Journal of Couple & Relationship Therapy

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Contemporary MFT Theories and Intimate Partner

Violence: A Review of Systemic Treatments

Megan Oka & Jason B. Whiting

To cite this article: Megan Oka & Jason B. Whiting (2011) Contemporary MFT Theories and
Intimate Partner Violence: A Review of Systemic Treatments, Journal of Couple & Relationship
Therapy, 10:1, 34-52, DOI: 10.1080/15332691.2011.539173

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Journal of Couple & Relationship Therapy, 10:34–52, 2011
Copyright © Taylor & Francis Group, LLC
ISSN: 1533-2691 print / 1533-2683 online
DOI: 10.1080/15332691.2011.539173

Contemporary MFT Theories and Intimate

Partner Violence: A Review of Systemic
Treatments

MEGAN OKA
Marriage and Family Therapy Program, Brigham Young University, Provo, Utah, USA
JASON B. WHITING
Marriage and Family Therapy Program, Texas Tech University, Lubbock, Texas, USA

As specialists in couples’ dynamics, marriage and family therapists

will inevitably be faced with issues of violence in the clients they
serve. However, there has been criticism of treating partner violence
systemically, and it is not clear whether MFT theories adequately
conceptualize and treat violence. This article examines current is-
sues that MFTs should be aware of when violence is an issue with
clients. Also, we critique how four contemporary family therapy
theories view and/or treat couple violence, both conjointly and in-
dividually. Specific implications for therapists who work from these
current models are presented, as are suggestions for future research.

KEYWORDS violence, theory, narrative, solution-focused, couples

INTRODUCTION

Although awareness of the scope of intimate partner violence has been

increasing in recent years, it is still unclear if marriage and family thera-
pists (MFTs) are well suited or qualified to assess for and address issues of
violence. On one hand, MFTs are relationship specialists who understand es-
calation, anger, blame, context, and patterns. On the other hand, as systems
thinkers, MFTs have been accused of neglecting personal responsibility as
it relates to perpetration of violence (Bograd & Mederos, 1999). It has also
been suggested that MFTs are more interested in relationship preservation
(at all costs) than they are in safety and necessary relationship dissolution.
Further, there is question as to how well MFTs address power and gender

Address correspondence to Megan Oka, Marriage and Family Therapy Program, Brigham
Young University, 274 TLRB, Provo, UT 84602, USA. E-mail: megan oka@byu.edu

34
 Contemporary Theories and Violence 35

differences, or if they miss crucial violence dynamics because of limited train-

ing in violence (Jory, 2004; Knudson-Martin & Mahoney, 2009). Despite the
criticisms, there is reason to hope that MFTs are becoming more prepared
to help individuals and couples identify, reduce, and eliminate violence
(Dersch, Harris, & Rappleyea, 2006). Although there are many important is-
sues relevant to MFTs and violence, this article briefly examines appropriate
approaches to treatment and assessment for MFTs working with violence.
Then we will review how several current MFT theories address violence.

Traditional Violence Treatments

Treating violence in a family or couple context has long been controversial.
The traditional paradigm for treating violent couples has been to separate
them and assign the male offender to a batterer intervention program while
female victims are sent to a support group (Gondolf, 1995). Many states
discourage or prohibit funding of programs that offer conjoint therapy as
the primary mode of treatment (Healey, Smith, & O’Sullivan, 1998). Bat-
terer intervention programs (BIPs) are typically psychoeducational groups
for violent men who are taught anger management skills, gender equality,
and responsibility (Feldman & Whiting, 2009). The rationale behind treating
men in male-only groups is that violent couples should not be seen together
for safety reasons, and perpetrators of violence have separate issues to work
through than victims of violence. However, these groups sometimes have un-
intended consequences. Batterers who work together may empathize with
one another and reinforce or generate new abusive behaviors (Augusta-Scot
& Dankwort, 2002). Also, batterer intervention groups have shown varying
levels of success in treating the problem, with recidivism and dropout very
common (Babcock, Green, & Robie, 2004). Another challenge with most
BIPs is that these groups assume that all violent men are the same, mean-
ing that all violent men fit the profile of batterer, and that the violence is
one-sided.

