Intimate Partner Abuse and Relationship Violence

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Intimate Partner Abuse and
Relationship Violence
This document was developed by the Intimate Partner Abuse and Relationship Violence Working Group. The working group was comprised of members from the following divisions:
Division of Family Psychology (Division 43), Society for the Psychology of Women (Division 35), Society for the Psychological Study of Lesbian, Gay, and Bisexual Issues (Division 44), Society for the Psychological Study of Ethnic Minority Issues (Division 45), and Society for the Psychological Study of Men and Masculinity (Division 51).
This document was developed as an interdivisional grant project, funded by the Committee on Divisions/APA Relations (CODAPAR). Its contents are derived solely from the Working Group on Intimate Partner Abuse and Relationship Violence and do not reflect policies or positions of the American Psychological Association.

Intimate Partner Abuse and Relationship Violence
How to use this guide:
Dear Colleague:
This publication is designed to promote education about partner abuse and relationship violence. It represents our recommendation to faculty members who would like to develop courses focused on partner violence. Additionally, for those faculty members who would like to merely add information about partner violence to their existing courses, the present information will be useful.
Students who will be working in the mental health field will undoubtedly encounter issues of partner abuse and relationship violence, whether they recognize such violence or not. Consequently, learning about issues of prevalence, theories, how to detect such abuse across differing communities (including ethnic minority and gay/lesbian/bisexual communities), the consequences of partner violence, strategies for prevention, forensic issues, and therapeutic interventions and services are included in this document.
Publication of this booklet has been sponsored by the Committee on Divisions and the American Psychological Association Relations (CODAPAR). The divisions involved in the development of this booklet/curriculum are the Division of Family Psychology (Division 43), the Society for the Psychology of Women (Division 35), the Society for the Psychological Study of Lesbian, Gay, and Bisexual Issues (Division 44), the Society for the Psychological Study of Ethnic Minority Issues (Division 45), and the Society for the Psychological Study of Men and Masculinity (Division 51). The members are shown below:
Intimate Partner Abuse and Relationship Violence Working Group
Chair: Michele Harway, Ph.D.
Members: Robert Geffner, Ph.D.—Division 43 David Ivey, Ph.D.—Division 43 Mary P. Koss, Ph.D.—Division 35 Bianca Cody Murphy, Ed.D.—Division 44 Jeffery Scott Mio, Ph.D.—Division 45. James M. O’Neil, Ph.D.—Division 51
Thank you for your interest in including partner abuse and relationship violence in your curriculum. Please feel free to share this publication with others.

History of the Project
In June of 1999, the CODAPAR of the American Psychological Association awarded an interdivisional grant to a group comprised of representatives from Divisions 43, 35, 44, 45 and 51 to develop a curriculum on partner abuse and violence. Then President-elect of Division 43 (Family Psychology), Michele Harway, Ph.D., had written the grant application in collaboration with presidents-elect of the other four divisions; at that time this included Phyllis Katz, Ph.D., of Division 35 (Women), Esther Rothblum, Ph.D., of Division 44 (Lesbian, Gay and Bisexual), Joseph Trimble, Ph.D. of Division 45 (Ethnic Minorities) and Michael Andronico, Ph.D. of Division 51 (Men and Masculinity). Following the official awarding of the grant, each division nominated at least one representative to form the core work group. In August, 2000, the outline of the curriculum was presented at the annual convention of the American Psychological Association in Washington, D.C. It was also presented in September, 2000 at the 5th International Conference on Family Violence in San Diego, CA. Subsequent to revisions and input from other experts on partner violence, the curriculum was finalized; the revised outline was presented at the annual convention of the American Psychological Association in San Francisco, August, 2001.
This curriculum is not the only effort sponsored by the American Psychological Association (APA) that focuses on interpersonal and relationship violence. Since 1988, APA has appointed various task forces dealing with some aspect of interpersonal violence, including the Child Abuse and Neglect Working Group, the Task Force on Male Violence Against Women, and Violence Against Children in the Family and the Community. In 1994, the APA Taskforce on Male Violence Against Women issued its report, (No Safe Haven: Male Violence Against Women at Home, Work, and in the Community). Also in 1994, the APA Presidential Task Force on Violence and the Family was appointed, and a report was published by APA in 1996 (Violence and the Family). These reports are good resources for this curriculum. Subsequently, an Ad Hoc Committee on Legal and Ethical Issues in the Treatment of Interpersonal Violence was appointed to specifically address some of the forensic and risk management issues involved in these situations. Two pamphlets were published in 1996 and 1997 that are good resources: Potential Problems for Psychologists Working with the Area of Interpersonal Violence, and Professional, Ethical and Legal Issues Concerning Interpersonal Violence, Maltreatment, and Related Trauma. Various Guidelines have also been published in APA journals that deal with this topic, and they are referenced throughout this guide. Most of the task forces and committees have recommended that graduate training and continuing education for psychologists concerning family violence be mandated or strongly urged in all states. The present document helps meet the need for a curriculum.
Note: We gratefully acknowledge the input of Janis Sanchez, Ph.D., Guy Seymour, Ph.D. and Yolanda Flores, Ph.D.

