Intimate Partner Violence (IPV) Assessment and Treatment

Reflection: Intimate Partner Violence (IPV) Assessment and Treatment

Instructions: ● Review all material in the module 3. ● Analyze the case scenario below. ● You will write a minimum of 500-word reflection using the Women in Violent

Relationships - Assessment, Risk, and Treatment PowerPoint and other collaborative literature listed in this module.

● Add a reference page listing multiple resources from the module.

Case Scenario Maria (32) is a married woman with two children (ages 6 and 9). She presents to therapy reporting increased anxiety, difficulty sleeping, and irritability. She initially describes her relationship as “stressful” and mentions frequent arguments with her husband, Daniel (35).

As the session progresses, Maria discloses that during arguments:

● Daniel has pushed her against a wall twice in the past year ● He frequently yells and calls her “useless” ● He controls most of the finances and questions her spending ● He checks her phone regularly and becomes angry if she speaks to male

coworkers

Maria reports that:

● She has slapped Daniel “a few times” during heated arguments ● She feels afraid when arguments escalate but says, “I also lose control

sometimes” ● She is unsure if she wants to leave the relationship ● She is worried about how separation would affect her children financially

She denies current severe physical injury but reports feeling “on edge all the time.”

1. IPV Identification

● Identify the most appropriate type of IPV (Johnson’s typology) ● Justify your answer using specific evidence from the case

● Explain why other types are less appropriate

2. Power and Control Analysis

● Analyze the power dynamics in the relationship ● Identify:

○ Controlling behaviors ○ Patterns of intimidation or fear

● 3. Safety Planning ○ Develop an initial safety plan for Maria ○ Include:

■ Immediate safety considerations ■ Resources/referrals ■ Child safety considerations

Women in Violent Relationships: Assessment, Risk, and Treatment

Family Violence SOW 4141

Dr. Patricia Temes, PhD, LCSW-QS

Learning Objectives

• Define Intimate Partner Violence

• Understand impact

• Differentiate types

• Conduct screening

• Identify risk/protective factors

• Apply safe treatment

Defining Intimate Partner Violence (IPV)

• Types of IPV • Physical violence • Sexual violence • Emotional abuse • Threats/coercion • Occurs in intimate relationships

Hidden Nature of IPV • Clients seek help for symptoms • Depression, anxiety, pain • Do not identify IPV • Clinicians must assess actively

Impact of IPV

• Mental: depression, PTSD

• Physical: chronic pain

• Self-worth, identity

• Impact on children

Decision to Leave

Often impacted by:

• Financial barriers

• Fear of retaliation

• Children concerns

• Emotional attachment

Prevalence

• 1 in 4 women are affected

• It is underreported

• It is often undetected

Counselor Role

• A professional can help by:

• Screening early

• Assessing the risks

• Using effective tools and interventions

• Ensuring safety

• Respecting autonomy

IPV Not One-Size

• Women can be victims or aggressors

• Patterns vary

• Tailored treatment needed

Johnson Typology

• Intimate Terrorism • Violent Resistance • Mutual Violent Control • Situational Violence

Overview of Johnson’s Typology • Developed by Michael Johnson (2008) • Organizes IPV based on:

– Power and control dynamics – Patterns of behavior (not just isolated incidents)

Core Principle: Not all intimate partner violence is the same—context, motivation, and control matter

Intimate Terrorism (Coercive

Controlling Violence)

Definition

• A pattern of violence where:

– One partner is both violent and controlling

– The other partner is not violent and is often fearful

• Violence is embedded in a broader system of:

– Domination

– Control

– Psychological manipulation

Intimate Terrorism (Coercive

Controlling Violence) cont.

• Key Characteristics

• Ongoing pattern (not isolated incidents)

• Includes:

– Physical abuse

– Emotional abuse

– Psychological control

– Isolation tactics

• Victim experiences:

– Fear

– Loss of autonomy

– Dependency

Intimate Terrorism (Coercive

Controlling Violence) cont.

Control Tactics May Include: • Monitoring movements • Financial control • Isolation from family/friends • Threats and intimidation • Gaslighting

Clinical Presentation Victim may:

– Appear anxious, fearful, or hypervigilant

– Minimize abuse – Feel trapped or unable to leave

Intimate Terrorism (Coercive

Controlling Violence) cont.

