{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T23:52:23Z","timestamp":1793922743396,"version":"4.8.0"},"reference-count":61,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2023,4,12]],"date-time":"2023-04-12T00:00:00Z","timestamp":1681257600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Delaware"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Integrative community therapy (ICT) is a methodology used in the public health arena to deal with problems facing communities such as depression, substance abuse, and stress. This approach is unique as it builds on critical pedagogy, cultural anthropology, communication, resilience, and systems theory. Additionally, creative arts therapies point to the utility of music as a therapeutic tool. This study employed ICT and a music workshop with domestic violence survivors in Quito, Ecuador, via a pre-post comparison group design. A total of 87 women completed the six-week study\u201449 in the intervention group and 38 in the comparison group. Measures were taken on self-esteem, general health, resilience, dating violence attitudes, and social support. Additionally, the intervention group answered open-ended questions about their experience, and some participated in a focus group (n = 21). The quantitative results indicated that there was improvement in the domains of general health, self-esteem, and social support for the intervention group compared to the comparison group. Themes from the qualitative responses indicated changes in the relationship with the aggressor, psychological and emotional changes, changes in feelings of social support, and changes for the future. The study found promising results for this approach with domestic violence survivors, possibly leading to a community-grounded, non-hierarchical, culturally-responsive intervention for this population.<\/jats:p>","DOI":"10.3390\/ijerph20085492","type":"journal-article","created":{"date-parts":[[2023,4,13]],"date-time":"2023-04-13T02:09:21Z","timestamp":1681351761000},"page":"5492","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Evaluation of Integrative Community Therapy with Domestic Violence Survivors in Quito, Ecuador"],"prefix":"10.3390","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7137-2544","authenticated-orcid":false,"given":"Chiara","family":"Sabina","sequence":"first","affiliation":[{"name":"School of Social Work, Rutgers University, New Brunswick, NJ 08901, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6107-2225","authenticated-orcid":false,"given":"Diego","family":"Perez-Figueroa","sequence":"additional","affiliation":[{"name":"Psychology and Behavioral Science Department, London School of Economics and Political Science, London WC2A 2AE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurent","family":"Reyes","sequence":"additional","affiliation":[{"name":"School of Social Welfare, University of California Berkeley, Berkeley, CA 94720, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo","family":"Campa\u00f1a Medina","sequence":"additional","affiliation":[{"name":"Muyumpa\u2014Community Therapy Training Center, Quito 170516, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eluzinete","family":"Pereira de Souza","sequence":"additional","affiliation":[{"name":"Muyumpa\u2014Community Therapy Training Center, Quito 170516, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Markovits","sequence":"additional","affiliation":[{"name":"Pa\u2019Arriba Foundation, Potomac, MD 20854, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea Carolina","family":"O\u00f1a Jacho","sequence":"additional","affiliation":[{"name":"Centro Ecuatoriano para la Promoci\u00f3n y Acci\u00f3n de la Mujer, Quito 170143, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gissel Katherine","family":"Rojas Bohorquez","sequence":"additional","affiliation":[{"name":"Centro Ecuatoriano para la Promoci\u00f3n y Acci\u00f3n de la Mujer, Quito 170143, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,4,12]]},"reference":[{"key":"ref_1","unstructured":"Instituto Nacional de Estad\u00edstica y Censos (2019). Encuesta Nacional de Relaciones Familiares y Violencia de Genero Contra las Mujeres, Instituto Nacional de Estad\u00edstica y Censos."},{"key":"ref_2","unstructured":"(2022, October 28). Organizaci\u00f3n de los Estados Americanos.Convenci\u00f3n Interamericana para Prevenir, Sancionar y Erradicar la Violencia contra la Mujer. Available online: https:\/\/www.oas.org\/juridico\/spanish\/tratados\/a-61.html."},{"key":"ref_3","unstructured":"(2022, October 28). Constituci\u00f3n de la Rep\u00fablica del Ecuador. Available online: https:\/\/www.asambleanacional.gob.ec\/sites\/default\/files\/documents\/old\/constitucion_de_bolsillo.pdf."},{"key":"ref_4","unstructured":"(2022, October 28). Declaraci\u00f3n Sobre el Femicidio. Available online: https:\/\/www.oas.org\/es\/mesecvi\/docs\/declaracionfemicidio-es.pdf."