Introduction
One of the most pertinent issues related to abuse is domestic violence (DV). According to Gulati & Kelly (2020), DV can include physical, sexual, emotional, and financial abuse, as well as dominating or forceful acts and behaviors. Domestic violence, also known as intimate partner violence (IPV), disproportionately affects women, with roughly one in every three women experiencing physical or sexual assault at some point in their lives (Gulati & Kelly, 2020). As such, Pantra et al. (2018) define IPV as “any behavior within an intimate relationship (married, unmarried, and live-in) that causes physical, psychological, or sexual harm to those in that relationship” (p. 494). In other terms, DV occurs when a person physically hurts their partner, spontaneously or intentionally. Common effects of DV and IPV include fear, safety concerns, posttraumatic stress disorder, and injury. Domestic violence entails oppression and control in relationships, often encompassing different kinds of non-physical and physical abuse happening concurrently. While DV can exist between a parent and their child, siblings, or housemates, IPV can occur solely between romantic partners who might or might not share a household.
Many nongovernmental and governmental agencies have recognized this issue as a critical social problem. Moreover, approximately 10 million individuals are abused by their partners each year in the US, with nearly half the female population reporting emotional abuse (Goelitz, 2020, p. 15). Contact sexual violence affected one in every three women and one in every six males. One in every six women and one in every nineteen men have experienced harassment by an intimate partner at some point in their lives (Pickelsimer, 2020, p. 6). People in non-heterosexual relationships likewise experience domestic violence problems. For example, Lutgendorf (2019) underlines that in both heterosexual and same-sex relationships, IPV can occur, albeit the risk is more significant in non-heterosexual couples. Furthermore, economically and socially underprivileged groups in the United States often experience high levels of domestic violence compared to other groups. For instance, more than half of Native American women have been physically assaulted by a spouse or partner (Kong et al., 2018). Thus, DV and IPV are crucial issues that annually impact multiple people in the US, especially women. As a result, the present paper aims to find the best assessment for the impact of DM and IPV and describe several prevention programs and treatment approaches related to the problem.
Assessment Question
As described earlier, the female population is at the highest risk of DV and IPV, especially those that have already encountered it. As a result, it is essential to address the need to prevent violence against women by providing an appropriate assessment that concerns the level of crisis in the patient’s relationship. Thus, an appropriate assessment question is how to identify, monitor, and recognize a high level of risk of further DV and IPV severity for a female victim in an heterosexual abusive romantic relationship.
Assessment Search Strategy
As follows from the question, the specific population for the assessment is female victims in heterosexual abusive romantic relationships. The specific problems of such clients include the possibility of physical, sexual, financial, and psychological abuse, as well as the risk of significant harm and death. Therefore, to identify the most suitable assessment protocols for preventing IPV, a set of keywords will be employed, as well as a specific focus on female safety and psychological health scholarly journals. The keywords include positive screening for DM, IPV critical incidents, degree of abuse, IPV impacts on health, IPV risk assessments, and suicide assessments.
Suitable Assessment Protocols
The high prevalence of DM and IPV cases in women’s lives necessitated forecasting future violence based on scientific knowledge in order to mitigate this risk. As a result, several risk assessment tools have been found, two of which are described in the present paper. Both assessment protocols measure the danger in a violent relationship and use the knowledge to plan aggressor control and victim protection.
The updated Danger Assessment (DA) is the first relevant assessment protocol of relevance. The DA represents a threat assessment tool to help women victims estimate their risk of homicide or serious harm at the hands of current or past male partners (Garcia-Vergara et al., 2022). The researchers utilized updated versions of the instrument to test it on battered women (with additional risk factors of homicide). Based on input from representative victims, the DA was developed into a culturally relevant risk evaluation framework for abused immigrant women. The updated versions of the DA include 20 items and 15 risk variables for intimate relationship femicide (Garcia-Vergara et al., 2022, p. 10). These include, for example, an increase in the frequency and intensity of violence, the availability of armed firearms in the home, sexual abuse, the batterer abusing drugs and being intoxicated regularly, and being aggressive outside the home. The instrument has four degrees of hazard based on how many statements are confirmed to be true.
