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

Trial Summary

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 data supports the effectiveness of the treatment Couples Therapy for Domestic Violence?

Research suggests that couples therapy can be as effective as traditional treatments for domestic violence, without increasing the risk of harm to women. Additionally, couples therapy has been shown to reduce relationship distress and improve emotional and behavioral health in various contexts. ^{1 2 3 4 5}

Is couples therapy for domestic violence safe?

Preliminary data suggests that carefully planned and delivered couples therapy does not increase the risk of injury for women, but more research is needed to confirm its safety. ^{1 2 3 6 7}

How is Couples Therapy for Domestic Violence different from other treatments?

Couples Therapy for Domestic Violence is unique because it involves both partners in therapy sessions, focusing on improving the relationship and communication, rather than treating individuals separately. This approach is considered in cases of mild-to-moderate violence where both partners wish to stay together, and it aims to address the dynamics of the relationship that contribute to violence. ^{3 7 8 9 10}

What is the purpose of this trial?

The purpose of this study is to understand whether the couple therapy that is used in practice is effective in preventing situational couple violence. More specifically, investigators will focus on couples with mild to moderate forms of situational couple violence to investigate how couples therapy can be effective in preventing the escalation and recurrence of situational couple violence. For this purpose, the response of partners to therapy will be investigated by integrating self-report questionnaires and psycho-physiological markers of emotion.

Research Team

Gunnur Karakurt, PhD

Principal Investigator

University Hospitals Cleveland Medical Center

Eligibility Criteria

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

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

Treatment Details

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.

Participant Groups

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+

Findings from Research

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]

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]

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]

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]

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]

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 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]

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 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 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]

References

1. United States pubmed.ncbi.nlm.nih.gov

Current status and future directions in couple therapy. [2011]

2. United States pubmed.ncbi.nlm.nih.gov

The Norway Couple Project: Lessons Learned. [2019]

3. United States pubmed.ncbi.nlm.nih.gov

Effectiveness of couples treatment for spouse abuse. [2019]

4. England pubmed.ncbi.nlm.nih.gov

Outcomes in couple therapy: reduced psychiatric symptoms and improved sense of coherence. [2006]

5. United States 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. [2021]

6. United States pubmed.ncbi.nlm.nih.gov

Single- and dual-trauma couples: clinical observations of relational characteristics and dynamics. [2004]

7. United States pubmed.ncbi.nlm.nih.gov

Domestic violence assessment procedures among couple therapists. [2015]

8. United States pubmed.ncbi.nlm.nih.gov

Battering and couples therapy: universal screening and selection of treatment modality. [2019]

9. United States pubmed.ncbi.nlm.nih.gov

Developing a manualized couples treatment for domestic violence: overcoming challenges. [2019]

10. United States pubmed.ncbi.nlm.nih.gov

Couples Therapy for Intimate Partner Violence: A Systematic Review and Meta-Analysis. [2019]