Recent Issues in Violence Treatment

In recent years, researchers have identified different kinds of violent men
and different kinds of violent relationships (e.g., Johnson, 2008; Holtzworth-
Munroe, Meehan, Herron, & Stuart, 1999). These findings suggest that dif-
ferent types of violence warrant different types of treatments. For example,
Holtzworth-Munroe and Stuart (1994) found that violent men tend to present
from one of three types: antisocial, dysphoric/borderline, and family only.
These scholars suggest that certain types of violent men (family only) can be
treated successfully, while others cannot.
Similarly, Johnson’s research (1995, 2008) has generated different typolo-
gies of violent couples, which align with Holtzworth-Munroe’s typologies of
36 M. Oka and J. B. Whiting

violent men. Of the four types of couples, two are most often found in re-
search and practice. Intimate terrorists are those commonly thought of as
batterers. Intimate terrorism tends to be one-sided violence, characterized
by coercive control and escalation of violence. Intimate terrorists are usually
either dependent or antisocial in orientation, and are similar to Holtzworth-
Munroe’s dysphoric-borderline and antisocial types. These types should not
be treated in couples’ therapy. Intimate terrorists are often violent partners
of women in shelters. Situational couple violence is characterized by mu-
tuality of violence and lack of control or domination by one partner. It
is commonly found in research on violence in community samples. While
still potentially serious, this type of violence is less likely to result in in-
jury and might be characterized by poor self-regulation skills and escalation
(Johnson, 2008). Less common are violent resistance and mutual violent con-
trol. Violent resistance refers to the partner of an intimate terrorist (usually
female) who may react to violence with violence but not in a controlling
way. Mutual violent control occurs when both partners are violent and con-
trolling. This typology comprises a very small portion of violent couples. This
typology is becoming more commonly accepted in research and practice set-
tings and corresponds well to existing research on violence (e.g., Gottman
et al., 1995; Holtzworth-Munroe and Stuart, 1994). Knowing the various types
of violence has important implications for practice (e.g., Greene & Bogo,
2002).
In assessing for violence, several factors are important to consider. First,
it is helpful to realize that violence is very common but often hidden. 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).
There exist helpful guidelines on assessing for violence in MFT (e.g.,
Bograd & Mederos, 1999; Greene & Bogo, 2002; Jory, 2004), and these as-
sessment findings will help determine what decisions clinicians should make.
For example, it may be the best practice to separate couples into standard
perpetrator/victim groups when intimate terrorism is found. However, for
milder types of violence (e.g., situational couple), it may be appropriate to
treat couples conjointly (e.g., Greene & Bogo, 2002; Stith, McCollum, Rosen,
Locke, & Goldberg, 2005). Couple treatments may be helpful for some types
of violence, since many couples experiencing violence do not want to sepa-
rate but do want the escalation and violence to stop (Stith et al., 2005). Also,
situational couple violence may be seen as the result of mutual provocation,
and conjoint treatment can help violent men and women recognize things
 Contemporary Theories and Violence 37

that trigger their violence, take responsibility for their actions, and leave
provocative situations (Goldner, 1998).
In order for couple work to be feasible, several factors must be present.
First, both spouses must agree to participate in therapy, and the violent
member must take full responsibility for any violence (or if the violence is
mutual, the male is willing to acknowledge his greater threat or physical
power). In addition, the violence should have been minor and infrequent,
and not based on intimidation or control. The therapist should ensure that
there are no risk factors for lethality and that there is no fear of retaliation
on the part of one partner following therapy (Bograd & Mederos, 1999).
If a therapist has carefully assessed for violence risk when working with
individuals or couples in therapy, then they need to consider how their
theoretical approach may fit for use when violence issues are present. We
will now look at systemic treatment of violent couples from several contem-
porary family therapy theories, including collaborative language, narrative,
solution-focused, and emotionally focused therapy theories. We will discuss
the philosophies of treating violent couples for each of these theories, as
well as recent studies on the effectiveness of using these models to treat
violent couples. We will conclude by talking about future directions for the
field of couple therapy in the treatment of couple violence.

CONTEMPORARY FAMILY THERAPY THEORIES AND TREATMENT

OF VIOLENCE

Many of the critiques of treating violence systemically list traditional or early

MFT theories that are closely tied to systemic assumptions (e.g., Structural,
Bowen Family Systems Theory, or Strategic—see for example, Hare-Mustin
et al., 1999). While there are legitimate concerns about treating violence with
traditional assumptions, we were interested to know how newer (contem-
porary) theories address issues related to violence. Contemporary theories
of family therapy are often more sensitive to culture, gender, power, or so-
cietal influences than were early MFT theories. Many contemporary theories
are founded in postmodern philosophy, which emphasizes creating meaning
through language construction and relationships. In addition, most contem-
porary theorists espouse the belief that the relationship between a therapist
and his/her clients should be collaborative, rather than hierarchical. Most
contemporary theories are strength-based, focusing on what clients do well,
rather than what is going wrong. These issues are relevant when considering
violence in treatment.
In this review we critique four contemporary approaches that have be-
come well accepted in the last two decades: narrative, collaborative language,
solution-focused, and emotionally focused therapy. The first three of these
38 M. Oka and J. B. Whiting

theories are founded in postmodern assumptions (Nichols & Schwartz, 2007).

