A Stress and Coping Approach to Intervention with Abused Women

By Carlson, Bonnie E. | Family Relations, July 1997 | Go to article overview

A Stress and Coping Approach to Intervention with Abused Women


Carlson, Bonnie E., Family Relations


Physical abuse, especially severe, chronic abuse, is a significant source of stress for women who experience it. A combination of external and internal factors can inhibit women from ending abuse in an intimate relationship. Counseling can be useful in addressing internal barriers. An ecological model of intervention is presented based on the Lazarus and Folkman (1984) conceptualization of stress and coping. The model also recognizes the stages abused women may experience in their appraisal of the abuse experience. The proposed model includes attention to an orientation to practice with this client group, engagement in treatment, assessment, intervention strategies, and evaluation of effectiveness.

Although an increasing amount of attention has been devoted to the problem of woman battering in recent years, there has been a rather limited focus on therapeutic work with abused women. This, in part, derives from the reservations of many in the battered women's movement regarding therapy with women who have been abused. This ambivalence appears to be grounded in four factors. The first is a concern that providing counseling for battered women implies preexisting deficits that contributed to their being abused, which in turn can lead to victim blaming (Dutton, 1992). Another concern is related to negative experiences with mental health providers reported by many battered women who have sought counseling, only to be held responsible for their own abuse or simply not be helped (Hamilton & Coates, 1993; McShane, 1979; Ross & Glisson, 1991; Saunders & Size, 1986). The third issue concerns the power imbalance inherent in most therapeutic relationships, risking the perpetuation of powerlessness in abused women (New York State Coalition Against Domestic Violence, N.D.). Finally, and perhaps most important, is the belief that what battered women need most of all is not therapy but rather other resources that will permit them to terminate abusive relationships if they wish to (Sullivan, 1991).

An alternative view of counseling for abused women maintains that the process of being abused, especially if the abuse has been chronic or severe, often results in a variety of consequences that compromise a woman's ability to effectively address abuse while still in a relationship or to recover from the effects of abuse and move on with her life. Some of these adverse consequences may serve as barriers to women being able to terminate abusive relationships.

Assumptions and Definition

A recent conceptualization by Johnson (1995), based on data from the 1985 Second National Family Violence Survey and other qualitative data, has identified two different types of domestic violence or abuse: common couple violence and patriarchal terrorism. The two are said to differ in terms of the nature, severity, and chronicity of abuse, as well as the gender of perpetrator and victim. Common couple violence tends to be used by both men and women, occurs with relatively low frequency in a relationship, tends not to be physically injurious, and does not show a pattern of escalation. In contrast, patriarchal terrorism tends to be perpetrated by men toward women, shows a pattern of escalation in frequency and severity over time, includes not only physical violence but also "economic subordination, threats, isolation, and other control tactics," (p. 284) and "is rooted deeply in the patriarchal traditions of the Western family" (Johnson, 1995, p. 286). Woman abuse as discussed in this paper is synonymous with patriarchal terrorism and is defined as a pattern of behaviors that can be physical (e.g., punching), emotional or psychological (e.g., ignoring), verbal (e.g., ridiculing), or sexual (e.g., coerced intercourse) that are intended to control or demean a woman by her partner.

It is assumed that each woman who experiences domestic abuse is the unique product of many factors including her age, cultural background, experiences in her family of origin, economic circumstances, sexual orientation, intelligence, and so forth. …

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