The Effect of Biofeedback on Intimate Partner Violence: A Randomized Controlled Trial

Studies on cognitive behavioral therapy (CBT) for IPV offenders show small or no effects on recidivism. Offenders may not fully benefit from CBT, because their awareness of arousal is low, leading to high arousal overtaking them and making it difficult to control their behavior. Biofeedback can support awareness of arousal. With this purpose, we developed a smartphone application, Good Reaction Is Prevention (GRIP), that when used in conjunction with a heart rate monitor, measures heart rate variability and notifies users when a personal stress threshold is surpassed. In a randomized controlled trial (N=40) we compare a 9-week CBT-based program aimed at developing self-control where IPV offenders are treated either with GRIP-app or receive treatment as usual (TAU) without biofeedback. Primary outcome measure is the Conflict Tactics Scale-2, measuring the frequency of different types of IPV. Secondary outcome measure is the Anger Bodily Sensations Questionnaire, measuring awareness of bodily signals that occur when feeling angry. We hypothesize that the GRIP-condition leads to a greater reduction in IPV frequency as measured by the CTS-2 and to a greater awareness of bodily sensations that accompany anger, when compared with the TAU-condition.

Primarily, we expect that the use of biofeedback will have beneficial effects on transfer to real-life situations, resulting in a decrease of intimate partner violence from pretest to posttest. Secondly, we hypothesized that biofeedback will increase awareness of bodily signals indicative of arousal. Exploratively, we aim to investigate the differences in HRV-values from pretest to posttest.

The study period is 9 weeks
Week 1: ABSQ, CTS-2, HRV
Week 2: ABSQ
Week 3: ABSQ
Week 4: ABSQ
Week 5: ABSQ
Week 6: ABSQ
Week 7: ABSQ
Week 8: ABSQ
Week 9: ABSQ, CTS-2, HRV

TAU (n = 20) = Patients in the TAU-condition receive a standard IPV treatment protocol which all IPV offenders at the Waag receive (i.e. the Safety for Partners treatment protocol). Duration: 9 weeks.