Domestic violence is a serious and dangerous issue that affects millions of people. If you or someone you know is experiencing abuse, it's crucial to understand that help is available and that no one deserves to be in an abusive relationship. This page provides essential information about getting help, staying safe, and understanding treatment options for those affected by domestic violence.
According to recent data from the Centers for Disease Control and Prevention, approximately 10 million people in the United States are affected by domestic violence each year, with as many as one in four women and one in nine men experiencing domestic violence in their lifetimes. The impact extends beyond physical harm, affecting mental health, economic stability, and overall quality of life.
Table of Contents
- Understanding the Danger of Domestic Violence
- Creating a Safety Plan
- Individual Therapy for Survivors
- Group Therapy and Support
- Why Couples Therapy May Not Be Safe
- Help for Children Affected by Domestic Violence
- Treatment for Those Who Use Violence
- Frequently Asked Questions
- Find Help and Resources
Understanding the Danger of Domestic Violence
Domestic violence encompasses economic, physical, sexual, emotional, and psychological abuse of individuals within intimate relationships. It occurs across all demographics, regardless of culture, race, religion, or socioeconomic status. Domestic violence causes worsened psychological and physical health, decreased quality of life, decreased productivity, and in some cases, mortality.
For those experiencing domestic violence, therapy must be used appropriately and with safety as the primary concern. Traditional couples therapy might not help—and could even be harmful—for those in relationships with domestic violence. Working on a relationship with an abusive partner can be dangerous, even with a therapist present. If your safety or your children's safety is in danger, the priority should be getting to safety rather than trying to fix the relationship.
Creating a Safety Plan
One of the most dangerous times for someone experiencing domestic violence is when they attempt to leave the relationship. This increased risk is why many people stay in violent relationships. Creating a comprehensive safety plan is essential for protecting yourself and your children.
Essential Safety Planning Steps:
Immediate Safety Measures:
- When tension increases and an argument seems near, identify which room in your home is safest
- Ensure the safe room has an exit and no weapons
- Memorize important identification numbers and phone numbers
- Always carry change for phone calls
Building Your Support Network:
- Create a contact list of safe people you can reach out to for help
- Develop a code word to use with family, friends, or coworkers to signal that you need help
- Identify safe places where you could go if you need to leave suddenly
Preparing to Leave:
- Consider opening a bank account or credit card in your name only
- Hide a bag of essential belongings somewhere in your house or with a trusted friend
- Gather important documents (identification, financial records, medical information)
- Plan for your pets' safety as well
When You're Ready to Leave:
- Go to a safe place or domestic violence shelter with your children
- Seek out legal, financial, and emotional support services
- If it's not safe or possible to take your children immediately, arrange for temporary protective custody
Digital Safety Considerations
Internet usage can be monitored and is impossible to erase completely. If you're concerned your internet usage might be monitored, call us at 800.799.SAFE (7233). When researching resources online:
- Use a computer at a safe location like a public library or friend's house
- Learn to clear your browser history
- Consider using incognito/private browsing mode
- Be aware that abusers may track phone usage and location
Individual Therapy for Survivors
Benefits of One-on-One Counseling
Individual therapy can be highly effective for survivors of domestic violence. These studies reported significant reductions in severity of mental health conditions like depression and PTSD, as well as an increase in social support and self-efficacy for the women who were involved in the study.
Individual therapy offers survivors:
- A safe space to process trauma without fear of retaliation
- Help identifying patterns of violence and creating safety plans
- Support in addressing self-esteem issues, anxiety, fear, and posttraumatic stress
- Tools to challenge negative beliefs about themselves
- Strategies for rebuilding their lives and relationships
Evidence-Based Approaches
Recent research has shown promising results for several therapeutic approaches:
Trauma-Focused Therapies: Trauma-focused interventions are specific approaches to therapy that recognize and emphasize how the traumatic experience impacts an individual's mental, behavioral, emotional, physical, and spiritual well-being. Cognitive-processing therapy (CPT) and cognitive-behavioral therapy (CBT) are the most common forms of trauma-focused interventions offered to survivors of DV and SV.
