Domestic Violence Treatment that Works

In their pioneering work, Lee, Siebold and Uken adapted Solution Focused Brief Therapy (SFBT) to the treatment of Domestic Violence Offenders. (Oxford University Press, 2003).

In my attempt to discover a treatment modality that would also work with couples in which there had been Domestic Violence, I discovered something called Domestic Violence Focused Couples Therapy (DVFCT) whose primary creator is Sandra M. Stith. This well-researched method takes as its foundation Solution Focused Brief Therapy (SFBT) and adapts it accordingly. (Stith, McCollum, Rosen, American Psychological Association, 2011, Couples Therapy for Domestic Violence: Finding Safe Solutions).

The approach of both SFBT and DVFCT posits that focusing on the strengths of domestic violence offenders (and in the case of couples both parties) is not only more important but is the key to creating lasting change. It utilizes the setting of goals and encouragement to achieve those goals as a way to “…assist their efforts to exclude violence from intimate relationships.” (Lee et. al., p.4). They go to great lengths to point out that when offenders take ownership of the problem and are held accountable for solutions to those problems, they do change and recidivism rates are significantly lower. It is an approach that focuses less on deficits and blame and more on solutions and strength. The work is done primarily in small short-term groups with extensive intake interviews at the outset and frequent measures to evaluate the effectiveness of the treatment.

However, creating solutions and capitalizing on strengths is harder than it sounds for domestic violence offenders who would not be in the position they are in if they were able to think clearly, act responsibly and not destructively and control their impulses. They are often self-hating and unable to see very much that is positive about themselves.

In my opinion and experience, this is because of the complex nature of the individuals themselves.

It is rare in my experience that Domestic Violence is the only thing going on in a relationship. Other factors include financial stress, infidelity, substance abuse, a history of exposure to violence and physical and emotional abuse, deep insecurity, attachment issues, and many forms of mental illness including depression, anxiety, bipolar disorder and personality disorders.

Known as “co-morbidity”, these other factors must be addressed in treatment in order for work from a strengths perspective to succeed. Consequently, I find myself exploring family history and making connections between past and present; recommending participation in 12-step programs to help people achieve and maintain sobriety; at times suggesting medication to help with depression and anxiety; helping with money management and spending (including compulsive spending) and so on.

In addition to more cognitive-behavioral techniques which focus on dysfunctional thinking (and dysfunctional behavior), I find myself in the role of “talk therapist”, working psychodynamically, listening to expressions of pain and suffering.

In other words, the people are complex. The help needed is too.

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