Training Curriculum in Relationship Violence
I. Introduction
Relationship violence, including physical, sexual, and psychological abuse, affects many millions of Americans. A US Department of Justice report of findings from the National Violence Against Women Survey involving 16,000 interviews (Tjaden & Thoennes, 1998) estimated that almost 2 million people are victimized in a 12 month period The study estimates that there are close to 9 million incidents of violence annually. Over one-third of the rapes and close to half of the physical assaults of women result in injuries. About 1 in 5 male victims is injured. Other studies indicate that among women victims, 76% were assaulted by an intimate partner as were 18% of male victims (Tjaden & Thoennes, 1998). A third of abusive incidents took place between relatives, and more than half were between spouses or ex-spouses. Partner abuse is found in every ethnic group in the United States. A second report from at survey devoted to intimate partner violence reported that (Tjaden & Thoennes, 2000), 1 out of every 5 women reported having been assaulted by an intimate partner at some time in her lifetime, versus 1 out of every 14 men. In the previous 12 months, 1.3 million women and 835,000 men had been physically assaulted by an intimate partner. However, women were 7 to 14 times more likely to experience serious acts of partner violence, and were significantly more likely to sustain injuries than men who were victims of intimate violence. Thus, it is important to distinguish between acts of aggression and those of abuse. Abuse usually includes an ongoing pattern of behavior, attitudes, and beliefs in which a partner in an intimate relationship attempts to maintain power and control over the other through the use of psychological, physical and/or sexual coercion. Abuse usually produces fear and trauma in those being victimized, whereas isolated aggressive acts may not. With sexual assault, even one sexual aggression can produce fear of rape and fear of men for life.
Until recently most studies of partner violence have been almost exclusively of heterosexual partners, with only limited information about prevalence/incidence of partner violence among gay, lesbian, bisexual and transgendered people. There is a growing body of evidence which suggests that same-gender partner violence is as common as heterosexual partner violence (Farley, 1996; Renzetti, 1992). The dynamics and types of violence in same-gender relationships are similar to heterosexual partner violence (verbal threats, public humiliation, destruction of property, abuse of children, sexual abuse and life-threatening acts). Like most intimate partner violence, same gender partner violence is often invisible and hidden (Lobel, 1986). Many people don't recognize same gender partner violence because partner violence is often portrayed as male violence against women. Island and Letellier (1991a) estimate that as many as 500,000 gay men are victims of domestic violence. Estimates of the prevalence of abuse in lesbian relationships vary widely as researchers have used different methods and questions to measure abuse. We do not have statistics about intimate partner violence for transgendered individuals in either heterosexual or same gendered couples, although there is anecdotal evidence that it does occur. Traditional views of gender roles, heterosexism, negative attitudes toward homosexuality, prejudice and discrimination based on sexual orientation contribute to unique issues of samegendered intimate partner violence. Transgendered individuals can be involved in heterosexual partner violence and same-gendered partner violence. Ignorance about transgender people, prejudice, and discrimination result in a lack of recognition of relationship violence and lack of

