Intimate Partner Violence-Situational (Bi-Directional) Couple Violence

1. Complete Objective Testing (1)

A. Each partner privately and confidentially completed an objective psychological test to identify the extent of the intimate partner violence.

B. Each partner privately and confidentially completed the revised Conflict Tactics Scale (CTS2).

C. The partners have completed the objective testing and the results were reviewed with them.

D. The partners have not completed the objective psychological testing and were redirected to do so.

2. Determine Individual versus Conjoint Treatment (2)

A. Individual sessions were used to assess the appropriateness of conjoint versus individual treatment.

B. A variety of factors were considered in selecting the appropriate modality of treatment, including antecedents, impact, function, fear, safety issues, extent of psychological coercion or abuse, openness to discuss issues directly, and resistance to disclose or discuss violence.

C. Conjoint treatment was recommended for the couple.

D. Individual therapy was recommended for the partners.

3. Discuss Elimination of Intimate Partner Violence (IPV) (3)

A. It was determined that violence seems to arise out of conflict rather than a desire to control.

B. It was assessed that neither partner is fearful of the other.

C. A discussion was held about why eliminating IPV should be the first treatment focus.

4. Discuss IPV on Continuum (4)

A. A discussion was held about how there is a continuum of conflict options.

B. IPV was identified as the riskiest, most out-of-control option on the continuum of how to resolve problems.

C. Conjoint and individual sessions were recommended to help the couple best keep conflicts from escalating to dangerous levels.

5. Teach Anger as a Natural Signal (5)

A. The partners were educated that the purpose of anger control is not to eliminate anger, because anger is an important and natural signal that something important is at stake.

B. Examples were provided to help the partners to understand the use of anger as a natural signal.

C. The partners were reinforced for displaying an increased understanding of the appropriate place for anger.

D. Additional information was provided as the partners failed to grasp the appropriate place for anger as a natural signal.

6. Teach about Anger as a Motivator (6)

A. The partners were taught about the concept that anger motivates the body's general response to fight a perceived threat.

B. The partners were taught about how the angry response to the perceived threat can either help or hurt one's self and the relationship.

C. The partners were reinforced as they displayed a clear understanding of how anger motivates the body's general response to fight a perceived threat, and how the response can either help or hurt the relationship.

D. Additional feedback was provided as the partners failed to grasp the motivating aspects of anger.

7. Educate about Goals of Anger Control (7)

A. The partners were educated about the importance of recognizing a provocative situation.

B. The partners were educated about the use of anger control to manage provocative situations in ways that strengthen rather than weaken the relationship.

C. The partners were provided with positive feedback as they displayed a clear understanding of the use of anger control to identify and manage provocative situations.

D. Remedial information was provided to the partners to assist in developing a greater understanding of how anger control can help to strengthen rather than weaken the relationship.

8. List Short-Term Anger Impact (8)

A. Each partner was asked to describe the ways in which anger has been destructive or helpful to themselves or their relationship in the short term.

B. The partners identified many immediate negative and positive consequences that have resulted from poor anger management.

C. The couple's denial about the negative impact of anger has decreased, and each partner has verbalized an increased awareness of both the negative and positive impacts of angry behavior.

D. Additional feedback was provided as the client failed to identify ways in which anger is productive or destructive to himself/herself or the relationship in the short term.

E. Additional information was provided as the client's partner failed to describe ways in which anger is destructive or productive to themselves or their relationship in the short term.

9. List Long-Term Impact (9)

A. Each partner was assisted in identifying the long-term reinforcers for anger (i.e., intimidation, obedience), as well as the negative consequences.

B. The partners identified many enduring reinforcers that have resulted from anger outbursts, as well as negative consequences, and these were processed within the session.

C. Additional feedback was provided as the client failed to identify ways in which his/her anger is either reinforcing or has a negative consequence in the long term.

D. Additional information was provided as the client's partner failed to describe ways in which anger is reinforcing or has a negative consequence in the long term.

