One way that counselors can help victims of intimate partner violence (IPV) is to create behavioral crisis response plans with clients who are perpetrating the abuse. We (the authors of this article) have both worked in various roles with IPV programs, from direct service and administrative roles to research and advocacy. We believe that working with perpetrators of IPV is an essential component of reducing domestic violence.

As such, we are familiar with the research for treating perpetrators of IPV and find the results are often weak. Most clients report an increased desire to change on self-report measures but frequently lack follow-through (for more, see the 2008 article “Motivational interviewing as a pregroup intervention for partner-violent men” by Peter Musser and colleagues in the journal Violence and Victims). We can do more as counselors by providing these clients with behavioral support as they work to change. We must give the clients real, behavioral techniques that they can use in the moment. In this article, we share behavioral techniques that counselors can pass on to their clients to bring about real behavior change.

Crisis response planning (also known as safety planning) refers to creating an actionable plan when faced with a maladaptive response to a situation. Crisis response planning is often used with clients experiencing suicidal urges (as Barbara Stanley and Gregory Brown shared in their 2012 article, “Safety planning intervention: A brief intervention to mitigate suicide risk,” published in Cognitive and Behavioral Practice). In the context of IPV, safety planning has historically been associated with helping victims prepare for and engage in behaviors that will keep them most safe when faced with threats from a partner (for example, see Christine Murray and colleagues’ 2015 article, “Domestic violence service providers’ perceptions of safety planning: A focus group study,” in the Journal of Family Violence). We are advocating for the use of a crisis response plan, similar to that of Stanley and Brown’s, with clients who perpetrate IPV.

Crisis response planning is effective for mitigating acting on harmful urges; in this case, it is to manage urges to engage in abusive acts. To be clear, the objective of the crisis response plan is crisis management. It is not a tool that will reduce the occurrence of the urges to engage in abusive acts, but instead one that targets managing urges.

When the client perpetrating the abuse has an urge to engage in aggression, they will use the skills from the crisis response plan (which they co-create with their counselor) to refrain from acting on the abuse. Utilizing the crisis response plan allows clients to decrease their emotional arousal and to train themselves to engage in an alternative behavior when they have an urge to aggress.

This is no small feat given that these clients may have an ingrained history of acting on their urge. For every second that they are engaging in a coping skill from their crisis response plan, they are not aggressing. If a client goes from immediately acting on the urge to delaying the urge for 10 minutes, then therapy would shift from a focus on riding the urge to problem-solving and cognitive restructuring.

A crisis response plan for perpetrators of IPV

The adapted crisis response plan by Stanley and Brown asks questions to help clients identify warning signs, coping strategies, people they can call, emergency contacts, how to make the environment safe, and the most important reason to not engage in abusive acts. It is recommended that clients repeatedly review the crisis response plan and carry it with them at all times. The following is a review of each section of the crisis response plan.

Identify warning signs. When asking clients who perpetrate abusive acts to identify warning signs that lead to abusive behavior, it is best to focus on cross-contextual experiences. For example, helping clients identify that they are more likely to engage in abusive behaviors when the dishes are not done is good, but what is more helpful is identifying their anger (which is likely an underlying emotion). Anger has been consistently identified as a proximal factor in IPV but is not consistently addressed in treatment for IPV. Identifying the anger as a warning sign will transcend more contexts and ultimately make the crisis response plan more helpful. Warning signs could include physiological arousal, emotions, and thoughts such as demandingness or personalization.

Activate internal coping strategies. Internal coping strategies keep the clients from engaging in abusive behavior against their partners. These strategies may not reduce their anger or the experience of their urges, but the goal of the strategies is to not act on the urge. As long as they are not choosing abusive behavior toward their partner, they are being skillful. Using distraction (e.g., watching TV, going for a walk, listening to music), practicing progressive muscle relaxation, or listening to a funny show, skit or video (humor is a useful intervention in reducing anger) can all be helpful.

