Addressing intimate partner violence with clients

By Bethany Bray

June 2019

Licensed mental health counselor Ryan G. Carlson had just earned his master’s degree when he began working on a grant-funded project to provide relationship education to couples in the Orlando, Florida, area. Overseeing the intake process as local couples came into the university-based research center to participate, he quickly learned two things: Domestic violence “is very prevalent — much more prevalent than I realized — and it’s complicated,” says Carlson, an associate professor of counselor education at the University of South Carolina. “Every case was a little bit different than the next.”

The National Coalition Against Domestic Violence reports that on average, nearly 20 people per minute are physically abused by an intimate partner in the United States. On a typical day, domestic violence hotlines across the country receive more than 20,000 phone calls.

Approximately 1 in 4 adult women and 1 in 7 adult men report having experienced severe physical violence from an intimate partner in their lifetime, according to the U.S. Centers for Disease Control and Prevention. In addition, 16% of women and 7% of men have experienced sexual violence from an intimate partner.

Carlson’s experience led him to study domestic violence while earning his doctorate, and it remains a career focus for him as he conducts research, does interdisciplinary work and conducts trainings for mental health professionals. “We assume when there’s violence in a couple’s relationship, they will tell us [in counseling]. What I’ve learned is if we don’t ask the right questions, they won’t tell us, and you shouldn’t ask those questions if you’re not ready for their disclosure,” he says. “It’s really complicated and emotionally charged. ... A victim’s safety should be at the center of every decision we make as counselors.”

Handle with care

Counselors who notice patterns of maladaptive behavior, self-esteem issues or what appears to be poor decision-making by clients may automatically want to roll up their sleeves and dive into goal-setting and other go-to techniques to foster change and growth. However, engaging in change-focused work when a client is experiencing IPV may be harmful, warns Taylor Cameron, a licensed professional counselor (LPC) and director of transitional housing at Denton County Friends of the Family, a nonprofit agency in Texas that provides support services to victims of domestic violence and sexual assault. It also offers an intervention program for offenders.

The tried-and-true counseling method of talking through clients’ life scenarios, behaviors and choices while asking questions such as “What could you have done differently?” or “What would you want to change if this happens again?” can be hurtful because a counselor may inadvertently be placing the responsibility for the abuse on the victim instead of on the abuser, Cameron says. She cautions that counselors must choose their language carefully to avoid making the client feel that they are somehow to blame for the abuse they have endured.

“Victims of domestic violence do many things to survive or to try to protect themselves within the relationship,” says Cameron, an American Counseling Association member. “However, the partner carrying out the abuse is solely responsible for the violence.” Ultimately, the client can’t control — and should never be made to feel that they shoulder the blame for — what their partner does, she emphasizes.

Carlson, who is also a member of ACA, agrees. He notes that it isn’t helpful for professional clinical counselors to identify client behaviors that could be changed or avoided when clients may have adopted those patterns as a means of self-protection.

“It’s important to be careful about how we phrase things with [these] clients,” says Carlson, director of the Consortium for Family Strengthening Research and coordinator of the Center for Community Counseling at the University of South Carolina. “Avoid anything that has to do with ‘what could you have done differently?’ questions, anything that would allude to how [the client] contributed to their current situation. ... It’s a delicate balance, but it’s really important to avoid language that [even inadvertently suggests] a victim is somehow at fault for being in that relationship.”

“It doesn’t matter what they change about themselves because that is not going to change the other person,” says Margaret Bassett, an LPC and deputy director at the Institute on Domestic Violence & Sexual Assault at the University of Texas at Austin. Counselor practitioners must consider the entire context of a client’s behavior to fully understand why they’re making those decisions, she says. Decisions that victims of abuse make — often for reasons of safety — can appear maladaptive from outside the context of the abusive relationship.

Bassett recalls a client who talked about agreeing to meet her estranged husband at a public library. Without understanding the full context of the situation — that if she didn’t meet with him, he had a history of escalating — a counselor might assume that the client was complicit in maintaining the abusive relationship rather than appreciate her layered safety planning, Bassett says.