},{"key":"ref_5","unstructured":"(2022, October 28). C\u00f3digo Org\u00e1nico de Organizaci\u00f3n Territorial, Autonom\u00eda y Descentralizaci\u00f3n. Available online: https:\/\/www.gob.ec\/regulaciones\/codigo-organico-organizacion-territorialcootad."},{"key":"ref_6","unstructured":"(2022, October 28). C\u00f3digo Org\u00e1nico Integral Penal. Available online: http:\/\/biblioteca.defensoria.gob.ec\/handle\/37000\/3427."},{"key":"ref_7","unstructured":"Organizaci\u00f3n de los Estados Americanos (2022, October 28). Declaraci\u00f3n sobre la Violencia y el acoso Pol\u00edticos Contra las Mujeres. Available online: https:\/\/www.oas.org\/es\/mesecvi\/docs\/declaracionviolenciapolitica-es.pdf."},{"key":"ref_8","unstructured":"Corporaci\u00f3n Utop\u00eda (2000). Fortalecimiento de las Comisar\u00edas de la Mujer y la Familia: Sistematizaci\u00f3n de las Comisar\u00edas de la Mujer y la Familia, Centro Ecuatoriano para la Promoci\u00f3n y Acci\u00f3n de la Mujer."},{"key":"ref_9","unstructured":"Cuvi S\u00e1nchez, M. (1999). Violencia Contra las Mujeres: La Ruta Cr\u00edtica en Ecuador, OPS\/OMS."},{"key":"ref_10","unstructured":"Medina, C., and Carrillo, P. (2007). Los Lenguajes de la Impunidad: Informe de Investigaci\u00f3n Delitos Sexuales y Administraci\u00f3n de Justicia, Centro Ecuatoriano para la Promoci\u00f3n y Acci\u00f3n de la Mujer."},{"key":"ref_11","first-page":"186","article-title":"Coloniality and psychology: The uprooting of knowledge","volume":"9","author":"Galindo","year":"2019","journal-title":"Rev. Polis Psique"},{"key":"ref_12","unstructured":"Barreto, A. (2013). Terapia Comunit\u00e1ria Integrativa Paso a Paso, Gr\u00e1fica LCR."},{"key":"ref_13","first-page":"174","article-title":"Impacto e tend\u00eancias do uso da Terapia Comunit\u00e1ria Integrativa na produ\u00e7\u00e3o de cuidados em sa\u00fade mental","volume":"17","author":"Lazarte","year":"2015","journal-title":"Rev. Eletr\u00f4nica Enferm. \u00d3rg\u00e3o Fac. Enferm. Univ. Fed. Goi\u00e1s"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1126\/science.847460","article-title":"The need for a new medical model: A challenge for biomedicine","volume":"196","author":"Engel","year":"1977","journal-title":"Science"},{"key":"ref_15","unstructured":"Hugon, N. (2013). La TCI & la Antropologia Cultural, Taller de Terapia Comunitaria Integrativa."},{"key":"ref_16","first-page":"1","article-title":"Creative arts, culture, and healing: Building an evidence base","volume":"8","author":"Archibald","year":"2010","journal-title":"Primatisiwin A J. Aborig. Indig. Community Health"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/j.curtheres.2017.03.001","article-title":"Roads to health in developing countries: Understanding the intersection of culture and healing","volume":"86","author":"Ibeneme","year":"2017","journal-title":"Curr. Ther. Res."},{"key":"ref_18","first-page":"33","article-title":"Community therapy: A participatory response to psychic misery","volume":"2010","author":"Barreto","year":"2010","journal-title":"Int. J. Narrat. Ther. Community Work"},{"key":"ref_19","unstructured":"Freire, P., and Faundez, A. (1989). Learning to Question: A Pedagogy of Liberation, The World Council of Churches."},{"key":"ref_20","unstructured":"Freire, P. (2000). Pedagogy of the Oppressed, The Continuum International Publishing Group Inc."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"41","DOI":"10.5294\/pacla.2015.18.1.3","article-title":"Comunicaci\u00f3n y buen vivir. La cr\u00edtica descolonial y ecol\u00f3gica a la comunicaci\u00f3n para el desarrollo y el cambio social","volume":"18","year":"2014","journal-title":"Palabra-Clave"},{"key":"ref_22","unstructured":"Lazarte, R. (2022, October 28). Terapia Comunitaria Reflexions. Available online: https:\/\/docplayer.es\/21015728-Terapia-comunitaria-reflexiones-rolando-lazarte.html."},{"key":"ref_23","unstructured":"Watzlawick, P., Beavin, J.B., and Jackson, D.D. (1967). Pragmatics of Human Communication: A Study of Interactional Patterns, Pathologies, and Paradoxes, Norton."},{"key":"ref_24","unstructured":"Hammond, D. (2003). The Science of Synthesis, University Press of Colorado. Exploring the Social Implications of General Systems Theory."},{"key":"ref_25","unstructured":"Leiva Olivencia, J.J., and Guti\u00e9rrez Valerio, R. (2018). Pr\u00e1cticas Pedag\u00f3gicas Para el Fomento de la Inter-Culturalidad en el Contexto Universitario: La Experiencia de la Universidad Estatal Amaz\u00f3nica Enconvenio con la Universidad de M\u00e1laga, Universidad Estatal Amazonica."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1037\/0003-066X.59.1.20","article-title":"Loss, trauma, and human resilience: Have we underestimated the human capacity to thrive after extremely aversive events?","volume":"59","author":"Bonanno","year":"2004","journal-title":"Am. Psychol."},{"key":"ref_27","unstructured":"Van der Kolk, B. (2014). The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma, Penguin Publishing Group."