appropriate services. Issues are much more complicated for lesbian, gay and transgendered people of color. The interface of racism with heterosexism, negative attitudes toward homosexuality, prejudice and discrimination based on sexual orientation and "transphobia" must be considered at all levels, from causation through treatment and service provision.
In terms of people of color, the National Violence Against Women survey (Tjaden & Thoennes, 2000) reported that Hispanic and non-Hispanic women were nearly equally likely to report physical assault or stalking victimization. There was slightly more such violence in the Black community than in the White community (with violence in all other communities being much lower), but in examining the income levels and the prevalence of violence, quite clearly there is more violence in families distressed economically. To the extent that African American families earn less than their White counterparts, the difference in domestic violence can be accounted for by SES and not ethnicity. Although research in relationship violence has not found it to be more prevalent in ethnic minority communities (Bachman & Saltzman, 1995), available figures may underestimate the true numbers of affected ethnic minority persons due to linguistic/cultural differences, fear of losing one’s community support base, and ethnic minority populations’ suspicion of researchers.
In addition to those directly involved in relationship violence, there is a wide network of family members who are exposed to violence within the family and suffer from its effects, including 3.3 to 10 million children (Carlson, 1984; Straus & Gelles, 1990). The exact number is not clear though since there have been methodological questions concerning the derivation of the prevalence rates. However, recent research has documented the numerous consequences for children exposed to interparental violence (for reviews, see Geffner, Jaffe, & Suderman, 2000; Holden, Geffner & Jouriles, 1998).
We also know that intimate partner violence is not restricted to married couples or committed couples. Dating violence including sexual and physical asssaults has been reported to affect 10% of high school students (Silverman, Raj, Mucci, & Hathaway, 2001), and up to 39% of college students (White & Koss, 1991). Between 1 in 4 and 1 in 5 college women will be raped during college according to most recent US Department of Justice data (Fisher, Cullen, & Turner, 2000). This rate has remained stable since the first national study in 1987 (Koss, Gidycz, & Wisniewski, 1987).
Because of their prevalence, physical, sexual and psychological abuse rank among the most pressing societal problems today. These forms of abuse not only often result in lifelong physical and mental health consequences for those involved, but they also can impact their interpersonal, social and economic functioning. The United Nations recently identified the mistreatment of women and girls as one of the top three global problems hindering development (United Nations General Assembly, 1993). In addition to affecting those most directly involved, partner abuse and violence also impacts medical, public health, criminal justice, and economic systems, and has wide-ranging public policy implications.
The prevalence of intimate partner abuse and relationship violence, combined with the severity of its impact at many levels, argues for the need for psychologists who are already engaged in their career, as well as those still in training, to be knowledgeable about a wide variety of issues

related to partner violence. It is the ethical and moral imperative of all mental health professionals, whether or not they intend to specialize in working with this population, to be informed and trained in appropriate assessment and intervention techniques. Moreover, psychologists must understand the coordinated community responses to partner violence and be aware of the roles they may play within it.
With this curriculum, we suggest that those involved in partner violence have special treatment needs and that those who treat them must do so with sensitivity and from a base of knowledge which comes from specialized training. Psychologists who do not have the requisite training potentially endanger their clients, and likely commit an ethical violation. Those who are teaching psychologists-to-be but who do not teach them about partner violence are abrogating their responsibility and risk perpetuating the conditions which foster this problem.
The curriculum which follows consists primarily of content areas which should be included in a course on intimate partner abuse and relationship violence. It is intended as a first step in the training of mental health professionals to understand, recognize, and intervene with this population. We do not expect that completion of a course that follows this curriculum will give a participant sophisticated expertise in this field. Rather, we see the contents of this curriculum as representing a minimum level of competence in partner abuse and violence.
Special structural considerations for teaching a course on Intimate Partner Abuse and Relationship Violence
While our intention in this document is to provide the content for this course, there are special structural issues that we believe are essential to consider in offering this curriculum. For example, personal experiences with relationship violence on the part of participants may require that instructors be especially sensitive to issues such as the right to privacy, and they should avoid teaching strategies that ask for public disclosure of trauma issues. The instructor should have clinical skills, ready referral sources and the ability to manage difficult interpersonal dynamics in the classroom. Participants should be made aware of the possible emotional impact of course materials prior to enrollment.
In addition to training in psychology and mental health practice, instructors should have specific training in family violence research, theory, assessment, and intervention. In addition, they should have a gender perspective of intimate relationships and special expertise or sensitivity to issues of cultural diversity and sexual orientation.
II. Goals and Learning Objectives
This curriculum is designed to promote education at both undergraduate and graduate levels pertaining to partner abuse and relationship violence. It is developed as a model for faculty members and others who desire to incorporate material regarding partner violence into already existing courses and for faculty who desire to develop courses that focus explicitly on partner

