Academic journal article Journal of Cognitive Psychotherapy

Conjoint Treatment of Intimate Partner Violence: A Cognitive Behavioral Approach

Academic journal article Journal of Cognitive Psychotherapy

Conjoint Treatment of Intimate Partner Violence: A Cognitive Behavioral Approach

Article excerpt

The purpose of this article is to describe the rationale and methods of couple-based interventions designed to treat and prevent intimate partner violence. Cognitive, affective, and behavioral individual and couple risk factors for violence are reviewed, as are therapeutic concerns regarding the use of conjoint treatment. Current conjoint treatments that are intended to reduce the incidence of abusive behavior among couples in which one or both partners have engaged in forms of psychological and/or mild to moderate physical aggression, do not engage in battering or severe violence, and desire to improve their relationships and stay together are described. We focus on our Couples Abuse Prevention Program (CAPP) that compares the efficacy of cognitive-behavioral couple therapy procedures and treatment as usual at a universitybased couple and family therapy clinic. Outcomes from the CAPP project and evaluations of the other programs demonstrate the potential of judiciously applied conjoint interventions for aggressive behavior in couple relationships.

Keywords: intimate partner violence; domestic violence; cognitive behavioral therapy; couple treatment

Approximately 30% of all married couples in the United States report at least one incident of violence between them (Straus & Gelles, 1990), and 1,300 deaths have occurred nationwide each year as a result of intimate partner violence (IPV; Centers for Disease Control, 2003). Although women do use aggression in rates comparable to males when a range of mild to moderate violent acts are considered (Archer, 2000; Frieze, 2005), research indicates that women are more severely victimized than men (Felson, Messner, Hoskin, & Deane, 2002) and male violence has more severe psychological and physical consequences (for a review, see Holtzworth-Munroe, Meehan, Rehman, & Marshall, 2002). Given their greater size and strength, men are more likely to inflict severe bodily harm on their female victims (Browne, 1993). In fact, national survey data indicate that each year, up to 2 million women are severely assaulted by their male partners (Straus & Gelles, 1990), and they are more likely to sustain injuries requiring medical attention (Stets & Straus, 1990).

TYPES OF COUPLE VIOLENCE

There is a growing consensus that couple violence can be differentiated into the less commonly occurring severe physical aggression (male battering of a female partner for the purpose of dominating and controlling her, combined with relatively low-level female aggression, mostly for selfdefense, and found among men court-ordered to violence treatment programs) and common couple violence (both partners engaging in mild to moderate physical aggression, more commonly occurring in distressed couples, and less likely to endanger the female and cause her fear; Frieze, 2005; Holtzworth-Munroe et al., 2002). Whereas even the milder forms of violence can elicit fear in both men and women and a sense of being a hostage, severe aggression is likely to be particularly traumatic and commonly deters some women from leaving the abusive relationship (Barnett, Lee, & Thelen, 1997; Towns & Adams, 2000).

Furthermore, forms of psychological aggression including hostile withdrawal, denigration of the partner, domination and threats of violence, and restriction of the partner's freedom and access to resources have been found to precede and co-occur with physical aggression, and the negative impact of psychological aggression on victims' psychological and physical wellbeing have been found to be similar to or even more severe than effects of physical aggression (Follingstad, Rutledge, Berg, Hause, & Polek, 1990; O'Leary, 2001). In addition, psychological aggression has been found to be a stronger predictor of marital dissolution than physical aggression (Jacobson, Gottman, Gortner, Berns, & Shortt, 1996). Reciprocity of verbal aggression and other forms of psychological abuse between partners is a hallmark of distressed couple relationships (Epstein & Baucom, 2002; Epstein, Baucom, & Rankin, 1993; Weiss & Heyman, 1997). …

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