Couples treatment for interpersonal violence: a review of outcome research literature and current clinical practices

Conjoint couples treatment for interpersonal partner violence (IPV) remains controversial despite a growing body of research and practice experience indicating that it can be effective and safe. In addition, developing typologies of couples who are violent suggest that a "one-size-fits-all" treatment approach to IPV is not appropriate and conjoint treatment may have a place in the treatment of at least some couples. In this article, we review the experimental studies and clinical practices of conjoint treatment. Based on this review, we suggest current best practices for this approach to treatment. Best practices include couples treatment as part of a larger community response to IPV, careful screening of couples for inclusion in couples treatment, modification of typical conjoint approaches to promote safety and ongoing assessment of safety with contingency plans for increased risk.     

Reducing situational violence in low-income couples by fostering healthy relationships

This work evaluated a psycho-educational intervention designed to reduce intimate partner violence (IPV) in low-income situationally violent couples. The primary objective was to evaluate the mechanism through which violence was reduced. It was hypothesized that IPV would be reduced via use of therapeutic skills taught during the intervention (i.e., friendship, sex/romance/passion, shared meaning, and conflict management skills). One-hundred-fifteen couples were randomly assigned to a treatment or no-treatment control group. Couples self-reported attitudes reflecting healthy relationship skills and IPV at multiple time points (baseline, post-intervention, and long-term post-intervention). Results support the notion that violence was reduced via an increase in intervention-based skills. Findings suggest that IPV can be safely reduced in low-income situationally violent couples via conjoint treatment focused on building healthy relationship skills.     

Unidirectional and bidirectional intimate partner violence among White, Black, and Hispanic couples in the United States

This article describes the rates and risk factors of unidirectional and bidirectional intimate partner violence (IPV) among White, Black and Hispanic couples in the US. Subjects constitute a multistage area probability sample representative of married and cohabiting couples from the 48 contiguous United States. Results indicate that most couples reporting violence engage in bidirectional IPV. Blacks are more likely than Whites to report bidirectional IPV. In addition, severe unidirectional and bidirectional IPV are more common among Blacks and Hispanics. The results also indicate that predictors of IPV vary depending on whether it is unidirectional or bidirectional. Unidirectional female-to-male IPV and bidirectional IPV are more associated with the characteristics of the female. In contrast, the occurrence of unidirectional male-to-female IPV is associated with a single risk factor, male childhood physical abuse. These findings highlight the importance of distinguishing different types of IPV and have important epidemiological and prevention implications.     

Systemic perspectives on intimate partner violence treatment

This article reviews changes in the research literature on intimate partner violence (IPV) since our earlier review (Stith, Rosen, & McCollum, 2003). A rationale for systemic treatment of IPV has emerged from research that has continued to document the limited effectiveness of single-gender treatment approaches for offenders and that has identified subtypes of abusive relationships, including situational couple violence, which often includes the reciprocal use of violence. Consistent findings from the available outcome research have demonstrated that for carefully screened couples who choose to stay together, systemic interventions decrease incidences of IPV and decrease the risk factors for IPV with no increase in risk. Implications for research and treatment are offered.     

Children Exposed to Intimate Partner Violence Describe Their Experiences: A Typology-Based Qualitative Analysis

Although much is known about the impact of intimate partner violence on children, few empirical studies have linked children’s experiences to typologies. This qualitative study, based on interviews with children 8–12 years of age living at women’s shelters in Sweden, explores how children describe the nature of the violence they have been exposed to with the aim of identifying patterns in the children’s experiences. The typologies developed by Johnson and colleagues and by Holtzworth-Munroe and colleagues are used as an analytical framework for analysis. Three main types of children’s experiences of intimate partner violence were identified: “Obedience-Demanding Violence,” “Chronic and Mean Violence,” and “Parenthood-Embedded Violence.” These the types can improve our understanding of the complex variety of children’s experiences of parental IPV by acknowledging how from children’s perspectives, experiences of IPV are closely connected to the perpetrator being their parent. The study provides examples of three different strategies that have implications for the factors that social workers may want to address when making judgments about custody, place of residence, and contact.     

