A Qualitative Study of Intimate Partner Violence From a Cognitive-Behavioral Perspective

Abstract

There is growing interest in the application of cognitive-behavioral therapy (CBT) to intimate partner violence (IPV) as a companion or possibly preferred approach to the Duluth model. The literature includes descriptions of adaptions of cognitive-behavioral (CB) treatment to IPV and even some treatment outcome studies. Yet, these adaptions are not typically grounded in the empirical examination of IPV focusing on phenomena specifically relevant to CB theory. The aim of this qualitative inquiry was to examine IPV from a CB perspective to lay the foundation for related treatment and research. Twelve heterosexual victims residing in shelters completed structured audiotaped interviews focusing on CB phenomena, that is, the cognitions, behaviors, feelings, interactions, and conditions victims experienced before, during, and after an IPV incident. Transcripts were coded and analyzed to develop a comprehensive categorized list of discrete IPV phenomena over time. Among the findings relating to violent incidents was indication that despite the progression of abuse that compel couples uncontrollably toward a violent episode, partners often engage in numerous preventive actions that turn out to be ineffective. The findings are ultimately intended to lay the groundwork for an instrument that can more accurately and comprehensively measure IPV phenomena emphasizing CB core concepts. Such a tool could be of benefit to CB therapists and researchers seeking to understand, identify, and target IPV behaviors.

Keywords

intimate partner violence qualitative research cognitive-behavioral

Study Relevance

The predominant practice approach for intimate partner violence (IPV), the Duluth model, yields equivocal outcome results. The aim of the present study was to further an alternative approach, cognitive-behavioral therapy (CBT), for the partners individually or together, which arguably demonstrates superior outcomes. Through qualitatively examining the victim affect, cognitions, behaviors, and conditions surrounding IPV, we hope to better understand and ultimately measure the dynamics of couples in the context of violent interactions. This study of victims was part of a larger research effort that included interviews of perpetrators, which will be reported in a subsequent article.

Treatment Effectiveness

Studies show that the most commonly used programs to reduce domestic violence are largely ineffective, and some actually increase the likelihood of violence (Stop Abusive and Violent Environments, 2013). Babcock, Canady, Graham, and Schart (2007) note that the predominant approach, the Duluth model, although embraced as the treatment of choice in most communities, does not reduce IPV recidivism. Court mandated programs are typically based on the Duluth model, a gender-specific psychoeducational approach that assists participants to unlearn their socioculturally reinforced violent behavior directed toward women. Violence is considered motivated by social norms of patriarchal power and control. Despite the lack of evidence supporting the Duluth model in the treatment of perpetrators, the vast majority of states continue to require this approach in their criminal justice systems (McCollum & Stith, 2008). Outcomes for Duluth-based victim interventions have often been questionable (e.g., see Eckhardt et al., 2013). For example, in a review of 22 studies, Wathen and MacMillan (2003) reported that there is no high-quality evidence-based research supporting the effectiveness of shelter stays to reduce violence (shelters typically employ the Duluth model). Furthermore, Hamel and Nicholls (2007) note that victims have demanded a greater say in intervention alternatives to the Duluth model. Outcomes for perpetrators are also important with regard to victim recovery, and meta-analyses results of court-mandated batterer programs were found to be equivocal (e.g., see Eckhardt et al., 2013; Whitaker & Niolon, 2009). Clearly, other interventions need to be considered, either as replacements or at least supplements to the current prevailing approach.

CBT has received increasing support in the literature as the preferred treatment. CBT has been employed to successfully reduce victim consequences of abuse such as depression and low self-esteem (de los Angeles Cruz-Almanza, Gaona-Márquez, & Sánchez-Sosa, 2006) or reducing depression in IPV trauma survivors (Iverson et al., 2011). In a randomized clinical trial, Johnson, Zlotnick, and Perez (2011) reported on a CBT-based program that yielded reductions in posttraumatic stress disorder (PTSD) symptoms as well as reducing the likelihood of reabuse, gains which continued at their 6-month follow-up. In a review of victim IPV programs, Eckhardt et al. (2013) found the strongest support for CBT in reducing negative symptoms associated with the abuse. The results of a recent meta-analysis of short-term therapies for IPV suggest that CBT-based interventions tailored to IPV survivors demonstrated the greatest improvements (Arroyo, Lundahl, Butters, Vanderloo, & Wood, 2017).

One variety of CBT, relapse prevention (Marlatt & Donovan, 2005), may hold promise as a model to better understand and treat IPV. Born from the addictions field, relapse prevention focuses on many of the same core issues as IPV such as loss of control and high-risk situations. Relapse prevention, as a core intervention in the treatment of IPV victims, has demonstrated effectiveness in decreasing physical, psychological, and sexual violence toward women in a methadone maintenance program (Gilbert et al., 2006), and reducing posttraumatic, depression, and anxiety symptoms for women in a treatment program (Crespo & Arinero, 2010). With regard to perpetrators, Murphy and Eckhardt (2005) provide detailed descriptions of the benefits of relapse prevention for IPV and how it might be applied.

Given the focus of the above CBT intervention to repair abusive relationships, unilateral treatment is possible; however, conjoint treatment might be considered under certain circumstances. Treating IPV couples conjointly is controversial due to the potential danger it may pose to the victim, blame that may be inadvertently shared by the victim (McCollum & Stith, 2008), and potential retaliation or fear of retaliation victims may face (Barnett, Miller-Perrin, & Perrin, 2011). Furthermore, the implicit bias inherent in couples counseling may promote the sustenance of an IPV relationship, often considered pathological, sometimes even dangerous. On the contrary, some argue that IPV may be effectively addressed by ameliorating the couple’s poor communication skills that is common with this population. Also, they may benefit from conjoint interventions to improve problem-solving skills and to learn ways to circumvent entrenched patterns of conflict. Most important, many victims want to repair the relationship and wish to include their partner in this venture (Barnett et al., 2011). Maiuro and Eberle (2008) report that 68% of states have standards that prohibit conjoint counseling in favor of gender-specific treatment, despite the latter’s questionable effectiveness. Still, O’Leary and Cohen (2007) contend that relationships characterized by psychological aggression and infrequent mild levels of physical aggression are good candidates for conjoint therapy. Presumably, intervention may prevent escalation to more serious and frequent violence. They add that research strongly supports couples therapy for IPV as an effective option. This may be because marital problems represent the biggest causal factor in partner aggression and “men’s only treatment groups may inadvertently lead some men to support one another’s negative attitudes and aggressive behaviors toward” their partners (O’Leary & Cohen, 2007, p. 284). McCollum and Stith (2008) described a number of conjoint therapy studies where either CBT or its sister, behavioral therapy, was effective in reducing IPV. One of the studies demonstrated superior outcomes compared with a gender-specific program found in the Duluth model.