violence. The curriculum seeks to enable future and current psychologists to recognize and address the issue of relationship violence.
Learning Objectives:
The objectives for both Undergraduate & Graduate Level courses are as follows:
1. To inform students/participants of the prevalence and consequences of partner violence.
2. To equip students/participants with definitions and a working knowledge of key concepts and terms. And a basic familiarity with nationwide surveys that document and track the frequency of the various forms of relationship violence.
3. To inform students/participants of the ethical and clinical significance of competency in recognizing, assessing, and responding to relationship violence.
4. To provide students/participants with knowledge pertaining to the historical and societal context of intimate partner violence within contemporary societies.
5. To inform students/participants of existing models for the conceptualization of relationship violence.
6. To provide students/participants with knowledge regarding risk factors for relationship violence.
7. To inform students/participants of the consequences of intimate partner abuse and relationship violence for victims, relationships, children, offenders, and society.
8. To inform students/participants of methods for screening and assessment in working with relationship violence.
9. To provide knowledge pertaining to prevention, community activation/ advocacy, and existing clinical interventions in application with cases of relationship violence.
10. To inform students/participants of forensic and criminal justice issues relevant to cases involving intimate partner abuse and relationship violence.
11. To provide knowledge regarding ethical and legal issues relevant for work with relationship violence.
12. To provide information about special considerations in working with same-gendered couples in which there is relationship violence.
13. To provide information and knowledge about culturally competent practice

Generally speaking, the content areas included below are intended to be covered in overview fashion for undergraduate students and in greater depth at the graduate level. Some issues may be more relevant for graduate than undergraduate students. For example, using Content Area 6, graduate students may need to have extended exposure to a wide variety of assessment instruments, whereas undergraduates’ knowledge may be more appropriately limited to an understanding of the needs for assessment rather than the specific instruments used for that purpose.
III. Curriculum There are a number of cross-cutting issues which affect this curriculum. Each of the following content areas is to be considered from the perspective of the victim, the perpetrator, and the larger relational context. The curriculum also considers the impact of gender, different cultures, and differing sexual orientations as well as the impact and interaction of disability, childhood victimization, and substance abuse on relationship violence and intimate partner abuse. Nine content areas have been identified for this curriculum:
1) definitions of intimate partner abuse and relationship violence, 2) prevalence and incidence of relationship abuse/violence, 3) causal models of relationship violence: Mediating variables, risk factors
(perpetrators) and vulnerability markers (victims), 4) effects of relationship abuse/violence, 5) community responses, 6) screening and assessing for the presence of relationship violence, 7) mental health intervention, 8) forensic issues, and 9) prevention of relationship violence and Promotion of Nonviolence.