Nobody’s business? White male privilege in media coverage of intimate partner violence

ABSTRACT

Portrayals of celebrities perpetrating Intimate Partner Violence (IPV) are ideal for understanding the association between gender and racial privilege in representations of social problems. Unlike prior scholarship on framing of IPV, with celebrity perpetrators, race can be analyzed as an important aspect. Using 330 news articles about 66 celebrities, I find patterns of reporting consistent with male privilege that sanctions men’s violence against women, whereas the differential treatment of Black men fosters a racialized interpretation that pathologizes Black men. Black men's IPV is more often criminalized, with criminal imagery included 3 times more often in articles about Black celebrities than White celebrities. By presenting violence as an escalation of mutual conflict and excusing it due to mitigating circumstances, such as inebriation, White men's violence is justified 2½ times more often than Black men's IPV. These findings contribute to sociological understandings of racial privilege in the social construction of IPV.     

Gender differences in attitudinal acceptance of intimate partner violence perpetration under attachment-relevant contexts

Attachment theory has been one of the leading theoretical frameworks in the last few decades for explaining physical violence within romantic relationships. In this study, the authors examined differences in attachment patterns and attitudinal acceptance of violence perpetrated in romantic relationships among men and women. The Attitudinal Acceptance of Intimate Partner Violence questionnaire was developed to measure acceptance of intimate partner violence (IPV) under attachment-relevant contexts of abandonment, as well as other contexts identified in the literature. Results indicated that men with higher degrees of attachment anxiety were more accepting of both male- and female-perpetrated IPV under contexts of abandonment, and men with higher degrees of attachment avoidance were more accepting of female-perpetrated IPV under contexts of abandonment. Implications for research and treatment are discussed.     

Health care providers' readiness to screen for intimate partner violence in Northern Nigeria

Research on screening for intimate partner violence (IPV) within health care in a sub-Saharan African context is rare. This paper assessed factors associated with the readiness to screen for IPV among care providers (HCP, n = 274) at Kano hospital, Nigeria. Readiness was measured using the Domestic Violence Health Care Providers' survey instrument, which measures grade of perceived self-efficacy in screening for IPV, fear for victim/provider safety, access to system support to refer IPV victims, professional roles resistant/ fear of offending clients, and blaming the victim for being abused victim. Social workers perceived a higher self-efficacy and better access to system support networks to refer victims than peers in other occupation categories. Female care providers and doctors were less likely to blame the victim than males and social workers, respectively. Younger care providers of Yoruba ethnicity and social workers were less likely to perceive conflicting professional roles related to screening than older providers of Hausa ethnicity and doctors, respectively. Implications of our findings for interventions and further research are discussed.     

Patterns of intimate partner violence in young adult couples: nonviolent, unilaterally violent, and mutually violent couples

This study examined nonviolent (NV), unilaterally violent (UV), and mutually violent (MV) patterns of perpetrated intimate partner violence in relation to dyadic relationship quality and partner injury. The respondents were 1,294 young adult, Add Health partners (AHP) and their non-Add Health partners (NAHP), in dating, engaged, or in marital relationships, who were participants in Wave III of the National Longitudinal Study of Adolescent Health (Add Health). Using both partner reports of perpetration to classify intimate partner violence (IPV) patterns resulted in 25% of couples with a MV pattern, and 75% of couples with a UV pattern; among those couples (41%) reporting any perpetrated IPV. Results also showed poorer relationship quality and higher partner sensation-seeking scores among MV and UV couples when contrasted with NV couples. Those couples with MV patterns were more likely to contain partner injury than those with UV patterns.     

Intimate partner violence: An application of attachment theory

ABSTRACT

Attachment theory has gained increased prominence over the past several decades in the fields of psychiatry, psychology, and social work. Attachment theory, however, has not been systematically applied to intimate partner violence (IPV), a phenomenon that disproportionately affects women in poverty. This article provides an overview of IPV as a social problem, reviews existing literature related to the application of attachment theory to IPV, discusses the theory’s strengths and limitations in understanding and resolving IPV, and considers areas for future knowledge development.     