Acceptance and Commitment Therapy (ACT): The aim of this study was to examine the effectiveness of group Compassion-Based Acceptance and Commitment Therapy (ACT) and group Schema Therapy on depression, stress, psychological well-being, and resiliency in female intimate partner violence (IPV) victims in Iran. For this purpose, a sample of 60 women who reported ongoing experiences of IPV were selected. Out of these 60 women, 20 were randomly assigned to the ACT treatment group, 20 to the Schema Therapy group, and 20 to the no-treatment control group.
Group Therapy and Support
Group therapy provides unique benefits for domestic violence survivors by connecting them with others who have had similar experiences. After training, they carried out advocacy activities, engaging different stakeholders and members of their social networks to address harmful social norms around GBV. At the end of the intervention, there were reported lower rates of IPV among the intervention community. Other interventions like the 'Framing Safety project', which focused on promoting agency and self-empowerment among survivors of violence, found that by providing means through which survivors of violence could tell their own stories and take ownership of this process, there was a resulting feeling of empowerment among the women.
Benefits of group therapy include:
- Shared experiences that help normalize feelings and reactions
- Building a support network with other survivors
- Learning from others' coping strategies and successes
- Reduced isolation and shame
- Opportunities for mutual support and encouragement
Creative and Alternative Therapies
Many survivors find healing through alternative therapeutic approaches:
- Art therapy provides creative outlets for expressing difficult emotions
- Music therapy helps process trauma through sound and rhythm
- Animal-assisted therapy helps survivors learn to trust again through connections with therapy animals
- Mindfulness-based interventions teach emotional regulation and stress management
Why Couples Therapy May Not Be Safe
Understanding the Risks
Couple therapists will encounter couple violence in their practice at some point. In this context, one of the main questions they must address is whether to continue with conjoint sessions. This study explores how couple therapists make sense of their decision whether or not to continue with conjoint sessions when violence has become an issue.
Couples counseling is generally not recommended when violence is present in the relationship. Here's why:
Power Imbalances: Coercive controlling violence typically unfolds within a framework of coercive control, where one partner repeatedly uses multiple coercive measures to control and dominate the other partner. In contrast, situational couple violence can be understood as the result of escalated conflicts where one or both partners contribute to the destructive interactional pattern.
Safety Concerns: Clinicians, case workers and some researchers are concerned that talking about sensitive topics in couple therapy sessions results in increased tension, which in turn creates a risk of intimate partner violence for the victims as well as the worry of violent retaliation after a session.
Foundation Issues: Couples counseling requires:
- Mutual respect between partners
- Shared responsibility for relationship outcomes
- Both partners feeling safe to communicate openly
- Willingness to change from both individuals
These conditions typically don't exist in relationships with ongoing violence.
When Couples Work Might Be Considered
In parallel with the high prevalence of violent behaviour in couples seeking therapy, it has been controversial and repeatedly debated as to whether couple therapy is safe, appropriate, or even an ethical form of treatment for partner violence. However, studies show that couple therapy can be appropriate and as effective as other interventions when both the violence and the couples are carefully screened and appropriately assessed for conjoint therapy.
However, this requires:
- The violent partner first completing treatment to stop abusive behaviors
- The survivor addressing their own trauma and safety needs
- Careful assessment by trained professionals
- Ongoing safety monitoring throughout treatment
Help for Children Affected by Domestic Violence
Children who witness domestic violence experience significant trauma that requires specialized intervention. In 2020, California began offering Medi-Cal (Medicaid) providers training, clinical protocols, and reimbursement for screening children and adults for adverse childhood events (ACEs), which include exposure to violence between parents. As of March 2023, ACEs Aware had trained more than 35,000 providers, who had screened more than 1.5 million Medi-Cal members.