“It was a brilliant move. It was safe to meet there because he couldn’t escalate without drawing attention,” Bassett explains. “Not meeting him just was not possible. This was meeting on her terms versus his terms. ... This ties into [a counselor] listening and really hearing what the person is saying and not judging it out of context. Really being able to say, ‘That is a brilliant idea that you had.’ It’s not a good or a bad choice. Instead say, ‘When I hear that, I hear the safety it creates.’”

Victims of abuse often adopt patterns and behaviors that are the best choices they can make in a bad situation, Bassett notes. Professional clinical counselors should listen carefully to understand the full context of clients’ lives and then validate the choices they are making to safely navigate abusive and potentially violent situations. “Respect that they’re making a decision and really understand their safety concerns so your intervention is helpful and doable,” Bassett says.

Power and control

IPV happens between partners of all cultures and backgrounds — couples who are married and unmarried, heterosexual and homosexual, wealthy and poor, religious and nonreligious, white, Asian, Hispanic, African American and every other race. In addition, IPV often intersects with sexual assault; homelessness or disruptions in housing, schoolwork or employment; financial trouble; parenting issues; and myriad other challenges that spill over into the mental health issues that commonly bring clients to counseling.

Although the terms domestic violence and intimate partner violence both include the word “violence,” the abuse doesn’t always have a physical component, or the violent behavior is combined with emotional, nonphysical manipulation. What defines a behavior or relationship as abusive is a common thread of power and control. In its simplest definition, domestic violence is an intentional pattern of behaviors used by the abuser to gain and maintain power and control over another person, Cameron explains.

“It’s important to recognize that abuse is not an anger management issue,” she says. “People who are truly experiencing an anger management issue will go off on their boss, their cousin, the random guy at 7-Eleven. Abuse is carefully targeted at one person.”

Controlling behaviors are one of the biggest red flags counselors should be listening for to determine if a client might be involved in an abusive relationship, either as a perpetrator or a victim. Examples include checking or monitoring a partner’s cell phone, email or social media, or insisting that a partner text when they arrive at and leave from work every day. Other cues for which Cameron stays alert include:

• Clients who clam up in session or appear to be afraid of their partner
• Clients who are isolated from friends and family
• Clients who feel they can’t go to work, school or social engagements because it upsets their partner
• If one partner is the sole decision-maker or in complete control of the couple’s finances
• If one of the partners continually feels guilty for their behavior
• A partner who exhibits extreme jealousy
• Clients who mention “walking on eggshells” around their partners
• Clients who are having thoughts of suicide or threatening to harm themselves or their abuser
• A partner who pressures the other partner to use drugs or alcohol or to not use contraception (or who lies about their own use of contraceptives)
• A partner who pressures the other partner to have sex or to perform sexual acts that the person is uncomfortable with
• Clients who talk about a partner belittling or embarrassing them in front of other people

Control tactics often go hand in hand with perpetrators minimizing or placing blame for their behavior, Cameron adds. Perpetrators of abuse may tell a victim that they wouldn’t have to act this way if the person came home from work on time, paid the bills on time, didn’t talk back, etc. Or, Cameron says, they may tell a partner, “It could have been a lot worse. I only shoved you. I didn’t punch you.”

In counseling, perpetrators may make statements such as, “I didn’t hurt her. I just punched the wall.” The behavior implies, however, that the perpetrator could have hurt the person, Cameron points out.

“Someone who is abusive will try and deflect attention away from the abuse,” Bassett says. “They will try and name what is happening. Maybe they push or strangle or pull their partner’s hair. But they will say, ‘I am not abusive because I never hit you. Have I ever hit you?’ or [point out that] there was no bruise. There’s a lot of crazy-making behavior that goes on. They’ll deny it ever happened or focus on something else. Abuse is a pattern of behavior, and the abuser will rationalize those patterns as something else. Pay attention to that as a therapist and help them to name the behavior [for what it is].”

If a client mentions that they fight a lot with their partner or that the partner has a temper or a “short fuse,” counselors can prompt the client to explain the fights, Cameron says. For example, “Tell me what these fights look like. Are there times [when] it feels unsafe?” Victims may use phrases such as “sometimes he is rough with me” or he “put hands on me,” not fully recognizing the behavior as abuse, she notes.