SASA! Together: An evolution of the SASA! approach to prevent violence against women

One in three women globally will experience intimate partner violence (IPV) with devastating consequences for individual survivors, their families and communities. While prevalence remains high, violence against women is not inevitable and community mobilization approaches have emerged as particularly promising for transforming the gender inequitable norms and practices that underlie violence. The SASA! Activist Kit to Prevent Violence Against Women (SASA!), developed by Raising Voices in 2008, provides a theory-based approach for mobilizing communities to transform power imbalances between women and men through critical discussion and positive action. In this article, we provide the rational for revising SASA! after ten years of program learning and formal research. We aim to contribute to the knowledge base around what works to prevent IPV by describing the core enhancements in the revised version--called SASA! Together—and linking these changes to Raising Voices’ program learning and broader advancements in the field. In addition, we reflect on how current debates—such as how best to “scale up” violence prevention programs—were considered and resolved in SASA! Together. The paper concludes by sharing lessons learned that may provide guidance for future revisions development and revisions of evidenced-based programs.     

PTSD symptoms among men and women survivors of intimate partner violence: the role of risk and protective factors

The purpose of this cross-sectional analysis of the National Violence Against Women Survey was to characterize current symptoms of posttraumatic stress disorder (PTSD) among 185 men and 369 women survivors of intimate partner violence (IPV). In this subsample, 24% of women and 20% of men had current moderate-to-severe PTSD symptoms. PTSD scores were higher for women than men. Protective factors that appear to increase resiliency of survivors were higher education and income, being currently married, and reporting that IPV had stopped. Higher physical or psychological IPV scores, current depressive symptoms, and the survivor having left the relationship at least once were associated with risk of moderate-to-severe symptoms of PTSD. Protective factors may be used to boost resiliency of IPV survivors and reduce PTSD symptoms.     

Problem Gambling related to Intimate Partner Violence: findings from the Pacific Islands Families Study

Intimate partner violence (IPV) and problem gambling are becoming increasingly significant public health issues, especially amongst Pacific populations within New Zealand, yet no general population studies have explicitly investigated the association between these factors. This study aims to determine whether problem gambling is an independent risk factor for IPV victimization in 700 couples with a Pacific infant, after accounting for problem drinking. Victimization of any and severe physical IPV was indicated for 33% and 18% mothers, and 38% and 22% fathers, respectively. For mothers, 1% were classified as problem gamblers and 15% as problem drinkers; while for fathers, 2% were defined as problem gamblers and 26% as problem drinkers. In this first published study to simultaneously relate current problem gambling to IPV victimization in a general population, no association could be found.     

The role of alcohol use in intimate partner violence and non-intimate partner violence

Alcohol use is a risk factor for violent victimization in general, and intimate partner violence in particular. However, there has been limited empirical attention on whether alcohol use is more often associated with IPV or non-IPV offenses. Further, few studies on the association between alcohol use and victimization have assessed for incident-specific alcohol use, or examined both victim and perpetrator alcohol use. We used data from the National Violence Against Women Survey to determine if incident-specific alcohol use is more prevalent in IPV or non-IPV physical assaults, and to determine if the association varied by gender. Results indicated that among women, perpetrator alcohol use was twice as likely in IPV incidents than in non-IPV incidents, but among men, perpetrator alcohol use was four times less likely in IPV incidents than in non-IPV incidents. Our results highlight the important role of gender in understanding the association between alcohol use and victimization risk.     

Narratives of aging in intimate partner violence: The double lens of violence and old age

PurposeWith the increase in life expectancy, couples living in intimate partner violence are aging together. The aim of this article is to explore the constructions of aging in intimate partner violence as narratives of couplehood or narratives of old age.Design and methodsThirty individual in-depth interviews with 15 older Israeli couples were tape-recorded, transcribed verbatim and analyzed using a narrative approach.ResultsThree main domains emerged from the data: health issue narratives, loneliness narratives and relationships with adult offspring narratives. Each of the narratives that emerged from the data analysis consists of a narrative of old age constructing IPV and a narrative of IPV constructing old age.ImplicationsConflictual couplehood dynamics, such as intimate partner violence in old age, is not one-dimensional, but is diverse and complex and this should be taken into consideration.     