Emotionally focused therapy is not considered a postmodern theory, and it is
founded on systems philosophy. However, it was included in this review be-
cause it espouses some postmodern tenets, such as de-pathologizing clients
and validating marginalized narratives that are important considerations in
treating violent couples (Johnson & Denton, 2002). Also, it is a newer model
that specifically addresses the issue of violence in a way that early models
did not.
One initial question we had in reviewing these contemporary, collabo-
rative treatments was how they handle collusion in therapy. In other words,
how can one maintain a collaborative, respectful stance with someone who
very well may be distorting what is happening in the relationship? Research
has shown that those in violent relationships tend to minimize, deny, or lie
about the amount of violence in the relationship, as well as their roles and
responsibilities (Logan, Walker, Jordan, & Leukefeld, 2006; Whiting, 2008).
Many therapists get recruited into believing the distorted picture that is pre-
sented, and many abusers are very persuasive, charming, and manipulative
(Goldner, 1998; Jory, 2004). While this may always be a challenge, and prob-
ably needs to be reviewed on a case-by-case basis, it is worth reminding
therapists that this point needs special attention when working with those
who present with issues of violence. In our review of these theories, we
attempt to identify how each of these approaches might deal with distortion
and avoid colluding with clients.

Narrative Therapy
Narrative therapy relies heavily on social constructionist assumptions about
how humans create meanings in their lives through interaction and lan-
guage. Rather than the therapist possessing the ultimate knowledge of truth,
truth is seen as co-created between therapist and client. A critique of narra-
tive therapy has been its departure from systems theory (Minuchin, 1998).
Indeed, narrative therapists believe that viewing clients in systemic terms
promotes the “therapist as expert” position, which devalues the knowledge
and richness of the client’s experience. In addition, narrative therapists see
systemic thinking as reinforcing the idea that problems are inherent in the
family system. Given that, it is not surprising that much of the literature on
narrative therapy and violence focuses on an individual or group therapy
approach (Augusta-Scot & Dankwort, 2002; Draucker, 1998; Jenkins, 1990).
These scholars have highlighted some of the strengths of narrative therapy
in dealing with violence in individuals. For example, narrative therapy cel-
ebrates the “unique outcomes” of survival and resilience that may occur
within a dominant narrative of suffering and victimization in women who
have been battered. Also, by externalizing problems, women who have been
battered recognize that they are not victims as they recognize that the abuse
 Contemporary Theories and Violence 39

is outside of them and not a part of their identities (Draucker, 1998). Further,
narrative therapy does not pathologize women’s responses to male violence,
the way problem-focused therapies tend to.
Augusta-Scot and Dankwort (2002) contrast a narrative approach to bat-
terer intervention programs with the traditional psychoeducational model
of batterer intervention programs. While psychoeducational groups tend to
focus on power, patriarchy, and anger management, narrative groups allow
batterers to talk about their own narratives of injustice. At the same time,
a narrative group also works within a pro-feminist structure that highlights
cultural constructions of gender and oppression. While narrative therapy al-
lows for men to talk about the injustices they feel they have suffered, this
storytelling is used as a way to invite individuals to place their choices in
context, not to excuse them (Jenkins, 1990). A narrative approach does not
focus on coercing batterers to admit to violence or telling men they are
wrong when they view their partners as deserving violence. The narrative
group challenges men to take a look at their violence and how it has affected
their lives and their relationships. Group facilitators work to externalize these
stories as part of a construction based on destructive cultural norms, such as
those involving patriarchy and male entitlement, as well as destructive beliefs
enforced by their families of origin. In these groups, men recognize the rela-
tionship between their destructive cultural/familial beliefs and their violence.
Their violence is reframed as injustice similar to what they have experienced
in their own lives from their families and society. This externalization helps
men to realize that their experiences with injustice have fostered in them a
desire for equality, and it reframes stopping relationship violence as a way
to take a stand against injustice.
Jenkins (1990) describes a narrative therapy–based program for men
who are violent. He advocates a theory of restraint—that men generally tend
to relate respectfully, sensitively, and nonviolently unless restrained from
doing so by harmful traditions, habits, and beliefs. His program involves
inviting men who behave violently to address their violence and to argue for
a non-violent relationship. Therapists invite men to examine how misguided
efforts to achieve desired goals for relationships have led to violence that has
escalated over time. Men externalize patriarchal beliefs that act as restraints,
and they acknowledge times when they have not been restrained by these
beliefs. The therapist offers “irresistible” invitations to challenge restraints.
Such invitations may take the form of “Can you handle a marriage in which
you control your own violence, or do you need [your partner] to try to
control it for you by keeping her mouth shut/walking on eggshells around
you?” (Jenkins, 1990, p. 88). The man is then invited to consider his readiness
to take new action, plan new action, and discover evidence of new action
in his life.
Jenkins makes it clear that individual therapy for violence is appropriate
until the man takes responsibility for his violence. Couple work with this
40 M. Oka and J. B. Whiting

