The effective use of cognitive behavioral therapy on immigrant women struggling with domestic violence
I. Introduction
Background
The impact of globalization has greatly increased the number of immigrants. The surge in the number of immigrants is projected to be on the rise especially within major geographical locations of the world. According to the UN population division, half of these immigrants are women while in some locations; the number of women immigrants forms the overwhelming majority. Migration is therefore one of the factors that have been linked to women vulnerability. Through migration, women become more dependent on their racial communities, families, employers, and husbands. Violence against women has been identified to be a special risk for refugee women. Researchers have identified that women immigrants experience a lot of victimization in relation to gender based violence. The immigrant women, who go through gender based violence, normally develop depression and trauma. This study therefore seeks to develop an evaluation of the effectiveness of cognitive behavioral therapy when administered on immigrant women.
Cognitive behavior therapy is a type of treatment involving psychotherapeutic techniques. The treatment is administered to patients to help them understand that their thoughts and feelings are an essential part of their behavior. The primary goal of this form of psychotherapeutic treatment is to teach patients that the one aspect in the world they have control of is their thoughts. Even though people have little or no control over circumstances happening in the world, they can choose how they interpret and deal with the situations.
Purpose of study
Depression and trauma have been identified to be major problems associated with domestic and gender based violence. The purpose of this study is to examine the effectiveness of cognitive behavior therapy when administered on women struggling with domestic violence.
Statement of problems
Studies have indicated that immigrant and refugee women experience high rates of domestic violence, between 30 percent and 50 percent. Around the world, at least a third of the women have experienced some form of violence, either domestic or gender based. For immigrants women, the Raj and Silverman (2002) say that majority of the perpetrators of domestic violence are intimate partners including husbands, boyfriends, or lovers. The risk for domestic violence is shared for all women in the US. However, refugees and immigrant women have increased levels of vulnerability because of their status. Some of the women immigrants may still be struggling with legal system in the US in order to be considered as legal immigrants thus hindering them from accessing some of the services and privileges enjoyed by legal citizens.
Depression and posttraumatic stress disorder has been associated with victims of domestic violence because of the high incidence of diagnosis. Immigrant women who have experience either or both physical and sexual abuse meet the criteria for posttraumatic disorder. Symptoms such as the victim’s cognitive assessment, early age onset, duration of exposure, and severity of the abuse have been found to worsen depression and posttraumatic disorder in these women. Addressing this issue there requires psychotherapeutic techniques of treatment such as cognitive behavioral therapy.
Research questions
This study will examine previous research on the effectiveness of cognitive behavior therapy in treating depression and posttraumatic disorder. It will also conduct a clinical randomized experiment to assess the effectiveness of the using cognitive behavior therapy on the immigrant women and victims of domestic violence. Therefore the study shall be based upon these two research questions:
Do the immigrant women who experience domestic violence continue to show symptoms of posttraumatic stress disorder after being under cognitive behavioral therapy treatment?
Do the female immigrant victims of domestic violence continue to show evidence of depression after being subjected to CBT treatment?
Hypothesis
Hypothesis 1: CBT is effective in treating depression and posttraumatic disorder in immigrant women struggling with domestic violence
Hypothesis 2: the immigrant women and victims of domestic violence do not continue to show symptoms of posttraumatic stress disorder after being under cognitive behavioral therapy treatment
Hypothesis 3: the immigrant women and victims of domestic violence do not continue to show evidence of depression after being subjected to CBT treatment.
Assumptions
The main assumption in this study is the fact that the use of CBT generally assumes the behavioral theory in understanding why people behave in a certain manner. It basically assumes that behavior and emotional reactions are learned. The focus of the will be helping the women to learn new ways in which to react to their experiences in relation to domestic violence. In additions, the women will also be helped to substitute the negative thoughts developed as a result of the experience with new and helpful thoughts that will enable them to change their perception and to handle the situation in a healthy manner.
Limitations
II. Review of literature
Hughes and Jones (2000) say that domestic violence is a huge problem faced by women of all races, status, religion, and cultural background. This implies that immigrant women also fall among the category of people vulnerable to domestic violence. Among the most common forms of violence have been identifies by Hughes and Jones (2000) to include sexual violence and physical violence. Women who go through these forms of domestic violence experience depression. Hughes and Jones (2000) says that depression is not the only DSM mental disorder linked to domestic violence, but these victims would sometime develop other DMS-III-R mental disorders such as mood swings, non-effective psychosis, and eating disorders. Depending on the level of severity, the women can experience up to 15 times the risk of developing antisocial personality than the none victims. The levels of depression have also been identified to greatly increase with continued exposure to domestic violence and severity of the violence.
