Conjoint Treatment of Couples
The treatment of couples experiencing a relationship consisting of domestic violence is a very controversial issue. Given the abusive nature of the relationship and the risk to further harm, many programs and therapist have expressly prohibited the interaction of the violent couple during treatment sessions. Many proponents of separate treatment sessions for each partner believe individual sessions are necessary due to the risk of further abuse by the perpetrator. This risk may stem from the emotional issues arising during the course of treatment, where the perpetrator may react. The programs and therapists that do see couples for conjoint therapy sessions often request or mandate that the perpetrator completes a batterer intervention and/or anger management course before attending conjoint sessions. This request or mandate is often necessary so that the perpetrator has developed positive coping behaviors that can be utilized when old patterns of interaction arise in or outside of treatment.
A growing number of clinicians are in support of conjoint treatment for couples experiencing domestic violence and intimate partner violence. Instead of putting the victim at risk of further endangerment, couples therapy may actually help to strengthen each partner's ability to resolve conflicts in a non-abusive manner together and in a controlled setting.
The abuse process between perpetrator and victim is often cyclical. This means a pattern of interaction develops between the abuser and the abused. Since this pattern involves both partners, both partners may want to stay together during treatment and often seek treatment together. Additionally, many couples who seek conjoint therapy for domestic violence live together. The abuse is often centered around situational conflict or violence. By addressing the specific types of situations both partners partake in, the progression toward conflict may be managed better. Many couples experiencing domestic violence also report low satisfaction in their relationship. Conjoint therapy can address all issues to improve the quality of the relationship.
Furthermore, individualized therapy may cause negative effects on the relationship. For example, the abuser may use tools learned in an anger management course to his advantage, such as using the "time-out" method as a form of psychological abuse by ignoring the concerns and feelings of a partner. Also, since the abuse process is a pattern that effects both partners, individualized treatment only helps the perpetrator and does not help the victim cope with past abuse or know his/her role in the cycle. Another reason is that the violence or abuse may be bilateral; that is both partners are abusive. Often one partner may be seen as the abuser because of signs of psychical abuse, however, there may be psychological abuse from the other partner that takes place in their pattern of interaction. And lastly, a therapist can better see the couple dynamics in conjoint therapy, and better help the victim gain confidence to leave if the relationship is not safe. Thus, though it is a very controversial area, the most effective treatment for partners experiencing domestic abuse is conjoint therapy in many cases.
While conjoint therapy may be a beneficial option for some couples, certain clinical guidelines should be used to ensure the safety of each partner as well as for seeking the best possible outcomes for the clients. Below are four areas a therapist should be aware of and use when seeing a couple with domestic violence issues.
1.) Assessment
-Written questionnaires or surveys, as well as face-to-face interviews should be use to assess the intensity, frequency, duration, and type of abuse in the relationship. Additionally, a therapist should assess to make sure each partner feels safe in sessions with the one another, and is willing to partake in conjoint therapy. The therapist should also make sure that he/she is comfortable with seeing the clients and believes the clients are a good candidate for conjoint therapy.
2.) Therapist Training
-The therapist should be fully qualified and trained to handle high conflict couples, as well as couples that experience domestic abuse. They should be knowledgeable on different types of abuse as well as being able to recognize the signs and characteristics of abuse. Advanced training in working with domestic abuse populations may be required.
3.) Community Collaboration
-Often a coordinated community response is necessary for the effectiveness of treatment for domestic abuse. Therapists should be aware of and knowledgeable about community centers, support groups, intervention programs, and shelters in the area. Close friends and family may also be included in the community response, but should be assessed that they do not perpetuate negative patterns of behavior.
4.) Safeguards
-Safeguards should be put in place to ensure the safety of all parties involved. Therapy is an emotional process that deals with many stressors which may evoke emotional reactions. Guidelines and techniques, such as cool-down methods or time-outs, should be taught and used in order to make sure any emotional reactivity does not escalate into abuse during sessions or outside of sessions.
