Distinguish the
violence and characteristics of violent
re-victimization relationships versus
healthy relationships
Promote the ability of
decision making
Teach participants problem-
solving strategies
8. Back to the Reflect and share feelings Summary and consolidation of
future and thoughts about the
group Importance of the group’s
Summarize the gains and
learned skills
Note. IPV = intimate partner violence.
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Key achievements
There are common inadequate
feelings that prevent
the action of those who
experience this problem
These same feelings can be
managed and replaced by
more appropriate feelings
Formulation of alternative
beliefs and thoughts
The importance of relaxing and
taking time for herself
Recognition that talking is
different from communicating
with someone
Advantages of being assertive
Importance of non-verbal
communication
Recognition of their rights
Knowledge of how to react in
different situations without
disrespecting others, but
without disrespecting herself
Importance of self-knowledge
and self-esteem for personal
well-being
Importance of self-knowledge
and self-esteem in relational
and personal performance
Warning signs of abusive
relationships
Base characteristics of healthy
relationships
all the lessons learned
goodbye but, above all, of
holding onto the support
network created in the group
16 Small Group Research 

Table 3.  Means, Standard Deviations, and ANOVA Repeated Measures for
Clinical Measures.

Pre-test Post-test Follow-up ANOVA

  M SD M SD M SD F df p ηp2

Beck Depressive Inventory-II

  Total score 19.43 11.5 9.65 9.27 12.23 10.65 13.17 2,42 <.001 .39
Outcome Questionnaire–45
  Total score 71.83 19.47 53.74 21.74 57.82 25.68 13.31 a 2,28 <.001 .39
 Symptom 43.26 11.85 32.13 13.88 33.95 16.23 9.6a 2,31 .002 .31
distress
 Interpersonal 17.70 6.20 13.48 6.30 13.59 8.16 6.47 2,42 .004 .24
relations
  Social role 9.52 3.96 7.39 4.34 8.45 3.57 2,37 2,42 ns
aGreenhouse-Geisser adjustment was used to correct for violations of sphericity.

about the responsibility of the perpetrator and less tolerance toward violence.
Social skills and coping strategies were enhanced.
The “Results” section is divided into clinical symptoms, main results, violent
behaviors and beliefs, and other measures. These domains are analyzed by
comparing the three assessments made during the pre-test, post-test, and
follow-up.

Clinical Symptoms
Depressive symptoms, assessed by the BDI-II (Beck et al., 1996; adapted by
Coelho et al., 2002), showed a significant decrease as the intervention evolved.
Women seemed to change from mild depression in the pre-test, to minimal
symptoms in post-test and follow-up, in a statistically significant way, F(2,
42) = 13.17, p < .001, with a moderate effect size value (see Table 3). Pairwise
comparisons of Bonferroni were computed, showing that depressive symp-
toms significantly decreased from pre- to post-test (p = .001), and from pre-
test to follow-up test (p = .004), maintaining the gains from post-test to
follow-up after 3 months. In addition, from pre-test to post-test, there was a
clinical significant change, as assessed by the RCI. In this way, participants
seemed to fully recover from depressive symptoms by the end of group
intervention.
The OQ-45 (Lambert et al., 1996; adapted by Machado & Klein, 2006) data
showed that general clinical symptoms evolved from a clinical-relevant condi-
tion at pre-test to one of no clinical relevance in post-test. In these assessments,

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Santos et al. 17

Table 4.  Means, Standard Deviations, and Friedman Repeated Measures for Scale
of Beliefs About Marital Violence.
Pre-test Post-test Follow-up Friedman

