A Qualitative Study of Intimate Partner Violence Universal Screening by Family Therapy Interns: Implications for Practice, Research, Training, and Supervision

Abstract

Although a few family therapy researchers and clinicians have urged universal screening for intimate partner violence (IPV), how screening is implemented-and, in particular, client and therapist response to screening-is vaguely defined and largely untested. This qualitative study examined the dilemmas experienced by couples and family therapy interns when implementing universal screening for IPV in an outpatient clinic setting. Twenty-two graduate students in a COAMFTE-accredited program were interviewed using qualitative research methods grounded in phenomenology. Three domains, 7 main themes, and 26 subthemes were identified. The three domains that emerged in this study include (a) therapist practice of universal screening, (b) client response to universal screening, and (c) therapist response to universal screening. Implications for practice, research, training, and supervision are discussed.

Contemporary MFT Theories and Intimate Partner Violence: A Review of Systemic Treatments

“…Bograd and Mederos (1999) found that even in a therapeutic situation, most couples do not disclose violence unless asked specifically about it. Additionally, most therapists only talk about violence with a couple who is presenting for issues of violence, and therapists vary widely in their screening processes of violent couples (Todahl, Linville, Chou, & Maher-Cosenza, 2008). However, research shows that 53% of couples in therapy have been violent at one time or another, suggesting that therapists in general need to be more assertive when assessing for violence (O'Leary, Vivian, & Malone, 1992).…”

Rape, Sexual Violence, and Acquiescence in Intimate Relationships: Screening, Assessment, and Clinical Decision Making

“…As depicted in the previous scenario, behavior may appear "mild" by conventional definitions and may not register for clients or therapists as IPV, though "mild" behavior can have severely negative consequences for individuals and interpersonal relationships. Failure to recognize "mild" violence and failure to carefully assess its impact can organize therapists to inadvertently deny and minimize the existence of and consequences of very common forms of IPV (Bograd & Mederos, 1999;Todahl, Linville, Chou, & Maher-Cosenza, 2008). As described by Jory (2004), "clinicians should never collude with minimization or denial by failing to address acts, such as slapping or pushing, directly as abuse" (p. 29).…”

Universal Screening and Assessment for Intimate Partner Violence: The IPV Screen and Assessment Tier (IPV-SAT) Model

“…Given the prevalence of IPV, its negative social and health impact, and its pertinence in clinical work (Centers for Disease Control and Prevention, 2008), several researchers have argued that family therapists and other healthcare providers should routinely screen for IPV (Bograd & Mederos, 1999;Stith et al, 2003;Todahl et al, 2008). However, researchers have not yet adequately investigated whether IPV universal screening improves treatment outcomes (Nelson, Nygren, McInerney, & Klein, 2004;Ramsay, Richardson, Carter, Davidson, & Feder, 2002;Wathen & MacMilan, 2003).…”

“…Although the IPV-SAT has been practiced at a university-based training clinic for approximately 5 years without known moderate or severe adverse effects, the IPV-SAT procedure has been studied only from the vantage point of practitioners-in-training and supervisors (Todahl et al, 2008). A random selection of 100 clients who were given the four IPV-SAT questions at the Center for Family Therapy (CFT) 5 responded in writing to 99% (396/400) of the items at the time of intake.…”