model is similar to individual work, as it invites both partners to challenge

their restraints related to violence. The woman is invited to examine her
restraints from accepting responsibility for her own actions and declining
responsibility for her partner’s actions. She is invited to externalize cultural
and family influences that have kept her from taking responsibility for her-
self. While monitoring safety of partners, the therapist invites the couple
to translate their ideas into actions and to anticipate obstacles. Couples are
counseled to avoid premature trust, and the man is invited to be sensitive
and understanding to his partner’s experience. Jenkins warns of couples who
report no violence by avoiding conflict. When a man has taken responsibility
for his feelings and has not engaged in violence for some time, a therapist
may challenge him to face up to conflicts in a nonviolent manner. Partners
are invited to strike a balance in terms of responsibility of maintaining the re-
lationship. In addition, partners are encouraged to achieve a healthy balance
between autonomy and togetherness in their relationship.
In an ethnographic study of therapists, O’Connor, Davis, Meakes, Pick-
ering, and Schuman (2004) found that half of therapists interviewed about
their experiences as narrative therapists had concerns about treating vio-
lence. Therapists reported feeling themselves switching from a postmodern
perspective (viewing the multiple realities of the situation) to a modernist
perspective (seeing violence as a matter of right and wrong). In their discus-
sion of this theme, the authors note that this may be a problem of beginning
narrative therapists. However, they also note that more research should be
done on narrative therapy and family violence. Specifically, studies should
explore the issues to consider when deciding if postmodern theories like
narrative are appropriate in working with family violence.

Collaborative Language
Collaborative language therapy is a postmodern theory that places empha-
sis on the way people explain their lives through their stories (Anderson
& Gehart, 2007). It assumes that humans each create their own meanings
for the language that they use and that couples have to make a deliberate
effort to understand one another. A collaborative language therapist works
to create a space where people can talk to one another and understand the
meanings the other makes of their world. The therapist is not a casual ob-
server of the couple’s process. Rather, he/she works actively with clients to
produce solutions to their problems. In this type of therapy, a therapist can-
not superimpose his or her view of what a violent couple looks like. Terms
like “battering,” “perpetrator,” and “victim” may be seen as limiting. Such cat-
egories or labels may restrict clients’ views of themselves to only these labels.
Levin (2007) detailed a study using collaborative language therapy with
women who were battered. Levin uses the language “women who have been
 Contemporary Theories and Violence 41

battered” to delineate between the client and her problem. Using qualitative
methods, this study focused on themes that are not commonly addressed in
quantitative studies. Such themes included feeling guilty for provoking her
partner and the feeling that she did not want to leave. Such themes have
systemic implications, even in the context of a relationship characterized as
battering.
In discussing clinical implications, Levin lists positive and negative rea-
sons to treat violent couples from a collaborative approach. Levin addresses
the notion that violent couples may distort or minimize the amount or the
role of violence in their relationship. She also points out the fear that couples
who discuss conflict in therapy may get inflamed in session, causing them to
be violent at home. In defense of treating violent couples in therapy, Levin
points out that couples who are turned away for couple therapy because
they are violent may not seek treatment elsewhere. One of the themes of
Levin’s research is that women who have been battered do not feel that
others hear them in their community. She points out that a therapist’s failure
to treat a violent couple seeking couple therapy may be another instance in
which this couple does not feel heard.
Levin then offers some considerations for treating a couple from a col-
laborative language lens. First, the therapist must determine how invested
each member of the couple is in therapy. In addition, the therapist must as-
sess how willing the couple is to discuss the violence. A couple’s willingness
to discuss violence in therapy indicates that they are acknowledging it as a
problem, which may indicate that the couple has begun the change process.
Collaborative language therapists create an environment for couples to tell
their stories—even if these stories are stories of violence. Working with a
couple systemically means that the therapist works to emphasize both sides
of the story and to help both partners be a contributing influence in telling
and modifying the story in the therapeutic process.
Another aspect of the collaborative relationship in this type of therapy is
the openness of the therapist. A collaborative therapist may be explicit about
what research and clinical experiences suggest about violence, including
escalation, the connection between violence and alcohol, and women having
a hard time leaving abusive relationships. However, a collaborative therapist
would take a not-knowing stance, asking the couple for their opinions about
these findings, and, in particular, about their own experiences, rather than
assuming an expert role. The therapist would ask for the couple’s input on
how to handle violence if it occurs during the course of therapy so that
intervention continues to be collaboration between the therapist and the
couple. Often, violent couples are wary of legal and other authority figures.
By maintaining a collaborative stance, the therapist may be able to approach
violent clients as a peer interested in helping them, rather than as an authority
figure ready to punish them.
42 M. Oka and J. B. Whiting