  M SD M SD M SD χ2(2) p W

Total score 45.43 17.62 39.91 13.63 37.59 13.64 12.54 .003 .285
Legitimation and banalization of 16.74 7.20 15.30 4.99 14.86 4.63 10.19 .006 .242
small violence
Legitimation of violence by 17.83 6.90 15.91 5.72 14.64 5.70 11.31 .004 .257
attribution to women’s
behavior
Legitimation of violence by 20.70 8.24 16.61 5.98 16.95 7.04 12.78 .002 .290
attribution to external causes
Legitimation of violence through 6.57 2.89 6.13 2.49 5.43 1.60 9.5 .009 .226
preservation of the intimate
family life

there was a reliable change, as suggested by RCI, reflecting a full recovery

from clinical symptoms by the participants. Gains were maintained at follow-
up assessment. Statistically significant differences were found throughout the
assessment events, Greenhouse-Geisser corrected, F(2, 28) = 13.31, p < .001,
with a moderate effect size (see Table 3). Results from pairwise comparisons of
Bonferroni showed that the decrease of clinical symptoms from pre-test to
post-test (p < .001) and follow-up (p = .016) events were statistically signifi-
cant. With regard to OQ-45 subscales, there was a general decrease from pre-
test to post-test, and maintained levels from post-test to follow-up, in terms of
mean values (Table 3). Subscales of symptom distress and interpersonal rela-
tions, which had values above the clinical cutoff score for the Portuguese popu-
lation, showed significant differences among the three assessment events.
Symptom distress showed statistically significant differences between pre-test
and post-test (p = .004). However, the interpersonal relations subscale pre-
sented statistically significant differences between pre-test and post-test (p =
.002), since the value at pre-test had no clinical relevance.

Violence Beliefs and Behaviors

This section examines how the intervention affected violence beliefs and
behaviors of the participants. From the Scale of Beliefs About Marital Violence
(Machado et al., 2007), data in the pre-test showed a global score of low toler-
ance to violence (see Table 4). This means that participants had a general ten-
dency to disagree with traditional beliefs about violence. However, the

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18 Small Group Research 

Table 5.  Means, Standard Deviations, and Friedman Repeated Measures for
Marital Violence Inventory.

Pre-test Post-test Follow-up Friedman

  M SD M SD M SD χ2(2) p W
Victimization 23.68 13.33 1.43 2.74 6.56 12.17 16.98 < .01 .566
Perpetration 3.29 4.98 0.09 0.42 0.31 0.70 11.53 .003 .384

intervention assisted participants to create beliefs more aligned with traditional

views of violence. Participant scores decreased, χ2(2) = 12.54, p = .003, as the
group process progressed toward the end. Kendall’s W indicated fairly strong
differences among the three events. According to Wilcoxon’s tests for paired
samples with the Bonferroni correction, total score reduced significantly from
pre-test to follow-up (p = .003). In regard to the questionnaire subscales, Factor
3, legitimization of violence by attribution to external causes, also reduced sig-
nificantly from pre-test to post-test (p = .004), and from pre-test to follow-up
(p = .012). Factor 4, legitimization of violence through preservation of the inti-
mate family life, showed statistical differences from the post-test to the follow-
up event (p = .012), as these types of beliefs reduced dramatically after group
intervention ended. Factor 1, legitimization and trivialization of small violence,
and Factor 2, legitimization of violence by attribution to women’s behavior,
also were reduced, but not at a statistically significant level.
Data from Marital Violence Inventory (IVC; Machado et al., 2007; see
Table 5) showed a clear prevalence of received victimization at intake. It
stated that violence in these couples was mainly perpetrated by men. Just a
small amount of violent behaviors were perpetrated by women against their
partners. These behaviors were understood, taking into consideration their
type and low prevalence, as reactive behaviors. In the post-test, there was a
clear decrease (p < .001) of the received behaviors, which translated into a
reduction of types of violent behaviors, frequency, and severity, that contin-
ued to decrease from pre-test to follow-up (p = .011), computing Wilcoxon’s
tests for paired samples with correction of Bonferroni. Perpetration also
dropped (p = .003) to near absence (M = .09), and continued to decrease from
pre-test to follow-up (p = .013), as computed by Wilcoxon’s tests for paired
samples with correction of Bonferroni.

Other Measures
Total scores from RSES (Rosenberg, 1965; adapted by Santos & Maia, 2000)
revealed that, at intake, women showed a medium level of self-esteem, which

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Santos et al. 19

Table 6.  Means, Standard Deviations, and ANOVA Repeated Measures for
Rosenberg Self-Esteem Scale.

Pre-test Post-test Follow-up ANOVA

M SD M SD M SD F df p ηp2

24.86 7.23 30.27 5.57 31.18 4.82 12.19a 1,30 <. 001 .37
aGreenhouse-Geisser adjustment was used to correct for violations of sphericity.