Carlson also recommends that counselors use carefully worded questions to follow up on statements made by clients to further explore the nature of their relationship experience. For example, ask clients how they handle conflict with an intimate partner and then use leading questions to learn more: When there is a disagreement, is it safe to talk about the disagreement? Is there any type of pushing, shoving, hitting, use of objects, physical violence, threatening language or name calling? Is jealousy a motivating factor? Does one partner place blame on the other, making statements such as, “You made me do this”? Is the partner violent or hostile outside of the relationship?

“Ask questions that determine if there is regret or remorse [after conflict] or if they recognize that there are other ways of handling conflict,” Carlson says.

In sessions with individual clients, Carlson recommends that counselors preface some of their most direct questions — such as “Are you afraid of your partner?” — with dialogue that prepares the client. “Say, ‘I have some questions for you about how you handle conflict in your relationship. They’re going to be very direct, and I wanted to give you a heads up, but it will help me better understand what you’re going through.’ Really tap into your basic counseling skills, the relationship-building skills that we learn early on, and emphasize those when such important questions are being asked,” Carlson says.

At the same time, Bassett adds, clinical counselors shouldn’t be afraid to ask hard questions of a client when appropriate. “Ask not just, ‘Has your partner physically assaulted you?’ but ‘Are you afraid of your partner?’ and be willing to explore that. Explore the emotional piece of abuse.”

Counselors can also supplement their own questions by using a formal questionnaire — Carlson recommends Brian Jory’s Intimate Justice Scale — or including questions on intake forms. Keep in mind, however, that clients may answer “no” to questions that later turn out to be a “yes” when explored in therapy.

Perpetrators of domestic violence often use manipulation to gain and maintain control over a person and keep them in the relationship, Cameron says. When alone with a partner, perpetrators sometimes threaten suicide if the partner ever were to leave them, or they make statements inferring that the partner would be worse off on their own: “If you leave, you won’t get any money”; “You will lose the kids”; “No one will ever love you. I’m the only one who will put up with you.”

“One of the biggest power tools is fear — abusers wield fear,” Cameron says. “They use fear to control their partner. In addition, abusers will often apologize for the abuse and say, ‘It will not happen again,’ without being accountable. Then they continue using control tactics.”

This can be complicated further if the couple’s friends and family take sides or if the victim comes from a culture or faith community that emphasizes submission to a partner, views marriage as an unbreakable bond, or values reconciliation over safety, Cameron adds.

Manipulation by a perpetrator can also extend to sexual assault, which often overlaps with domestic violence, Bassett says. “It’s also common for an abusive person to force or pressure sex [with an intimate partner]. They will define the experience as nonabusive and lay the groundwork for the survivor to agree to sex so that they aren’t forced,” she says. “The abuser is [then] able to say that they agreed to sex, making them complicit in what is actually a sexual assault. The abuser defines the experience, and the survivor needs the space and safety to name their experience [in counseling].”

Hard questions, empathetic listening

Most of all, clients who are currently in or have been in an abusive relationship in the past need a safe space to feel heard and validated and to be connected to resources to address their safety, Cameron says. It’s no surprise that building a therapeutic bond is especially important with these clients.

“Communicate that you believe them,” Cameron urges. “The most restorative thing [for the client to hear is] ‘it’s not your fault, and it’s not OK that they are doing this to you.’”

“It’s incredibly important to be nonjudgmental,” agrees Carlson. “There are so many practitioners who have a personal connection to this topic, it can be an emotive experience. The time of disclosure is a very important moment for the victim and can be filled with a lot of embarrassment and shame. When they are deciding how much to disclose, it’s often based on how they feel it will be received. ... It’s important to manage your emotions in that moment because it’s such an important moment.”

“You may leave the room and feel, ‘Oh my gosh, this is an emergency. I have to get this person out.’” Carlson continues. “But remember that this is their daily reality. They’ve been living with this [abuse] for a while. It feels like an emergency to you, but to act on that may put the victim in danger. It’s important that the victim drives the steps of what happens next.”

