2006, Vol. 74, No. 5, 920 –929
Copyright 2006 by the American Psychological Association
0022-006X/06/$12.00 DOI: 10.1037/0022-006X.74.5.920
The Effects of Forgiveness Therapy on Depression, Anxiety, and
Posttraumatic Stress for Women After Spousal Emotional Abuse
Gayle L. Reed and Robert D. Enright
University of Wisconsin—Madison
Emotionally abused women experience negative psychological outcomes long after the abusive spousal relationship has ended. This study compares forgiveness therapy (FT) with an alternative treatment (AT; anger validation, assertiveness, interpersonal skill building) for emotionally abused women who had been permanently separated for 2 or more years (M ϭ 5.00 years, SD ϭ 2.61; n ϭ 10 per group). Participants, who were matched, yoked, and randomized to treatment group, met individually with the intervener.
Mean intervention time was 7.95 months (SD ϭ 2.61). The relative efficacy of FT and AT was assessed at p Ͻ .05. Participants in FT experienced significantly greater improvement than AT participants in depression, trait anxiety, posttraumatic stress symptoms, self-esteem, forgiveness, environmental mastery, and finding meaning in suffering, with gains maintained at follow-up (M ϭ 8.35 months, SD ϭ
1.53). FT has implications for the long-term recovery of postrelationship emotionally abused women.
Keywords: spousal emotional abuse, forgiveness therapy, depression, anxiety, posttraumatic stress
strongly with negative outcomes of psychological abuse. Moreover, Follingstad et al. (1990) found that 72% of participants reported that emotional abuse had a more negative impact than physical abuse. The negative psychological outcomes of spousal psychological abuse include depression (O’Leary, 1999; PimlottKubiak & Cortina, 2003; Sackett & Saunders, 1999), anxiety
(Dutton & Painter, 1993), posttraumatic stress disorder (Astin,
Lawrence, & Foy, 1993; Enns et al., 1997; Pimlott-Kubiak &
Cortina, 2003; Woods, 2000), low self-esteem (Aguilar & Nightingale, 1994), learned helplessness (Follingstad et al., 1990; Launius & Lindquist, 1988), and an ongoing, debilitating resentment of the abuser (Seagull & Seagull, 1991). A number of researchers
(Astin et al., 1993; Dutton & Painter, 1993; Sackett & Saunders,
1999; Woods, 2000) have demonstrated that these negative outcomes last well beyond the end of the abusive relationship.
Considering the serious, enduring impact on the psychological health of the emotionally abused partner, the theoretical and empirical literature on efficacious postrelationship, postcrisis treatment for spousal psychological abuse is sparse. There is a lack of empirical evidence for the efficacy of one treatment that is currently recommended for these women: brief therapy with a focus on anger validation (with subsequent mourning of associated losses from the abuse), assertive limit-setting, and interpersonal skill building. Neither Mancoske et al. (1994) nor Rubin (1991) provided clear empirical support for the efficacy of this brief therapy for emotionally abused women. A review of the current literature did not produce empirical evidence for the efficacy of other therapeutic approaches for emotionally abused women.
One promising new area of treatment is forgiveness therapy
(FT). Research on FT has established a causal relation between forgiving an injustice and both the amelioration of anxiety and depression and an improvement in self-esteem (Al-Mabuk, Enright, & Cardis, 1995; Coyle & Enright, 1997; Freedman & Enright, 1996; Lin, Enright, Mack, Krahn, & Baskin, 2004; Rye et al.,
2005). FT directly targets ongoing resentment, which can lead to
Spousal emotional abuse is a significant problem, with approximately 35% of women reporting such abuse from a spouse or romantic partner (O’Leary, 1999); in addition, women often demonstrate negative psychological outcomes long after this abuse.
Despite the frequent calls for efficacious therapies for these…