Approaches for behavioral therapy have been based on the social learning model where depression and posttraumatic stress disorder are considered to be a series of mental behaviors that are learnt as people interact with situations in their environment. These behaviors are also considered to be negative behaviors which can be changed or replaced with positive behaviors using principles of behavioral theory.
According to Asian, Latino, and Korean immigrant women have reported cases of domestic violence by their intimate partners. Around 30 to 50 percent of the women are either abused physically or sexually by their partners. Additional surveys conducted in the US have proved the statistics provided in the study by . Despite the increase in evidence of domestic violence among immigrant partners, little effort has been made to address the situation. Majority of the studies that focus on immigrant women and domestic violence include sample immigrants from south America, central America, Mexico, Middle East, South Asia, and East Asia. The study by indicate that the vulnerability of immigrant women to gender based violence is increased by social context, laws permitting male dominance, and culture.
III. Methodology
The study will be longitudinal experimental study.
Procedure
The study expects to administer cognitive behavioral therapy to identified sample participant of domestic violence among the Asian and Latino community in America. The researcher will first identify participants through local health care facilities in the US. It is within these facilities that women experiencing gender based violence and domestic violence may come seeking for attention. Additionally, some of these women may approach faith based organizations for help. The researcher will also identify some of the participants for this study in the local faith based organization. Therefore, one health facility and one rescue center, which is expected to be faith-based, will be selected for the study. The participants must either complaint of repetitive cases of violence against them by their intimate partners or be diagnosed for depression and posttraumatic disorders within the selected health facility. However, the latest edition of DSM criteria for mental and psychological disorders will be used for determining depression and posttraumatic disorder within the selected participants. A total of 200 immigrant women will be selected and subjected to the DSM-IV criteria for establishing cognitive and mental disorders. This will follow subjecting the diagnosed patients to treatment using cognitive behavioral therapy. The treatment will be conducted over a period of four months by qualified professionals. Within this period, the participants will be monitored for the manner in which they are coping with the situation at home. It is also expected that follow up will done over another period of three months to establish whether the treatment is still working or not.
Instrument
The methods of data collection shall involve interviews and surveys. Interviews shall be conducted both physical and electronic questionnaires which shall be available within the location of the study. Preparing a questionnaire to interview is one of the most difficult tasks as it plays vital role to reach conclusion and provide recommendation in accordance with the research problem. The researcher has the opportunity to use own discretion as it is not pure science. In addition, it is not essential to follow specific direction. The motivation behind the designing a questionnaire is to avoid unreasonable observation and opinion of the respondents as questionnaire binds the respondents to focus only on the particular problem area. However, it is essential to consider survey objectives, data collection method and question response format to measure the required deadline and output to collect data and conduct research work. In addition, questions can be formatted structured and unstructured way; therefore, this study would consider structured format in order to concentrate on the cardinal issues, such as, symptoms of depression and posttraumatic disorders. It is necessary to avoid leading or biasing questions, implicit alternatives, implicit assumptions and generalisations. Here, it is important to mention that the wording of the questions would not be complicated because questionnaires should consist of ordinary words with unambiguous words. Moreover, the researcher should design questionnaire considering the vocabulary level and educational background of the respondents, otherwise, most of the respondents would not be able to address the importance of the question. In this context, the researcher of this dissertation would consider the cultural and educational background of the respondents.
Data analysis
It can assume that many patients of depression and posttraumatic disorders would not have completed the questionnaire or survey form in recommended way, thus, feedback would full of error. As a result, it needs to apply several techniques in order to analyze the data without error and get fruitful outcomes. In this context, the researcher of this study would verify all the survey form in order to edit unintentional mistakes, incompatible and fabricated information about the behavior of credit card sales staff and the customers’ responds in this regards. For the purpose of inspection, the variables would be coded in such way that would not be difficult to analyze the data and it would be easy to the readers, for example, the independent variable in each of the model would be considered by following some special techniques. As the questionnaire has designed with directional options and recommend selecting one option from multiple choice, it would be considered error if any respondent mark on more than one option in a particular question. At the same time, if any respondent forget to answer any question or give incomplete questionnaire, then it needs to edit to remove such mistakes. After completing the editing the primary data, it would be analyzed and graphically presented by using Microsoft excel.
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