The Impact of Group and Individual Psychotherapy in a Self-Defence
Program on Women's Well-Being
Gulnora Bogdalova, Azizbek Aloxanov and Sardor Xudoynazarov
National University of Uzbekistan named after Mirzo Ulugbek, Tashkent, Uzbekistan
Keywords Domestic Violence towards Women, Trauma, Post-Traumatic Stress Disorder (PTSD), Cognitive
Behavioural Therapy (CBT), Mindful Self-Compassion (MSC), Adult Attachment Theory (AAT), Art
Therapy, Self-Reflection, Self-Acceptance, Self-Care, Self-Compassion, CBT Techniques.
Abstract Domestic violence within Uzbek families is a prevalent issue. This study explores the effects of individual
and group psychological sessions, utilizing trauma-focused cognitive-behavioural and art therapy approaches,
as part of a program supporting the psychological well-being of girls and women engaged in self-defence
training. Qualitative data indicates that participants found both group and individual sessions to be effective.
The study concludes with a discussion of limitation and implications for future research.
1 INTRODUCTION
"I'm afraid of him and his family too," a woman
wrote to us after her husband nearly killed her in front
of witnesses. Raised in a conservative family, she was
taught that a woman must always obey, and her
husband insists she has only duties, no rights. He
keeps all her documents and money, leaving her with
no resources. With five children and no supportive
relatives, she feels trapped and helpless. She adds,
"He humiliates and beats me. I fear for my life. Please
help."
This woman's distressing situation was shared by
the Independent Information Project Against Gender-
According to Irina Matvienko, the project organizer,
when they started accepting anonymous stories in
June 2019, they received 200 stories in the first month
alone, and the flow of stories has not stopped. They
continue to receive 3-8 stories per day, particularly
from Russian speakers in Uzbekistan, who are a
minority but have internet access.
Regrettably, domestic violence against women is
largely overlooked in Uzbekistan. The untreated
trauma inflicted on women endures throughout their
lives and gets perpetuated across generations. The toll
on individuals, families, and Uzbekistan as a whole is
immeasurable.
*
Corresponding author
Common gender norms in Uzbek families often
negatively affect the development of young spouses'
sense of responsibility. Men tend to prioritize their
own needs over the emotional well-being of family
members, especially their wives, viewing their role as
one of dominance in family and marriage relations.
On the other hand, women prioritize their husbands'
needs and family issues over their own interests. They
also believe the husband's role is one of dominance
over the family (Hikmatullaeva, 2019).
As a psychologist involved in the "Self-Defence
for Women and Girls" project, I have observed that
most women hold the belief that marriage offers the
best future for girls, even if it means relinquishing
control over their own destinies. They are expected to
stay at home, take care of children, and serve their
husbands, as well as their in-laws. Critical decisions
in young families are often made by the husband's
parents, and the mother-in-law is often perceived as a
source of stress and violence by the young wife.
Surveying young people, the majority agree that
there is a problem of family abuse in society, with
women and children being the primary victims of
violence. Causes of violence within families include
disobedience, low levels of education, cultural norms,
unemployment, and strained spousal relationships
(Latipova et al., 2020). A survey by the Republican
Centre for the Study of Public Opinion (2021)
indicated that the majority find physical violence by
114
Bogdalova, G., Aloxanov, A. and Xudoynazarov, S.
The Impact of Group and Individual Psychotherapy in a Self-Defence Program on Women’s Well-Being.
DOI: 10.5220/0012478300003792
Paper published under CC license (CC BY-NC-ND 4.0)
In Proceedings of the 1st Pamir Transboundary Conference for Sustainable Societies (PAMIR 2023), pages 114-118
ISBN: 978-989-758-687-3
Proceedings Copyright © 2024 by SCITEPRESS – Science and Technology Publications, Lda.

a husband against his wife unacceptable. However, it
is concerning that 10.3% of respondents view
violence as permissible in certain circumstances, such
as when a woman provokes her husband.
The authoritarian family model is rooted in the
cultural belief that children and wives should be
subject to paternal authority. Many in Uzbekistan
hold the opinion that a husband and father must
sometimes resort to cruelty to maintain discipline.
Emotional aspects of family and marital relationships,
as well as the destabilizing effects of violence on
families and individuals, are often not well
understood by family members and local authorities.
Reconciliation between spouses is prioritized over
addressing the issue of violence (Latipova et al.,
2020). Freedom of expression can foster
understanding and mutual support, leading to greater
satisfaction and stability in family and marital
relationships (Robles, Slatcher, Trombello, &
McGinn, 2014), a concept not always realized by
spouses.
Girls and women would benefit greatly from
understanding that domestic abuse causes trauma and
has a profound impact on their behaviour and lives.
They need to learn when to seek help and how to
stand up for themselves.