Content Area 1: Definitions of Intimate Partner Abuse and Relationship Violence
The course begins with a discussion of what relationship violence is, how the behaviors that comprise it are defined, and how it overlaps with violence against women and family violence, which are the parent fields of study.
Summary of issues to be covered in Content area 1
Key Definitions
• Relationship Violence
This term includes physical, sexual, psychological abuse and stalking committed by one partner against the other in a relationship (all of these terms are defined below). Although relationship violence affects both genders, women are victimized more often and sustain more severe injuries. For this reason, relationship violence is sometimes viewed within the scope of the field of violence against women. Relationship violence includes but is not limited to acts committed by family members against other family members, so it may also fall within the topics examined in the field of family violence. Specifically excluded from relationship violence are acts committed by parents or other adult family members against children or elderly persons (i.e., child maltreatment and elder abuse, respectively). Although these serious forms of abuse involve people who are “related,” they are not partners in an “intimate relationship” as it has been conceptualized for this curriculum. Thus, developing a working model of what constitutes relationship violence is informed by definitions of violence against women and family violence. Relationship violence also occurs in heterosexual, gay and lesbian relationships, and we recognize that not all relationship violence is perpetrated by men or committed on women.
• Violence Against Women
The APA Taskforce on Male Violence Against Women defined violence as, “Physical, visual, verbal, or sexual acts that are experienced by a woman or a girl as threat, invasion, or assault and have the effect of hurting her or degrading her and/or taking away her ability to control contact (intimate or otherwise) with another individual” (Koss, Goodman, Browne, Fitzgerald, Keita & Russo, 1994, p.xvi.). Among the forms of violence against women that fall outside the scope of relationship violence are workplace violence and sexual harassment. Other forms of violence against women are more common internationally than in the United States, including denying food and resources to girls in societies that favor male offspring, commercial trafficking in women and forced prostitution (sexual slavery, sexual torture and sexual humiliation) (Koss & Kilpatrick, 2001). The National Research Council Panel on Violence Against Women concluded that whether one uses a narrow definition or broader definition of violence

against women, definitions of the individual components are also needed. (Crowell & Burgess, 1996).
Family violence refers to acts of physical, sexual and psychological maltreatment on which one person controls or intends to control another person’s behavior. The misuse of power and control is usually involved and usually results in some type of harm to the family members involved (APA, 1996a). As stated above, there are important topics within family violence that fall outside of relationship violence in the context of the present curriculum, such as child neglect and maltreatment or elder abuse. There are also forms of family violence that are more common from a global perspective than in the United States, such as female genital mutilation, genital contact as part of cultural rituals, and child rapes occurring under the guise of arranged marriages. Definitions of common terms are shown below:
• Victim is a target of violence (Saltzman, Fanslow, McMahon, & Shelley, 1999).
• Perpetrator is a person who inflicts violence or abuse (Saltzman et al., 1999).
• Relationship partners - spouses (current and former), nonmarital partners (current and former), dates and girlfriends or boyfriends (heterosexual and same-sex; Saltzman et al., 1999). Persons who have just met and are in the preliminary stages of intimacy are considered within the scope of this definition of relationships.
• Physical abuse encompasses, but should not be limited to a continuum of acts that range from slaps to killing of men (homicide) and women (femicide). This includes pushing, shoving, hitting, punching, kicking, choking, assault with a weapon, tying down or restraining, leaving the person in a dangerous place, and refusing to help when the person is sick or injured.
• Sexual assault is a continuum from forcible rape to nonphysical forms of pressure that compel individuals to engage in sex against their will. Sexual assault takes many forms within relationships, including marital, date, and acquaintance rape. Three central elements characterize legal definitions of rape: lack of consent; penetration, no matter how slight or independent of whether ejaculation occurred; and compelling participation by force, threat of bodily harm, or with a person incapable of giving consent due to intoxication or mental incapacitation. Sexual assault also includes acts such as sexual degradation, intentionally hurting someone during sex, assaults upon the genitals, including use of objects intravaginally, orally, or anally, pursuing sex when someone is not fully conscious or afraid to say no, and coercing an individual to have sex without protection against pregnancy or sexually transmitted diseases.
• Psychological abuse refers to: acts such as degradation, humiliation, intimidation and threats of harm; intense criticizing, insulting, belittling, ridiculing, and name calling that have the effect of making a person believe they are not worthwhile and keep them under the control of the abuser; verbal threats of abuse, harm, or torture directed

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Intimate Partner Abuse and Relationship Violence