Thinking critically about cross-cultural implementation—Swedish social workers’ experiences of testing the Kids’ Club method for helping child and mother victims of intimate partner violence

There are calls for evidence-based methods for helping children to deal with experiences of Intimate Partner Violence (IPV) in many countries. Therefore, it has been commonplace to implement such methods from outside of their home country. The aim of this study is to examine Swedish social workers’ experiences of testing the American Kids’ Club method for child and mother victims of IPV. After having tested leading Kids’ Club groups, seventeen social workers at four different locations were interviewed using a semi-structured interview guide. The results indicate that the social workers generally accepted the method. This was related both to some general features of the method and to their perceiving it as somewhat flexible. According to the social workers, the method needs some cultural adaptation to better suit the Swedish social services setting, otherwise it cannot be fully accepted. Finally, they thought that successful implementation depended on an organizational structure that enabled enough children to be referred to the programme as well as either high personal commitment or an organization that prioritized the method. Based on these results, we conclude that importing an American evidence-based group method to help children exposed to IPV to Sweden demands attention to issues of cultural adaption.     

Lesbian women and household labor division: A systematic review of scholarly research from 2000 to 2015

ABSTRACT

Recent studies have begun to attend to distribution of household labor within same-gender couples compared to heterosexual couples, yet much of the available research with lesbian couples has attempted to superimpose division of household labor frameworks developed with heterosexual couples (e.g., gender role socialization, exchange bargaining theories) to fit the experiences of same-gender couples. Using two academic search databases, the present article provides a systematic review of the available 28 peer-reviewed articles published from 2000–2015 about lesbian partnerships and household labor divisions. Results indicate that lesbian couples engage in a more equal distribution of household labor than heterosexual couples, and that lesbian women often opt to eschew traditional gendered divisions of chores in favor of other factors such as quality of task or ability. The systematic review uncovered notable constraints in the demography of participants (e.g., race, socioeconomic status, geographic location) across studies. Strategies for deepening the depth and breadth of this line of work for future researchers, and implications for relationship satisfaction are also discussed.     

Challenges of implementing restorative justice for intimate partner violence: An Islamic perspective

ABSTRACT

Intimate partner violence (IPV) is currently recognized as a critical public health concern and a human rights issue. Not surprisingly, Muslims – a religiously and socio-culturally diverse faith-based populace – are not an exception. To address this complex area of criminal justice and social policy, some scholars advocate implementing restorative justice (RJ) approaches. While RJ approaches have been traditionally used in Islamic cultures for conflict resolutions, to date, few studies have investigated how RJ operates in dealing with IPV in Muslim countries and communities. This article explores how RJ approaches towards IPV operate in some Muslim countries/communities, and offers insights into developing culturally and religiously appropriate ways of implementing RJ in IPV situations among Muslims. Given the prevalence of IPV among Muslims, the question is particularly important and timely. Taking exclusively limited examples of RJ approaches that have been used to mediate IPV cases in Muslim countries and communities, this paper found one significant challenge in the RJ approaches among Muslims: community acceptance of IPV. To reduce IPV in Muslim society, it is necessary to develop treatment models and techniques that meet cultural and religious needs. This paper found that since RJ is not alien to Islamic teachings, RJ approaches can be implemented effectively in dealing with IPV among Muslims by ensuring justice and equity of the abused woman. The findings of this paper will assist policymakers, practitioners, and service providers in providing religiously and culturally appropriate care when addressing IPV issues among Muslims.     

A qualitative study of intimate partner violence universal screening by family therapy interns: implications for practice, research, training, and supervision

Although a few family therapy researchers and clinicians have urged universal screening for intimate partner violence (IPV), how screening is implemented-and, in particular, client and therapist response to screening-is vaguely defined and largely untested. This qualitative study examined the dilemmas experienced by couples and family therapy interns when implementing universal screening for IPV in an outpatient clinic setting. Twenty-two graduate students in a COAMFTE-accredited program were interviewed using qualitative research methods grounded in phenomenology. Three domains, 7 main themes, and 26 subthemes were identified. The three domains that emerged in this study include (a) therapist practice of universal screening, (b) client response to universal screening, and (c) therapist response to universal screening. Implications for practice, research, training, and supervision are discussed.