Trauma-focused cognitive behavioural therapy (TF-CBT) for domestic abuse with an individual at risk of ongoing threat of further harm: a single case experimental design

Post-traumatic stress disorder (PTSD) and complex-PTSD (cPTSD) can be experienced following experiences of domestic abuse (DA). People who have experienced DA are likely to face re-victimisation, especially when the threat of DA is ongoing. Trauma-focused cognitive behavioural therapy (TF-CBT) is recommended for PTSD. However, there are often concerns about offering this intervention where there is ongoing threat due to fears of desensitisation to risk and lack of stability. Recent reviews have illustrated that, on the contrary, TF-CBT can be effective at reducing PTSD and does not necessarily increase risk. However, research is lacking in community settings. The present case study utilised a single-case experimental design to measure the assessment (Phase A) and treatment (Phase B) of PTSD in response to DA using a TF-CBT model in a community NHS setting where there was a threat of further DA due to ongoing contact with the perpetrator. PTSD, anxiety, and depression scores reduced, and improvements were seen in idiosyncratic measures. Results are discussed in line with ongoing debates regarding offering TF-CBT to those at risk of ongoing threat. Key learning aims (1) To be able to individualise and apply TF-CBT, based on Ehlers and Clark’s (2000) model, to cPTSD arising from DA in a community setting. (2) To recognise the value in offering treatment for cPTSD when the threat of further harm is ongoing. (3) To consider what additional factors may need to be taken into account in the treatment of cPTSD from DA in community settings where there is ongoing risk.