Table 7.  Means, Standard Deviations and ANOVA Repeated Measures for Scale
of Satisfaction With Social Support.

Pre-test Post-test Follow-up ANOVA

  M SD M SD M SD F df p ηp2

Total score 43.09 13.25 50.05 11.04 50.18 17.57 4.12a 2,32 .034 .17
Friendship 14.50 5.79 18.00 4.43 17.05 6.31 6.12 2,42 .005 .23
Intimacy 11.64 4.57 13.23 3.75 13.82 5.56 2.55 2,42 ns
Family 10.18 3.7 10.82 3.54 10.64 4.01 .403a 1,30 ns
Social activities 6.88 3.21 7.91 3.21 8.68 3.36 2.23 1,31 ns
aGreenhouse-Geisser adjustment was used to correct for violations of sphericity.

increased at post-test and was maintained at follow-up. The differences from

pre-test to post-test and follow-up are statistically significant, Greenhouse-
Geisser corrected, F(1, 30) = 12.19, p < .001 (see Table 6). Pairwise compari-
sons of Bonferroni were computed, showing statistically significant differences
from pre-test to post-test (p = .002) and from pre-test to follow-up (p < .001).
The total score according to the Social Support Satisfaction Scale (ESSS;
Ribeiro, 1999) indicated a decrease from pre- to post-test while maintaining
gains in follow-up at a statistically significant level, Greenhouse-Geisser cor-
rected, F(2, 32) = 4.12, p = .034 (see Table 7). Pairwise comparisons were
computed, showing no statistical significant differences between assessment
events, with the adjustments of Bonferroni. Among the subscales, the one
related to friendship is the one with the highest scores, meaning that partici-
pants perceive friends as an effective form of social support. Scores on this
subscale increased from pre-test to post-test (p = .001).

Discussion
This study examined the effectiveness of a group intervention program of
female victims of IPV in a relatively brief (eight sessions) group format.

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20 Small Group Research 

The main conclusion reveals that the intervention created effective out-
comes, as other studies had already observed (e.g., Briere & Jordan, 2004;
Coker et al., 2002; Constantino et al., 2005; Iverson et al., 2009; Lundy &
Grossman, 2001). At intake, women invited to participate in the interven-
tion presented clinical levels of symptomatology, and at the conclusion of
the group intervention, the women’s main symptoms were reduced in sever-
ity and intensity; the indexes of clinical significance of the intervention
were highly satisfactory. Thus, important and significant improvements in
depressive and general symptoms were achieved, as well as in women’s
self-esteem, social support, and tolerance for intimate violence. Furthermore,
improvements were consolidated and increased over time. These results
provide evidence that the design of the intervention met the demands and
needs of female victims of IPV, improving their psychological well-being.
Initial results showed high scores for depressive symptoms dominance in
female victims, along with general relevant symptoms. As intervention
evolved, the depressive symptoms decreased until the absence of depressive
symptoms in the end of the intervention. Regarding the general symptoms,
the path was similar. Women also evolved from a condition with clinical
symptoms to a condition of symptoms without clinical relevance at the end of
intervention. However, regarding the subscales of the measure used, the sub-
scale of social role did not decrease significantly. This might mean that
women still view themselves as dissatisfied or in conflict with their social
roles, family life, leisure, and work. It worth noting that some of them are
living in shelters and not able to perform these socially expected roles, or this
aspect of their lives was still affected by psychological problems (Lambert
et al., 1996). The absence of a control group prevents further discussion
regarding the prevention of severe mental health issues in women IPV.
However, group intervention seemed to be effective in reducing clinical
symptoms from pre-test to post-test, and gains were upheld at follow-up
assessment. Tutty, Bidgood, and Rothery (1996) found, in a follow-up assess-
ment 3 months after an intervention program in shelters, that women living
independently improved their assessment of support and self-esteem. The rat-
ers’ assessment was also very positive for the same variables and also for
coping abilities and safety. These results are very similar to several research
studies on group intervention that address clinical symptoms (cf. McBride,
2001; Constantino et al., 2005; Schwartz et al., 2004). These studies, com-
bined with the results of this study, emphasize the potential positive impact of
group intervention for female victims.
Generally, tolerance toward the use of violence in intimate relationships
decreased in the participants. Although that is not always an assessed dimen-
sion, some studies revealed a similar tendency (Rinfret-Raynor & Cantin,

