Systemic perspectives on intimate partner violence treatment.

This article reviews changes in the research literature on intimate partner violence (IPV) since our earlier review (Stith, Rosen, & McCollum, 2003). A rationale for systemic treatment of IPV has emerged from research that has continued to document the limited effectiveness of single-gender treatment approaches for offenders and that has identified subtypes of abusive relationships, including situational couple violence, which often includes the reciprocal use of violence. Consistent findings from the available outcome research have demonstrated that for carefully screened couples who choose to stay together, systemic interventions decrease incidences of IPV and decrease the risk factors for IPV with no increase in risk. Implications for research and treatment are offered.

An outsider in my own home: attachment injury in stepcouple relationships.

This multiple-case study explored women's relational experiences as attachment injury patterns in distressed stepcouple relationships and how these experiences might be attributable to stepcouple status. The first author interviewed five stepmothers with biological children, using open-ended interview questions developed from attachment theory and existing research regarding attachment injury and stepfamily formation. Data analysis using the pattern-matching method derived and explored markers of attachment injury in the women's stepcouple relationships. The four categories of attachment injury showed significant attribution to stepfamily issues. This supports past stepfamily research suggesting that stepcouples face unique challenges. Further, these findings suggest that the language of attachment injury accurately describes stepcouples' problems and the usefulness of conceptualizing and addressing these problems in an attachment injury framework.

The development of the Solution Building Inventory.

Throughout the past 70 years, a great deal of research conducted on defining and testing problem-solving skills has led toward solution-focused practices and philosophies. As a result, some literature exists illustrating the efficacy of solution-focused practices. However, no published research exists on the factors that contribute to solution building. This study tested for components of solution building while creating a solution building inventory. Results from a factor analysis failed to find specific factors within solution building; thus solution building appears to be a unidimensional concept. Implications for using the solution building inventory are discussed.

Using mindfulness meditation to teach beginning therapists therapeutic presence: a qualitative study.

Some of the more difficult to define aspects of the therapeutic process (empathy, compassion, presence) remain some of the most important. Teaching them presents a challenge for therapist trainees and educators alike. In this study, we examine our beginning practicum students' experience of learning mindfulness meditation as a way to help them develop therapeutic presence. Through thematic analysis of their journal entries a variety of themes emerged, including the effects of meditation practice, the ability to be present, balancing being and doing modes in therapy, and the development of acceptance and compassion for themselves and for their clients. Our findings suggest that mindfulness meditation may be a useful addition to clinical training.

Using metaphors to explore the experiences of powerlessness among women in 12-step recovery.

12-Step programs of substance abuse(1) recovery are the most utilized mutual-help models in the United States. A pivotal aspect of 12-Step is the often-controversial idea of powerlessness. There is debate about the usefulness of the concept of powerlessness, especially for women in recovery. This study used a metaphor-elicitation interviewing technique to examine the experiences of powerlessness among 13 women of varied racial, ethnic, and socioeconomic backgrounds, ages 21 to 60, who had an average of 9.5 years of recovery. Interviews were conducted during a 6-month span between 2004 and 2005 in the Washington, DC metropolitan area. Open and axial coding was used to determine emergent themes. Concepts of powerlessness were found to be process oriented and developmental. Some metaphors indicated positive emotions around powerlessness such as relief, whereas others indicated negative emotions such as fear. Implications for future research and study strengths and limitations are included.

Couples treatment for interpersonal violence: a review of outcome research literature and current clinical practices.

Conjoint couples treatment for interpersonal partner violence (IPV) remains controversial despite a growing body of research and practice experience indicating that it can be effective and safe. In addition, developing typologies of couples who are violent suggest that a "one-size-fits-all" treatment approach to IPV is not appropriate and conjoint treatment may have a place in the treatment of at least some couples. In this article, we review the experimental studies and clinical practices of conjoint treatment. Based on this review, we suggest current best practices for this approach to treatment. Best practices include couples treatment as part of a larger community response to IPV, careful screening of couples for inclusion in couples treatment, modification of typical conjoint approaches to promote safety and ongoing assessment of safety with contingency plans for increased risk.

Solution-focused group therapy for level 1 substance abusers.

The present study compared solution-focused group therapy (SFGT) with a traditional problem-focused treatment for level 1 substance abusers. Outcome research on the effectiveness of solution-focused group therapy is minimal, especially in treating substance abusers. In the present study, clients were measured before and after treatment to determine therapeutic effectiveness. Clients in the solution-focused group significantly improved on both the Beck Depression Inventory and the Outcome Questionnaire. The clients in the comparison group did not improve significantly on either measure. Therapist skill level and adherence to theoretical models were measured in each group to reduce confounding variables.

