Conflict is expected in relationships, but the act of violence is not. In the global phenomenon of intimate partner violence (IPV) and international research on effective models for its eradication, Human Systems Therapy (HST) represents a recommended and auspicious form of intervention. The aim of the present research was to empirically evaluate the effectiveness of the HST model in IPV. HST is a systemic model that has been developed over time and has shown significant results in couple and family therapy. It is a multi-level, brief therapy that intervenes in relationships, utilising First and Second Order Cybernetics principles and methods. This present research, conducted as a Multiple Case Study, investigated the effectiveness of HST in eighteen individuals (nine heterosexual couples) referred to therapy by the Public Prosecutor’s Office following a complaint of physical violence by one member of the couple against the other. The investigation of HST effectiveness was conducted using a mixed data collection method, encompassing both quantitative and qualitative data. The Revised Conflict Tactics Scale (CTS2) was administered to record and evaluate the conflict tactics employed by the couples, and the Differential Emotions Scale-modified (DES.MOD) was used to record and assess the degree of positive and negative emotions experienced by the couple members before and after the interventions. The results indicated that the HST model can bring statistically significant changes to the couples’ relationships concerning the eradication of violence and increase positive emotions between them.
KeywordsHuman Systems Therapy (HST)Intimate Partner Violence (IVP)Couple TherapyHierarchyRelationshipsTechniques
Anderson, H., & Gehart, D. (2007). Collaborative Therapy Relationships and Conversations That Make a Difference. Routledge/Taylor & Francis Group.
APA (2011). Evidence-Based Case Study Guidelines for Couple and Family Psychology. https://www.apa.org/pubs/journals/cfp/evidence-based-case-study-guidelines
APA Task Force (2006). Evidence Based Practice in Psychology. https://www.apa.org/pubs/journals/features/evidence-based-statement.pdf
Beasley, C., & Ager, R. (2019). Emotionally Focused Couples Therapy: A Systematic Review of Its Effectiveness over the Past 19 Years. Journal of Evidence-Based Social Work, 16, 144-159. https://doi.org/10.1080/23761407.2018.1563013
Beck, J. S. (2020). Cognitive Behavior Therapy, Third Edition: Basics and Beyond. Guilford Press.
Bell, K. M., & Naugle, A. E. (2008). Intimate Partner Violence Theoretical Considerations: Moving towards a Contextual Framework. Clinical Psychology, 28, 1096-107. https://doi.org/10.1016/j.cpr.2008.03.003
Bograd, M. (1992). Values in Conflict: Challenges to Family Therapists Thinking. Journal of Marital and Family Therapy, 18, 245-256. https://doi.org/10.1111/j.1752-0606.1992.tb00937.x
Broderick, C. B., & Schrader, S. S. (1981). The History of Professional Marriage and Family Therapy. In A. S. Gurman, & D. P. Kniskern (Eds.), Handbook of Family Therapy (pp. 3-35). Brunner/Mazel.
CDC National Center for Injury Prevention and Control, Division of Violence Prevention (2021). Risk and Protective Factors for Perpetration. https://www.cdc.gov/violenceprevention/intimatepartnerviolence/riskprotectivefactors.html
Cluss, P., & Bodea, A. (2011). The Effectiveness of Batterer Intervention Programs. https://fisafoundation.org/wp-content/uploads/2011/10/BIPsEffectiveness.pdf
de Shazer, S. (1991). Putting Difference to Word. Norton.