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Santos et al. 21

1993; Tutty et al., 1993). Sessions that allowed participants to reflect on partner
responsibility in the violence and myths about IPV might have contributed to
this decrease. However, violence tolerating beliefs do not seem to characterize
these women, due to the low score obtained at the beginning of the interven-
tion. This outcome brings to question whether females who have a low toler-
ance for violence were more likely to self select to participate in the intervention.
As the women had already realized that they could not tolerate violence, they
may have been more willing to enter group intervention, as a prior drive toward
change. Nevertheless, at the end of the group intervention, these beliefs changed
and women became even less tolerant to violent behaviors.
The group intervention also seemed to contribute to a decrease of violence
suffered by female victims and also perpetrated by women. The group ses-
sions as a whole might have contributed toward women holding the offender
responsible for their abusive behavior and also toward expanding the role of
strategies that women would usually adopt. Therefore, with the women’s par-
ticipation in the group, they seem to be better prepared to handle the violent
behaviors from their partners, and to control and defend themselves without
the use of violence. Other studies under a group format revealed a decrease
on violence suffered by women (e.g., McBride, 2001; Rinfret-Raynor &
Cantin, 1993; Tutty et al., 1993).
Self-esteem is commonly assessed in group effectiveness studies. In this
study, it revealed significant improvement, as the group intervention focused
on women’s empowerment and social reinforcement throughout the sessions.
At intake, self-esteem levels were not very low, which may be due to fact that
the majority of the participants were no longer in the abusive relationship.
Even with the initial moderate self-esteem scores, participation in the group
increased self-esteem levels significantly. Results from literature made this
result expectable, as an increase of self-esteem of women is a sustained
achievement following group treatments (e.g., Cox & Stoltenberg, 1991;
Rinfret-Raynor & Cantin, 1993; Tutty et al., 1993).
Some authors have found an increase in the perception of social support in
female victims involved in group intervention (cf. Constantino et al., 2005;
Tutty et al., 1993). Coherently, results showed that social support improved
total score and friendship levels. This subscale improvement might have been
promoted by the group experience and relationships that started in the inter-
vention. In fact, during the sessions, women started to form friendships and
to arrange get-togethers outside the scope of the group, which might explain
the higher score obtained in the subscale of friendship.
In summary, data reveal encouraging results achieved by women who ben-
efit from the program. Data showed that women evolved to a condition of
well-being characterized by no clinical symptoms, low tolerance to violence,

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22 Small Group Research 

sense of self-esteem, ability to seek social support, and no violence in their

lives. These results provide evidence that the developed group intervention
program is effective. A closer examination of data shows that although gains
were maintained at follow-up, total scores showed slight increases. This raises
the question of the time frame needed to bring about psychological changes
and also for these to endure over time. Although the literature omits this
aspect, we propose that intervention groups could be followed by booster ses-
sions. Also noteworthy is the fact that these programs are an economical and
effective way to raise women’s awareness regarding choosing risky partners
or situations (Iverson et al., 2011). In addition, clinical levels of symptomatol-
ogy revealed by women at intake may also interfere with their ability to pick
safe partners or to terminate an abusive relationship (Iverson et al., 2011).
This research addressed some concerns about intervention with battered
women also addressed by Abel (2000). The intervention was conducted
according to a specific theoretical framework and structured explicit treat-
ment process, which might contribute to the clients’ positive outcomes.
Along with treatment integrity, an effort was also made to make the assess-
ment protocol explicit and adequate. An interesting indicator of the treat-
ment’s adequacy was the inexistence of dropouts. Efforts were made to
develop a specific program tailored to the Portuguese context, and to per-
form an adequate assessment of its effectiveness, and disseminate the results.
A frequently described design limitation was surpassed by the inclusion of
the follow-up assessment. As Abel (2000) stated, “The ability to conduct
follow-up research on the women who participate in practice effectiveness
research is essential to increasing our confidence in the intervention effec-
tiveness” (p. 74). In future studies, it will be important to include follow-up
assessments during a period of, at least, 12 months. An additional contribu-
tion of this study is that it provided IPV female victims with treatment from
qualified workers who have experience with IPV victims.