10. Review Anger Management Success (10)

A. Each partner was asked about ways in which anger has been managed or deescalated appropriately in the past.

B. The client was encouraged to implement the technique of managing or deescalating his/her anger as they did in the past.

C. The client's partner was encouraged to implement the previously successful techniques of managing or deescalating his/her anger.

11. Review Counterproductive Anger Experiences (11)

A. Each partner was asked about counterproductive ways in which anger has been managed in the past.

B. The client described his/her negative experiences regarding managing his/her anger in the past, and these were processed.

C. The client's partner identified past counterproductive attempts to manage or deescalate anger, and these were processed.

12. Identify Different Perceptions Regarding Anger Control (12)

A. The partners were helped to identify ways in which one partner's deescalating strategies have been perceived as a provocation to the other partner (e.g., partner's withdrawal is perceived as a provocative rejection by the partner).

B. The partners were provided with positive feedback as they identified how one partner's deescalation strategies were perceived as a provocation to the other partner.

C. Additional examples have been provided as the partners failed to identify how deescalation strategies have been perceived as a provocation by the other partner.

13. Contract for Prohibition of Abuse (13)

A. Both partners were asked to sign a contract stipulating that no abusive behavior will occur, even when feeling angry.

B. Both partners were reinforced for contracting for a prohibition of abusive behavior.

C. The partners have refused to sign a contract for a prohibition of abusive behavior, and conjoint treatment was terminated.

14. Identify Anger Cues (14)

A. The partners were assisted in identifying various levels of behavioral, cognitive, and affective cues in regard to anger.

B. The partners were assisted in identifying the behavioral, cognitive, and affective cues for being at a low level of anger (1–30 on a 1–100 scale).

C. The partners were assisted in identifying the behavioral, cognitive, and affective cues for being at a moderate level of anger (31–50 on a 1–100 scale).

D. The partners were assisted in identifying the behavioral, cognitive, and affective cues for being at a danger zone level of anger (51–70 on a 1–100 scale).

E. The partners were assisted in identifying the behavioral, cognitive, and affective cues for being at an extreme zone level of anger (71–100 on a 1–100 scale).

F. The partners were provided with positive feedback as they identified a variety of behavioral, cognitive, and affective cues for different levels of anger.

G. The partners were provided with additional feedback regarding the behavioral, cognitive, and affective cues of being at different levels of anger.

15. Train in Emotion Recognition (15)

A. The partners were trained to recognize and label emotions other than anger.

B. The partners were asked to identify the emotions that often precede anger.

C. The partners were reinforced for displaying a comprehensive understanding of the emotions that trigger anger and how to recognize them.

D. The partners have not mastered the recognition and labeling of emotions related to anger and were provided with remedial feedback in this area.

16. Assign Anger-Tracking Homework (16)

A. The partners were assigned to track anger experiences, listing the situations that trigger anger, as well as the thoughts and behaviors that occur during anger-eliciting situations.

B. The partners have completed the anger-tracking homework, and this material was reviewed and processed.

C. The partners have not completed the anger-tracking homework and were redirected to do so.

17. Identify Anger Cues (17)

A. The partners were assisted in identifying various levels of behavioral, cognitive and affective cues in regard to anger.

B. The partners were assisted in identifying the behavioral, cognitive and affective cues for being at a low level of anger (1–30 on a 1–100 scale).

C. The partners were assisted in identifying the behavioral, cognitive and affective cues for being at a moderate level of anger (31–50 on a 1–100 scale).

D. The partners were assisted in identifying the behavioral, cognitive and affective cues for being at a danger zone level of anger (51–70 on a 1–100 scale).

E. The partners were assisted in identifying the behavioral, cognitive and affective cues for being at an extreme zone level of anger (71–100 on a 1–100 scale).

F. The partners were provided with positive feedback as they identified a variety of behavioral, cognitive, and affective cues for different levels of anger.

G. The partners were provided with additional feedback regarding the behavioral, cognitive and affective cues of being at different levels of anger.