In an extensive review of outcome studies that were either randomized or quasi-experimental designs, Partner Abuse State of Knowledge (PASK) researchers found support for the effectiveness of conjoint IPV treatment and found CBT to be the approach with the strongest empirical support (Eckhardt et al., 2013; Hamel, 2012). Hamel (2009) cautions, however, that couples therapy for more severe cases of IPV is contraindicated.

Purpose, Significance, and Implications

The purpose of this research was to expand our understanding of IPV drawing from CBT theory, an approach with growing support for its effectiveness, as the central theoretical perspective. The findings are intended to improve the effectiveness of a CBT intervention model for IPV as will be discussed below. The three central research questions were as follows:

Research Question 1: What are the antecedents that precipitate the violence?

Research Question 2: What transpires during a violent event?

Research Question 3: What are consequences of the event?

Each of these questions, representing different time periods, were addressed with the victim identifying her feelings, behaviors, cognitions, interactions, and conditions associated with the violence. The result was to compile and categorize a listing of activities representing high-risk situations, which could be employed in assessments of IPV clients as targets of change similar to Alan Marlatt’s highly successful relapse prevention for substance abuse (Marlatt & Donovan, 2005). Given the existence of effective CBT models in the field of addictions and the application of new CBT IPV models, this research aims to facilitate the growth of CBT in working with individuals and couples in abusive relationships. Clearly, there are distinct characteristics of IPV couples that differ from addicts and prevent the simple one-size-fits-all transfer of CBT addiction models to counseling those in abusive relationships. Once the distinct characteristics of IPV are identified, the related high-risk situations can be used to target and change violence precipitating activities and conditions.

Method

Recruitment and Selection Criteria

Twelve heterosexual female victims of IPV were recruited through five domestic violence agencies within a city in the Deep South to participate in this study. The agencies all incorporated the Duluth model into their treatment protocols. These subjects were screened from 22 women who initially contacted us to participate. Fliers were both posted at these agencies and distributed by the agency’s domestic violence counselors who were invited to assist. Criteria for inclusion were that the subject was currently in a heterosexual abusive relationship lasting at least 1 year. Subjects could not be incarcerated nor could there be a pending legal case relating to partner abuse (which might bias their responses). Also, they were at least 18 years old and receiving services for the IPV. This treatment requirement was included due to the risk of retraumatization as a product of participating in this study. We stopped recruiting participants after interviewing 12 subjects because we had reached saturation of data.

Participants

The 12 subjects ranged in age from 20 to 48, with a mean of 40.4 (SD = 8.1) years. They were mostly African American (68%); the rest were White. Average income was around US$50,000 (M = US$50,514; SD = 28,887). However, the distribution was trimodal with about a third in the US$20 to US$25K range, a third in the US$40 to US$50K range, and a third in the US$80 to US$100K range. Five were married, five were single, one was divorced, and one was separated. They had been with the abuser on an average 11 years (M = 11.08, SD = 8.54) with the range between 1 and 26 years evenly distributed. Of that time together, they had been abused, on the average, 7.5 years (M = 7.50, SD = 8.32), with the range from 1 to 23 years. Most were abused fewer than 5 years; however, two reported that they were abused for 23 years. Six were unemployed, four worked full-time, one worked part-time and one was on Supplemental Security Income (SSI). All of their partners worked full-time. Nine subjects were receiving treatment at the shelter where they resided, two were receiving treatment through a private therapist, and one was receiving treatment through a crisis center. Two reported that they were currently living with their partners at the time of the interview; the others were living in shelters. Their educational levels spread quite evenly from less than a high school diploma to college educated. All but three had at least one child. Two thirds reported an arrest history; half of those were for domestic violence. Seven reported IPV-related emergency room visits or hospitalizations, three of them had multiple visits.

Procedures

The interviews were conducted by the author and three second-year master of social work students who were trained by the author in research interviewing techniques and received information through readings, discussions, and videotapes to sensitize them to IPV issues and their potential biases. Interviews were held in the audiovisual laboratory at the school of social work, except for two subjects who were interviewed in the counseling office of a safe house. The structured interviews were audiotaped and lasted 1 to 1.5 hr. Along with audiotaping, interviewers took field notes to capture nonverbal communications and manner of communication (e.g., tone or volume). Participants received US$100 for taking part in this study. They provided written informed consent and the research was approved by the University Human Subjects Institutional Review Board.

The interview protocol was semistructured and initiated with various demographic questions, some relating to their abuse history. This was followed by specific questions about IPV inquiring first about a typical abusive incident followed by questions concerning their worst abusive incident. Both the typical and worst abusive scenarios involved inquiries about what happened before, during, and after the incident; and for each time period, interviewees were asked about their verbal interactions, feelings, cognitions, behaviors, and conditions relating to the abuse (e.g., ongoing employment problems, tension over victim completing housework, etc.). For example, the subject would be asked to remember the worst IPV incident, beginning with what happened just before. He or she would be specifically and separately asked to discuss the verbal interactions, his or her behaviors/interactions, thoughts, feelings, and the conditions (e.g., rough day at the office, partner had a drinking problem and had been drinking, etc.).

The interview questions were developed to address core cognitive-behavioral (CB) principles derived from the literature. For example, the “before, during, and after time periods” were derived from the now classic “ABCs” for assessing contingencies (Ellis, 2001). “ABC” is an acronym for Antecedents (before), Behavior (during) and Consequences (after). The areas of assessment (i.e., verbal interactions, feelings, cognitions, behaviors, and conditions) noted above were derived from two sources of CBT intervention theory. One source was Gambrill (1977) who characterized three areas of assessment as behavior, cognitions, and affect. Behavior encompasses verbal interactions. However, I wanted to make this explicit to the subject. So, I noted verbal interactions separate from behaviors. “Conditions” was derived from Marlatt and Donovan’s concept of high-risk situations in addictive behaviors that, similar to IPV, explain an important phenomenon predictive of engaging in the problem behavior (Marlatt & Donovan, 2005). A brief family of origin abuse history, a notable IPV risk factor (Terrazas-Carrillo & McWhirter, 2015), was also gathered along with questions regarding the remediation of the abuse. However, these findings will be reported elsewhere, given that history is not typically emphasized in the CBT approach.