Prevalence & Context

• Most commonly:

– Male perpetrator → female victim

• Often portrayed in:

– Media

– Legal cases

– Shelters and crisis services

Important:

• Although highly visible, this type is less common than others

Intimate Terrorism (Coercive

Controlling Violence) cont.

Clinical Implications

• High risk for:

– Severe injury

– Lethality

• Requires:

– Immediate safety planning

– Individual treatment (NOT conjoint therapy)

• Focus on:

– Protection

– Empowerment

– Resource connection

Violent Resistance

Definition

Occurs when:

– A victim uses violence in response to ongoing abuse

– Violence is defensive rather than controlling

Violent Resistance

cont.

Key Characteristics

• Reactive rather than proactive

• Motivated by:

– Self-protection

– Survival

• Not part of a broader pattern of control

Violent Resistance cont.

Clinical Considerations: • High risk of misinterpretation: • Victim may be incorrectly labeled as:

– “Aggressor” – “Mutually abusive”

Assessment Focus On: • Identify:

– Who holds power and control – Context of violent incidents

• Explore: – Fear levels – Patterns over time

Violent Resistance cont.

Clinical Implications

• Avoid:

– Victim-blaming

• Provide:

– Trauma-informed care

– Safety planning

• Validate:

– Survival strategies

Mutual Violent Control Definition

• Both partners:

– Are violent

– Attempt to control each other

Key Characteristics

• Reciprocal aggression

• High conflict

• Power struggle dynamic

Mutual Violent Control cont.

Clinical Presentation

• Relationship marked by:

– Instability

– Escalation cycles

– Mutual fear and hostility

Mutual Violent Control cont.

Clinical Implications

• Requires:

– Careful, structured assessment

High risk situation:

– Violence may escalate quickly

• Often NOT appropriate for conjoint therapy without stabilization

Situational Couple

Violence

Definition

• Violence occurs:

– During conflict escalation

– NOT driven by ongoing control

Key Characteristics

• Episodic rather than chronic

• Triggered by:

– Arguments

– Poor communication

– Stress

Situational Couple

Violence cont.

Behavior Pattern

• Either partner may engage in violence

• Does NOT involve:

– Systematic domination

– Ongoing fear-based control

Prevalence

• Most common form of IPV

• Research indicates:

• Bidirectional violence is more common than one-sided violence

Situational Couple

Violence cont.

Clinical Presentation

• Clients may report:

– “We just argue and it gets out of control”

• Less fear compared to intimate terrorism

Clinical Implications

• May be appropriate for:

– Couples therapy (with caution)

• Focus areas:

– Communication skills

– Conflict resolution – Emotional regulation

Cross-Cutting Clinical Insights

Importance of Context • Same behavior ≠ same meaning • Must assess:

– Pattern – Intent – Control dynamics

Bidirectional Violence • Research shows:

– Many relationships involve mutual aggression

• However: – Mutual aggression ≠ equal power

One-Size- Fits-All Approach is Ineffective

Traditional models: – Focus only on male perpetrators Johnson’s typology highlights: – Need for tailored interventions

Application for Clinical Practice • Assessment Questions • Who is afraid of whom? • Is there a pattern of control? • What triggers the violence? • Is violence reactive or controlling?

Treatment Matching

Type Recommended Approach

Intimate Terrorism Safety planning, individual therapy

Violent Resistance Trauma-informed care, validation

Mutual Violent Control Intensive assessment, caution

Situational Violence Couples therapy (if safe)

Treatment

Safety Planning • Emergency contacts • Exit plans

Conjoint Therapy • Only if safe • Assess both partners

Avoid Conjoint Therapy if: • Fear present • High risk

Risks

Risk Factors • Substance abuse • Weapons • Mental illness

Socioeconomic Risks • Poverty • Unemployment • Early parenthood

Developmental Risks • Childhood abuse • Exposure to IPV

Protective Factors

• Support

• Housing

• Employment

Strengths-Based

• Focus on resilience, self esteem, self confidence

Modern Approach

Interventions should include:

• Trauma-informed

• Individualized

Treatment Goals should address:

• Ending violence

• Increasing safety

Priorities should focus on:

• Safety first

• Accurate assessment

Ethics • Confidentiality vs safety

• No victim blaming

Reference Kopala, M., & Keitel, M. (Eds.). (2017). Handbook of counseling women (2nd ed.). SAGE Publications.