Denton, W. H., Wittenborn, A. K., & Golden, R. N. (2012). Augmenting Antidepressant Medication Treatment of Depressed Women with Emotionally Focused Therapy for Couples: A Randomized Pilot Study. Journal of Marital and Family Therapy, 38, 23-38. https://doi.org/10.1111/j.1752-0606.2012.00291.x
Downes, R. E., & Jeronimus, B. F. (2022). A Scoping Review of Systemic Interventions against Domestic Violence in the Netherlands: Practice, Proof, and Perspectives. https://doi.org/10.31234/osf.io/skn5y
Dudley, D. R., McCloskey, K., & Kustron, D. A. (2008). Therapists Perceptions of Intimate Partner Violence: A Replication of Harway and Hansen’s Study after More than a Decade. Journal Aggress Maltreat Trauma, 17, 80-102. https://doi.org/10.1080/10926770802251031
Eckhardt, M., Murphy, M., Whitaker, D., Sprunger, J., Dykstra, R., & Woodard, K. (2013). The Effectiveness of Intervention Programs for Perpetrators and Victims of Intimate Partner Violence. Partner Abuse, 4, 196-231. https://doi.org/10.1891/1946-6560.4.2.196
European Institute for Gender Equality (EIGE). https://eige.europa.eu/gender-statistics/dgs/indicator/genvio_int_sur_phy__prev_phys_sex__ ipv_grand/bar/year:2012/geo:BE,BG,CZ,DK,DE,EE,IE,EL,ES,FR,HR,IT,CY,LV,LT,LU,HU,MT,NL,AT,PL,PT,RO,SI,SK,FI, SE,UK/type:phys/period:LYP/perpetrator:partner/activity:TOTAL/education:TOTAL/age:TOTAL
Fredrickson, B. L., Tugade, M. M., Waugh, C. E., & Larkin, G. R. (2003). What Good Are Positive Emotions in Crisis? A Prospective Study of Resilience and Emotions Following the Terrorist Attacks on the United States on September 11th, 2001. Journal of Personality and Social Psychology, 84, 365-376. https://doi.org/10.1037/0022-3514.84.2.365
Galanakis, M., Stalikas, A., Pezirkianidis, C., & Karakasidou, I. (2016). Reliability and Validity of the Modified Differential Emotions Scale (mDES) in a Greek Sample. Psychology, 7, 101-113. https://doi.org/10.4236/psych.2016.71012
General Secretariat for Family Policy and Gender Equality. (In Greek) https://www.isotita.gr/wp-content/uploads/2020/12/1%CE%B7-%CE%88%CE%BA%CE%B8%CE%B5%CF%83%CE%B7-%CE%B3%CE%B9%CE%B1-%CF%84%CE%B7-%CE%92%CE%AF%CE%B1-%CE%BA%CE%B1%CF%84%CE%AC-%CF%84%CF%89%CE%BD-%CE%93%CF%85%CE%BD%CE%B1%CE%B9%CE%BA%CF%8E%CE%BD.pdf
Goldner, V., Penn, P., Sheinberg, M., & Walker, G. (1990). Love and Violence: Gender Paradoxes in Volatile Attachments. Family Process, 29, 343-364. https://doi.org/10.1111/j.1545-5300.1990.00343.x
Greenberg, L. S. (2015). Emotion-Focused Therapy: Coaching Clients to Work through Their Feelings. American Psychological Association. https://doi.org/10.1037/14692-000
Greenberg, L. S. (2017). Emotion-Focused Therapy. The American Psychological Association. https://doi.org/10.1037/15971-000 https://www.apa.org/pubs/books/Emotion-Focused-Therapy-Ch-1-Sample.pdf
Gurman, A., & Fraenkel, P. (2002). The History of Couple Therapy: A Millennial Review. Family Process, 41, 199-260. https://doi.org/10.1111/j.1545-5300.2002.41204.x
Hyde-Nolan, M. E., & Juliao, T. (2012). Theoretical Basis for Family Violence. In R. S. Fife, & S. Scharger (Eds.), Family Violence: What Health Care Providers Need to Know (pp. 5-16). Jones & Bartlett Learning.
Johnson, S. M., & Greenberg, L. S. (1995). The Emotionally Focused Approach to Problems in Adult Attachment. In N. S. Jacobson, & A. S. Gurman (Eds.), Clinical Handbook of Couple Therapy (2nd ed., pp. 121-146). Guilford Press.
Johnson, S. M., & Greenberg, L. S. (2013). The Heart of the Matter: Perspectives on Emotion in Marital Therapy. Routledge. https://doi.org/10.4324/9780203777206
Kalaitzaki, A. E., Birtchnell, J., & Kritsotakis, E. I. (2010). The Associations between Negative Relating and Aggression in the Dating Relationships of Students from Greece. Partner Abuse, 1, 420-442. https://doi.org/10.1891/1946-6560.1.4.420
Karakurt, G. et al. (2016). Couples Therapy for Intimate Partner Violence: A Systematic Review and Meta-Analysis. Journal of Marital and Family Therapy, 42, 567-583. http://rave.ohiolink.edu/etdc/view?acc_num=osu1354712628 https://doi.org/10.1111/jmft.12178
Lebow, J. L., Chambers, A. L., Christensen, A., & Johnson, S. M. (2012). Research on the Treatment of Couple Distress. Journal of Marital and Family Therapy, 38, 145-168. https://doi.org/10.1111/j.1752-0606.2011.00249.x
Lee, M. Y., Uken, A., & Sebold, J. (2004). Accountability for Change: Solution-Focused Treatment with Domestic Violence Offenders. Families in Society: The Journal of Contemporary Social Services, 85, 463-476. https://doi.org/10.1177/104438940408500405
Levin, S. B. (2007). Hearing the Unheard: Advice to Professionals from Women Who Have Been Battered. In H. Anderson, & D. Gehart (Eds.), Collaborative Therapy: Relationships and Conversations That Make a Difference (pp. 109-127). Routledge/Taylor & Francis Group.