Limitations and Future Directions

Despite the declared success of this intervention study, there are some limita-
tions that must be acknowledged. The first limitation is the small sample size,
which does not allow robust analyses and limits the generalizability of the
findings. Second, we rely only on self-report data. Both of these limitations
seem to be practically endemic in this field. In a prior literature research,
Matos, Machado, Santos, and Machado (2012) found that convenience sam-
ples are used in effectiveness research because women seek secure settings
and their problems need to take their security and confidentiality into account.
Random selection of participants would be a rather difficult task; however,

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Santos et al. 23

future studies should use larger sample sizes and introduce new measures to
evaluate the changes of women.
In addition, this study does not include a control group, as it is considered
that is not ethical to have a waiting list, bearing in mind the needs of victim-
ized women. The change assessment was made taking in consideration the
differences between assessment events. Nevertheless, it is not taken for
granted that treatment gains were indeed a reflex of the group intervention.
They might be due to other factors, for instance, group cohesion, or even
some characteristics of the participants (e.g., not being in an abusive relation-
ship during intervention; institutional reference).
Finally, although there were statistically significant changes on some mea-
sures from pre-test to post-test and to follow-up, some of the women were still
facing clinical rates of symptomatology. It is possible that some women may
have benefited from additional treatment or that this format does not always
answer all the individual needs of its members. Although a longer program
might be favorable for some, it would use more resources and time, which
could jeopardize the women’s commitment to the group. Future research
should evaluate shorter versus longer programs to define optimal length of the
intervention. Also, a longer follow-up period would be important to fully
assess the impact of treatment on long-term risk for IPV victimization.
Nonetheless, despite the brevity of the group interventions, the extent of
change is encouraging. Another aspect worth taking into consideration in
future studies would be to evaluate the process of change through Innovative
Moments Coding System, as it was used in previous studies in individual
therapy (cf. Gonçalves, Matos, & Santos, 2009). Also, it would be important
to assess the women’s readiness to change, through the assessment of, for
instance, the stage of change prior entering the treatment (e.g., transtheoreti-
cal model from Prochaska & DiClemente, 1982).
In conclusion, the results from this study are promising regarding the
effectiveness of group intervention as a response for female victims of IPV.
Findings suggest that the current intervention has positive impact on female
victims of IPV, so more research investment in this area would be needed to
address women’s psychological well-being.

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research,
authorship, and/or publication of this article.

Funding
The author(s) disclosed receipt of the following financial support for the research,
authorship, and/or publication of this article: This study was partially conducted at

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24 Small Group Research 

Psychology Research Centre (UID/PSI/01662/2013), University of Minho, and sup-

ported by the Portuguese Foundation for Science and Technology and the Portuguese
Ministry of Education and Science through national funds and co-financed by FEDER
through COMPETE2020 under the PT2020 Partnership Agreement (POCI-01-0145-
FEDER-007653). Additional support was provided by the Commission for Citizenship
and Gender Equality (CIG) and the Presidency of the Council of Ministers (Portugal).

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Author Biographies
Anita Santos, PhD, is currently an assistant professor at ISMAI—Maia University
Institute, Portugal, and also a clinical psychologist. She has been developing outcome
and process research on narrative and cognitive-behavioral therapy, namely, with vic-
tims of intimate partner violence. Her research interests are related with therapeutic
processes of change.
Marlene Matos, PhD, is a professor at School of Psychology, University of Minho,
Portugal, and the director of the Master in Applied Psychology. She is an expert in
forensic psychological evaluation and has been developing research on victimology at
CIPsi (Researcher center).
Andreia Machado is a fellow researcher at the Research Center on Psychology of the
School of Psychology of University of Minho, Portugal. Her doctoral dissertation was
on male victims of intimate partner violence. Her areas of expertise include victimol-
ogy and forensic evaluation.

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