Therapeutic interventions in intimate partner violence: an overview

Preventing violence and enhancing mental health among clients of an invitro fertilization clinic in Jordan: results of a pre/post pilot test of the use of cognitive behavioral therapy

INTRODUCTION

Infertility increases women's risk of intimate partner violence (IPV). Cognitive behavioral therapy (CBT) is commonly used to treat mental health problems among fertility treatment seeking patients. CBT has not been tested for its potential to reduce IPV in this population. We pilot test the use of CBT to prevent IPV and improve patients' mental health in a fertility clinic in Jordan.

METHODS

Of 38 eligible fertility-treatment seeking couples, 16 consented and underwent up to 11 CBT sessions (average = 9) over 3 months. Interviews at baseline and 16 weeks post intervention (endline) assessed IPV, quality of life, social support, coping, and fear of spouse. Wilcoxon signed-rank and McNemar's tests were used to assess change in outcomes.

RESULTS

At baseline, women's rates of IPV, depression, and anxiety were 75%, 87.5%, and 75% respectively, whereas men's rates of depression and anxiety were each 80%. Average baseline post-traumatic stress disorder (PTSD) symptoms for men and women were 3.3 and 2.7 respectively out of 5. IPV decreased 25% after treatment, and women reported less spousal fear. For both men and women, depression, anxiety, and PTSD symptoms decreased and social support and fertility quality of life improved.

CONCLUSION

Psychosocial support should be standard of care for the treatment of infertility given the burden of mental health problems and IPV and the utility of CBT in this patient population. Co-design with couples is needed to identify strategies to bolster participation along with population-based interventions to combat the stigma of infertility and mental health service use and enhance women's status.

Interactive effects of mindfulness and negative urgency on intimate partner aggression perpetration

Intimate partner aggression (IPA) is a costly and incompletely understood phenomenon. Negative urgency, the tendency to act impulsively in response to negative affect, is predictive of IPA perpetration. Mindfulness, by virtue of its emphasis on nonreactivity to negative affect, is an opposing force to urgent tendencies that may mitigate the negative urgency-IPA link. Yet, no research to date investigates the interactive effects of negative urgency and mindfulness on IPA perpetration. Two studies were conducted that measured and manipulated multiple facets of mindfulness alongside measures of negative urgency and tendencies of IPA perpetration (combined N = 508 undergraduate students in monogamous intimate relationships). Counter to our preregistered predictions, we found that negative urgency's association with greater IPA perpetration increased at higher levels of mindfulness. These findings suggest that mindfulness may not be a protective factor against IPA perpetration for individuals higher in negative urgency, but rather may serve as a risk factor.

Improving Policy and Treatment Interventions for Sexual and Gender Minority Perpetrators of Intimate Partner Violence to Reduce Adverse Health Outcomes

Intimate partner violence (IPV), understood as physical, sexual, and psychological aggression, is a pernicious health problem that is as or more prevalent in sexual and gender minority (SGM) relationships as in heterosexual and cisgender ones. IPV has many impacts, including physical and psychological health consequences. Effective treatment of abusers is needed to reduce IPV in SGM communities. Yet IPV in SGM relationships is understudied, making it difficult to determine whether current treatment, designed for people who identify as cisgender and heterosexual, is effective for SGM IPV abusers. This perspective identifies policy barriers to and recommendations for improving IPV perpetrator treatment for SGM individuals.

The Effectiveness of Culturally Specific Male Domestic Violence Offender Intervention Programs on Behavior Changes and Mental Health: A Systematic Review

The objective of domestic violence intervention programs is to address perpetrator behavior. However, the suitability and effectiveness of these programs in confronting problematic behavior for ethnically diverse groups is unclear. Therefore, the aim of this systematic review was to cohesively examine whether such programs are effective in reducing recidivism, changing perpetrator behavior, and addressing mental health issues for culturally diverse groups. Several databases were searched for peer-reviewed articles that included culturally specific components or ethnically diverse cohorts in offender intervention programs. 10 articles met the inclusion criteria. The findings demonstrate greater effectiveness of programs with greater cultural engagement: through culturally trained facilitators, addressing the cultural and patriarchal norms relevant to the specific client group, and discussion of gender roles and attitudes to gender equality specific to the cultural context. Such programs achieved some positive outcomes including: reduced recidivism, improved mental health, and better attitudes to gender equality. However, the findings are limited to a few ethnically diverse groups, and not all studies measured all outcomes listed above. This review suggests the development and implementation of suitable offender intervention programs that address perpetrator behavior and mental health in ethnically diverse client groups. When culturally relevant and effective programs are implemented, it could lead to men's modification of perpetrating behavior and create safer family relationships.

Why Does He Do It? What Explanations Resonate During Counseling for Women in Understanding Their Partner's Abuse?