Impact on Children
Children who witness domestic abuse may experience:
- Sleep disturbances and nightmares
- Academic difficulties and trouble concentrating at school
- Behavioral problems including aggression or withdrawal
- Physical symptoms like headaches and stomach aches
- Emotional issues including anxiety, depression, and fear
Thackeray J, Livingston N, Ragavan MI, et al. Intimate partner violence: role of the pediatrician. Pediatrics 2023;152(1):e2023062509. 10.1542/peds.2023-062509 emphasizes the critical role healthcare providers play in identifying and supporting these children.
Therapeutic Interventions for Children
Play Therapy: Young children often have difficulty expressing their feelings verbally. Play therapy allows them to process trauma through developmentally appropriate activities.
Parent-Child Interaction Therapy: Jenney A, Scott K, Wall M. Mothers in mind: exploring the efficacy of a dyadic group parenting intervention for women who have experienced intimate partner violence and their young children. Int J Child Maltreat. 2022;5(1):57–79.
Trauma-Focused Cognitive Behavioral Therapy (TF-CBT): This evidence-based treatment helps children process trauma, develop coping skills, and strengthen the parent-child relationship.
Long-Term Considerations
Without appropriate intervention, children who witness domestic violence may:
- Develop unhealthy coping mechanisms
- Experience ongoing mental health challenges
- Be at increased risk for being in abusive relationships as adults
- Have difficulty forming healthy relationships
Early intervention is crucial for breaking the intergenerational cycle of violence.
Treatment for Those Who Use Violence
Understanding Perpetrator Interventions
Treatment for individuals who have used violence in relationships has evolved significantly. Over the years, PIPs differed in terms of theoretical frameworks to prevent and diminish the risk of IPV. The early interventions were based on the Duluth model, which views IPV as a manifestation of patriarchy or male socialization. According to this perspective, the perpetrator uses violence to maintain power and control over their partner. Therefore, these early PIPs are based on a gender perspective with a psychoeducational approach aimed at modifying the attitudes of male perpetrators toward women.
Current Evidence-Based Approaches
Cognitive Behavioral Therapy (CBT): CBT for perpetrators of IPV aims to transform hostile cognitive biases, work on affect dysregulation, and address skill-based deficiencies, including assertiveness, communication, and problem-solving.
Motivational Interviewing: Motivational Interviewing (MI)—both exclusive or combined with CBT—consistently improved treatment engagement, readiness for change, and program completion, although its effects on IPV behaviors were mixed or non-significant across most reviews.
Third-Wave Therapies: More recently, new approaches based on mindfulness principles, such as Acceptance and Commitment Therapy, have been applied to perpetrators of IPV.
Challenges and Considerations
The literature underscores the importance of addressing the motivation of IPV perpetrators, given their notably high dropout rates and the consequences of non-treatment completion (e.g., dropout is a predictor of IPV recurrence).
Key challenges include:
- High dropout rates from treatment programs
- Motivation and readiness to change
- Addressing co-occurring issues like substance abuse
- Ensuring victim safety during treatment
- Long-term behavior change maintenance
Court-Mandated Treatment
When domestic violence cases go to court, treatment may be mandated for the perpetrator. There is a need for robust evidence on the effectiveness and cost-effectiveness of domestic abuse perpetrator programmes in reducing abusive behaviour and improving wellbeing for victim/survivors. While any randomised controlled trial can present difficulties in terms of recruitment and retention, conducting such a trial with domestic abuse perpetrators is particularly challenging.
Frequently Asked Questions
Is it ever safe to stay with someone who has been violent?
Safety must always be the top priority. While some people who use violence can change with appropriate treatment, this process takes time and commitment. Never stay in a situation where you or your children are in immediate danger. Work with trained professionals to assess your specific situation and create a safety plan.
How do I know if therapy will help my situation?
The type and effectiveness of therapy depends on many factors, including the nature and severity of the violence, safety concerns, and each person's willingness to engage in treatment. Individual therapy for survivors is generally recommended as a first step. A trained therapist can help assess what additional interventions might be appropriate and safe.
What should I look for in a therapist?
