Treatment Of Domestic Violence

Treatment

Intro

Stages of Healthy Gay Relationships

Intro To Domestic Violence

Introduction to Gay Male Domestic Violence

Treatment Of Domestic Violence

Treatment Of Domestic Violence

DV Links

References

Thus, as explained above, domestic violence in gay and lesbian couples is a serious problem, just as it is in straight couples. Until recently, the problem has been completely discounted by many researchers and writers, and has received very little theoretical and empirical attention. Newer work has shown that some of what is known based on violence in straight couples can serve as a starting point for understanding violence in gay couples. However, because many research and theoretical models were based only on straight batterers and victims, empirical results of testing these models can only serve as a starting point to understanding gay domestic violence.

Treatment options may be similarly understood. Just as treatment providers for batterers and victims in straight couples require a specific knowledge base, so do providers for batterers and victims in gay couples. However, because of the additional complexities of working with gay and with lesbian relationships, this knowledge base, built on treatment straight couples, can only serve as a starting point for intervention for gay couples. Several points for treatment can still be offered, however.

First, the therapist must have a solid knowledge base about the dynamics of domestic violence, based on general theory as well as on specific research about violence in gay couples. This knowledge base would include an understanding of:

the assessment of specific risk factors for violence, as well as recognition of changing risk factors depending upon the couple's stage in "The Cycle of Violence"
the importance of focusing on physical safety of the victim in treatment and periodic "safety check-ins" to assure the situation remains safe for the victim
the power differences between batterer and victim, both those that are "acquired" as well as those that are "inherent"

Further, it should be noted that the therapist must not blame the victim. Blaming could take the form of conceptualizations of relationship violence as being something for which both partners are responsible. Many therapists make this mistake when working with straight couples as well. However, blaming could also take the form of failing to recognize abuse, and instead classifying it as mutual combat, based on misconceptions about gay couples.

It must also be noted that the treatment provider must be aware of the lack of adequate community resources, and the prejudice the client is more likely to experience in the legal system. This lack of external resources means the treatment provider may need to reconceptualize their role, shifting from "one of many" providers with straight victims to being the primary or even only point of intervention for gay victims.

These two notes are especially important in working with gay victims, as they are already a stigmatized population. Failure to recognize the victim's specific needs and resources available is likely to only compound the trauma.

Second, the therapist must be Gay and Lesbian Affirming. The therapist must be knowledgeable of issues such as coming out, normal gay and lesbian relationship development, societal response to gays and lesbians, internal and external homophobia, and theoretical biases in psychological theory.

This is likely to require an examination of any personal biases for the treatment provider. Such biases may be obvious, as in seeing domestic violence as "proof" of the untenability of gay relationships, or more subtle, as in minimizing the risk for harm and encouraging gay victims to fight back and defend themselves.

Third, there is considerable debate about the appropriateness of couples counseling with violent couples, be they straight, gay, or lesbian.

Island and Letellier (1991) go so far as to say that couple's counseling is never appropriate. This view makes some sense. Clinicians working with violent couples struggle with a number of concerns, including that couples therapy:

reinforces the batterer's efforts to "make up," possibly making it harder for the victim to freely choose to stay or leave the relationship
may redefine one person's choice to be violent as "a couple problem"
requires careful decision-making regarding client safety outside of the therapy office
prevents accurate monitoring of abuse potential, as the victim is likely to be afraid to report honestly if the potential is high
could cause more violence after therapy has stirred troublesome issues and conversations or if the victim reports the abuser's actions honestly
is demanding, as work with abusers stirs deep feelings and possible transference in therapists to punish batterers and protect victims

Some argue that under specific circumstances, couples therapy might be possible. Holtzworth-Munroe and colleagues (1995) note that there is no data supporting that this approach to treatment is more effective than individual therapy. However, there is no evidence that this approach is less effective than individual treatment. Individual therapy for batterers, however, has low rates of success. For example, Edelson and Grusznski (1989) conducted an intense treatment program including educational self-help groups, therapeutic groups, and individual therapy for heterosexual batterers and found that at a five month post-treatment follow-up, 67% of batterers were reported to have been non-violent by their female partners. However, 43% of the men were reported to have made threats of violence. Thus, in actuality, only 24% of the men could be considered "success cases," who did not become violent or threaten violence toward their partner. Gondolf's (1997) study similarly showed that verbal abuse continued after treatment for 70% of abusive men.

Holtzworth-Munroe and colleagues (1995) offer that couples therapy would offer several benefits over individual treatment, including that couples therapy:

gives the therapist a more accurate picture of the violence, since it is not based solely on the abuser's report, which is likely to be minimized
allows for the same techniques and information to be given to both partners, including education about domestic violence and personal responsibility for one's actions and safety, as well as attention to warning signs that the abuser is at risk to lose control over his anger
can focus on better communication patterns that could help prevent risky situations in which the batterer is prone to lose self-control
provides a "safe place" to discuss difficult and anxiety-provoking topics

Prerequisites for potentially successful couples treatment would include:

the violence did not fit a pattern of abuse and control
the violence only happened once, perhaps twice (separated by a long interval)
the batterer takes full responsibility for the abuse and is willing to seek treatment to gain better control of his actions
the batterer is willing to comply with "safety check-ins" and reports by the victim, which typically should be conducted without the batterer present
a clear set of terms under which therapy would be ended (such as a "relapse" into any violence, or the use of manipulative efforts to control)

In these kinds of cases, there are a few basic procedures that would help:

a "no violence" contract that specifically states there is to be no violence between the parties, and that should they become violent, they must report this to the therapist within one day
part of the "no violence" contract would also include no threats of violence
the batterer may be required to begin work on his own of some kind (individual therapy, anger management classes, group therapy, etc...) to begin to address his anger problems, perhaps including attention to physiological signs, relaxation therapy, etc...
there is a safety plan in place for the victim, which spells out under what circumstances he will leave the home; the therapist should meet individually with him to spell out a safe place to go (e.g., a friend or family member who knows the relationship has been violent), and this place should remain secret from the batterer
there is a safety plan for the batterer, which spells out triggers or physiological signs he can use to warn himself that he is loosing control of his temper, "calming activities" he can engage in to soothe his anger, and a contact person he can go to for support and honest feedback who is aware of the violence in the relationship
a "no threats" contract that specifically states neither partner will make threats to end the relationship; this would not preclude leaving the home, but it would stipulate that any decision to leave would be reported at a therapy session
a "no discussion" list of topics; these would include "crazy buttons" or issues that are too volatile for the couple to discuss outside of session, and an agreement for both partners not to discuss these outside of session, and what to do if the other brings up these issues

Of note, work with domestic violence cases is never easy. Some research (Edelson & Grusznski, 1989) shows that even under the most intensive treatment conditions (individual, educational, and group therapy), physical abuse may end in a large number of cases, but many abusers continue to be manipulative, controlling, and threatening in their relationships, and thus therapeutic gains are limited. When there are no or limited resources specifically targeting gays in violent relationships in the community, it is possible that even fewer gains can be made.