Engaging suffering: towards a mindful re-visioning of family therapy practice.

The myth of problem-free living is easily identifiable in Western culture through its childhood fairy tales and modern love stories. Even if inadvertently, the field of mental health perpetuates this myth with the very concept of "mental health," which implies a state without suffering. Using mindfulness, Buddhists assume an alternative stance towards suffering: rather than eliminate it, they compassionately engage it. This article explores the potentials of mindfulness as an alternative approach to suffering within the context of marriage and family therapy. Family therapists can integrate mindfulness principles into their work to help clients shift how they relate to the unique forms of suffering that one encounters in intimate relationships, such as abuse, divorce, rejection, and loss.

Steve de Shazer and the future of solution-focused therapy.

Steve de Shazer who, along with Insoo Kim Berg, co-founded the Solution-Focused Brief Therapy (SFBT) approach, recently passed away. In this article we will offer a brief biographical sketch and then discuss the current state of the art of SFBT as it applies to practice, training, and research. Future directions for SFBT, such as the emergence of professional associations, the increased research interest in SFBT as evidenced-based practice, the recent focus on process-research to determine the mechanisms of change within SFBT, and the application of SFBT to education are discussed.

Partner relationship quality and drug use as predictors of women's substance abuse treatment outcome.

This study examined the relationship of relationship quality and partner's drug use on treatment outcomes for women in outpatient drug treatment. The sample consisted of predominately heterosexual couples where the female partner was in drug treatment. Both the partners' perception of relationship quality and the interaction of female client and her partner's perception of relationship quality were significant predictors of one of the outcome variables-the client's posttest report of days of drug use during the previous 30 days. Interestingly, clients reported more days of drug use when their partners reported higher relationship quality. A similar pattern was found with the ASI Drug composite score as the dependent variable except that the interaction term was not significant in that analysis. In addition, partners' relationship quality scores were associated with female clients' treatment completion. A higher proportion of women whose partners reported higher relationship quality failed to complete treatment. Partners' reports of pretest and posttest drug use were not related to women's treatment outcomes.

Treating intimate partner violence within intact couple relationships: outcomes of multi-couple versus individual couple therapy.

An experimental design was used to determine outcomes of a domestic violence-focused treatment program for couples that choose to stay together after mild-to-moderate violence has occurred. Forty-two couples were randomly assigned to either individual couple or multi-couple group treatment. Nine couples served as the comparison group. Male violence recidivism rates 6 months after treatment were significantly lower for the multi-couple group (25%) than for the comparison group (66%). In contrast, men in the individual couple condition were not significantly less likely to recidivate (43%) than those in the comparison group. In addition, marital satisfaction increased significantly, and both marital aggression and acceptance of wife battering decreased significantly among individuals who participated in multi-couple group therapy, but not among those who participated in individual couple therapy or the comparison group.

Negotiated time-out: a de-escalation tool for couples.

Many state domestic violence intervention standards mandate that treatment for offenders should be separate from any treatment offered to victims. In this article we advocate that in cases of low-level violence, when couples choose to remain together, certain aspects of treatment should be offered conjointly. Specifically, our feedback from victims and offenders suggests that one tool generally taught to offenders-time-out--is often ineffective and can be used abusively when partners are not taught the tool concurrently. We describe the negotiated time-out procedure that we developed and use feedback from our clients to illustrate its usefulness.

Effectiveness of couples treatment for spouse abuse.

Despite its controversy, carefully conceptualized and delivered couples treatment appears to be at least as effective as traditional treatment for domestic violence, and preliminary data suggests that it does not place women at greater risk for injury. However, the body of research on which these conclusions rest is sparse. Only six experimental studies have been done, each using different eligibility criteria, outcome measures, and treatment approaches. Thus, further study of this modality is warranted. Marriage and family therapists have an important part to play in continuing to develop and test innovative ways of helping couples end violence and improve their relationships--an endeavor that promises to improve the quality of the partners' lives as well as those of their children.

Developing a manualized couples treatment for domestic violence: overcoming challenges.

This paper describes challenges faced in a four-year project to develop a manualized couples treatment program for domestic violence. The couples treatment program is an add-on to a male batterer program where the male partner has perpetrated mild-to-moderate violence, yet both partners want to remain together. The project involved the cooperation of a variety of community agencies and referrals from key domestic violence programs. While some anticipated challenges did not materialize over the course of the project, unanticipated challenges did. Qualitative data collected from therapists and clients throughout the project was used to refine the treatment approach.