Couples Therapy for Domestic Violence

Overseen By Gunnur Karakurt, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University Hospitals Cleveland Medical Center

Must be taking: Psychotropic medication

Disqualifiers: Severe violence, Firearms, Substance misuse, others

Compensation: Varies

Number of Visits: Unknown

Duration: 8 weeks

16 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if couples therapy can prevent mild to moderate situational couple violence from worsening or recurring. Researchers will study couples' reactions to therapy using surveys and emotional responses. The trial is open to heterosexual couples who have been together for at least a year, experience mild to moderate violence, and both wish to remain in the relationship. As an unphased trial, it offers couples the chance to contribute to important research that could enhance relationship dynamics and prevent future violence.

Will I have to stop taking my current medications?

The trial does not require you to stop taking your current medications as long as you have been stable on them for the past 12 months and have not been hospitalized for psychiatric reasons in the past 2 years.

What prior data suggests that this therapy is safe for couples?

Research shows that couples therapy for addressing intimate partner violence is generally well-received. Studies have found that this therapy can safely help couples manage conflicts and prevent violence from escalating. No major reports of negative effects directly caused by the therapy have emerged, indicating that the treatment is considered safe for participants. However, each couple should discuss any concerns with the therapists to ensure the therapy suits their needs. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about using couples therapy as a treatment for domestic violence because it takes a unique approach compared to traditional methods like individual therapy or crisis intervention. Unlike these standard options that typically address the needs of the individual, couples therapy focuses on improving communication and relationship dynamics between partners. This method provides a space for both individuals to work together on their issues, which could lead to more sustainable and long-term solutions. By addressing the root causes of conflict within the relationship itself, it offers a promising alternative that might prevent future instances of violence more effectively.

What evidence suggests that couples therapy could be effective in preventing situational couple violence?

Research has shown that couples therapy, tested in this trial, can assist those dealing with situational couple violence, characterized by less severe conflict and not ongoing abuse. Studies suggest that this therapy may prevent future violence by enhancing communication and understanding between partners. Some evidence indicates that couples in therapy argue less and develop better problem-solving skills. However, experts caution that therapy might not suit all couples, particularly those experiencing severe violence or control. Overall, couples therapy could be beneficial for those with milder relationship issues. Participants in this trial will receive couples therapy either immediately or after an 8-week waiting period as part of the control group. ^{1 3 5 6 7}

Who Is on the Research Team?

Gunnur Karakurt, PhD

Principal Investigator

University Hospitals Cleveland Medical Center

Are You a Good Fit for This Trial?

This study is for heterosexual couples over 18 years old who have been in a relationship for at least one year and experience mild to moderate situational couple violence. Both partners must be willing to undergo therapy together, aiming to stay in the relationship. They should not have severe intimate partner violence or history of violent offenses, and they must be stable on any psychotropic medication for the past year.

Inclusion Criteria

My partner and I are both over 18.

Couples must have mild to moderate forms of situational couple violence

My partner and I are both participating in this study together.

Exclusion Criteria

Couples will be excluded if there is a discrepancy between partners' reports of violence in the Conflict Tactic Scale

Participants will be excluded if currently suicidal and/or psychotic and/or moderately ill at the pre-screening

I have been stable on my psychiatric medication for over a year.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Waiting Period

Control group undergoes an 8-week waiting period before starting therapy

8 weeks

Treatment

Couples receive therapy to prevent escalation and recurrence of situational couple violence

8 weeks

Follow-up

Participants are monitored for changes in IPV and psychophysiological regulation

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Control
• Couples Therapy

Trial Overview

The trial investigates if couples therapy can prevent escalation and recurrence of situational couple violence among couples with mild to moderate issues. It involves self-report questionnaires and psycho-physiological markers to assess emotional responses before and after therapy sessions.

How Is the Trial Designed?

Group I: Couples Therapy Experimental Treatment 1 Intervention

Couples Therapy

Group II: Control Placebo Group 1 Intervention

Couples Therapy after an 8 week waiting period

Who Is Running the Clinical Trial?

University Hospitals Cleveland Medical Center

Lead Sponsor

Trials

348

Recruited

394,000+

Keming Gao

Lead Sponsor

Trials

4

Recruited

910+

National Center for Advancing Translational Science (NCATS)

Collaborator

Trials

100

Recruited

32,100+

National Center for Advancing Translational Sciences (NCATS)

Collaborator

Trials

394

Recruited

404,000+

Published Research Related to This Trial

The project aimed to develop a couples treatment program for domestic violence, specifically for cases where the male partner had committed mild-to-moderate violence and both partners wished to stay together.