Conjoint therapy for dealing with domestic violence is still a very controversial issue. However, for many couples, it may be an effective means to treat the issue. If conjoint therapy is used to address domestic abuse then proper and appropriate assessment, therapist training, community collaboration, and safeguards must be in place to ensure the safety of the clients.
A growing number of clinicians are in support of conjoint treatment for couples experiencing domestic violence and intimate partner violence. Instead of putting the victim at risk of further endangerment, couples therapy may actually help to strengthen each partner's ability to resolve conflicts in a non-abusive manner together and in a controlled setting.
The abuse process between perpetrator and victim is often cyclical. This means a pattern of interaction develops between the abuser and the abused. Since this pattern involves both partners, both partners may want to stay together during treatment and often seek treatment together. Additionally, many couples who seek conjoint therapy for domestic violence live together. The abuse is often centered around situational conflict or violence. By addressing the specific types of situations both partners partake in, the progression toward conflict may be managed better. Many couples experiencing domestic violence also report low satisfaction in their relationship. Conjoint therapy can address all issues to improve the quality of the relationship.
Furthermore, individualized therapy may cause negative effects on the relationship. For example, the abuser may use tools learned in an anger management course to his advantage, such as using the "time-out" method as a form of psychological abuse by ignoring the concerns and feelings of a partner. Also, since the abuse process is a pattern that effects both partners, individualized treatment only helps the perpetrator and does not help the victim cope with past abuse or know his/her role in the cycle. Another reason is that the violence or abuse may be bilateral; that is both partners are abusive. Often one partner may be seen as the abuser because of signs of psychical abuse, however, there may be psychological abuse from the other partner that takes place in their pattern of interaction. And lastly, a therapist can better see the couple dynamics in conjoint therapy, and better help the victim gain confidence to leave if the relationship is not safe. Thus, though it is a very controversial area, the most effective treatment for partners experiencing domestic abuse is conjoint therapy in many cases.
While conjoint therapy may be a beneficial option for some couples, certain clinical guidelines should be used to ensure the safety of each partner as well as for seeking the best possible outcomes for the clients. Below are four areas a therapist should be aware of and use when seeing a couple with domestic violence issues.
1.) Assessment
-Written questionnaires or surveys, as well as face-to-face interviews should be use to assess the intensity, frequency, duration, and type of abuse in the relationship. Additionally, a therapist should assess to make sure each partner feels safe in sessions with the one another, and is willing to partake in conjoint therapy. The therapist should also make sure that he/she is comfortable with seeing the clients and believes the clients are a good candidate for conjoint therapy.
2.) Therapist Training
-The therapist should be fully qualified and trained to handle high conflict couples, as well as couples that experience domestic abuse. They should be knowledgeable on different types of abuse as well as being able to recognize the signs and characteristics of abuse. Advanced training in working with domestic abuse populations may be required.
3.) Community Collaboration
-Often a coordinated community response is necessary for the effectiveness of treatment for domestic abuse. Therapists should be aware of and knowledgeable about community centers, support groups, intervention programs, and shelters in the area. Close friends and family may also be included in the community response, but should be assessed that they do not perpetuate negative patterns of behavior.
4.) Safeguards
-Safeguards should be put in place to ensure the safety of all parties involved. Therapy is an emotional process that deals with many stressors which may evoke emotional reactions. Guidelines and techniques, such as cool-down methods or time-outs, should be taught and used in order to make sure any emotional reactivity does not escalate into abuse during sessions or outside of sessions.
Conjoint therapy for dealing with domestic violence is still a very controversial issue. However, for many couples, it may be an effective means to treat the issue. If conjoint therapy is used to address domestic abuse then proper and appropriate assessment, therapist training, community collaboration, and safeguards must be in place to ensure the safety of the clients.
(Stith & McCollum, 2011)