Solution-Focused Brief Therapy

Solution-focused brief therapy (SFBT) grew out of early systemic theories
and claims to be a systemic theory. However, SFBT is seen as a more prag-
matic alternative to traditional family therapy theory and is also considered
a postmodern theory due to its assumptions about the power of language
to create reality (de Shazer et al., 2007). Unlike traditional systemic theories,
SFBT focuses on solutions rather than the problems. SFBT also focuses on
the future, in which the problems are solved, rather than the past, in which
the problems were created. In SFBT, the therapist decides who in the sys-
tem to treat based on who comes to therapy, in the postmodern tradition
of not imposing a therapist’s reality on the clients. Further, SFBT is systemic
because the solutions explored in therapy are inherently interactive. In ad-
dition, SFBT maintains the systems theory tenet that if change occurs in one
part of the system, it will radiate out into other parts of the system.
SFBT has been used to treat both those who have perpetrated couple
violence and those who have had violence perpetrated against them. Accord-
ing to SFBT’s assumptions, a therapist could work with an individual member
of a violent couple, and that could change the violent dynamic of the couple
(Milner & Singleton, 2008; Lee, Sebold, & Uken, 2007). By working with
one partner to change his/her individual behavior, whether or not he/she is
violent, it will change the pattern of interaction in his/her relationship.
Like other postmodern theories, solution-focused therapy tries not to
pathologize couples coming in for any issue, including violence. Stith et al.
(2005) have developed a solution-focused model of couple therapy with do-
mestic violence. They suggest that it is insufficient to only work with individ-
uals in traditional violence treatments. In their view, changing one partner’s
violence is not likely to change the couple violence if it is mutual. They also
acknowledge that batterer intervention programs do not address relationship
difficulties that may be contributing to violence. The authors also argue that
failing or refusing to provide services for both partners may be destructive
should the partner who is being abused choose to stay in the relationship.
Stith et al. (2005) outline this approach in the domestic violence focused
couples therapy model (DVFCT). Therapists can use this model of therapy as
a means of assessment as well as treatment. The authors reiterate that only 6%
of women who seek treatment identify violence as a problem during intake.
However, during a violence assessment, 53% admit that there has been
violence in the relationship. This finding supports others who suggest that
people in violent relationships may choose not see the violence as a problem
or may minimize the scope of the violence due to fear of consequences
from their partners or because it is shaming (see also Jory, 2004; Whiting
& Oka, 2009). Even though they operate within an SFBT framework, Stith
et al. (2002) still promote practical steps of assessment, including having
therapists conduct interviews about the violence with each of the partners
 Contemporary Theories and Violence 43

individually and having couples fill out violence assessment instruments

(e.g., the Conflict Tactics Scale) in separate rooms. The therapist ensures
that both partners have voluntarily consented to therapy and that there has
been no severe violence, such as injury or hospitalization. In keeping with
research on batterers, the therapist also assesses to make sure that neither
partner has been violent outside the home. Finally, therapists have the couple
sign a no-violence contract.
In the Stith et al. model, prior to beginning treatment, couples complete
6 weeks of anger management courses in gender-specific groups. These
groups focus on accountability and responsibility for anger and violence, and
they give facilitators of the groups the opportunity to encourage individual
therapy if they deem it necessary.
In outlining the program’s theoretical basis for treatment, the authors
make the distinction between primary and secondary theoretical orientations.
This means that while the authors adhere primarily to SFBT tenets in their
work with violent couples, they are not philosophical purists. Here, the
authors seem to be acknowledging the difficulties encountered by beginning
narrative therapists (O’Connor et al., 2004), that it is difficult to maintain
postmodern stances of social construction and collaboration when dealing
with a subject like violence. They acknowledge that while their primary
theoretical orientation is SFBT, they must rely on other pragmatic orientations
when tenets of SFBT do not fit with treating violent couples, such as when
safety is threatened. The authors highlight the strengths-based appreciative
stance as a principle from SFBT that they retain when working with violent
couples, meaning that clients are competent and bring their own strengths
and resources into therapy. Other SFBT interventions include helping clients
create detailed descriptions of solutions to help clients reach their goals
and to collaboratively identify changes that have already happened in the
client’s lives. Therapists also describe their clients’ lives as fluid to help them
recognize already-existing solutions. In addition, the goals that clients set for
themselves structure treatment, rather than goals imposed on the couple by
the therapist.
For this model to be successful the couple must be intrinsically moti-
vated to end violence in their relationship—the therapist will not impose
that goal on the couple, even if he/she discovers violence is present in the
relationship. For this reason, the assessment phase is critical for working with
violent couples to determine their commitment to ending violence in their re-
lationships. However, an SFBT therapist recognizes that there is no one way
to treat a problem and that each couple can and should find their own path
to a solution. After addressing the tenets of SFBT that the DVFCT program
adopts, the authors discuss constraints that may prevent a therapist from
using SFBT in treating violent couples. These constraints include the recur-
rence of violence, and lack of progress if the perpetrators do not understand
how much pain and suffering has been caused by their violence. In working
44 M. Oka and J. B. Whiting

