Identifying and Responding to Abuse During Couples Therapy

Couples in an abusive relationship often seek therapy for other issues and fail to

mention abuse. A few of the reasons they don’t identify it:

• Victims are invested in the relationship and think couples therapy will convince the partner to change.

• The abusive partner threatens consequences for speaking about it.

• The abuser does not view their behavior as inappropriate and persuades their partner they are to blame.

• Neither one recognizes inappropriate or aggressive behavior.

Regardless of the reason they do not identify abuse, traditional couples therapy risks harming the victim. This places the therapist in a difficult position. Red flags that alert you to abuse or its possibility follow, along with my recommended assessment process.   

Red Flags

The following behaviors signal caution, that there may be a power imbalance due to a

partner using some form of abuse.  

• One partner dominates the conversation, speaking over the other, answering for them, or diminishing what they say.

• One partner looks at the other before responding, which often indicates fear about how they will respond to what they say.  

• During a session, you witness signs of abuse or manipulation, such as twisting statements, threats, contempt, name-calling, minimizing abusive actions, or justifying harmful behavior.

  
  

When you see red flags, it is crucial to adjust your assessment strategy to better understand the relationship dynamics. Victims usually suffer retaliation if they name abuse from their partner, so proceed with caution. A recommended approach is the Four Session Assessment[i] described below, which allows for a comprehensive evaluation and enhances the safety of the victim.

In cases of witnessing abusive behavior in sessions, it’s important to name it. Objectivity is important but don’t confuse that with neutrality about abuse. To summarize my article How to Handle Abuse Revealed During Couples' Therapy, state:

• The abusive behavior is not okay.

• The one using it is the only person who can stop it.

• You can only help them as a couple after abuse stops.

• You have faith that the one using abuse can stop it with help.   

An example of beginning the conversation: “I insist upon therapy being a safe space and what you said just now was abusive. Let’s talk about how it interferes with your goal of preserving your relationship and what you think about that.”

An abuser who is committed to maintaining their power and control in the relationship often refuses to address their behavior. Nevertheless, your intervention gives important information and support to the victim, even if they aren’t ready to confront the problem then.  

Four Session Assessment with Couples Therapy

When I practiced therapy, I used this intake process with all couples. I found it helpful in gathering information and understanding each of their dynamics even when abuse was not present. In addition, it enhanced my ability to identify abuse early in therapy.

Initial Phone Call:

Inform the couple that you use a four session assessment to gain understanding of how best to help them. Schedule all four sessions up front to ensure the intake process occurs within a good timeline.

Session 1 

The first session is with both partners. Gather information regarding why they are there and what success looks like to them. Take note of how they relate to one another, such as:

• Do they express affection?

• Do you witness any red flags?

• What are their attachment styles?

• What do each want to change?

  
  

Sessions 2 & 3 

During individual meetings, explore more fully any issues you noticed during the joint session. Inquire about how conflict was handled in their family of origin and then move to how they handle conflict with their partner. Ask about their partner’s behavior during disagreements and how it affects them. Inquire about whether they feel safe in the relationship, letting them know you ask this question of everyone.

Examine their motivation for any behavior you think is inappropriate or abusive. Addressing motivation helps discern the primary aggressor if there is inappropriate behavior by both partners. In particular, is their motivation to maintain control or self-defense.

• Victims sometimes react aggressively to abuse, but their motivation is self-defense, or occasionally a mistaken notion that their partner will recognize how harmful the behavior is and stop abusing them. Victim aggressive behavior stops when abuse stops.

• Those who feel entitled to abuse desire power and control in the relationship without empathy for their partner’s needs or desires. They do not alter their behavior when their partner changes or sets limits but instead escalate it.  

If abuse is disclosed, ask if the victimized partner is comfortable discussing their concerns in the joint recommendation session.

• Always respect their wishes regarding confidentiality. When someone does not feel safe, provide information regarding resources that can develop safety plans.

• If they want you to share information with the partner, agree upon what you’ll say about it.  

Session 4 

The fourth session is a joint one in which you give recommendations for what would best help the relationship. How you give recommendations should be based on whether the victimized partner permits disclosure of abuse concerns during the joint session.

• If the victim is concerned about their safety, tell both that individual work is needed before couples’ therapy will be helpful to them. Give your observations and rationale for recommending separate therapy while maintaining the victim's confidentiality. Indicate that individual work enhances the success of couples therapy.  

• If the victim says you can share what they said, be direct in talking about abuse. Emphasize their joint strength in facing this issue and ask for the aggressive partner’s response.  

  
  

Educate them about healthy relationship behavior and show empathy for any background the contributed to learning unhealthy or abusive behavior. Affirm the importance of learning new behavior to improve their relationship satisfaction.   

Refer the person using abusive behavior to a provider specializing in power and control issues, not generic anger management. Educate yourself about referrals available in your community.

Refer the victimized partner to a therapist specializing in partner abuse or trauma. If you provide this type of therapy to the victim, indicate that future couples work will likely happen with another provider unless you and both parties are comfortable with it. The provider who treats abuse often is in a better position to provide the couples therapy, as an existing trust allows them to address any abuse of power more effectively.

Summary

Couples therapy requires careful assessment to ensure power is balanced in the relationship and abuse is not present. Therapists should watch for signs of abuse, such as fear or one partner dominating sessions. A four session assessment process is recommended to allow for safe disclosure of abuse. If abuse is identified, it’s crucial to prioritize safety, offer resources, and recommend individual therapy before continuing with couples counseling. Referral for individual work promotes safety for the victim and reduces the chance of the abuser being able to misuse therapy to maintain their control over their partner.  

[i] “The Four Session Assessment in Couple Therapy,” Chambers A.L. (2018)  In: Lebow J., Chambers A., Breunlin D. (eds) Encyclopedia of Couple and Family Therapy. Springer, Cham. https://doi.org/10.1007/978-3-319-15877-8_679-1