The interview questions were made concrete and relatively specific with the intent of enhancing reliability across interviews. The structured interview protocol was piloted with 20 clients from a safe house who examined the items for clarity and suggested changes. (A copy of the interview protocol can be found online at http://tssw.tulane.edu/files/ager-victim-interview-questions-onlinedoc.)

Interviewers received training in nonbiased interviewing to minimize leading the respondent and other potentially biasing interactions (e.g., see Kvale, 1996). To further ensure fidelity of the interviewing, the research team met weekly to review tapes and field notes, to determine whether there were problems in the clarity and sensitivity of our questions, and to make minor adjustments if necessary. Only one question was affected. It was intended to examine racial or ethnic influences, including internalized racial stereotypes/biases. However, the question failed to yield helpful information and appeared to unintentionally cause participant discomfort. Even after adjustment, the question continued to demonstrate problems and was dropped, along with the data it generated, after the third interview.

Analysis

Broadly conceived, this study was intended to represent an inductive method of understanding and adapting the CB approach to IPV. Rather than achieving this through using a more traditional deductive method where one generates a list of IPV interactions derived solely from the literature or experts in the field, the results were based on victims sharing their actual IPV experiences. This arguably embodies greater validity and accuracy.

The analysis in this study followed the tenets of constructivist grounded theory, which involves inductive methods aimed at theory development. In contrast to traditional grounded theory, which typically begins with no theoretical perspective at all and then builds theory from the data collected, constructivist grounded theory employs a predetermined perspective, CBT in this case, to guide the investigation of the subjects’ experiences (Charmaz, 2006). CBT theory provides the lens, established through the questions and coding, that ensures that perspective. As a result, a distinct CBT theory as it specifically and uniquely relates to IPV is intended to emerge from the ground up through subject descriptions of their violent interactions guided by CB focused questioning, as explicated above.

In concert with Creswell (2007), the categories and subcategories, presented in the “Results” section, were developed at “multiple levels of abstraction.” Although the broader CB categories of “Before,” “During,” and “After” from the structured interview were retained in the results, intermediate CB categories from the interview questions (i.e., feelings, behaviors, cognitions, dialogue, and conditions) were sometimes replaced with labels that more clearly reflected the underlying concepts (see Table 1).

Table 1.

Victim Activities Occurring Before, During, and After IPV.

Before The IPV Event (Antecedents)

I. Life circumstances/situations

A. Mental instability

1. Perpetrator

a. Risky behaviors (e.g., driving recklessly/dangerously)

b. Easily loses his temper

c. Extreme aggressiveness

d. Denial (acts like it didn’t happen; believes he will change, despite the fact that no concrete steps are taken)

e. Considers abuse justified (thinks it’s okay, says he isn’t sorry)

2. Victim denial

a. Don’t believe it’s happening

b Rationalizes that abuse is okay

c Acts like it never happened

d. Believes it will change despite strong evidence to the contrary

B. Relationship dynamics

1. Long-standing communication difficulties

a. Constant threats to leave

b. Chronic arguing

c. Avoiding emotional expression . . . till it explodes

d. Perpetrator difficulties (discussing problems without losing temper, discussing emotions)

2. Control

a. Perpetrator control over victim

(1) General

(a) Controls all decisions

(b) He sets all rules

(d) Monitors victim’s life (checking up on her whereabouts, going through personal belongings)

(2) Behavior

(a) Need to ask permission to do things

(b) Highly critical and verbally abusive about things victim does

(3) financial

(a) Purchases (decides all purchases, scrutinizes and criticizes expenditures, restricts purchases)

(b) Withholding money

(4) Social isolation, restricting

(a) Friends

(b) Going out/leaving house

(d) Victim from looking at strangers

(e) All contacts (i.e., general restriction from leaving home or communicating with individuals outside the home)

5) To get compliance, threatened with abuse, withholding drugs, suicide

b. Victim assertions to be free from control

3. Predictability of perpetrator initiating abuse: Lack of clear precipitating or preventive cues

a. Can happen any place (as opposed to certain places serving as buffers or safe zones)

b. Can happen in front of any one (as opposed to certain people or all people serving as buffers from violence, for example, won’t fight in front of children)

c. Can sometimes happen with no clear precipitating factor

4. Victim preparation to retaliate

a. Third party (e.g., If he physically abuses again, I will get someone to hurt him)

b. Victim will retaliate herself (e.g., Began preparing for abuse by keeping weapons under the bed)

5. Pessimistic about whether change is possible

C. Economic conditions of couple (financial problems, unemployment, underemployment)

D. Life stresses

1. General multiple stresses

2. Financial problems

3. Job-related: Stress at work, unemployed, underemployed

E. Third-party negative involvement/Influence

1. Extended family abusive toward victim or condones abuse

2. Family, neighbor’s friends

a. Stir anger concerning IPV relationship

b. Family tacitly aware of abuse and stays quiet

c. Significant problems with parent(s) surrounding her abuse

d. Children targeted for abuse

3. P’s infidelity

II. Precipitants (triggers)

A. Emotional expressions

1. Perpetrator’s extreme reactivity

2. Bad mood

3. Jealousy

4. Feeling unloved/ignored/unappreciated

B. Verbalizations

1. Meanness (goading, showing spite)

2. Disrespect (insults/put downs, mocking, name-calling, cursing, perpetrator shaming/embarrass partner in front of others, accusing, shouting)

3. Arguing

4. Expressions or withholdings that are untrustworthy (keeping a secret, lying, withholding information, not keeping word

C. Behaviors

1. Control related

a. Victim not following perpetrator’s rules

b Victim not meeting “responsibilities” (being late; household responsibilities such as cooking, cleaning, and laundry)