Bassett agrees: “Be very aware that your goal [as a counselor] is not that they should leave the relationship. That needs to be a goal they make themselves. They have to own it, because any decision they make will potentially have ramifications for them.”

Cameron notes that taking decisions out of the hands of clients is one of the worst mistakes counselors can make when working with victims of IPV. “They’ve already had someone control their life, and we don’t want to step into that role,” she says. “The victim has the best knowledge about what they need.”

It’s vital for practitioners to explore a client’s experience with genuine care, says Paulina Flasch, an ACA member and an assistant professor in the professional counseling program at Texas State University. “Really show concern and empathy and don’t sound like you’re interrogating them,” says Flasch, who runs a family violence research team at Texas State and worked at a domestic violence agency before and during her master’s program. “Focus on the counselor-client relationship, and ask [hard questions] because you really care. Share that what you’re hearing sounds abusive and that it must have been really hard [to go through]. ... If you’re hearing that a past relationship was abusive, it’s important to call it that and identify its aftereffects. It can help validate their current experience and help them understand why they’re struggling. Help them look at patterns and how things tie together. ... It’s a very powerful moment when the client connects the dots.”

“This is a person whose boundaries have been violated and who has not had safety and security — and we [counselors] have to be careful with that,” Flasch continues. “We have to let them know there will be a different response and they won’t be demeaned. If they went through that, they’re strong. Recognize that.”

All of the counselors interviewed for this article recommend using psychoeducation techniques and the Power and Control Wheel system (available at theduluthmodel.org) to talk through what a healthy relationship looks like (and does not look like) with clients who have experienced IPV. Bassett also stresses that work with IPV clients must be trauma-informed.

Emotionally focused therapy (EFT), expressive therapies, bibliotherapy or cinematherapy, grounding techniques and decision-making exercises can also help IPV clients, Flasch notes, as can attending support groups for IPV survivors in addition to counseling.

Victims of domestic violence often grapple with intense feelings of guilt or shame, sometimes made worse by harmful stereotypes and society’s general misunderstanding of the complexity of abuse. Victims can hear messages such as “Why didn’t you just leave him?” or “Why didn’t you get out sooner?” in both direct and indirect ways in popular culture, from family and friends, or in offhand remarks by acquaintances.

The reality is that it’s not that simple, Flasch notes. Victims of domestic violence are in the most danger when they are ending a relationship with their abuser (see sidebar below). In addition, domestic violence often creeps into a relationship slowly over time in ways that are unrecognizable to the victim.

The relationship “hasn’t always been dangerous,” says Flasch, who has a private practice in Austin, Texas, and specializes in working with couples and individuals who have experienced trauma. “There have been a lot of pieces that have kept them in the relationship. If they had known this was going to happen, they would have never been in the relationship. Intimate partner violence is the breaking down of a human. They completely lose their sense of self and begin to believe everything the abuser has said about them. It happens smally and slowly.”

Pointing out this trajectory to the client emphasizes that it wasn’t their fault and helps them learn what to look for in future relationships, Flasch adds. “Normalize it with the client. This [IPV] is very common and very similar in the ways it comes to happen,” she says. “It’s a systematic breakdown of a person that happens in very small steps that no one would recognize unless you know what you’re looking for. Helping them understand what and how it happened can help take away some of that fault and blame. Then work on empowerment. Victims have had to ask their abuser for everything. It’s our job to get their voice back.”

Planting seeds

In addition to providing a safe space to be heard and empowered, counseling can be a place for victims of IPV to learn what a healthy relationship looks like. This is especially true for clients whose histories include past trauma (in addition to IPV) or who haven’t been exposed to healthy relationships in their life, Flasch notes.

“The counselor may be that first one, that first good relationship and having a feeling of being in a room with someone who cares,” she says. “Model that through your interaction with clients. Psychoeducation is a big part of working with [IPV] victims and survivors.”

Flasch suggests using the Power and Control Wheel while discussing what it feels like to be in a healthy relationship: What aspects are present? What does respect look like? How do arguments start and end? What does equality look like?