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1300\/J146v14n01_03","article-title":"Conceptualizing trauma and resilience across diverse contexts: A multicultural perspective","volume":"14","year":"2007","journal-title":"J. Aggress. Maltreat. Trauma"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1037\/a0039671","article-title":"The resilience portfolio model: Understanding healthy adaptation in victims of violence","volume":"5","author":"Grych","year":"2015","journal-title":"Psychol. Violence"},{"key":"ref_30","first-page":"964","article-title":"A terapia comunit\u00e1ria como estrat\u00e9gia de promo\u00e7\u00e3o \u00e0 sa\u00fade mental: O caminho para o empoderamento","volume":"11","author":"Filha","year":"2009","journal-title":"Rev. Eletr\u00f4nica Enferm. \u00d3rg\u00e3o Fac. Enferm. Univ. Fed. Goi\u00e1s"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Guimar\u00e3es Lemes, A., Marcelino da Rocha, E., Ferreira do Nascimento, V., Jacinto Volpato, R., Sousa Oliveira Almeida, M.A., Franco, S.E.d.J., Bauer, T.X., and Villar Luis, M.A. (2020). Benefits of Integrative Community Therapy revealed by psychoactive drug users. Acta Paul. Enferm., 33.","DOI":"10.5020\/18061230.2020.10629"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2028","DOI":"10.1590\/0102-311X00000913","article-title":"Contributions by Integrative Community Therapy to users of Psychosocial Care Centers (CAPS) and family members: Thematic oral history","volume":"29","author":"Carvalho","year":"2013","journal-title":"Cad. Sa\u00fade P\u00fablica"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1590\/S1983-14472013000300020","article-title":"Community integrative therapy: Situations of emotional suffering and patients\u2019 coping strategies","volume":"34","author":"Rocha","year":"2013","journal-title":"Rev. Ga\u00facha Enferm."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1590\/S0034-71672012000400021","article-title":"Enfermagem e a implanta\u00e7\u00e3o da Terapia Comunit\u00e1ria Integrativa na Estrat\u00e9gia Sa\u00fade da Fam\u00edlia: Relato de experi\u00eancia","volume":"65","author":"Jatai","year":"2012","journal-title":"Rev. Bras. Enferm."},{"key":"ref_35","first-page":"114","article-title":"Pesquisas brasileiras sobre terapia comunit\u00e1ria integrativa","volume":"15","author":"Azevedo","year":"2013","journal-title":"Rev. Bras. Pesqui. Sa\u00fade"},{"key":"ref_36","first-page":"79","article-title":"Contribui\u00e7\u00f5es da terapia comunit\u00e1ria para o enfrentamento das inquieta\u00e7\u00f5es de gestantes","volume":"9","author":"Holanda","year":"2007","journal-title":"Rev. Eletr\u00f4nica Enferm. \u00d3rg\u00e3o Fac. Enferm. Univ. Fed. Goi\u00e1s"},{"key":"ref_37","first-page":"e55067","article-title":"Social representations of integrative community therapy by the elderly","volume":"38","author":"Moura","year":"2017","journal-title":"Rev. Ga\u00facha Enferm."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"271","DOI":"10.26673\/tes.v16iesp.1.13737","article-title":"An\u00e1lise da efetividade da Terapia Comunit\u00e1ria Integrativa na sa\u00fade biopsicossocial de diferentes popula\u00e7\u00f5es: Uma revis\u00e3o integrativa","volume":"16","author":"Silva","year":"2020","journal-title":"Temas Educ. Sa\u00fade"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1","DOI":"10.5020\/18061230.2020.10629","article-title":"A terapia comunit\u00e1ria integrativa no cuidado em sa\u00fade mental: Revis\u00e3o integrativa","volume":"33","year":"2020","journal-title":"Rev. Bras. Promo\u00e7\u00e3o Sa\u00fade"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1426","DOI":"10.1111\/inm.12900","article-title":"Integrative Community Therapy\u2014Interventive strategies in the reduction of depression symptoms in adolescents: A quasi-experimental study","volume":"30","author":"Alves","year":"2021","journal-title":"Int. J. Ment. Health Nurs."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Case, C., and Dalley, T. (2014). The Handbook of Art Therapy, Routledge. [3rd ed.].","DOI":"10.4324\/9781315779799"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1002\/jts.20509","article-title":"Help seeking among victims of crime: A review of the empirical literature","volume":"23","author":"McCart","year":"2010","journal-title":"J. Trauma. Stress"},{"key":"ref_43","first-page":"189","article-title":"Efficacy of a group intervention program with women victims of gender violence in the framework of contextual therapies","volume":"36","year":"2020","journal-title":"An. Psicol."},{"key":"ref_44","unstructured":"Goldberg, D.P., and Williams, P. (1988). A User\u2019s Guide to the General Health Questionnaire, NFER-Nelson."