Recommendations for working with domestic violence survivors, with special attention to memory issues and posttraumatic processes.

Abstract

This article proposes principles for working effectively with survivors of domestic violence. Recommendations are based on a review of the available literature and organized within the following sections: therapist competence, therapeutic framework and relationship, assessment and diagnosis, the structure of the treatment process and relationship, interventions for dealing with posttraumatic reactions, and group interventions. The relevance of the delayed memory debate for domestic violence survivors is also discussed. The complexity of battering dynamics and the need for sensitive, competent treatment of victims are emphasized throughout the article.

A review and critical appraisal of measures of therapist-patient interactions in mental health settings

“…Increased use of exploration is associated with more positive relationship ratings. 30,41,[50][51][52][53][54][55][56][57][58][59][60][61][62] …”

“…28 In addition, therapists who impose their values on patients tend to have poorer alliances. 39,56,72,[106][107][108][109] …”

“…For example, confidentiality and boundary issues may be challenged when working with victims of violence and abuse, 56,110 consideration of boundary issues is sometimes problematic when working with patients with learning disabilities, 111 and abuse of power happens when therapists form sexual relationships with their patients. 71 …”

“…39,56,93,95,104,106,115,116 This suggests that there are engagement and relationship issues in working with patients from minority ethnic groups. 117,118 Again, there is little research on whether patients should be matched with therapists from the same ethnic background, social class, religion, and so on.…”

“…31,32,54,56,58,59,61,112,116,[121][122][123] Processes Several reviews suggest that better management of the above factors requires therapists to be flexible in their approach to the relationship, to be reflective about their practice, and to gain greater understanding of the socio-political forces that influence their attitudes and greater knowledge of the cultural background of their patients. Therapists' recognition of their own values is also an important part of this process.…”