2 METHODS
Pilot research was conducted as part of a program
sponsored by an Alumni Outreach Grant from the
U.S. Embassy in Tashkent: The Self-Defence Classes
for Women and Girls. The program aims to equip
women and girls with the skills and confidence to
protect themselves and promote overall well-being.
The physical self-defence training program is
supplemented with mental health services to address
past trauma, as well as the assistance of a lawyer and
social worker.
The project was divided into four rounds, each
lasting three months, from February 2021 to February
2022. The mental health round included weekly
group sessions for ten weeks, along with 5-10
individual sessions for each participant who chose to
see the psychologist. There were two participant
groups: 13-18 years old and over 18 years old. For
this study, feedback from the over-18 group was used.
As participation in the psychological sessions was
voluntary, the number of participants varied from
round to round. A total of twenty-eight participants
agreed to answer the questionnaire.
In the first round, group sessions focused on
teaching and practicing self-help techniques.
Cognitive-behavioural approaches and mindfulness
techniques were employed to help participants
regulate intense emotions such as anger, anxiety, and
guilt. Individual sessions aimed to foster cognitive
processing for understanding past experiences and
facilitating post-traumatic growth.
To address potential barriers to participating in
the psychological aspect of the project, group
sessions commenced with discussions about the
stigma associated with mental health.
The treatment methodology was developed based
on questions raised in the pilot sessions of the first
round and on existing research about gender-based
violence and PTSD treatment.
Cognitive Behavioural Therapy (CBT) challenges
unhelpful ways of thinking that may result from
trauma and is recommended by the American
Psychological Association (APA) as an evidence-
based intervention for PTSD.
Mindful Self-Compassion (MSC), developed by
C. Neff, can improve emotional reactions and mental
health outcomes for individuals who have
experienced trauma.
Adult Attachment Theory (AAT) plays a role in
the relationship between intimate partner violence
and PTSD symptoms, and it can be utilized to treat
attachment anxiety and dependency.
Art Therapy allows nonverbal aspects of trauma
experiences to be expressed, providing emotional
distance and a more objective perspective.
The purpose of this pilot study with women and
girls in Uzbekistan was to examine the outcomes of
the combination of CBT, self-compassion techniques,
attachment style psychoeducation, and art therapy.
The research questions were as follows: 1) Does
the program have any impact on participants? 2) If
yes, what kind of impact?
Individual questionnaires were used to collect
participants' feedback after each round, focusing on
their expectations, how those expectations were met
during group and individual sessions, the benefits
they gained from the sessions, and their feelings
during the sessions (e.g., feeling safe and
understood).
For qualitative data analysis, the main researcher
enlisted two psychologists familiar with the focus of
the study, research questions, and the nature of the
therapeutic techniques. They independently analysed
the data and developed categories and a coding
manual. The data was then linked to the different
categories, and main themes were identified. The
results were summarized and reviewed by other
researchers.
The Impact of Group and Individual Psychotherapy in a Self-Defence Program on Women’s Well-Being
115

3 RESULTS AND DISCUSSION
The qualitative research analysis revealed the
following categories: participant expectations,
reported benefits from psychological sessions, and
community impact.
Participant Expectations. The most commonly
expressed expectations from participants included
seeking help with anxiety, fear of leaving the home,
coping with panic attacks resulting from violence at
home, dealing with trauma from childhood abuse, a
desire to be heard and supported, and the wish to
improve themselves.
Reported Benefits from Psychological Sessions.
Participants reported several positive outcomes from
the mental health part of the program, such as being
able to identify violent behaviour, managing anxiety,
practicing self-reflection, experiencing self-
acceptance and self-compassion, feeling empowered
to improve self-care, and using acquired CBT
techniques.
Identifying Violence. Some participants initially
had difficulty recognizing violent behaviours.
However, group sessions discussing various types of
violence helped them understand its impact on their
lives and personalities and how to protect themselves.
Self-reflection. Participants found that mental
health services helped them sort out their feelings and
view problems and life from different angles,
resulting in more positive perspectives.
Self-Acceptance. Participants reported accepting
their vulnerability and learning to embrace and be
compassionate towards their weaknesses.
Self-compassion. Participants experienced a shift
from self-criticism to self-compassion, allowing them
to comfort themselves and begin healing from
trauma.
Managing Anxiety. Participants reported
improved anxiety management, reduced hyper-
arousal, and decreased avoidance of difficult
situations.
Empowerment. Participants felt more resourceful,
confident in their ability to cope with difficulties, and
more in control of their lives.
Self-protection Skills. Some participants felt
more empowered to stand up for themselves,
particularly against domestic violence.
Relationship Improvement. Improved
communication and personal boundaries resulted in
better quality relationships for some participants.
Self-care. Participants reported utilizing the skills
learned during the sessions to take better care of their
mental health.
