Interview With Sandra M. Stith About Couples Therapy for Domestic Violence

In this video, recorded at the 2011 APA Convention in Washington, DC, author Sandra M. Stith talks about her book, Couples Therapy for Domestic Violence. (5 minutes)


Interviewer [Female Voice]: Research shows there's a surprisingly high incidence of interpersonal violence in couples. What's new about your approach to this problem?

Sandra Stith: Well, for many years, people believed that you only work with domestic violence individually. So in 1995, we received funding from the National Institute of Mental Health to develop a treatment program specifically targeting couples who want to stay together after low to moderate intimate partner violence had occurred. So ours was really the first program that was empirically tested and developed to work with couples that want to stay together after there has been an experience of domestic violence.

Interviewer: What are the advantages of treating couples jointly and when is joint treatment of partners not an option?

Sandra Stith: Well I'm glad you asked the question about in particular when it is not an option. The approach that we've used is a very safety-focused approach, and the approach really is addressing ending domestic violence. So we're looking for couples in our work who recognize and admit the kind of issues that they have, the violence that's occurred. We're looking for both husbands and wives who complete assessment instruments indicating that they agree in the amount of violence that's occurred. So for instance, if a husband says that he shoved his wife once, and the wife says that he's raped her, beat her, broken her arms, broken her legs, they would not be accepted in the program because they have not — he has not come to terms and been able to admit what's going on as far as the level of violence. So we also have people with serious problems with substance abuse, with serious mental health issues that have not been treated. Those people need individual work or maybe batterer intervention treatment before they would begin couples treatment.

But the advantage of couples treatment is that what we know is that many couples, even when there's been fairly serious domestic violence, choose to stay together, they choose to live together. So they may have — a husband may actually or a wife participate in an intervention program for domestic violence, but every day they have to make decisions: Is my child going to be put in special ed? Is my mother-in-law going to come and visit? How are we going to pay the bills? How are we going to keep the nanny employed and who's going to pick up the laundry? Those kinds of issues that happen every day have to be resolved by couples. So when he's going to a program by himself, they still have to come home and resolve those issues if they live together.

In addition, one of the factors that we found and others have found, biggest predictor of whether the one partner continues to be violent is if the other partner is violent. And in our work 92 percent — while we were originally only accepting clients where the husband was the primary aggressor, we found that 92 percent of the women self-reported that they had also shoved, pushed, slapped their partner. So if we don't also address the partner's level of aggression, the way they deal with conflict, we don't teach these couples new conflict skills, all of the things that he could learn in a batterer program, and the ways he could change his beliefs about women or beliefs about the appropriateness of violence, is probably not going to be very effective if she continues to use violence or if they don't learn skills together to manage conflict.

Interviewer: Committing violence against a partner is not something most people will admit to. How can clinicians be sure they're not missing a history of violence in couples?

Sandra Stith: Well, one of the things that I've advocated for, and has the American Psychological Association, is the universal screening for all couples who come in. Even though most couples who come in will say they're coming because they want to enhance their relationship, because there was an affair, because they're trying to reconnect or build a spark, that doesn't mean that there's not also ongoing physical aggression happening in their relationship.

So in our book, we spend a lot of time talking about assessment. We spend a lot of time talking about asking questions about separate sessions, making sure that you assess the husband separately from the wife, and that you carefully assess asking question about shoving and pushing, not about violence. We find that most couples do not believe that the aggression that happens in their relationship is actually violence — that's something that other people do.