IPV and Therapy Brochure for Human Services Professionals: Cycle of Violence, Safety, Ethics and Couples Therapy

For counselors, therapists, social workers and human services professionals

Intimate Partner Violence and Therapy

Recognizing IPV, keeping clients safe, and providing ethical, effective care

Did you know? About 41% of women and 26% of men in the U.S. have experienced contact sexual violence, physical violence and/or stalking by an intimate partner, with an IPV-related impact such as fear, injury or PTSD symptoms (Leemis et al., 2022).

1. What is IPV?

Intimate partner violence is abuse or aggression in a romantic relationship, by a current or former spouse or dating partner. It includes:

• Physical violence
• Sexual violence
• Stalking
• Psychological aggression, including coercive control, isolation, threats, and financial and digital abuse

IPV occurs across all ages, genders, sexual orientations, cultures and income levels. At its core is a pattern of power and control.

The cycle of violence

1. Tensionbuilding2. Incidentabuse occurs3. Reconciliationapology, denial4. Calm“honeymoon”Cycle ofviolenceAdapted from Walker (1979)

Walker (1979) described a repeating cycle: tension building, an abusive incident, reconciliation (apologies, promises, minimizing) and calm. The cycle helps explain why survivors may stay or return. Over time, the calm phase may shorten and the violence escalate. Not every abusive relationship follows this pattern; many involve constant coercive control.

2. Safety comes first

• Screen every client privately, never in front of a partner: “Has your partner ever hurt, threatened or frightened you?”
• Assess lethality with tools such as the Danger Assessment. Red flags: strangulation, access to firearms, threats to kill, escalating violence, recent separation, stalking.
• Use safety plans, not “no-violence contracts.” A contract alone does not prevent abuse and may give false reassurance. A safety plan is a collaborative, practical plan for staying safe.
• Safety plan elements: warning signs; safe places to go; trusted contacts and a code word; emergency bag with documents, medications and money; safe technology use; plans for children and pets; protective orders.
• Respect autonomy: leaving can be the most dangerous time. Support the survivor’s choices rather than pressuring them to leave.
• Remember the many forms IPV takes, including tech-facilitated abuse, financial control and immigration-related threats.

Resources

• Emergency: call 911
• National Domestic Violence Hotline: 1-800-799-SAFE (7233), text START to 88788, or chat at thehotline.org
• StrongHearts Native Helpline: 1-844-762-8483
• love is respect (teens and young adults): text LOVEIS to 22522
• 988 Suicide & Crisis Lifeline: call or text 988
• Local help: dial 211, search shelters at domesticshelters.org, or contact your state domestic violence coalition

Local resources: add your area’s shelter, legal aid office, batterer intervention program and police victim advocate here.

3. Ethical challenges

• Confidentiality and its limits: explain limits at intake. Know duty-to-warn/protect laws (since Tarasoff, 1976) and mandatory reporting for child or elder abuse.
• Couples confidentiality: decide on a secrets policy; disclosures of abuse made privately must never be revealed in a way that endangers the survivor.
• Do no harm: some interventions, like conjoint sessions with an abusive partner, can increase risk.
• Neutrality vs. safety: systemic neutrality must not mean treating abuse as a “shared” problem or blaming the survivor.
• Competence: IPV requires specialized training; refer or consult when needed (ACA, 2014; AAMFT, 2015).
• Diversity and bias: avoid stereotypes about who perpetrates or experiences IPV, including LGBTQ+ and male survivors.
• Documentation: records can be subpoenaed; document objectively and protect safety-sensitive details.
• Self-care: vicarious trauma is common; use supervision.

4. Couples therapy when there is IPV: pros and cons

Potential benefits (only after careful screening)

• Many couples want to stay together and prefer joint treatment
• Addresses relationship dynamics, communication and conflict escalation
• Both partners learn de-escalation and time-out skills
• Specialized conjoint programs have reduced violence for carefully screened couples with situational violence (Stith et al., 2004)

Risks and drawbacks

• Survivor may not speak freely; disclosures may trigger retaliation after sessions
• Implies shared responsibility for violence; may reinforce victim-blaming
• Abusive partner may manipulate therapy or the therapist
• Can increase danger, especially with coercive, controlling violence (“intimate terrorism”; Johnson, 2008)

Bottom line: conjoint therapy is contraindicated with ongoing severe violence, coercive control, fear of the partner, or active substance abuse. Consider it only after individual screening, when violence has stopped, both partners choose it freely, and safety is monitored at every session.

5. How therapy can address IPV

For survivors

• Trauma-informed, empowerment-based counseling that restores choice and control
• Treatment of PTSD, depression and anxiety (e.g., trauma-focused CBT, cognitive processing therapy)
• Advocacy and case management: housing, legal and financial help
• Support groups to reduce isolation and shame

For people who use violence

• Accountability-focused batterer intervention programs
• CBT for anger, emotion regulation and challenging beliefs that justify abuse
• Treatment of co-occurring substance use

For families and communities

• Support for children exposed to IPV
• Coordinated community response with shelters, courts, healthcare and law enforcement
• Prevention: healthy relationship education