with violent couples, the authors acknowledge that therapists must be more
directive and instructive than an SFBT therapist would normally be.
In addressing pain and anger related to violence, the authors acknowl-
edge that it may seem to run counter to SFBT’s focus on future events and
strengths. However, they cite de Shazer and Isebaert (2003) on the impor-
tance of “honoring the problem,” pointing out that clients who feel like their
pain is not being acknowledged can feel marginalized and unheard. In order
to help her partner understand her suffering, a woman may present her story
with emotion not typically accessed in SFBT. However, helping the couple
discuss and validate one another’s pain will help the couple get to a place
where they are able to take a more solution-oriented view. The therapist can
then use more solution-focused questions like, “What will your partner be
doing the next week that will tell you that he now really understands the
effect the abuse had on you?” (de Shazer and Isebaert, 2003, p. 422).
The authors also address problems associated with relapse in violence
as well as other problematic behavior. As SFBT therapists, the authors ad-
dress the discouragement clients are prone to feel when they have relapsed,
and the fear that things will never change. From an SFBT perspective, it is
important to ask strengths-based questions and to look for exceptions to
the problems. The therapist may ask questions related to the couples’ ability
to limit the relapse. However, when therapists are dealing with violence,
the primary concern must be for the safety of the couple. Therapists may
interview the partners individually to determine if conjoint sessions should
continue and to determine a safety plan.
Last, the primary aggressor may be frustrated with his/her partner’s lack
of trust. While the therapist and the couple should expect that the trust will
happen as a result of the steps the couple is taking to manage their anger
and become nonviolent, they must also recognize that trust may not happen
quickly or easily. The aggressor is encouraged to be sensitive to his/her
partner’s experience. The therapist, again, uses strengths-based questions
to help the aggressor talk about how he can be more understanding, for
instance, “How can you show her that you are prepared to be patient?”
or, “How will you resist the urge to demand her to trust you prematurely?”
(Stith et al., p. 424).

Emotionally Focused Therapy

Emotionally focused therapy (EFT) combines experiential therapy with sys-
tems and attachment theories. EFT therapists ask their clients to be emotion-
ally vulnerable with one another in order to strengthen or repair attachment
bonds. Part of EFT’s success with couples comes from how it changes the
focus to primary emotions such as sorrow and fear instead of secondary emo-
tions such as anger. By treating the primary emotions, therapists help cou-
ples stop their anger from escalating, which, in turn, may help situationally
 Contemporary Theories and Violence 45

violent couples avoid getting to the point of using violence against one an-
other. EFT has been empirically studied in many situations (Wood, Crane,
Schaalje, & Law, 2005). However, the founders make explicit their philos-
ophy of working with violent couples, stating that it is not an appropriate
model of therapy for violent couples. Johnson gives theoretical rationale for
why this is so:

EFT is not used . . . where there is ongoing abuse and violence in a

relationship, or where there is evidence that the exposure of vulnerability
will place a partner at risk, as in the case of a highly verbally abusive
husband who in the session unrelentingly demeans his partner, mocking
her when she speaks of her suicidal depression (Johnson, 2004, p. 114).

It may be that this is referring to only the more severe types of violence, as
we will discuss later. There is EFT scholarship that suggests that are aspects
of this approach that address violence. For example, studies on EFT with
trauma survivors (Woolley & Johnson, 2005) have led researchers to draw
connections between trauma and violence. The authors state that working
with couples where trauma has occurred, in either childhood or adulthood,
is different from working with other couples. Traumatized couples tend to
have more distress and more difficulty regulating their emotions. They have
a harder time turning to one another for comfort. Consequently, couples
may find themselves resorting to violence or substance abuse in an effort
to cope with their emotions. Woolley and Johnson highlight the need for
psychoeducation regarding trauma. However, they do not address what to
do with couples where violence has taken place as a result of trauma. Susan
Johnson clarified this in an address to the Texas Association of Marriage and
Family Therapy (2009) by distinguishing between violence and abuse: In
her definition, abuse occurs in a relationship when one partner feels he/she
has no voice, or when one partner is scared of or dominated by the other
partner. Johnson made it clear that EFT should not be used with couples
where control and fear are part of the relationship. In the absence of this,
violence is treated in the context of EFT like any other relational problem.
Johnson’s definition of abuse in this context mirrors intimate terrorism and
supports the notion that conjoint therapy should not be done with intimate
terrorist couples but may be applicable with situationally violent ones.
Jarry and Paivio (2006) describe how EFT could be used with individuals
in the treatment of anger and aggression. The authors make a case for couple
therapy in this context, citing the therapeutic environment as a safe place
for couples to express emotions without fear of angry outbursts. They place
strong emphasis on the therapist’s ability to validate clients as a means to
deescalate anger. In addition, they write about couples continuing reparative
work outside the therapy session. In this way, the authors put a lot of trust in
a couple’s ability to be vulnerable with one another, and in the experiential
46 M. Oka and J. B. Whiting