Since the DA has versions adapted for immigrant women, it supports several languages, which increases the assessment feasibility. Moreover, the short form and long years of practice with little resources make it feasible. Internal consistency reliability and interrater reliability were the approaches most commonly utilized to establish tool dependability (Garcia-Vergara et al., 2022). The first pertains to the degree to which the various components of an instrument work together to consistently assess a construct, as measured by Cronbach’s coefficient. Hence, the reliability measured by the intraclass correlation coefficient is 0.83 for the updated version of the DA, which is considered high (Garcia-Vergara et al., 2022, p. 12). Furthermore, the predictive validity of the tool is measured through criteria such as sensitivity and specificity ranging from 0.69 to 1 and from 0 to 0.62, both higher in the intense danger level (Garcia-Vergara et al., 2022, p. 12). The DA and guide that supports it can be found online, which makes it accessible to multiple professionals. The assessment is appropriate for the identified population since it has been specifically designed for females who repeatedly experience violence and provides trauma-related questions.
Next, the Severe Intimate Partner Risk Prediction Scale (SIVIPAS) might be seen as a suitable assessment tool for the identified population. The SIVIPAS contains 20 items, some of which are comparable to those in the DA (Garcia-Vergara et al., 2022, p. 12). Detachment, harassment, escalation of violence, death threats, threats with harmful objects or firearms, sexual abuse, excessive jealousy or controlling tendencies, and other behaviors are examples. The components different from DA include a male or woman immigrant, breaching protection orders, physical violence in front of others that causes injury, the desire to inflict serious injuries, a man with a mental disorder, justification for violent behavior, and others. The assessment categorizes risk into three degrees based on positive replies to questions.
SIVIPAS’s feasibility is likewise to DA’s due to the ease of implementation and simplicity of instruction and interpretation of the results. As for reliability, Garcia-Vergara et al. (2022) report it to be 0.71, which is slightly higher than the accepted 0.70 (p. 12). Moreover, “SIVIPAS has a sensitivity ranging from 0 to 0.138 to 1 and a specificity from 0 to 1” (Garcia-Vergara et al., 2022, p. 13). Hence, it has less predictive validity than DA due to its lesser ability to recognize acute cases. Unfortunately, information regarding SIVIPAS is present only in the article in Spanish and secondary sources, which makes it not available to a large audience. However, SIVIPAS seems appropriate for the specific needs of IPV female victims due to its questionnaire content and reliability.
Effectiveness Question
The severity and widespread nature of the problem make it a prominent topic for prevention and treatment proposals. As such, it is essential to identify the specific efficient methods that can help a female victim of IPV either before or after the outbreak of abuse. Thus, at this point, the question should be whether there are evidence-based prevention and treatment approaches for female victims of IPV or DV that could be found and used by the aforementioned victims.
Prevention Programs, Interventions, and Treatment Approaches Search Strategy
To identify several practical approaches to the problem, several strategies were used. For example, to find a prevention program, examples of keywords used to identify prevention programs included educational awareness, professional assistance, gender equality, and nonviolent relationship. The keywords were combined with phrases such as systematic review, IPV, and DV prevention, which were also used with the other two approaches. Secondly, to find an appropriate treatment approach, the employed keywords included anxiety, depression, violence prevention, self-esteem, social support, and stress management since these issues and needs correspond to those present in IPV victims. Thirdly, an intervention was searched through the keywords DV emergency, batterer programs, violence education, and community response.
Suitable Treatment Approach
An effective treatment approach to deal with the problem of domestic violence is cognitive behavioral therapy (CBT). CBT is a type of psychotherapy that assists a patient in determining the connection between behaviors, feelings, and thoughts and how they impact people’s life circumstances. CBT is effective in dealing with various mental health situations and issues. Studies have also shown how this treatment approach effectively manages pervasive behaviors and thoughts (Southward et al., 2021). Thus, CBT assists in breaking the cycle of one’s thoughts or behaviors. Considering that all mental disorders accompany dysfunctional thoughts that result in maladaptive presentations at the behavioral and emotional levels, one can see how CBT is an effective intervention for women facing domestic violence.