2. Pursuing partner when he or she withdraws

3. Excessive alcohol or other drug use

4. Selfishness

5. Perpetrator destroying objects

6. Perpetrator behaving aggressively/threateningly

7. Victim crying

III. Preventive factors

A. Communication

1. Victim avoiding (volatile subjects during escalation, arguing back, nagging)

2. Constructive conversation

a. Victim problem solving

(1) Focusing on problem rather than emotions

(2) Replace getting even with problem resolution

b. Listening

c. Managing extreme emotions through self-talk

d. Apologizing for hurting other person

e. Acknowledge other’s positive change

B. Victim make/keep the partner happy

1. Maintain personal responsibilities (e.g., maintaining house, cooking)

2. Doing nice things for partner

3. “Looking good” for partner

4. Emotional sensitivity

a. Being sensitive/aware of his or her mood and act to soothe or uplift it

b. Showing or being receptive to affection

C. Victim safety

1. Being prepared to leave

2. Staying “on guard”

D. Managing one’s alcohol and other drug abuse

E. Victim drawing from faith (e.g., praying)

F. Third party

1. Drawing from the healthy advise of others (e.g., those who oppose abuse)

2. Involved as buffer (used only in relationships where presence of third

party serves as a buffer from abuse or escalation)

a. Invite/involve friends, extended family, acquaintances

b. Go to public places

c. Involve children

3. Neighbors or family offer help

During The IPV Event

I. Feelings

A Victim

1. Emotionally injured (hurt, rejected, sad, disrespected, violated, betrayed, worthless)

2. Worried (nervous, paranoid)

3. Reactive (angry, vengeful)

4. Helpless (powerless, hopeless, resigned)

5. Objectifying experience (surprised, pitied P, feel like someone else is abusing her/out of body experience)

B. Perpetrator (insecure, fear of being left)

II. Behaviors

A. Physical violence

1. Perpetrator (punch, slap, force victim to have sex)

2. Victim (hit, used violence to defend self)

B. Perpetrator intimidation (destroy property, throw things)

C. Victim’s ineffective attempts to control/manage abuse

1. Emotional outbursts

a. Crying “to soften him”

b. Screaming (to bring others to help, to shame, or embarrass him)

2. Feign that the abuse didn’t matter

III. Verbal communications

A. Perpetrator threats

1. Physical harm (kill, hurt, sexual violence toward victim)

2. Emotional harm (destroy valued possessions, embarrass)

3. Use children as targets (kidnap children, fight for custody)

4. Suicide

5. Perpetrator’s family (e.g., If she puts him in jail, his family will hurt her)

B. Victim (threatens to leave/abandon/divorce/separate, kicks the perpetrator out)

IV. Victim cognitions (concerns)

A. About someone being hurt

1. Perpetrator (e.g., fear/thoughts of killing him)

2. Self

3. Children

4. Other (neighbors, friends, family; for example, perpetrator threatens others if they protect her)

B. About perpetrator taking kids

V. Victim prevention activities

A. Seeking safety

1. Leaving to (safe part of house, neighbor/friend/family)

2. Soliciting someone’s help (family, friend, neighbor, police, if in danger)

B. Calming self/managing anger (thinking about pain/hurt inflicted, what others will think)

C. Calming perpetrator

After The IPV Event

I. Victim consequences and reactions

A. Visible injuries (bruises or cuts)

B. Victim employment problems (marks on victim drawing attention, being late or missing work)

II. Emotional reactions

A. Victim (hatred, anger, outrage, sadness, crying, fear, guilt [felt responsible, deserved], shame, embarrassment, hopelessness, helplessness, calloused)

B. Perpetrator (shame, embarrassment, sadness, cry, fear of being left, disbelief/confusion that the abuse happened)

III. Behaviors (actions)

A. Victim withdrawal

1. Leave/stay away from home; go to friend/neighbor, family, hotel/motel

2. Victim sexual/intimacy withdrawal

3. Withdrawing within the home/relationship (being in different room or away from home when possible)

B. Filing a legal complaint

IV. Verbal responses

A. Threats to (leave, end relationship, take children, harm her if she leaves or takes children)

B. Verbal reactions

1. Provocative (not initiating or responding to talk, complaining, retaliatory)

2. Conciliator: “Talk it out”

V. Victim cognitions

A. Responsibility/blame (self, partner, both self and partner)

B. Plan to leave

V. Third-party involvements

A. Victim interactions

1. Involving or talking with friends, family, neighbors, police

2. Hiding/cover-up from friends, family, neighbors, police,

a. Tell kids to keep quiet about/hide abuse

b. Cover up injuries with makeup, excuses, lies

c. Don’t go out in public until bruises heal

B. Others initiating contact

1. Involving (place to stay, listen, protection)

2. Hiding/cover-up (who “covers up”)

a. Children

b. Extended family

c. Friends/neighbors (pretend it didn’t happen, don’t intervene)

VI. Reconciliation

A. Reconnecting (calling, talking to, seeking out, getting back together after living apart)

B. Romance or kindness (affection such as requesting or showing affection, intimacy, sex, perpetrator gifts

C. Dramatic romantic statements: We belong together/Can’t go on without you

D. Perpetrator and/or victim taking blame and apology

E. Victim forgiving or not forgiving perpetrator

1. Verbal forgiving/not forgiving

2. Internal forgiving/not forgiving

3. Dropping charges

4. Deciding to go back with him

F. Perpetrator promises (never to abuse again, to change)

VII. Prevention

A. Victim acknowledging or seeking to challenge and stop the abuse

1. Discussing

a. How abuse happens (trying to understand)

b. Alternatives to abuse

2. Asserting

b. He needs to stop the abuse

c. How she feels about the abuse

d. She won’t hide abuse

e. Confronting the reality of abuse (e.g., calling it abuse)

f. What the abuse looks like

g. He needs help

3. Self-examination/reflection

a. Impact on children

b. Accepting seriousness of problem

4. Setting up counseling for self and/or for couple

B. Setting up plan of action to use when at risk for violence

1. Place to go

2. Children having protected place to go in case abuse is directed at them

3. Anger management strategies

C. Managing emotions

1. Maintaining positive self-concept/esteem (deflated by abuse)

2. Committing to not fighting

D. Victim establishing independence

1. Developing better relationships with others or making new friends

2. Taking classes/job training

3. Getting a job

4. Leaving perpetrator

E. External forces if situation is dangerous

1. Involving family or friends in solution

2. Legal intervention (e.g., restraining order, filing complaint)

Note. IPV = intimate partner violence.

The goal in the data processing was to transform the information collected into a classification of the various conditions and activities involved in the buildup, initiation, course, and the aftermath of a violent episode. So, only those elements that specifically related to this progression of the episode survived. Although the typical aim of the qualitative approach is to provide the richness of that data within the context of one’s lived experiences, the present study deviated from this somewhat, focusing more on the collection of discrete interactions, conditions, and psychological processes. This would lend itself more to the ultimate aim of this inquiry—to develop a comprehensive understanding of IPV from a CB perspective. This would also lay the groundwork for the development of an instrument for both research and practice, as will be discussed later. An example of how grounded theory is employed to generate themes, subthemes, and ultimately questionnaire items is provided in Rowan and Wulff (2007).