18. Inquire about Constructive and Destructive Anger Levels (18)

A. The partners were asked about what levels of anger have been constructive in the past.

B. The partners were asked about what levels of anger have been destructive in the past.

C. Positive feedback was provided as the partners displayed significant insight regarding the constructive and destructive levels of anger in the past.

D. The partners failed to identify the constructive and destructive levels of anger in their past experience and were provided with additional feedback in this area.

19. Inquire about Erosion of Anger Control (19)

A. The partners were asked about the level of anger at which effective control over behavior has begun to erode.

B. Positive feedback was provided as the partners displayed significant insight regarding the erosion of anger control.

C. The partners failed to identify the level at which effective anger control breaks down and were provided with additional feedback in this area.

20. Inquire about When to Use Anger Management Skills (20)

A. The partners were asked about what level of anger necessitates the use of anger management skills.

B. The partners were asked about when they have needed to use anger management skills in the past.

C. Positive feedback was provided as the partners displayed significant insight regarding the level of anger at which management skills must be implemented.

D. The partners failed to identify when anger management skills must be introduced and were provided with additional feedback in this area.

21. Teach the “Pause, Calm, and Think” Technique (21)

A. The partners were taught about the “Pause, Calm, and Think” technique.

B. Partners were taught how to pause the conversation, letting the other partner know that you want to pause the discussion.

C. Partners were taught the calm-down technique, focusing on diaphragmatic breathing, counting to ten, etc.

D. The partners were taught the think phase, taking responsibility for ways in which one is making the conflict worse, planning on how to respond in a mindful, nonescalating manner.

E. The partners were encouraged to examine thinking by asking themselves how true their thinking is, how situational their thinking is, and whether this will get them what they want.

F. The partners were reinforced for their understanding of the “Pause, Calm, and Think” technique.

G. The partners have struggled with the use of the “Pause, Calm, and Think” technique and were provided with remedial instruction in this area.

22. Practice “Pause, Calm, and Think” Technique (22)

A. Partners were asked to practice the “Pause, Calm, and Think” technique within the session.

B. The partners utilized real-life experiences to practice the “Pause, Calm, and Think” technique within the session.

C. The partners were assigned at-home implementation of the “Pause, Calm, and Think” technique.

D. The partners' use of the “Pause, Calm, and Think” technique in at-home situations was reviewed.

23. Educate Partners about Therapy Boundary (23)

A. The partners were educated regarding the negative impact that can occur during the therapy process if one of the partners is critical or angry about what the other partner says in a session.

B. Positive reinforcement was provided to the partners for their acceptance of the need to refrain from being critical or angry with each other for what is said in the session.

C. The partners are often critical or angry with each other for what is said in the session, and further intervention was delayed until this issue could be resolved.

24. Educate about Respect in Sessions (24)

A. The partners were educated regarding the need for each to respect the other in sessions, especially when feelings become strong.

B. Emphasis was placed on the therapist's responsibility for maintaining control of the session and for interrupting the partners' destructive patterns of interaction.

C. Encouragement was provided as the partners agreed to abide by the therapist's directions if the session process becomes destructive.

D. The partners have accepted the therapist's guidance within the session when feelings became strong and disrespect occurred.

E. The partners have failed to accept the therapist's direction when strong feelings led to disrespectful behaviors, and further interventions were postponed until this issue could be resolved.

25. Describe History of Victimization (25)

A. Each partner was asked to describe any history of psychological and/or physical victimization in childhood.

B. The physically abusive partner was supported while describing a history of psychological and/or physical victimization in childhood.

C. The abused partner was supported while describing a history of psychological and/or physical victimization in childhood.

D. Neither partner identified or acknowledged any history of psychological and/or physical victimization in childhood.

26. Educate about Destructive Consequences of Abuse (26)

A. The partners were educated regarding the destructive consequences that partner abuse has on each partner.

B. The harmful effects of partner abuse on the children were emphasized.

C. The partners were reinforced for their understanding of how each family member can be negatively affected by partner abuse.