CBT is relevant for victims of DV because they often accept abuse since they have deficits in their health, financial status, or behavior. After the therapy, they can quickly exit a relationship when they fail to comprehend that their thoughts have been distorted. CBT can dramatically assist in determining one’s triggers and finding the right tools to manage the circumstances mentally and emotionally. Whereas a person’s new healthy behaviors may not prevent an abuser from continuing their deeds, this treatment approach gives the victim the power and confidence to manage the situation appropriately.
When in a CBT session, victims are often shown how perpetrators employ violence to let out their anger and get compliance. During these sessions, therapists always encourage victims to change their thoughts about violence while improving their anger management strategies, social skills, nonviolent assertiveness, and communication skills (Southward et al., 2021). Typically, CBT deals with the emotions leading to violent behaviors and a person’s perception of women. People engaging in CBT become acquainted with specific skills they can employ to successfully deal with their day-to-day problems and skills they can employ to attain legitimate objectives and goals.
The treatment sessions might prolong for several months, individually or in a group, and combined with participation retention strategies. Considering how many intervention programs for dealing with domestic violence are expensive, many people who experience domestic violence do not seek counseling. However, group treatment is more cost-efficient due to the scale of the service, which makes CBT more affordable for the victims of DV (Southward et al., 2021). Moreover, some sessions are sponsored by community centers that aim to prevent abuse or help its survivors (Southward et al., 2021). Thus, the low cost of group sessions contributes to the rationale behind choosing CBT for IPV consequences treatment. The coping mechanisms that people get while in their CBT sessions assist them in managing their psychological reactions and traumatic experiences they underwent. Moreover, people attending CBT sessions can be assisted in correctly controlling their economic and financial situation.
Next, the approach has a built-in mechanism for increasing its feasibility. For example, after intake and missed appointments, CBT specialists include phone reminders and supportive handwritten letters. As a result, dropout rates are reduced by these actions (Pickelsimer, 2020). Moreover, the CBT approach incorporates self-help, group, and individual protocols concerning the victims’ sociocultural needs, which increases the feasibility of the treatment by satisfying the diverse demand of the individuals.
The level of empirical support for CBT is substantially high. There is no denying how CBT is a psychological treatment with concrete scientific evidence that aims to deal with differential mental disorders. In addition to its effectiveness and efficiency, this treatment approach has been inculcated into major intervention guidelines and is regarded as the first choice compared to other treatment modalities. For example, the majority of the CBT therapy cases studied were more beneficial than not getting therapy, with substantial effect sizes in PTSD, self-esteem, depression, overall distress, and daily functioning (Crespo et al., 2021). Moreover, CBT geared mainly toward IPV survivors had the most significant impact sizes. The success and applicability of CBT are evident in how it drives people to think about violence and situations which cause violence to happen.
Nevertheless, some researchers believe that evidence is still inconclusive concerning the efficiency of CBT in dealing with domestic violence perpetrated by men against women. This criticism is present due to the fact that there are no high-quality randomized controlled trials on the issue (Pickelsimer, 2020). For example, a few randomized assessments of CBT show men who abuse their wives, with most of these studies being done in the US, and these researches use small sample sizes (Pickelsimer, 2020). Thus, a critical suggestion for future research on using CBT in dealing with domestic violence is to stress presenting detailed explanations of the interventions, reporting the study design, and how the study was conducted.
Conclusion
To conclude, DV and IPV are significant issues that primarily affect the female population. To change the dynamic of the existing abuse, researchers and therapists have developed assessment tools and therapies for IPV victims. The present paper has identified that DA and SIVIPAS are the most appropriate protocols for recognizing and mitigating the risks of lethal violence against heterosexual women being abused. Moreover, the most suitable therapy for the mentioned population is CBT due to the possibility of reduced cost, feasibility for diverse needs, and a considerable level of evidence.
References
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