Making a list of the elements in a healthy relationship can also help, Flasch says. “It’s not tangible [to clients] sometimes. There’s so much self-blame and lack of trust of themselves and their own instincts. They often don’t trust themselves to make decisions or recognize if something [in a relationship] is dangerous.”

It can also be helpful for counselors to talk through boundary issues with IPV survivors, including what is and isn’t their responsibility in a relationship, Bassett adds.

“With someone who is abusive, that person will not accept responsibility [for abusive behavior]. The person who is being abused typically will accept full responsibility,” she says. “They may claim, ‘Oh, he’s Dr. Jekyll and Mr. Hyde. He’s so sweet, but when he drinks, or goes off his medication [he turns dangerous].’ That’s just not true: The good parts and the loving parts are part of the [control] strategy. Be very clear about that. … Help them not to buy into it, overtly or covertly.”

Couples counseling and safety

A relationship in which IPV is present has, at its core, an imbalance of power and control. This imbalance makes couples counseling an unsafe environment for the person experiencing the abuse, Carlson stresses. If a counselor is working with a couple exhibiting signs of IPV, he or she should take steps to terminate couples counseling as soon as possible while ensuring the victim’s safety, Carlson says.

“If power and control exist in the couple’s dynamic, it’s generally not safe to be in a setting [i.e., couples counseling] where they’re both on equal ground being asked to practice healthy behaviors and make changes,” he explains. “That can’t happen when there’s inequality.”

Cameron agrees. “Each session is posing a safety risk for the victim. In couples counseling, we’re asking both parties to be accountable for solving problems in the relationship, and part of the control tactics [of IPV] is making the victim feel that it’s their fault.” Perpetrators of abuse may retaliate against their partners after counseling sessions in reaction to what was said or disclosed, she says.

On the flip side, abuse victims may say only what they need to say to keep from “making waves” with their abusers during counseling sessions. In addition, “an abuser may be very charming and manipulate the counselor,” Cameron says. Counselors who don’t recognize the manipulation or other possible indicators of IPV can end up unintentionally colluding with the abuser, she points out.

Both Cameron and Carlson recommend that counselors — whether they work with couples or individuals — seek training on IPV to stay informed on best practices and forge connections with local domestic violence agencies. It is important to establish these working relationships ahead of time so that counselors can readily consult with specialists when they identify signs of IPV with a client (or a couple) on their caseload, Carlson says. “Consultation [with an IPV specialist] helps to create a methodical, well-thought-out plan for that point forward,” says Carlson, noting that any consultation must be done within ethical guidelines and without sharing any identifying details about the individuals involved.

Once a counselor has identified that IPV is present in a relationship, the steps to terminate couples counseling must be handled delicately. Counselors should never let the abuser know that they suspect abuse is taking place, Cameron emphasizes. At the same time, a fine balance must be maintained to ensure that a victim doesn’t lose contact with the counselor and is connected to resources before couples counseling is terminated.

“Never confront abuse head-on with both parties in the room. That will put the survivor at risk,” Cameron says. “Get creative for ways to get the survivor alone. ... Come up with a reason to separate them and then check in with the survivor. Ask them if they feel safe at home. Just straight up asking if they are being abused — they are not going to recognize it that way. Often, the abuser has worked really hard to convince the victim that there is no abuse.”

Cameron has known counselors who separate the couple by asking one of the partners to fill out paperwork in the waiting room. Practitioners can also try to speak over the phone outside of session to clients who are suspected targets of abuse, as long as they ensure the client is alone for the call, Cameron adds.

Carlson notes that it’s not uncommon in couples counseling for a practitioner to meet with one of the clients individually to work on an issue. Counselors can fall back on that as an excuse to separate a couple when it is suspected that IPV is present, he says.

“When [you] first meet with a couple, separate them to fill out an intake questionnaire and speak with them individually. That way, you set a precedent of talking separately,” Carlson says. “Then, you can say later, ‘We are going to meet individually to follow up on some of the things we talked about’ [at intake]. There is precedence, and it doesn’t seem out of the ordinary.”