},{"key":"ref_45","first-page":"839","article-title":"The 12-item general health questionnaire (GHQ-12): Reliability, external validity and factor structure in the Spanish population","volume":"20","author":"Dresch","year":"2008","journal-title":"Psicothema"},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Rosenberg, M. (1965). Society and the Adolescent Self-Image, Princeton University Press.","DOI":"10.1515\/9781400876136"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Crespo, M., Arinero, M., and Soberon, C. (2021). Analysis of effectiveness of individual and group trauma-focused interventions for female victims of intimate partner violence. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18041952"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Saez, G., Lopez-Nunez, C., Carlos-Vivas, J., Barrios-Fernandez, S., Rojo-Ramos, J., Adsuar, J.C., and Collado-Mateo, D. (2021). A multicomponent program to improve self-concept and self-esteem among intimate partner violence victims: A study protocol for a randomized controlled pilot trial. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18094930"},{"key":"ref_49","first-page":"323","article-title":"Validation of a brief version of the Social Provisions Scale using Canadian national survey data","volume":"39","author":"Orpana","year":"2019","journal-title":"Health Promot. Chronic Dis. Prev. Can. Res. Policy Pract."},{"key":"ref_50","first-page":"37","article-title":"The provisions of social relationships and adaptation to stress","volume":"Volume 1","author":"Jones","year":"1987","journal-title":"Advances in Personal Relationships"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"379","DOI":"10.2147\/IJWH.S160619","article-title":"Construct validity and factor structure of a spanish-language social support questionnaire during early pregnancy","volume":"10","author":"Friedman","year":"2018","journal-title":"Int. J. Women\u2019s Health"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1080\/10705500802222972","article-title":"The Brief Resilience Scale: Assessing the ability to bounce back","volume":"15","author":"Smith","year":"2008","journal-title":"Int. J. Behav. Med."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"e101","DOI":"10.1037\/pas0000191","article-title":"Reliability and validity of the Brief Resilience Scale (BRS) spanish version","volume":"28","year":"2016","journal-title":"Psychol. Assess."},{"key":"ref_54","first-page":"241","article-title":"Calvete Zumalde, Esther, Orue Sola, Izaskun. The Acceptance of Dating Violence scale (ADV): Psychometric properties of the Spanish version","volume":"29","year":"2017","journal-title":"Psicothema"},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Abdelazeem, B., Abbas, K.S., Amin, M.A., El-Shahat, N.A., Malik, B., Kalantary, A., and Eltobgy, M. (2022). The effectiveness of incentives for research participation: A systematic review and meta-analysis of randomized controlled trials. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0267534"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1080\/01609513.2013.767130","article-title":"Exploring a Domestic Violence Intervention Curriculum for Immigrant Mexican Women in a Group Setting: A Pilot Study","volume":"36","author":"Hysjulien","year":"2013","journal-title":"Soc. Work Groups"},{"key":"ref_57","unstructured":"Merriam, S.B. (2009). Qualitative Research: A Guide to Design and Implementation, Jossey-Bass."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1177\/0886260504263875","article-title":"Observations from practice: Support group membership as a process of social capital formation among female survivors of domestic violence","volume":"19","author":"Larance","year":"2004","journal-title":"J. Interpers. Violence"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1111\/j.1542-2011.2011.00137.x","article-title":"Reaching Latinas with Our Bodies, Ourselves and the Guia de Capacitacion para Promotoras de Salud: Health education for social change","volume":"57","author":"Bonilla","year":"2012","journal-title":"J. Midwifery Women\u2019s Health"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1177\/1540415316629681","article-title":"Self-empowerment of immigrant Latina survivors of domestic violence: A promotora model of community leadership","volume":"14","author":"Serrata","year":"2016","journal-title":"Hisp. Health Care Int."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1037\/a0022977","article-title":"A call for a social network-oriented approach to services for survivors of intimate partner violence","volume":"1","author":"Goodman","year":"2011","journal-title":"Psychol. Violence"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/8\/5492\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:15:03Z","timestamp":1760123703000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/8\/5492"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,12]]},"references-count":61,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2023,4]]}},"alternative-id":["ijerph20085492"],"URL":"https:\/\/doi.org\/10.3390\/ijerph20085492","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,12]]}}}