The findings indicate that the program had a
positive impact on participants, helping them develop
coping strategies, increase self-awareness, and foster
a compassionate and empowered attitude towards
themselves and their relationships.
"Taking care of oneself is another valuable insight
that I gained from this project. Each day, I make an
effort to prioritize my physical well-being, emotional
state, and overall health. When I feel stressed, I use
the Safe Place technique, which our psychologist
taught us, and it has been immensely helpful. I have
also incorporated meditation, dance therapy, art
therapy, and skincare routines for my face and body
to uplift my spirits and relax."
"I have learned to stop bringing work home every
day and to avoid overworking and exhausting myself.
While I still approach my tasks with the same
diligence and responsibility, I now assess my own
limits more wisely."
Acquiring CBT Techniques. Some participants
shared in their feedback how they utilized the
techniques they learned to manage challenging
situations in their lives.
"I have learned how to analyse my thoughts since
they greatly influence our emotions. Our assumptions
can be harmful, so I now manage my thoughts to
avoid misconceptions about reality. Keeping a record
of my thoughts in a table format, as we were taught,
will help me work on changing destructive thought
patterns."
"At the beginning, I was overwhelmed by a
whirlwind of uncontrollable thoughts, and I struggled
to cope. Although I won't claim that everything
magically improved, I do feel more at ease than
before."
Facing Trauma and Difficult Situations. Another
reported outcome of the training was the ability to
face trauma and seek post-traumatic growth.
"I have learned to approach painful topics
carefully and safely, cope with feelings of guilt, and
develop a greater sense of self-worth."
"The gentle and safe assistance in healing trauma
associated with violence has been most helpful."
"I may have made subtle changes, nothing
extraordinary, but any progress is a victory in my
eyes. I understand that fixing things will take time,
but the individual sessions have made a significant
difference in my progress."
Community Impact. Participants described how
the training influenced their relationships and how
they shared their newfound knowledge with friends,
colleagues, and relatives.
"I have been sharing the techniques I learned with
my friends. For instance, we practice mindful walking
PAMIR 2023 - The First Pamir Transboundary Conference for Sustainable Societies- | PAMIR
116

together and then share our impressions and feelings
with each other."
"I explained to my younger sister about the nature
of violence and preventive measures against bullying,
cyberbullying, and online exploitation."
"After our session, I started expressing my needs
and feelings not just to my friends but also to my dad,
which encouraged my mom to join in and express her
feelings and frustrations as well as communicate her
needs."
As this program aims to introduce girls and
women to the availability and importance of
psychological help, it is encouraging that most
participants continued their journey in self-help by
utilizing available resources. For example, one
participant is working on addressing emotional
violence from her partner and overcoming depression
following the death of her father. During her
participation, she found a good job that allowed her
to seek additional professional help to heal her deep
wounds from complex PTSD.
4 CONCLUSION
To safeguard girls and women from the prevalent
acceptance of family abuse in Uzbekistan as normal,
it is essential to educate females about the
consequences of violence and empower them to put
an end to it, thereby breaking the cycle in their own
families.
The demand for teaching women to combat
domestic violence is widespread, as women are eager
to acquire skills for self-care and self-management.
The findings from our pilot study demonstrate that the
Self-Defence Classes for Girls and Women project,
especially the psychological aspect, has played a
significant role in addressing trauma, fostering post-
traumatic growth, and empowering women.
The results suggest considering Schema Therapy
for future use, as it incorporates most components of
this mental health service program, including CBT,
MSC, and attachment theory. Implementing it in
group sessions could lead to deeper unpacking and
healing of trauma.
To enhance the success and well-being of
Uzbekistanis, several steps can be taken:
1. Conduct a public campaign to raise awareness
that physical punishment and humiliation are harmful
to families and the nation.
2. Provide treatment for abused children to
overcome their trauma and break the cycle of abuse
in the next generation.
3. Enhance the availability of parent education to
replace abusive authoritarian practices with more
effective child-rearing skills.
4. Promote the accessibility of government-
initiated programs designed to protect women, such
as the laws safeguarding women from harassment and
abuse (2019) and guaranteeing children's rights
(2007). Women should be informed about their
ability to obtain protection orders and find shelter,
psychological support, and legal services at crisis
centres. Currently, few women and girls are aware of
these programs.
By addressing the traumas of domestic violence
and replacing abusive family patterns with nurturing
and effective parenting skills, Uzbekistani families,
individuals, and the nation as a whole will benefit.
Unlocking the full potential of women, rather than
suppressing it, is Uzbekistan's greatest resource.
REFERENCES
APA (2017). Clinical Practice Guideline for the Treatment
of Posttraumatic Stress Disorder (PTSD) in
Adults. Washington, DC, USA: American
Psychological Association. https://www.apa.org/ptsd-
guideline Google Scholar
Bond, Sharon & Bond, Michael. (2005). Attachment Styles
and Violence Within Couples. The Journal of nervous
and mental disease. 192. 857-63.