Coding guidelines were developed to enhance the reliability of our analysis. Three MSWs and the author first independently reviewed five pages of transcripts and then developed rules to address the few discrepancies that arose in the separate codings. Following the new rules, we reviewed the second five pages and our agreement improved to a bit over the 95% agreement. These coders were unable to continue work with the study and another MSW was hired to complete the rest of the coding, following training and reaching 95% concordance with previous coders. Categorization was generated by the same social worker under the guidance and in collaboration with the author.

Coding involved the extraction of discrete abuse-related variables, capturing them in a few words (summarizing) and then categorizing them. The phrases were then categorized based on time (i.e., before, during, and after the incident), with more specific subcategories emerging from the data.

Triangulation was employed to enhance the validity of the data, as suggested by Creswell (2007). Following the categorization of data, this author conducted a careful review of the literature to both support the data that emerged, and to determine whether there were any further categories not noted. Following this, three experts in the field of IPV were solicited to review the categories and suggest revisions or additions. One of the experts was a colleague who published over 50 IPV articles along with a book. From my literature review, I identified six experts and consulted with my colleague concerning which two from this list or from his knowledge of the field would be best equipped to evaluate my results. My colleague, along with the two he selected from my list, was asked to independently review the results, which were essentially Table 1, for omissions or problems. Each provided written feedback and was paid US$100 for their time and assistance. As will be described in the discussion, these outside sources served to reinforce the findings of the qualitative data in that they found the results to be comprehensive. However, in a few circumstances, there were some notable differences between the data collected and the literature. A summary of the categories and variables are presented in Table 1.

Results

Three overarching categories structured the interviews and consequently the results—what happened before, what happened during, and what happened after the IPV event. The reader should note that the results deviate from typical qualitative reports. Because the aim of the study is to identify discrete phenomena that transpire over the course of IPV rather than to capture the richness of victim stories, the results will not include specific quotations. Rather, the results will be comprised of a categorized list of various features of IPV, each feature coming from one or all of the subjects, so as to compile a comprehensive representation of the course of partner violence.

Before the IPV Event (Antecedents)

As noted in Table 1, antecedent activities and characteristics fall into three categories: Life circumstances/situations, Precipitants (triggers), and Preventive factors.

Life circumstances/situations

Life circumstances/situations involve characteristics that predispose couples toward discord and, in IPV relationships, toward violence. They are much like landmines, which, if disturbed by a precipitant, can quickly explode into IPV. As reflected in the table, they represent one of the most prominent components of IPV. They include such areas as mental instability, relationship dynamics, life stressors, or third-party involvement. With regard to mental instability, victims do not typically label their partners or themselves as suffering from a type of mental disorder such as depression or narcissism. Rather, they presented some of the perpetrator’s behaviors that were unstable, such as engaging in risky dangerous behaviors or having an explosive temper. Interestingly, they label denial, both their own and their partner’s, as a significant mental problem related to the abuse.

Relationship Dynamics were most commonly mentioned as a Life Circumstances/Situations leading to abuse. The largest category in Relationship Dynamics was Perpetrator Control, which played a huge role in most of the subjects’ relationships. This control tended to permeate several areas of the victim’s lives, often coupled with a set of rigid rules intended to regulate her financial, social, and domestic activities. The perpetrator’s rules also disempowered the victim, making her more dependent on the perpetrator. Rules were typically enforced with physical abuse and threats. Third-Party Involvement/Influence was another notable category in Relationship Dynamics. It represented a significant factor in abuse throughout the progression of IPV, as will be noted throughout the “Results” section.

Precipitants (Triggers) is the next major category listed in Before the IPV Event. This category merely notes the many feelings, words, and behaviors common during the buildup of an IPV incident.

Preventive Factors is the last major category. Partners engaged in numerous preventive attempts to circumvent the escalation of conflict. It was somewhat unexpected that this would emerge as a significant dynamic, given that subjects were not specifically asked about it. But, clearly, it played an important role, and has treatment implications, as will be discussed later.

During the IPV Event

The actual initiation of the violent incident was typically associated with various actions and reactions, much of which was distinct from the previous antecedent phase. The “During” phase is divided into five categories: Feelings, Behaviors, Verbal Communications, Cognitions, and Prevention.

Feelings

As one can imagine, feelings were experienced intensely and spanned from deep pain to resignation. Virtually all felt emotionally injured including such feelings as hurt, disrespected, even violated. Not surprisingly, many felt worried, given that they were in danger of being seriously injured or worse. Most felt considerable anger, some to the point of wishing to avenge their hurt. Given that many if not all were physically overpowered by the perpetrator, some shared that they felt helpless and resigned to the belief that they could do nothing to stop the violence. Some were surprised when the abuse began. Others would objectify what was happening and even pity the abuser. Some could depersonalize the experience, stepping outside their body, as if they were observing themselves and the abuser in violence. Perpetrator feelings were mentioned. But, surprisingly, it was not typically rage. Instead, victims mentioned their partner’s fear—being afraid and insecure about the victim leaving him.

Behaviors

Physical violence represented the most common behaviors described by victims. “Hitting” was by far mentioned most frequently; however, punches and slaps were also reported as was forced sex. Victims also mentioned that they hit the perpetrator, most often in self-defense. Perpetrators also intimidated victims by throwing things or destroying property (e.g., violently breaking something and punching wall with fist). Victims often engaged in attempts to control or manage the violence; however, their attempts were ineffective. Some victims used emotional outbursts such as crying, “to soften him,” or screaming, to bring others to help or shame/embarrass the perpetrator. A few victims pretended the abuse didn’t matter.

Verbal communications

Interestingly, victims indicated that verbal communications during the actual abusive incident were typically threats. Perpetrator threats of physical harm were common, such as hurting, killing, or committing sexual violence toward the victim. Perpetrators also threatened victims with emotional harm such as destroying a valued possession(s), or embarrassing her. Sometimes children were used as targets or the perpetrator would threaten to kidnap the children or fight for custody. One subject indicated that the perpetrator had threatened suicide. Another subject indicated that her partner threatened to have his family hurt her if she put him in jail.