Flasch agrees and suggests that couples counselors do full individual sessions with both partners after the first two or three sessions, regardless of whether IPV is suspected. In these sessions, counselors should always assess for IPV. She suggests asking questions such as “How do you and your partner show respect for each other?” and “Tell me about your arguments: How do they start and end, and who initiates?”

A counselor’s next step should be to connect the victim with local support services. This must also be handled carefully, Cameron says. For instance, a client could put a domestic violence hotline number in their phone under another name, or the counselor could give the information verbally to the client to remember and look up later. Cameron also recommends that counselors leave pamphlets and other information about domestic violence resources in the lobbies and restrooms of their offices for all clients to see and have access to.

If appropriate, Cameron recommends that counselors also connect perpetrators with a local batterer or offender program.

“It’s important to work in collaboration with your local [domestic violence] agency,” Cameron says. “For us to address abuse in our communities, there needs to be community accountability for abusers, and that can’t just come from domestic violence agencies. It needs to come from all aspects of the community. You’re not going to end domestic violence just by dealing with the aftermath.”

Once clients are given information about IPV resources, it’s up to them to seek help when they are ready and feel safe doing so, Carlson adds. It’s not a counselor’s role to ensure the client has followed up with those resources.

“Sometimes nothing happens,” Carlson acknowledges. “You present resources and opportunities and they know they have options, and that’s the biggest step they want to take at this point in time.”

Relationships post-IPV

Dating and forming new relationships can play a part in the healing process for survivors and help them learn more about themselves, their boundaries and their limits, says Flasch, who co-authored the article “Considering and Navigating New Relationships During Recovery From Intimate Partner Violence” in the April issue of the Journal of Counseling & Development. Counselors should be aware that the risk exists for survivors of IPV to find themselves in another abusive relationship. However, forging new healthy relationships — with a counselor as a support and ally — can be a helpful step in the right direction, she notes.

“Survivors have to work through these issues for a lifetime, so waiting for the ‘right time’ to date post-healing may never come,” Flasch says. “A counselor can be a great support for a survivor. We know that most people continue to date. To say that you should be healed completely before you go out, it’s not realistic. And healthy relationships can be incredibly healing. Having a person who is safe and loving and accepting is a huge benefit. We [counselors] shouldn’t necessarily discourage dating but help them navigate the process. Educate them about red flags and warning signs, and celebrate the successes of milestones reached through dating. Also [process] triggers and things that get in the way.”

“Having experiences with other people and then processing it in counseling can be very powerful and helpful to healing,” she continues. “We can be great allies and celebrate with clients when they try something new.”

For the journal article, Flash and her co-authors studied the experiences of IPV survivors who went on to try new relationships, ranging from casual dating to marriage. Through these relationships, participants reported learning to trust themselves and their instincts and “reclaim parts of themselves lost during the IPV relationships,” Flash wrote with her co-authors, David Boote and Edward H. Robinson.

Dating post-IPV “can be a process for survivors to try and find corrective experiences and explore trust, make decisions that are theirs and be their own person, [and] learn about control and boundaries,” Flasch says. “But this is also a very scary process and one that has a lot of layers to it, so it can bring challenges. It can be hard to learn to trust when it’s been taken away from you in the past.”

IPV: Need-to-know points for counselors

One of the most misunderstood aspects of intimate partner violence (IPV) is how complicated and dangerous leaving an abusive partner can be, says Taylor Cameron, a licensed professional counselor (LPC) and director of transitional housing at a Texas nonprofit that provides support services to victims of domestic violence and sexual assault. The power imbalance of abusive relationships often means that one partner has severely restricted the other’s access to finances, friends and family members, and community resources. Separating from an abuser often means starting life over, which is why there is an intersection of IPV and homelessness, she says. These factors are only exacerbated when children are involved or when the victim experiences other forms of systemic oppression such as racism, homophobia or classism.

“They are often trapped between violence and homelessness,” Cameron says. “The abuser has often messed up their credit and finances or totally controlled them, so they’re starting from scratch. The most dangerous time for a victim is during separation and when they are separated [because] the abuser is losing the power they have worked to gain and maintain.”