10.1097/01.nmd.0000146879.33957.ec.
Campbell, M., Decker, K. P., Kruk, K., & Deaver, S. P.
(2016). Art Therapy and Cognitive Processing Therapy
for Combat-Related PTSD: A Randomized Controlled
Trial. Art therapy: journal of the American Art Therapy
Association, 33(4), 169–177.
https://doi.org/10.1080/07421656.2016.1226643
Collie, K., Backos, A., Malchiodi, C., & Spiegel, D. (2006).
Art therapy for combat-related PTSD:
Recommendations for research and practice. Art
Therapy, 23(4), 157-164. Retrieved from
https://ezaccess.libraries.psu.edu/login?url=https://ww
w.proquest.com/scholarly-journals/art-therapy-
combat-related-ptsd-
recommendations/docview/1320266972/se-
2?accountid=13158
Crespo, M., & Arinero, M. (2010). Assessment of the
Efficacy of a Psychological Treatment for Women
Victims of Violence by their Intimate Male Partner. The
Spanish Journal of Psychology, 13(2), 849-863.
doi:10.1017/S113874160000250X
Germer, C. K., & Neff, K. D. (2015). Cultivating self-
compassion in trauma survivors. In V. M. Follette, J.
Briere, D. Rozelle, J. W. Hopper, & D. I. Rome
(Eds.), Mindfulness-oriented interventions for trauma:
Integrating contemplative practices (pp. 43–58). The
Guilford Press.
The Impact of Group and Individual Psychotherapy in a Self-Defence Program on Women’s Well-Being
117

Hikmatullaeva, Rano (2009). Gender features in concepts
of family and marriage relations as a factor
determining family life. Theses for the degree
Candidate of psychological sciences. Tashkent.
Iverson, K. M., Gradus, J. L., Resick, P. A., Suvak, M. K.,
Smith, K. F., & Monson, C. M. (2011). Cognitive–
behavioural therapy for PTSD and depression
symptoms reduces risk for future intimate partner
violence among interpersonal trauma
survivors. Journal of Consulting and Clinical
Psychology, 79(2), 193-202.
doi:http://dx.doi.org/10.1037/a0022512
Kural, A.I., Kovacs, M., (2022). The role of anxious
attachment in the continuation of abusive relationships:
The potential for strengthening a secure attachment
schema as a tool of empowerment. Acta Psychologia,
Volume 225,103537. ISSN: 0001-6918.
https://doi.org/10.1016/j.actpsy.2022.103537.
Latipova, Nodira & Ganiyeva, Marifat & Абдувалиева,
Мумтозхон & Omonkul, Ziyaeva. (2020). Family
violence in modern Uzbekistan. 11. 3926-3943.
International Journal of Psychosocial Rehabilitation,
Vol. 24, Issue 04, 2020. ISSN: 1475-7192
https://www.researchgate.net/publication/340163724_
FAMILY_VIOLENCE_IN_MODERN_UZBEKISTA
N
Latif, M., Husain, M., Gul, M., Naz, S., Irfan, M., Aslam,
M., . . . Naeem, F. (2021). Culturally adapted trauma-
focused CBT-based guided self-help (CatCBT GSH) for
female victims of domestic violence in Pakistan:
Feasibility randomized controlled trial. Behavioural
and Cognitive Psychotherapy, 49(1), 50-61.
doi:10.1017/S1352465820000685
NHS INFORM (2021). PTSD and CPTSD self-help guide.
https://www.nhsinform.scot/illnesses-and-
conditions/mental-health/mental-health-self-help-
guides/ptsd-and-cptsd-self-help-guide
Republican Centre for the Study of Public Opinion
(15.05.2021). Citizens' opinion about the family:
attitudes, relationships, guidelines.
https://ijtimoiyfikr.uz/ru/issledovaniya/obschestvo/mn
enie-grazhdan-o-seme-ustanovki-vzaimootnosheniya-
orientiry.htm
Robles, T. F., Slatcher, R. B., Trombello, J. M., & McGinn,
M. M. (2014). Marital quality and health: a meta-
analytic review. Psychological bulletin, 140(1), 140–
187. https://doi.org/10.1037/a0031859
Scott, S., & Babcock, J. C. (2010). Attachment as a
Moderator Between Intimate Partner Violence and
PTSD Symptoms. Journal of family violence, 25(1), 1–
9. https://doi.org/10.1007/s10896-009-9264-1
Tesh, M., Learman, J., & Pulliam, R. M. (2015). Mindful
self-compassion strategies for survivors of intimate
partner abuse. Mindfulness, 6(2), 192–201.
doi:10.1007/s12671-013-0244-4
PAMIR 2023 - The First Pamir Transboundary Conference for Sustainable Societies- | PAMIR
118