Cognitions

Few cognitions were mentioned as prominent during the violence. Those cognitions mentioned typically related to fear—fear of emotional, but mostly physical injury. For example, some were afraid of themselves being seriously injured, or that their children might be harmed physically. A few feared the perpetrator might kidnap the children. Some mentioned they were afraid that the perpetrator might injure a friend, family, or neighbor who had come to her assistance. On the contrary, some victims feared they might injure or kill the perpetrator.

Prevention

Even in the midst serious abuse, some victims were able to engage in preventive activities. The most commonly mentioned involved seeking safety. Some victims would find a safe haven in their home, or leave the house and seek refuge with a neighbor, friend, or family member. Some victims attempted to calm themselves and better manage their anger, using concerns about pain/hurt inflicted or what others might think, as incentives. Some victims attempted to calm the perpetrator.

After the IPV Event

Consequences of physical injuries

When the victim suffered visible physical injuries, family and friends frequently asked about it. This sometimes caused problems in their relationships due to judgments and blaming, or served as a source of support and encouragement to bring about changes in the IPV relationship. IPV-related injuries sometimes resulted in similar problems at work, not only when the injuries were noticeable, but also when the victim was hospitalized or missed work.

Emotional reactions, behaviors, verbal responses, and cognitions

With regard to emotional reactions, victims reported intense responses not only for themselves, but for their partners as well. Intense anger and outrage was the predominant emotion expressed, sometimes leading to hatred. Many expressed sadness, manifested with crying. On a deeper level, victims expressed fear about the perpetrator or about the future of their relationship. Some expressed guilt, based on feeling responsible for the abuse or even that it was deserved. Many felt shame or embarrassment while others expressed hopelessness about salvaging their relationship. For those with a longer history of abuse, they sometimes turned off their feelings and were left with a sense of callousness about the situation and their partner.

According to victims’ perceptions, perpetrators shared many of these same feelings. For example, many were very sad and cried when interacting with their partner. Some felt deep shame and embarrassment about the abuse. However, they expressed different emotions as well. Some expressed shocked and found it hard to believe that they had perpetrated such violence. Some expressed fear of being left.

With regard to behaviors, some victims left home temporarily, and considered leaving permanently. Of those victims, some temporarily stayed with a friend or family member; and if not available, they stayed in a hotel or found refuge in a safe house. Almost all victims withdrew in other ways as well. They withdrew their intimacy, and if they were still in the home, they avoided the perpetrator whenever possible. Many victims stayed indoors until the bruises and cuts healed. Some victims filed a complaint against the perpetrator.

Verbal responses came mainly in the area of threats: threats to leave, take the children, and, sometimes, these threats were met with counterthreats or retaliation. Their conversations were provocative, complaining, vengeful for some, or involved complete silence and avoidance for others. Eventually, conversations became conciliatory, as will be discussed below.

The victims’ major cognitions during this time were sorting out responsibility and blame. Victims struggled with whether it was their fault, the perpetrators fault, or both of their faults.

Third-party involvements

Victims sometimes approached others (e.g., friends, family of origin, children, police), and sometimes others approached them. Victims would either engage others in covering up the abuse, such as keeping quiet and making excuses, or ask for assistance, such as acquiring a place to stay, protection, or someone who would listen.

Reconciliation

Reconciliation took on many forms but, generally, focused on the couple putting the abuse behind them. Typically, the couple would experience distancing for a period of time and then an attempt or series of attempts to reconnect, through the phone, face-to-face, searching for and finding the partner, and eventually reconnecting, would be made. Reconciliation often involved romance and kindness, initiated primarily by the perpetrator, such as showing affection, intimacy/sex, gift giving, dramatic romantic statements such as “I can’t go on without you,” and/or apologies from one or both partners. This was typically followed by forgiveness or a refusal to forgive, which influenced whether charges were dropped if they were filed and whether they reunited. Interestingly, many victims separated the verbal from the internal forgiving. Some victims might give one without the other, such as verbally giving forgiveness, but not being able to let go of the anger. During this process of reconciliation, perpetrators sometimes made promises either that they would change, or that they would never again abuse their partner.

Prevention

Many victims attempted to move their relationship beyond just reconciliation. They worked to prevent the abuse from occurring again. For example, some victims initiated conversations or self-introspection to better understand and change the abuse. A victim might approach the perpetrator and together attempt to understand how the abuse happens and to plan alternatives to the abuse. Victims often felt they had considerable leverage during reconciliation, which they used to assert the need to stop the abuse, express deep feelings about the abuse, and no longer hide the abuse. In situations where the perpetrator is in denial, the victim might confront the perpetrator with facts about the seriousness of the abuse and the fact that he needs help. Some victims demanded that they pursue counseling together.

Victims shared how they set up a plan of action so as to prevent a future violent episode. They prearranged a place to go in case they and maybe their children were in danger. Some prepared anger management strategies to use in situations at high risk for violence. Victims sometimes attempted to manage problematic emotions through maintaining a positive self-concept that may have been previously deflated by the abuse, or by making a commitment to avoid abusive fighting. Some victims reduced their dependency on the perpetrator by taking classes or job training, getting a job, or even leaving the relationship temporarily. Some victims established or strengthened outside relationships, which also bolstered their independence. Finally, many victims spoke of involving third parties to assist them. This might involve family or friends who are willing to provide assistance and protection, or legal intervention, such as pursuing a restraining order or filing a complaint against the perpetrator.

Results of the Triangulation

As indicated earlier, this investigator used triangulation to improve the validity of the final product, that is, the development of a comprehensive list of CB activities surrounding an IPV incident. Three IPV experts reviewed the findings and this author conducted a careful review of the literature. Although the findings uncovered some important areas not carefully addressed in the literature, there were a few areas addressed in the literature and suggested by the consultants that did not emerge in the interviews: perpetrator stalking (Owens, 2016), community poverty and crime, victim and perpetrator psychopathology, and more severe forms of physical violence and intimidation (e.g., concussions, broken bones or teeth, brandishing guns or knives, hurting or killing pets; Hines & Malley-Morrison, 2005). These differences between the interviews and literature/consultants will be addressed more carefully in the “Discussion” section.

Discussion

The results provide a systematic listing of the feelings, behaviors, cognitions, and conditions associated with an abusive IPV incident. In one sense, it is somewhat comprehensive in that it provides a detailed account of the CB activities. However, it is somewhat limited in that it is not intended to cover all theories, such as psychodynamic or systems theories. For example, it does not cover non-CB traits such as family history, which is central to psychodynamic and some forms of systems theory.