Intimate partner violence (IPV) is a complex and multifaceted problem gaining increasing attention within mental health research and practice. IPV explanations focus on both individual and systemic levels; however, it is increasingly acknowledged that a single level explanation may not be sufficient. The practices of clinical disciplines may, however, still privilege an explanation at one level over another, which will influence how they work with clients. It is likely that one such clinical group, psychologists, may play a critical role in helping victim-survivors to understand and explain their experiences of IPV. However, we were unable to find any studies focusing on women's perceptions of psychologists' role in this. Additionally, we know little about women victim-survivors' perceptions of why their partners use IPV. To address these gaps, the research question for this study was: What explanations resonate during counseling for women in understanding their partner's abuse? To explore this question, 20 women who had seen psychologists after experiencing IPV participated in semi-structured interviews. The interviews were analyzed using reflexive thematic analysis and three themes constructed from the data. The first two themes, narcissist description was helpful and not all bad all the time, showed that the women found it powerful in their healing processes when psychologists offered the opportunity to discuss their partners individual characteristics as explanations for their use of IPV. The third theme, structural explanations, showed that some of the women also reflected on wider structural contexts. Implications for clinical practice include the potential healing effect when practitioners can move along a continuum of explanation levels, covering both the inner and outer worlds. Implications for research into IPV perpetration are that women hold expertise and insight into individual perpetrators and could make valuable contributions to this field.

A psychodynamic contribution to the understanding of anger - The importance of diagnosis before treatment

This paper starts from the claim that a shared understanding of anger, in both its normal and psychopathological dimensions, is missing and that there are various therapeutic paths that seem to be less effective than those related to other pathologies. A major limitation of anger research and of its treatments lies in the lack of precise clinical diagnoses to inform therapy. For this reason, the first aim of our work is to survey critical literature in order to find useful elements to differentiate anger, starting from the evidence of negative and positive outcomes of treatments. Such evidence will then be enhanced in our proposal of interpretation and intervention, within a dynamic framework and with particular reference to Orefice’s thought. The core focus is to explore the different functions that anger has for the patient and to investigate the elementary functioning of the self. Our reading of the phenomena related to anger will provide useful tools both for understanding the dynamics underlying anger and as a guide for clinical intervention.

The Role of Complex Trauma and Attachment Patterns in Intimate Partner Violence

OBJECTIVE

Even if the relationship between adverse childhood experiences and intimate partner violence (IPV) has already been established, there are no sufficient studies examining the relationships between these factors and attachment representations, specifically attachment disorganization. Thus, this study aimed to explore, in a sample of women who experienced IPV (a) the presence of interpersonal adversities during childhood, and (b) attachment representations, with a particular focus on disorganization.

METHODS

Women's representations of attachment experiences were investigated through the Adult Attachment Interview, while the presence of various forms of interpersonal adversities during childhood was assessed using the Complex Trauma Questionnaire. The results of the IPV group (n = 98) were compared with those of women with no history of IPV (control group, n = 81).

RESULTS

Women in the IPV group showed higher values of multiple forms of adverse experiences within their caregiving system. They presented significantly higher rates of disorganized states of mind regarding attachment, indicative of a lack of resolution regarding traumatic experiences, and of disorganized working models resulting from complex trauma. Our results highlighted that, more than the presence of traumatic experiences, it is their irresolution - reflected in the disorganized states of mind regarding attachment at the Adult Attachment Interview - to be a significant predictor of IPV.

CONCLUSION

These results suggest underline the significance of offering a trauma- and attachment-informed therapy to those who experience IPV. Such results could help both clinicians and researchers in formulating clearer guidelines for IPV interventions.

Qualitative reappraisal of perspectives, prevalence, and management of family violence among the Yoruba people: a study of representatives of some Yoruba ethnic subgroups from Ile Ife

Objective

The analysis of changing definitions and perspectives of violating behaviors within cultural contexts will inform the responses and interventions that will mostly reduce the occurrences of family violence.

Methods

This study used focus group discussions of purposively selected participants to generate data that were analyzed using content with themes of definition, perspectives, prevalent forms, persons mostly affected, perpetrators, and management strategies among the Yoruba people.

Results

There were multiple words and descriptions in the local Yoruba language for abuse and violence, but no single word for either of the two concepts. Common forms of family violence identified were verbal assaults from parents to children, among couples, siblings, physical assault of children by parents, physical assault of parents by children, neglect of children, parents, spouses mostly wives, sexual harassment, and sexual violence. Neglect of wives and children was perceived to be increasing, occurring in one in four houses. Sexual harassment and sexual violence were perceived to be rare, but the latter not an issue in marriage. A variant of sexual “touching” said to be tolerated with unmarried young people was identified as common among this ethnic group. Age and gender were dominant factors in the use of common forms of violence. Informal approaches were methods of management of family violence but perceived inadequate.

Conclusions

This study concluded that family violence is a common phenomenon occurring among family members. Hence, formal acceptable interventions that will be appropriate for this ethnic subgroup are required.

"Dreaming Undreamt Dreams" in Psychological Counseling with Italian Women Who Experienced Intimate Partner Violence: A Phenomenological-Interpretative Analysis of the Psychologists' Experience

In psychological consultations with women who survive Intimate Partner Violence, it is essential to work on elaboration of the trauma as a complex trauma within the context of a relationship. We consider dreams to be a symbolic-representative process, which requires the right psychic, relational and contextual conditions to occur, and that is hindered when trauma is present. The objective of the present study is to investigate the meanings that psychologists working at anti-violence centers attribute to the clinical intervention with women victims of IPV, with a focus on the area of sleep and dreaming in a traumatic experience, and in the clinical work on the trauma. Twelve female psychologists were interviewed using the Interpretative Phenomenological Analysis methodology. From the analysis of the interviews, three main themes emerged: (1) Day and night, neither awake nor asleep, (2) Anti Violence Centers: setting as a container of emotion? and (3) dreaming undreamt dreams. The study highlights the importance of dreams as an indicator not only of psychic and mental functioning but also of the psychological relationship within a specific context.