D. The partners were provided with remedial information regarding the effects partner abuse has on all family members.

27. Educate about Assertive Communication (27)

A. The partners were educated about the differences between nonassertive, assertive, and aggressive communication.

B. The partners were provided with specific examples of nonassertive, assertive, and aggressive communication.

C. The partners identified their own examples of nonassertive, assertive, and aggressive communication and were provided with feedback about these examples.

28. Identify Function of Abuse (28)

A. The partners were assisted in understanding the function of partner abuse.

B. The partners endorsed specific functions of partner abuse, although it was acknowledged that this was an inappropriate way to meet this need.

C. The partners were assisted in developing nonabusive means to accomplish the goals previously achieved through partner abuse.

29. List Alternative Behaviors (29)

A. The aggressive partner was assigned to list several positive alternative behaviors to be engaged in when anger is felt.

B. The aggressive partner identified several positive alternative behaviors (e.g., taking time out, calling a friend, taking a walk, writing out feelings, reviewing a list of negative consequences), and these were reviewed within the session.

C. The aggressive partner has not developed a list of positive alternative behaviors to use when anger is felt and was redirected to do so.

30. Process Recent Aggression (30)

A. An analysis of recent examples of the aggressive partner's angry feelings or anger outbursts was conducted.

B. “Alternatives to Destructive Anger” from the Adult Psychotherapy Homework Planner, 2nd ed. (Jongsma) was assigned.

C. The homework assignment has been completed, and key concepts were reviewed.

D. The uncompleted homework assignment was reassigned, and the reasons for noncompletion were reviewed and problem-solved.

E. Alternative behaviors that were available for the aggressive partner's angry feelings were identified.

31. Teach About Self-Change Plan (31)

A. The partners were taught about the five components of a self-change plan: (1) describe the behaviors that would be changed; (2) examine the pros and cons of the current behaviors; (3) set a goal, describing as precisely as possible what is to happen; (4) create an action plan, pinpointing a specific plan for enacting the goal; and (5) evaluate the enactment of the plan.

B. The partners were asked to practice the use of the self-change plan in-session.

C. Positive feedback was provided as the partners displayed a mastery of the self-change plan technique

32. Rate Implementation of Self-Change Plan (32)

A. The partners were asked to make a global evaluation of how they did on implementing the self-change action plan before the next session.

B. The partners were asked to jot down short answers to questions such as “What did we actually do?”, “What positives resulted?”, “What negatives resulted?”, and “What do we need to do from here?”

C. The partners have rated themselves on the self-change action plans and the results were reviewed.

D. The partners have not rated themselves on the self-change action plan and were redirected to do so.

33. Reinforce Assertiveness (33)

A. The partners were reinforced for assertive behaviors during the session.

B. When the partners described assertive behaviors engaged in between sessions, positive feed-back was provided.

C. The partners have not used assertiveness in situations between the sessions and were redirected to do so.

34. Identify Negative Communication Patterns (34)

A. The partners were assisted in identifying negative communication patterns in the relationship that accompany and/or increase the likelihood of physical aggression.

B. The partners were reinforced for identifying and acknowledging their negative communication patterns (e.g., vocally blaming the partner for problems, fast reciprocation of a partner's anger, lack of empathy, contempt for or lack of respect for the partner, defensiveness, refusal to change, resistance, withdrawal, coercive control/entitlement).

C. The partners denied any pattern of negative communication in the relationship and were provided with specific examples of this from in-session contacts.

35. Teach Positive Communication Skills (35)

A. Role-play and behavioral rehearsal were used to teach the partners positive communication skills (e.g., problem identification, “I” statements, listening skills, problem-solving skills, behavioral contracting).

B. The couple was reinforced for their mastery of positive communication skills (e.g., problem identification, “I” statements, listening skills, problem-solving skills, behavioral contracting).

C. The partners were assigned to practice positive communication skills as homework.

D. The partners have been regularly using positive communication skills, and the benefits of this were reviewed.

E. The partners have not completed homework assignments related to positive communication skills and were redirected to do so.