Qualitative feedback from therapists and clients was crucial in refining the treatment approach, highlighting the importance of adaptability in therapeutic programs for domestic violence situations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Developing a manualized couples treatment for domestic violence: overcoming challenges. Stith, SM., Rosen, KH., McCollum, EE.[2019]

A national survey of 620 couple therapists revealed that less than 4% consistently follow established guidelines for screening domestic violence, which include universal screening through separate interviews and questionnaires.

Many therapists do not prioritize the victim's safety when choosing treatment methods, potentially leading to the use of conjoint therapy in situations where it is unsafe due to relationship violence.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Domestic violence assessment procedures among couple therapists. Schacht, RL., Dimidjian, S., George, WH., et al.[2015]

In a comprehensive study of couple therapy in Sweden, significant reductions in overall psychiatric symptoms and depressive symptoms were observed, with improvements of 50-55% for both men and women, indicating the therapy's effectiveness in addressing marital distress.

Despite the short duration of treatment, many couples achieved normal levels of psychiatric symptoms, with 73-78% reaching these values, demonstrating that couple therapy can lead to substantial improvements in mental health with limited intervention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Outcomes in couple therapy: reduced psychiatric symptoms and improved sense of coherence. Lundblad, AM., Hansson, K.[2006]

The article provides a framework for assessing domestic violence in couples, helping therapists determine which couples can safely participate in conjoint therapy.

It emphasizes the importance of conducting lethality assessments and offers criteria for excluding couples from therapy, ensuring that therapists are informed by domestic violence literature that is often overlooked in family therapy practices.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Battering and couples therapy: universal screening and selection of treatment modality. Bograd, M., Mederos, F.[2019]

The article outlines a clinical framework for understanding the unique dynamics of couples where one or both partners have a history of trauma, based on focus group discussions.

It highlights the necessity of applying a 'trauma lens' in therapy to recognize the individual and systemic impacts of traumatic stress on relationships, ensuring that therapists do not miss critical cues during treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Single- and dual-trauma couples: clinical observations of relational characteristics and dynamics. Nelson, BS., Wangsgaard, S., Yorgason, J., et al.[2004]

A large randomized trial and companion studies have identified key factors that can improve couple therapy outcomes, including client feedback, the therapeutic alliance, and assessing couple goals.

The article provides specific guidelines for therapists to integrate research findings into their practice, addressing the gap between couple therapy research and real-world application.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Norway Couple Project: Lessons Learned. Sparks, JA.[2019]

A nationwide study in Germany involving 554 couples found that while couple therapy is effective, about 50% of couples do not experience improvement, and the effect sizes in real-world settings are significantly lower than those in controlled efficacy trials.

The study identified 64 factors that influence relationship quality and stability, some of which correlate with therapy outcomes and separation rates, suggesting these factors could help predict the success of couple therapy in practice.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness of Couple Therapy in Practice Settings and Identification of Potential Predictors for Different Outcomes: Results of a German Nationwide Naturalistic Study. Roesler, C.[2021]

A systematic review and meta-analysis of six studies indicates that couples therapy may be an effective treatment for intimate partner violence in certain situations, despite the general caution among professionals regarding its use.

The review highlights the need for careful consideration and selection of couples therapy as a treatment option, given the serious nature of intimate partner violence and the potential risks involved.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Couples Therapy for Intimate Partner Violence: A Systematic Review and Meta-Analysis. Karakurt, G., Whiting, K., van Esch, C., et al.[2019]

Carefully designed couples treatment for domestic violence can be as effective as traditional methods and does not seem to increase the risk of injury for women, based on preliminary data from six experimental studies.

The current research is limited and varies in methods, indicating a need for more comprehensive studies to explore and validate the effectiveness of couples treatment in reducing domestic violence and improving relationships.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness of couples treatment for spouse abuse. Stith, SM., Rosen, KH., McCollum, EE.[2019]

Couple therapy has been shown to significantly reduce relationship distress for many couples, with various therapeutic approaches yielding positive outcomes.

Despite the overall effectiveness, a notable number of couples do not experience significant improvements or may even worsen after therapy, highlighting the need for further research on factors influencing treatment success.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Current status and future directions in couple therapy. Snyder, DK., Castellani, AM., Whisman, MA.[2011]

Citations

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About Intimate Partner Violence

Intimate partner violence (IPV) is abuse or aggression that occurs in a romantic relationship. Intimate partner refers to both current and former spouses and ...