Crisis Intervention

Risk assessment and safety conditions

The absolute priority when violence is suspected is safety. Before considering any couple intervention, the therapist must assess the level of risk.

Joint therapy is contraindicated if there is active violence, fear of retaliation for speaking out in session, or inability of one partner to express him/herself freely due to coercion.

The presence of weapons, recent escalation of aggression, and threats of homicide or suicide should be inquired about.

If violence is ongoing, couple treatment can be dangerous, as the issues discussed in session could trigger aggression at home.

In these cases, referral to protective services and separate individual therapy is the ethical protocol to follow.

Strengthening self-awareness and self-esteem.

If working with a victim (either in a context where the violence has ceased and there is a safety agreement, or in individual therapy), the focus is on rebuilding the eroded "self."

Techniques such as Socratic dialogue are used to help the person recognize the reality of their situation, overcoming denial and minimization ("Do you think it is normal to have to ask permission to leave?").

The objective is for the victim to stop blaming herself for the aggressor's behavior and to recover her self-concept and autonomy.

Work is done to identify her support networks, her capabilities and her basic rights.

Empowering the victim to value herself is the antidote to the dependency that enables the cycle of abuse.

Ethical considerations about confidentiality

Information management is critical. The therapist must be transparent about the limits of confidentiality.

If a situation of imminent risk to the life of an adult or any suspicion of child abuse (which often coexists with intimate partner violence) is disclosed, the professional has an ethical and legal obligation to break confidentiality and notify the appropriate authorities.

However, in situations of non-immediate lethal risk to adults, caution should be exercised so as not to increase the danger to the victim.

Decisions about reporting or intervention should be made, to the extent possible, in collaboration with the victim and within a structured safety plan.

The therapeutic contract should clearly state that viol