elements of therapy to enable the continuation of the secure environment of

the therapy room in the couple’s home.
Paivio and Carriere (2007) describe spousal abuse as “instrumental
anger” and discuss how to treat instrumental anger using EFT. Instrumental
anger is used to control others. They point out that individuals who use
anger and aggression to get their desires accomplished often lack awareness
of feelings other than anger. To intervene with instrumentally angry people,
the authors suggest confronting them, helping them to access their needs,
and then teaching them more adaptive strategies to accomplish their goals
and desires. Implicit emotion coaching involves the therapist’s responses
that help direct clients to access and label their emotions. Emotion aware-
ness training borrows from dialectical behavior therapy (Linehan, 1993).

DISCUSSION

The treatment of intimate partner violence is a subject that is complex and

fraught with challenges. However, as discussed, there are times when family
therapy theories may be appropriate to work with individuals or couples who
have experienced violence. We will summarize some of the main clinical and
research implications for each theory that has been discussed.

Narrative Therapy
Few studies have focused specifically on narrative therapy with violent cou-
ples. However, Freedman and Combs (2002) assert that narrative therapy is
as applicable to “couples struggling to reclaim their relationship from vio-
lence and abuse,” as it is for couples presenting for other types of couples
therapy (p. 322). Again, this may suggest an application for couples where
both members are willing to own their role in the violence and are willing
to resist the invitation to blame the other. Jenkins’ discussion of narrative
therapy with violent couples outlines a protocol in which couples are en-
couraged to do just that. O’Connor et al. (2004) in their study of beginning
therapists indicate that, while beginning therapists may not understand how
to treat violent couples using narrative therapy, as their understanding of
and training in narrative therapy increases, these insecurities will be over-
come. However, the authors do not cite any studies in which therapists have
done this, or give any guidelines as to how this is to be done, especially
when safety is in question. Following the assertion by Freedman and Combs
(2002), it may be presumed that a narrative therapist would work with a
violent couple the same way he/she would work with any other couple,
by listening, questioning, externalizing the problem, and looking for unique
outcomes. However, future research could include studies following up on
 Contemporary Theories and Violence 47

the O’Connor et al. study, focusing on how therapists with more experience
treat violence, as well as how they feel about their abilities to do so.

Collaborative Language Therapy

Like the DVFCT model, Levin’s (2007) model of treating couples using col-
laborative language therapy stipulates that couples not be violent during
therapy. Levin agrees with the DVFCT model that the therapist not impose
his/her solutions on the couple. Rather than imposing a safety plan at the
outset of therapy, the therapist collaborates with the couple to determine
what the couple will do if they relapse into violence during therapy. In this
way, Levin sidesteps the problem of the therapist imposing his/her reality
on the couple in an order to keep them safe. Levin does not address issues
of control or power in the context of an intimate relationship. This may
be important for therapists working with couples whose relationships are
characterized by battering or intimate terrorism. The reality that the cou-
ple presents may be distorted (Whiting, 2008), which would complicate the
couple’s ability to collaborate with the therapist to solve their problems. Fu-
ture research or expanse of this particular model of treatment could include
addressing these issues of control or power.

Solution-Focused Brief Therapy

Stith et al. (2002) discuss where they see SFBT as inadequate for working
with couples, particularly when the therapist needs to set boundaries about
violence. One of the ways in which DVFCT does this is by requiring an anger
management course, which has both psychoeducational and group therapy
qualities. While it may be seen as a critique of this model that it cannot remain
theoretically consistent when working with specific populations, it can also
be seen as a strength that the authors are not so rigid in their theoretical
beliefs that they have lost sight of the importance of safety in working
with violent couples. It can also be seen as a strength in that the authors
acknowledge the departure from the theory and articulate justification for
their departure. In working with violent couples, it is important for clinicians
to prioritize the safety of the couples above allegiance to a particular model.
In addition, the authors detail the process of “honoring the problem,”
which may mean delving into the emotions of the partner who feels hurt
and betrayed by the violence, and helping the other partner acknowledge
and validate the hurt. While this was a concept developed by de Shazer,
it seems on the surface to be a departure from the traditional SFBT model,
which focuses on the future rather than past pain, as well as the problem
rather than the solution. However, SFBT is based on pragmatism, rather than
on theory. De Shazer et al.’s (2007) concern for making sure the client’s pain
does not go unacknowledged indicates an understanding that if the client
48 M. Oka and J. B. Whiting

feels unheard and invalidated by the therapist or his/her partner, therapy

has little chance of progressing, and clients will have a harder time focusing
on future solutions.