According to Cameron, IPV victims are at the highest risk of lethality under the following circumstances:

• When the couple has separated or is in the process of separating
• If sexual abuse or sexual coercion is present in the relationship
• If an abuser makes threats of homicide or suicide
• When a restraining order is filed
• If the victim is pregnant
• If strangulation is occurring
• If violent behavior is occurring outside of the home (which indicates the abuser has escalated to the point where he or she does not care if other people see the behavior, Cameron says)
• If there is involvement with child protective services
• If the abuser has access to weapons
• If the abuser exhibits stalking behaviors
• If law enforcement is involved

Counselors should also keep in mind that even when victims leave an abusive relationship, they may still come in contact with their abusers — and be put at risk for retraumatization — through legal proceedings, child custody hearings or stalking behavior, adds Paulina Flasch, an assistant professor in the professional counseling program at Texas State University.

“Just because someone is no longer in an IPV relationship doesn’t mean they’re no longer in it. Remember that and equip them with tools [to cope],” Flasch says.

• The National Domestic Violence Hotline (800-799-7233) is available around the clock, seven days a week, for speakers of more than 200 languages. Visit thehotline.org for downloadable brochures and other resources to share, including Power and Control Wheels.
• Power and Control Wheels are also available for download (in a number of languages) at theduluthmodel.org.
• The National Center on Domestic and Sexual Violence (ncdsv.org) has Power and Control Wheel models specific to the needs of LGBTQ and immigrant populations, as well as one for community accountability.
• Ryan G. Carlson recommends two assessment tools for counselors: the Continuum of Conflict and Control-Relationship Scale (by Carlson, Tiffany L. Rogers, Naomi J. Wheeler, Viki Kelchner, Sandy-Ann M. Griffith and Xun Liu, published June 2017 in Measurement and Evaluation in Counseling and Development); and the Intimate Justice Scale (by Brian Jory, published May 2007 in the Journal of Marital and Family Therapy)
• Find ethical guidelines regarding when counselors should breach confidentiality and report abusive behavior to authorities in the 2014 ACA Code of Ethics (specifically Standards B.2.a. and B.6.h.) at counseling.org/knowledge-center/ethics.
• ACA has interest networks that focus on intimate partner violence, women’s issues, sexual wellness and other topics. Find out more at org/aca-community/aca-groups/interest-networks.
• Blog post by Taylor Cameron on the intersection of homelessness and domestic violence: org/intersection-of-domestic-violence-and-homelessness
• “Considering and Navigating New Relationships During Recovery from Intimate Partner Violence,” by Paulina Flasch, David Boote and Edward H. Robinson, published April 2019 in the Journal of Counseling & Development

• Why Does He Do That? Inside the minds of angry and controlling men by Lundy Bancroft
• Battered Women’s Protective Strategies: Stronger Than You Know by Sherry Hamby
• Coercive Control: How Men Entrap women in Personal Life (Interpersonal Violence) by Evan Stark
• Safety Planning with Battered Women: Complex lives/Difficult Choices by Jill Davies, Eleanor J. Lyon and Diane Monti-Catania
• The Verbally Abusive Relationship by Patricia Evans
• Domestic Violence Advocacy: Complex lives/Difficult Choices by Jill Davies and Eleanor J. Lyon

• “Working through the hurt” feature article by Bethany Bray, April 2014
• “The wise support system in domestic violence rescue efforts” online exclusive by David L. Prucha, April 2018
• “The relationship as client” cover story by Laurie Meyers, October 2016
• “Triumph tales: Counselors’ domestic violence research project blossoms into website, social media campaign highlighting survivors’ personal stories,” online exclusive by Bethany Bray, March 2014
• “Becoming shameless,” cover story by Laurie Meyers, May 2017
• “Counseling survivors of sexual assault” Knowledge Share by Brooke Bagley and Joel Diambra, September 2016
• “Effective ways to approach sexual assault response,” Member Insights by Hasmik Chakaryan, July 2018

Bethany Bray is a senior writer and social media coordinator for Counseling Today. Contact her at bbray@counseling.org.

Letters to the editor: ct@counseling.org