Look for therapists who:
- Have specific training in domestic violence and trauma
- Prioritize your safety in all treatment decisions
- Understand the dynamics of power and control in abusive relationships
- Respect your decisions and autonomy
- Offer evidence-based treatments
- Can provide appropriate referrals to other services
Can children recover from witnessing domestic violence?
Yes, with appropriate support and intervention, children can heal from trauma. Early intervention is crucial. Based on 20 years of experience in California, this commentary provides detailed examples of 2 DV prevention strategies: interrupting intergenerational transmission and addressing macrolevel drivers. Family-strengthening approaches to prevention and justice and increasing economic security are key.
What if I'm not ready to leave?
Many factors influence the decision to leave an abusive relationship. If you're not ready to leave, focus on:
- Creating a safety plan for emergency situations
- Building a support network
- Seeking individual therapy to process your experiences
- Documenting incidents of abuse
- Learning about available resources
- Trusting yourself to make decisions when you're ready
How can friends and family help?
Supportive friends and family can:
- Listen without judgment
- Respect the survivor's decisions and timeline
- Help with safety planning
- Provide practical support (childcare, transportation, temporary housing)
- Learn about domestic violence dynamics
- Connect survivors with professional resources
Find Help and Resources
Crisis Hotlines (Available 24/7)
National Domestic Violence Hotline
- Phone: 800.799.SAFE (7233)
- Text: Text START to 88788
- Online chat: TheHotline.org
- TTY: 1-800-787-3224
Love is Respect - National Teen Dating Abuse Helpline
- Phone: 866.331.9474
- Text: Text "LOVEIS" to 22522
- Online chat: loveisrespect.org
StrongHearts Native Helpline
- Phone: 844.762.8483
- Available for Native Americans and Alaska Natives
National Sexual Assault Hotline
- Phone: 1-800-656-HOPE (4673)
- Online chat: hotline.rainn.org/online
Online Resources
- National Resource Center on Domestic Violence: nrcdv.org
- National Coalition Against Domestic Violence: ncadv.org
- DomesticShelters.org: Find local shelters and resources
- National Center on Domestic Violence, Trauma & Mental Health: ncdvtmh.org
How Therapy Can Help
If you're ready to seek professional help, therapy can provide:
- A safe, confidential space to process your experiences
- Evidence-based treatments for trauma and related mental health concerns
- Support in developing coping strategies
- Assistance with safety planning
- Connection to additional resources and services
- Help rebuilding self-esteem and healthy relationships
[Find a Therapist](/therapists) - Search our directory for therapists specializing in domestic violence and trauma
Remember: You deserve to live free from violence and fear. Help is available, and healing is possible.
References:
- Administration for Children and Families. (2024). ACF hotlines and helplines. https://acf.gov/acf-hotlines-helplines
- Centers for Disease Control and Prevention. (2024, February). Reports and publications: National Intimate Partner and Sexual Violence Survey (NISVS). https://www.cdc.gov/nisvs/documentation/index.html
- Chen, J. I., Houtsma, C., Smith, L. J., Wisco, B. E., Gradus, J. L., Harvey, M. A., & Kennedy, C. J. (2023). Examining the effectiveness, acceptability, and feasibility of virtually delivered trauma-focused domestic violence and sexual violence interventions: A rapid evidence assessment. Trauma, Violence, & Abuse, 24(3), 1580–1594. https://doi.org/10.1177/15248380231193431
- Cleary Bradley, R. P., Friend, D. J., & Gottman, J. M. (2024). Is it safe enough? An IPA study of how couple therapists make sense of their decision to either stop or continue with couple therapy when violence becomes the issue. International Journal of Environmental Research and Public Health, 21(1), 73. https://doi.org/10.3390/ijerph21010073
