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Article Excerpt
Mental health counselors regularly counsel clients who are in intimate relationships with partners who are violent. There is a dearth of literature addressing safety-related considerations when counseling clients in relationships that involve intimate partner violence (IPV). The authors draw on the literature to address safety-related counseling considerations that can be applied when counseling these clients. This article provides information about how to accurately assess IPV, explores safety-related ethical issues that arise when counseling clients in IPV relationships, and explains the use of safety plans as a tool for promoting the safety of clients in IPV relationships.
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Intimate partner violence (IPV) is the term commonly used to encompass violence perpetrated by any relationship partner, not just a spouse (Campbell, 2004). At some point in their lifetimes, 34% of women are victims of IPV (Browne, 1993; Tjaden & Thoennes, 2000). People from all socioeconomic, age, and racial backgrounds can become victims (Browne, 1993).
Intimate partner violence has significant short- and long-term consequences. For instance, 30-55% of female homicides are perpetrated by intimate partners (Campbell, 2004; Nicolaidis et al., 2003), and IPV is the direct cause of 21% of female emergency room visits each year (Browne, 1993). IPV also affects children; it is estimated that 3.3 million children each year witness IPV, and many of these children experience enduring long-term impacts (American Psychological Association [APA], 1996).
The psychological consequences of IPV for victims include depression, anxiety, and suicide (Coker et al., 2002). Victims of IPV often develop such psychological problems as increased rates of post-traumatic stress disorder, depression symptoms, self-injury, anxiety, psychosomatic complaints, substance abuse, and lowered self-esteem (Bacchus, Mezey, & Bewley, 2003).
The increased risk of psychological problems associated with experiencing IPV increases the likelihood that victims will seek out counseling services. Because mental health counselors often encounter clients who are involved in violent relationships with intimate partners, their ability to facilitate the client's safety, and accurately assess the potential for further violence is "a required professional ability" (Elbogen, 2002, p. 591).
A review of the counseling literature reveals no discussion of the counselor's role in assessing and facilitating the safety of clients who are experiencing IPV. This article provides information related to safety-related ethical issues, accurate assessment of violence, and the use of safety plans to promote the safety of clients who are in IPV relationships. Because women are most at risk for IPV (U.S. Department of Justice, 2002), the main focus of the article will be on women as victims.
A lack of training on IPV might help explain counselors' inability to accurately identify and intervene when counseling clients who are in dangerous relationships (Walker, 2004). In a recent survey of 500 American Mental Health Counselors Association members, Bozorg-Omid (2007) found that 50% of those surveyed reported that they received no training in graduate school on the topic of IPV. Of the 50% of participants who did receive training, 78% reported that the training was inadequate. Therefore, it is important that increased discussion of this topic occurs within the professional literature and within counselor training programs. This article is an attempt to bridge this gap and contribute to the development of the literature base that might help educate counselors on issues associated with IPV and client safety.
RISK FACTORS FOR IPV
General Predictors of IPV
Certain perpetrator characteristics correlate with engaging in IPV. Controlling behaviors and jealousy in the context of intimate relationships are predictors of later IPV (Campbell et al., 2003; Glass, Koziol-McLain, Campbell, & Block, 2004). Related to these characteristics, individuals who have ideologies that focus on having power and control over women are at increased risk of perpetrating IPV (Glass, Koziol-McLain, Campbell, & Block, 2004). Mossman (1995) provided a profile of individuals who may be at risk of doing so. The characteristics included being male, being youthful, having low socioeconomic status, minimal educational attainment, the presence of violent role models, having an abuse history, loss of a parent, experiencing violence during adolescence, a culture that regards violence as an acceptable way to resolve conflicts, the availability of weapons, lower intelligence levels, neuropsychological impairments, substance abuse/dependence, and the presence of a psychotic disorder.
Predictors of Escalated Violence or Homicide
The most serious IPV-related risk is partner homicide. The risk of female homicide is heightened when, for whatever reason, there is an increase in the severity or frequency of abuse (Campbell, 2003; Glass, et al., 2004). Various risk factors that predict escalated IPV and homicide have been identified. According to Campbell et al. (2003), stalking, strangulation, forced sex, abuse during pregnancy, a pattern of escalating severity or frequency of physical violence, perpetrator suicidality, a perception of impending danger on the...
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