Core Findings and Implications for Research and Practice

Notable findings of this study include the following: (a) preventive activities occur even during the most extreme violent interactions; (b) preventive activities are different depending on whether they occur before, during, or after the incident; (c) broader systems play a significant role in IPV; (d) a period characterized by distancing is a notable phase following the violent incident; and (e) a comprehensive list was compiled of exclusively CB constructs associated with IPV. These findings represent contributions to the literature that are intended to help shape our understanding of IPV, including its manifestation through a CB lens.

Preventive activities occur even during the most extreme violent incidents

One of the most notable findings of this study was that the progression toward an IPV incident is not a constant buildup of tension until an abusive incident occurs. More typically, the tension undulates toward and away from abuse. Also, these preventive activities represent a significant factor in abuse progression. Feelings, behaviors, and thoughts at times escalate and at times suppress or circumvent the violence. There is little if any acknowledgment in the literature that the partners engage in preventive activities when in the midst of an IPV incident. A clinical implication of this finding is that counselors can use a strengths-based approach by building on these preventive activities to circumvent the violence. Similarly, researchers might examine the critical features that lead a couple toward a violent versus a nonviolent outcome. It should be noted that questions concerning prevention were never asked during this facet of the interview; they merely emerged as subjects described an IPV incident.

Some of the preventive actions overlap Hamby’s (2014) research and writings on protective strategies of victims. She contends that the victim needs to be understood from a strengths perspective with the capacity to develop strategies to protect herself and her loved ones as well as avoid nonphysical repercussions of IPV such as loss of custody of her children or homelessness. Victim reports from the current study also noted protective strategies. Many of these strategies were similar to those mentioned by Hamby such as drawing strength from one’s religion or spirituality, carrying out an escape plan, or reaching out for help from neighbors or family. Clearly, such strategies represent an integral part of the violent episode and can represent an effective resource from which to circumvent IPV.

Distinctiveness of preventive activities with stage

Related to the previous subsection, these preventive activities are different depending on whether they occur before, during, or after the violent incident. Before the incident, partners may attempt to talk more constructively by avoiding volatile subjects when someone is irritated, doing something rewarding for the partner, or drawing from third-party resources to reduce stress or provide advice and support. During the incident, preventive efforts are more commonly safety and protection oriented, such as leaving the partner. Following the incident, preventive activities are initially more reflective, which can ultimately focus on making deeper changes in the relationship (e.g., challenging their denial about IPV, reducing relationship dependency through victim receiving education and training, and making commitments regarding safety). Given the changing nature of the preventive efforts before, during, and after an incident, researchers and service providers may develop and evaluate interventions that best fit the stage of IPV. For example, given that couples are more change oriented and reflective just following an abusive incident, they may be more prone toward counseling and change commitments.

Broader systems play a significant role in IPV

Third-party involvement has been mentioned in the literature as a potential vehicle of protection with the criminal justice system receiving the most attention (McClennen, 2010). But, less attention is given to family members or friends as resources of change (Wallace & Roberson, 2011). For example, victims may seek the involvement of third parties to prevent or interrupt a violent episode. Results from the present study suggest that many victims already reach out to third parties who may have the potential of serving as an invaluable resource to circumvent the abuse. The results of this study also suggest that third-party involvement sometimes has a negative impact and can exacerbate an already volatile situation, which is something that has little if any attention in the literature. Another interesting finding is that third-party presence, such as having a child or extended family member present, or even being in a public place with strangers, can suppress violence in certain couples. It should be noted that such a prevention strategy is not always indicated. For example, the use of children as shields against violence is risky and may result in them becoming targets. Dobash and Dobash (2012) point out that children are not the only third-party individuals at risk for perpetrator violence. Friends, family, and others who ally with the victim are also sometimes targeted. Third-party individuals may serve as sources of psychological support or they may triangulate the couple and further entrench them in pathology. In brief, third-party involvement was mentioned prominently in the present study suggesting that it needs to be included in the assessment and treatment of IPV. They represent resources as well as precipitants and maintainers of the abuse, and thus should be considered as part of the treatment plan. However, the extent to which these third parties may be placed in danger also needs to be considered when assessing their involvement as a resource. As noted earlier, larger systems such as churches (and pastors) were also mentioned by victims as influences in their IPV difficulties and both researchers and service providers need to examine and evaluate such systems as both resources and potential roadblocks to change.

Partner distancing as a notable part of the phase following the violent incident

Walker (1979) is one of just a few experts who give careful attention to what happens following the incident labeling it the Honeymoon or Make up phase. However, this characterization is incomplete. It focuses on the reconciliation which, based on results from the present study, is only half of the story. As noted above, another prominent aspect of this phase is withdrawal, possibly to cool down, decide whether to leave, or to heal the tremendous hurt or even trauma that has occurred. As acknowledged by Walker, this phase represents a critical facet in the establishment and maintenance of IPV. It may provide distance for couples who become overly enmeshed, or it may provide pleasurable rewards associated with reconciliation through the gifts, apologies, and newfound openness to discuss problems. Of course, the mental health implications are that this phase may either further entrench the couple in a cycle of violence or provide an optimum opportunity for a successful intervention. In the unilateral treatment of alcoholism, Sisson and Azrin (1986) found that intervening, following a severely problematic drinking episode that had occurred, represented an optimum time for change as the drinker’s vulnerability and openness to receive help is heightened. Similarly, IPV perpetrators are likely more open to change just after a violent episode. In fact, to let this opportunity pass, and to follow it with a rewarding reconciliation period without expectation of change, one may inadvertently reinforce and solidify the cycle of violence.

Identification of a comprehensive list of CB IPV constructs

Perhaps the most notable contribution of this study was the development of a comprehensive list of concrete CB IPV constructs and related activities. These activities can provide a foundation for assessing victims of IPV and evaluating interventions aimed at changing related problematic behaviors. The categorized list developed in this study shares many similarities to what Marlatt and Donovan (2005) define as high-risk addiction behaviors along with resiliency factors. For example, for some IPV couples, jealous statements by the perpetrator may represent a high-risk situation that quickly gets out of control and spirals into heated arguments ending in a violent incident. Through the identification of CB IPV constructs compiled in this study, high-risk situations along with preventive resources can be more readily assessed, targeted for change, and evaluated in research and intervention.