Emotionally Focused Therapy

Johnson (2004) addresses the issue of violence explicitly by saying that EFT is
not suitable for couples that continue to be violent during treatment because
the process of EFT can leave an abused partner vulnerable to being mocked
and demeaned. Johnson’s initial summation of violence fails to take into
account the possibility that violence may be systemic, although her later
work (2009) makes provision for systemic treatment of violence. However,
the question of safety in working with couples, for either the couple or the
therapist is not answered in EFT literature. While Paivio and Carriere (2007)
addresses the use of EFT with anger and aggression, it is never discussed
as a treatment for violent couples. It is viewed as an individual problem,
rather than a problem of mutual escalation. Despite the fact that Paivio and
Carriere’s (2007) works do not mention it, the methods Paivio uses could
easily be applied in a couple setting, using principles of EFT to teach couples
how to de-escalate their conflict before it becomes violent.
Although there appears to be limited research on using EFT with vio-
lent couples, certain tenets of EFT seem to lend themselves well to working
with situationally violent couples. EFT has its theoretical basis in attachment
theory in that it states that couples get angry and lash out at one another
because their attachments to one another have been injured. These attach-
ments to one another constitute a basic biological need. Holtzworth-Munroe
and Clements (2007) explained partner violence in terms of attachment, the-
orizing that people whose attachment needs are unmet may react with high
levels of anger and violence. In other words, the violent partner may feel
the threat of abandonment or separation from his/her partner and protest
it with violence (Dutton, 1995). It may be helpful for clinicians working
with violent couples to view the violence as a response to an attachment
threat, and to address attachment needs in therapy. Further research with
EFT could include research on its effectiveness at cessation of situational
couple violence.

Summary and Cautions

There are a few things which the various theories seem to support in working
with violence. All imply that they are concerned with the safety of both
partners. All presuppose that, while the violence may be mutual, the man
is likely to be a more serious aggressor, if only because of his size and
strength (Johnson, 1995). All stipulate that in order to work with violent
couples, the violence must be infrequent and minor, with no severe injuries
 Contemporary Theories and Violence 49

or hospitalization. All theories recognize that both partners must be willing to

participate in therapy and be willing to change. Not all the literature reviewed
adequately described a specific procedure for treating couples. However, the
studies that did acknowledged the importance of safety and the process of
working safety into theory, or the justification for putting aside the theory
for the sake of safety.
This review was not without limitations. To limit the scope of the study,
only a few contemporary theories were reviewed. The only theories that
were included in the study were those that either described treatment of
violent couples or gave rationale for not treating violent couples. There
were some contemporary theories, such as internal family systems theory
that were not represented at all, as well as integrative approaches (O’Leary
& Vega, 2005) that were not reviewed in order to keep the article focused.
Some have addressed violence in more detail (e.g., SFBT) and were therefore
given more attention in the body of the article. In addition, while several
literature searches were conducted to find all studies related to these four
contemporary theories, there is a possibility that other studies exist that were
not reviewed here.

Future Directions
With the exception of DVFCT, none of the contemporary theories reviewed
have empirically validated their models for working with violent couples.
Further research should include both the development and the empirical val-
idation of specific models of treatment, including quasi-experimental studies.
For example, the principles discussed in narrative approaches for treating vi-
olence (e.g., Jenkins, 1990) could be further refined into a more specific,
manualized treatment, progressing through specific types of assessments
and interventions. These treatments could then be implemented in quasi-
controlled settings and applied with various types of populations. However,
the size and scope of such studies may make them difficult to accomplish
without funding and resources. Other types of research could add evidence
to the application of these theories, including interviews or focus groups with
clients who have experienced such treatment, or with therapists who pro-
vided them. Case studies detailing treatment of violent couples using specific
theoretical models would also be useful to help clinicians understand how
one might approach these issues from a specific model (e.g., White, 1988).
This review has implications for MFT training programs. Supervisors
who work with therapists in training need to be aware of violence indicators
and help supervisees do the same. The decision whether to treat couples
where violence is an issue that should be addressed in training programs,
regardless of the models being used. This review may help therapists better
understand how to assess for violence, the parameters for seeing violent
couples conjointly, and how to be faithful to a model while doing so. Given
50 M. Oka and J. B. Whiting

the scope and severity of the problem of violence in intimate partnerships, it

is important for MFTs of all theoretical orientations to be prepared to address
this issue when it arises in the therapy room.

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