Intimate partner violence (IPV) is a pervasive public health problem that warrants the attention of therapists and mental health professionals. An estimated 37% of women and 30% of men in the United States have experienced some form of IPV victimization in their lifetime (Smith et al., 2017). Members of racial (Black et al., 2011; Rosay, 2016), sexual (Breiding et al., 2014), and gender minority groups (Langenderfer-Magruder et al., 2016) are at increased risk of IPV victimization. IPV victimization is linked with a host of negative outcomes, such as anxiety, depression, posttraumatic stress symptoms, suicidal ideation, substance use, and stress (Bosch et al., 2017; Cavanaugh et al., 2011; Spencer et al., 2019); many of these outcomes may lead someone to seek clinical services.
Given the high prevalence of individuals experiencing IPV in their relationships, coupled with the negative consequences associated with IPV, mental health professionals should develop a knowledge base that enables them to identify and treat IPV when it is appropriate and safe to do so. In their article published in Practice Innovationsopens in new window, Brooke M. Keilholtz and Chelsea M. Spencer explore risk factors associated with IPV, assessment considerations, and treatment options for couples who are appropriate candidates for couples IPV interventions. Although treating IPV within the context of the couple is controversial given the violence that defines the problem, existing research suggests perpetrator-focused treatment yields mixed results (Arias et al., 2013; Cheng et al., 2021; Eckhardt et al., 2013), with the potential for negative effects for the perpetrator of IPV (Edleson & Tolman, 1992). Additionally, a meta-analysis of couples treatments found success in treating IPV, but only for couples experiencing situational violence. Situational violence is the most common type of violence and is related to reactivity and situational factors rather than the maintenance of control and fear (Karakurt et al., 2016).
Implementing a thorough assessment to ensure couples treatment is appropriate will aid in protecting the victim, which is the priority. No one-size-fits-all approach to treating violence exists, and conjoint treatment is not a suitable approach for all couples experiencing IPV in their relationship. Conducting an assessment of the type of IPV inflicted, the couple’s level of relationship commitment and satisfaction, the couple’s commitment to ending the violence, and the presence of any substance use or mental health disorders is essential in deciding whether to move forward with a couple’s treatment. This assessment should be done with each partner separately and privately to promote safety and honest disclosures.
After a proper assessment is completed and if the appropriateness of couples therapy is established, the couple should be treated according to a standardized protocol that promotes a safe and intentional approach. Four couple-based approaches to treating IPV are introduced within the article: domestic violence–focused couples therapy (a general treatment approach), behavioral couples therapy (for couples experiencing substance abuse and IPV), the Creating Healthy Relationships Program (for low-income parents experiencing violence), and the No Kids in the Middle intervention (for high-conflict coparents). Although all are unique in their approaches, they share common factors, such as establishing safety-building skills to promote conflict management and relationship satisfaction. Knowing what resources and treatment programs are available within the community makes appropriate referrals possible, whether couples qualify for conjoint treatment or would benefit from individual work.
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