Limitations

Four limitations deserve mention: potential problems in generalizability, response bias and related error, lack of focus on mental health issues, and limited triangulation in some parts of the data analysis. With regard to generalizability, all subjects were recruited from safe houses. They had all seen counselors; most had seen several. Consequently, their IPV situation was considerably more severe than that faced by typical domestic violence victims. Whitaker and Niolon (2009) point out that most IPV couples are engaged in abuse that is “low level, conflict based” (p. 170), which is not reflective of this sample. Nevertheless, there are notable advantages to drawing from a sample of subjects with more severe IPV. The purpose of the study was to provide a comprehensive account of what happens before, during, and after a violent incident. Those from more severe situations might provide a much broader array of experiences, with varying levels of violence, not encountered by those who experience strictly milder abuse.

Another way in which this sample may have not been representative of the general population is that they were drawn from a metropolitan area in the Deep South. Sixty-eight percent of the sample was African American. This was proportionate with the population of the city where they were recruited but not with the national average. Cheng and Lo (2015) noted several differences between African American, White, and Hispanic women in IPV-related areas such as mental disorders, incidence of violent acts, and mental health seeking behavior. Clearly, White women were underrepresented in this sample and Hispanic and other races and cultures were not represented at all. As Grossman and Lundy (2007) indicate, it is possible that domestic violence may manifest itself differently among varying racial groups, including those not represented in this sample. Another way the sample was not representative of the general population is that it was drawn from an urban environment with mostly midlevel incomes that may manifest IPV different than individuals from rural or other environments with higher or lower income levels. For example, poverty has been found to be highly associated with IPV (e.g., see Ely & Flaherty, 2009; Hines & Malley-Morrison, 2005). In short, it is possible that the cultural, racial, regional, urban, and socioeconomic status (SES) characteristics of this sample affected the results and further inquiry may uncover additional IPV factors not presented here.

The characteristics of this sample may also explain some of the discrepancies found between the literature and sample findings. Perpetrator stalking was not reported by the sample possibly because they were currently in a safe house and had previously lived with their partners at least 1 year. Both of these situations are not conditions under which stalking will normally occur. According to the literature, living in an impoverished or crime-ridden community were predictors of IPV (Hines & Malley-Morrison, 2005). However, the sample was predominantly middle class and may not reflect some of the manifestations of such environments. The sample also didn’t include the most extreme IPV cases that involve severe physical harm (e.g., concussions, broken bones). Such abuse is prominently and frequently highlighted in the literature (e.g., Hines & Malley-Morrison, 2005).

Response bias represents another possible limitation. Barnett et al. (2011) write that retrospective data collection in this population is potentially plagued by memory lapses, reluctance to recall, and unconscious response errors. Add to that the desire from the subjects in this study to present themselves to the interviewer in a positive light, and the possibility of distortion increases further. This may explain why there was limited mention of reciprocal violence by the subjects, whereas some literature suggests that victim perpetration of violence is extremely common (Whitaker & Niolon, 2009). To minimize such distortion, the questions were structured to be specific and inquired about concrete activities or interactions such as feelings, thoughts, behaviors, and verbal interactions.

There was a surprising absence of mental health pathology mentioned in the interviews, particularly in light of the considerable literature on its prevalence (e.g., see Andrade, O’Neill, & Diener, 2009). It is possible that interviewers would have received more detail on this subject, had they asked subjects directly. Participants were asked whether they or their partners had ever been hospitalized due to mental health problems. But, it may have been more effective to ask more broadly about the presence of mental illness for either partner.

Finally, further triangulation of data analysis might have strengthened the methodology. As mentioned in the “Method” section, the vast majority of the data were analyzed by a single master’s level coder under the direction of the author of this article. It is possible that having more than one coder review the data may have yielded slightly different results. However, as described earlier, concordance of that coder with previous coders was adequate, and measures were taken to improve that concordance further.

Future Directions

Drawing from the findings that seek to identify the major constructs and activities involved in IPV, the next step would be the development and validation or an instrument. Given the growing use of CBT as well as support for its effectiveness, such an instrument would be useful in both the treatment and research of IPV. With regard to treatment, the instrument could help to identify high-risk emotions, behaviors, cognitions, and conditions that might be targeted for change or signal potentially violent situations (e.g., heavy alcohol use, one or both shouting). Also, the instrument might identify protective factors that the therapist can help the client(s) employ to circumvent violence (e.g., talking about certain volatile subjects in a public place if that represents a protective factor). As noted earlier, CBT couple intervention for IPV has achieved promising outcomes (McCollum & Stith, 2008) and should be considered as an option if it does not endanger the victim. Furthermore, many victims want to repair the relationship and wish to include their partner in this venture (Barnett et al., 2011). Clearly, the results presented here suggest that IPV is a pattern of multiple victim–perpetrator interactions with several opportunities for intervention and change. The current study was coupled with a parallel study of perpetrators to be reported later, the result of which will provide an opportunity to describe and ultimately measure both victim and perpetrator behavior that can be identified and targeted for change. This would add to our ability to understand, identify, and target change in couple as well as unilateral intervention.

With regard to research, the instrument could be used to determine the extent to which these activities occur in IPV relationships. Or, one can examine whether certain IPV activities are associated with victims or perpetrators fitting specific typologies. Bridging both practice and research (i.e., outcome evaluation), a pre- and posttreatment testing can examine whether, and to what extent, there is change in the various activities surveyed. This touches on a few applications of the categories identified in this study as well as the potential instrument, which is the ultimate goal of this empirical endeavor.

Footnotes

Acknowledgements

The author would like to extend his gratitude to research assistants Lucy Cordts, Brandi Glaspie, Harpreet Samra, and Jose Vega.

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was funded through the Tulane Research Enhancement Fund (Award # 545752-U1-545752G1).

Author Biography

Richard D. Ager’s major areas of interest and research expertise are family practice, substance abuse, IPV, treatment outcome, and teaching/training counselors and students in evidence-based practices. As director of the Porter Cason Institute, he facilitates the development and provision of training in advanced family practice to students, faculty, and community practitioners. As director of the Center for Life Long Learning, he brings in expert speakers to provide workshops to help social workers keep abreast of current practices in our field. His current research interest focuses on adapting an evidence-based practice employed in substance abuse to intimate partner violence. His teaching background includes clinical and community practice, organizational theory, family practice, human behavior and the social environment, qualitative research, and addictions.

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