Effectiveness of Couples Treatment for Intimate Partner Violence: A Systematic Review

Purpose: The current response to intimate partner violence (IPV) is a combination of legal penalties and rehabilitation for perpetrators. Most interventions are event-driven, mandated by the criminal justice system. Participants enter treatment because they were found guilty of a criminal offense and subsequently mandated to batterer treatment as a condition of their parole or probation, despite the lack of evidence for the efficacy of batterer intervention programs (BIP’s). Treating couples conjointly has historically been controversial and some argue that this may have adverse effects on victims. Studies have explored the possibilities of conjoint treatment since the 1980’s; however a systematic review or meta-analysis of these findings has not been conducted. To address this gap, this study addressed the following research questions: 1) Are couples interventions effective for reducing psychological and physical abuse, when accounting for their methodological rigor? 2) Are interventions more effective depending on their length and whether they include individual sessions? 3) Does methodological rigor vary by publication date? 4) Does couples treatment have adverse effects on victims?

Methods: A systematic search of 10 databases was conducted to identify studies published between 1970 and the present. Studies in peer-reviewed journals were included if they met the following criteria: 1) conducted couples treatment; 2) measured outcomes related to IPV; 3) presented statistical analysis of data. Methodological rigor of each study was assessed using an adapted version of the Methodological Quality Rating Scale (9 items, with possible total scores of 0-10). Total scores were used to distinguish studies with higher and lower rigor using a median split. The primary outcomes of interests (psychological and physical abuse) were compared across studies based on the Outcome Attainment index (combining rigor with statistical significance).

Results: Fourteen studies met inclusion criteria. Nine of the twelve studies measuring physical abuse as an outcome presented significant findings. Seven of the eight studies measuring psychological abuse also had significant findings. There was not enough variation in the outcomes of studies for those receiving couples treatment vs. participants receiving couples treatment plus individual sessions to determine if a pattern existed between the two groups. Of the nine studies presenting information on the number of treatment sessions, all of the studies that implemented a program involving ≥10 sessions (N=6) had significant reduction in physical abuse, indicating that number of sessions matters for influencing physical violence. However for psychological abuse, outcomes did not vary based on number of sessions. Results also indicate there has been improvement in the methodological rigor of studies overtime. None of the studies found that couples treatment had adverse effects on victims.

Conclusions/Implications: Findings indicate that under certain circumstances, couples treatment shows evidence for reducing physical and psychological abuse in IPV, providing evidence for further exploring this form of treatment. These findings can aid researchers in developing interventions that are tailored more specifically to the needs of perpetrators/victims instead of suggesting everyone involved in IPV should receive the same treatment. Funding may be needed for longer programs and couples treatment may be safely incorporated into BIP’s.