A skill that many clients like is changing one’s temperature. It involves holding one’s breath underwater for 30 seconds to activate the mammalian dive reflex, at which point the temperature causes the client’s heart rate to decrease, also lowering their anger levels. If they are not able to hold their breath underwater for 30 seconds (e.g., by using a sink), they can splash cold water on their face or use ice cubes. Clients may be more likely to use this coping strategy if they practice it in session. If they are wearing a Fitbit or something similar, they can instantly see the effects. This skill is commonly used as a crisis management skill in dialectical behavior therapy.

The most important thing is finding and listing the skills that work for your client.

Activate external coping strategies. It is important to help clients build self-efficacy by using their internal coping skills first. However, if they are not able to manage the urge or think they may still engage in aggression, then it is best for them to call someone. Calling a friend or a family member can serve as a distraction. The client does not necessarily need to tell the person about their urge to engage in abusive behavior. If your client can identify a friend who loves to talk about themselves, now is the time for them to call that friend. Talking to someone on the phone decreases the likelihood that the client will act on their urge. If that is not effective, they can call someone they trust (e.g., a close friend or family member, a spiritual guide) to speak to about the situation. If they are still fighting the urge to aggress, they can contact a crisis resource (see the resources provided at the end of this article).

Plan ahead. In addition to intervening, the crisis response plan also works as a preventive measure by focusing on what the client can do to make the environment safe. This could mean removing threatening objects (e.g., knives) or speaking through a locked door. For instance, if the client or their partner know they are about to have a difficult conversation concerning finances, they could agree to have the conversation standing on opposite sides of a physically locked door in the home so they are separated from each other, or they could agree to have another person present. Many clients who perpetrate IPV will not engage in abuse behaviors toward their partner in front of another person.

Lastly, the crisis response plan asks the client to name the most important reason for them to change. It is best to frame the reason in a positive direction (“I want a strong, healthy relationship with my wife and kids”) rather than the absence of something (“I don’t want to get divorced”). This reason reminds the client what they are working toward, so it is best to bring up this reason frequently in treatment.

Practice. The crisis response plan works best when it is rehearsed outside of the triggering context. Similar to basketball players rehearsing their form in practice so that they can shoot the ball in the game (and under pressure), a client needs to rehearse these behaviors prior to using them in the moment.

Behavior change is hard, particularly for clients who engage in abusive behaviors toward their partners. Trying to come up with alternative behaviors while angry is unlikely, particularly given that anger is associated with tunnel vision. Practicing these skills ahead of time allows the client to expand their behavioral repertoire in the heat of the moment.

Additionally, behavior change is challenging given that clients’ abusive behaviors have been positively reinforced in the short term. Clients who engage in IPV often get what they want after committing the abusive act (e.g., punishing their partner). Counselors working with clients who perpetrate abuse know that abusive behaviors are learned behaviors. The crisis response plan assists in clients learning new, more positive behaviors between sessions.

Working with perpetrators is an essential part of reducing instances of IPV and increasing victim safety. Crisis response plans provide an effective tool for counselors to use in their work with these clients.

 

Additional resources

• The National Domestic Violence Hotline (800-799-7233) is available 24/7 for speakers of more than 200 languages
• Crisis response plan template
• Counseling Today’s July 2019 cover story, “Addressing intimate partner violence with clients”

 

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Thomas DiBlasi is an assistant professor at St. Joseph’s College where he teaches undergraduate students and researches domestic violence, anger, aggression and revenge. He has given presentations locally, nationally and internationally and has published predominantly on anger and aggression. He is a member of the leadership committee for the special interest group of Forensic and Externalizing Behaviors. Contact him at tdiblasi@sjcny.edu.

Kelly Smith is a licensed professional counselor and approved clinical supervisor who began her work with sexual assault and domestic violence (SA/DV) agencies in 2006. She is also a certified partner abuse intervention professional. Beginning in 2015, she facilitated partner abuse intervention program groups and, most recently, served as director of abuse intervention services for a comprehensive SA/DV organization in Illinois. She is an assistant professor in the Department of Counseling at Springfield College with a research agenda that includes addressing issues related to perpetrators of IPV. Contact her at ksmith27@springfieldcollege.edu.

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