- Craven, S. S., Powell, T., & Johnson-Motoyama, M. (2023). Counseling interventions for victims of intimate partner violence: A systematic review. Journal of Counseling & Development, 101(3), 321-334. https://doi.org/10.1002/jcad.12478
- Creech, S. K., & Taft, C. T. (2023). Promoting the use of evidence-based practice for those who engage in intimate partner violence. American Journal of Preventive Medicine, 65(6), 1147-1149. https://doi.org/10.1016/j.amepre.2023.08.006
- Cunha, O., Pedrosa, J., Rodrigues, A. C., & Caridade, S. (2024). Short motivational program for perpetrators of intimate partner violence: A feasibility study. Journal of Police and Criminal Psychology, 39(3), 680-695. https://doi.org/10.1007/s11896-024-09680-z
- Dell'Aquila, M., D'Agostino, A., Malvini, A., Vicari, S., & Stallone, T. (2024). Interventions for perpetrators of intimate partner violence: An umbrella review of systematic reviews. Clinical Psychology Review, 114, 102471. https://doi.org/10.1016/j.cpr.2024.102471
- Doswell, A., Kazmir, S., Kaufman, M., Raguz, A., Guttentag, A., & Spector, N. D. (2024). Impact of intimate partner violence on children. Pediatric Clinics of North America, 72(3), 509-523. https://doi.org/10.1016/j.pcl.2024.12.005
- Huecker, M. R., King, K. C., Jordan, G. A., & Smock, W. (2023, April 9). Domestic violence. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK499891/
- Lopez, L. V. (2024, April). Domestic violence: Prevention past due. Health Affairs Scholar, 2(4), qxae035. https://doi.org/10.1093/haschl/qxae035
- Love is Respect. (2024). National Teen Dating Abuse Helpline. 1-866-331-9474. https://www.loveisrespect.org/
- Micklitz, H. M., Glass, C. M., Bengel, J., & Sander, L. B. (2023). Efficacy of psychosocial interventions for survivors of intimate partner violence: Protocol for a systematic review and meta-analysis. BJPsych Open, 9(1), e9. https://doi.org/10.1192/bjo.2022.625
- Montesanti, S. R., Wellman, M., Wild, T. C., & Silverstone, P. H. (2023). Effectiveness of trauma- and violence-informed care interventions: A systematic review. Current Psychology, 42(28), 24567–24583. https://doi.org/10.1007/s12144-022-03553-6
- National Center on Domestic Violence, Trauma & Mental Health. (2024). Resources and publications. https://ncdvtmh.org/
- National Domestic Violence Hotline. (2024). Get help. 1-800-799-7233. https://www.thehotline.org/
- National Institute of Mental Health. (2024). Child and adolescent mental health. https://www.nimh.nih.gov/health/topics/child-and-adolescent-mental-health
- National Resource Center on Domestic Violence. (2024). Information & resources for survivors. https://nrcdv.org/
- Nikparvar, F., Sasanian, F., Spencer, C., & Stith, S. (2023). Effectiveness of compassion-based acceptance therapy and schema therapy on intimate partner violence victims' psychological health. Journal of Interpersonal Violence, 38(17-18), 9845–9868. https://doi.org/10.1177/08862605231169736
- Ogden, L., McTavish, J. R., & MacGregor, J. C. (2020). A systematic review of intimate partner violence interventions focused on improving social support and/mental health outcomes of survivors. PLoS ONE, 15(6), e0235177. https://doi.org/10.1371/journal.pone.0235177
- Sousa, M., Andrade, J., Rodrigues, A. C., Caridade, S., & Cunha, O. (2024). The effectiveness of intervention programs for perpetrators of intimate partner violence with substance abuse and/or mental disorders: A systematic review. Trauma, Violence, & Abuse, 25(5), 3396-3415. https://doi.org/10.1177/15248380241270063
- StrongHearts Native Helpline. (2024). Native American domestic violence support. 1-844-762-8483. https://strongheartshelpline.org/
- Substance Abuse and Mental Health Services Administration. (2023). Domestic violence awareness month: SAMHSA's commitment to raising awareness and hope for survivors. https://www.samhsa.gov/blog/domestic-violence-awareness-month-samhsas-commitment-raising-awareness-hope-survivors