McCollum, E. E., & Stith, S. M. (2008). Couples Treatment for Interpersonal Violence: A Review of Outcome Research Literature and Current Clinical Practices. Violence and Victims, 23, 187-201. https://doi.org/10.1891/0886-6708.23.2.187
McGoldrick, M., & Gerson, R. (1999). The Genogram. Assessment Tool for the Family. Kedros. (In Greek)
Minuchin, S. (1974). Families & Family Therapy. Harvard University Press. https://doi.org/10.4159/9780674041127
Nelson, T., & Kelley, L. (2001). Solution-Focused Couples Group. Journal of Systemic Therapies, 20, 47-66. https://doi.org/10.1521/jsyt.20.4.47.23085
Oka, Μ., & Whiting, J. (2011). Contemporary MFT Theories and Intimate Partner Violence: A Review of Systemic Treatments. Journal of Couple & Relationship Therapy, 10, 34-52. https://doi.org/10.1080/15332691.2011.539173
Papadakaki, M., Tzamalouka, G. S., Chatzifotiou, S., & Chliaoutakis, J. (2009). Seeking for Risk Factors of Intimate Partner Violence (IPV) in a Greek National Sample: The Role of Self-Esteem. Journal of Interpersonal Violence, 24, 732-750. https://doi.org/10.1177/0886260508317181
Papadioti-Athanasiou, V., & Softa-Nall, L. (2012). Schools of Family-Systemic Therapy. Topos. (In Greek)
Paritsis, N. (2003). The Intelligence of Life. Systemic Psychiatry, Vol. I. BETA.
Paritsis, N. (2006). Therapy and Evolution of Human Systems. Systemic Psychiatry, Vol. II. Athens: BETA.
Paritsis, N. (2010). Human Systems Therapy. Systems Research and Behavioral Science, 27, 336-348. https://doi.org/10.1002/sres.1012
Paritsis, N. (2012). Human Systems Therapy. Is There Compositional Equivalence? Metalogos, 22, 8-22. (In Greek)
Paritsis, N. (2020). Human Systems Therapy: Use of Interpersonal Relations in Promoting Therapeutic Change. Psychology Research, 10, 383-394. https://doi.org/10.17265/2159-5542/2020.10.001
Paritsis, N. (2022). A New Human Systems Therapy. Systemic Psychiatry, Vol. III. BETA. (In Greek)
Paritsis, Ν. (2021). Manualizing Human Systems Therapy towards a Few-Sessions Therapy. In Μ. Mariotti, G. Saba, & P. Stratton (Eds.), Handbook of Systemic Approaches to Psychotherapy Manuals (pp. 81-100). Springer. https://doi.org/10.1007/978-3-030-73640-8_5
Sander, F. M. (1979). Individual and Family Therapy: Toward an Integration. Jason Aronson.
Saunders, D. G. (2017). Group Interventions for Partner Abuse. In C. D. Garvin, L. M. Gutiérrez, & M. J. Galinsky (Eds.), Handbook of Social Work with Groups (pp. 344-359). The Guilford Press.
Schneider, C., & Brimhall, A. S. (2014). From Scared to Repaired: Using an Attachment-Based Perspective to Understand Situational Couple Violence. Journal of Marital and Family Therapy, 40, 367-379. https://doi.org/10.1111/jmft.12023
Sexton, T., Gordon, K. C., Gurman, A., Lebow, J., Holtzworth-Munroe, A., & Johnson, S. (2011). Guidelines for Classifying Evidence-Based Treatments in Couple and Family Therapy. Family Process, 50, 377-392. https://doi.org/10.1111/j.1545-5300.2011.01363.x
Slootmaeckers, J., & Migerode, L. (2019). E.F.T. and Intimate Partner Violence: A Roadmap to De-Escalating Violent Patterns. Family Process, 59, 328-345. https://doi.org/10.1111/famp.12468
Snyder, D. K. (1999). Affective Reconstruction in the Context of a Pluralistic Approach to Couple Therapy. Clinical Psychology: Science and Practice, 6, 348-365. https://doi.org/10.1093/clipsy.6.4.348
SOS Helpline in the Region of Crete. (In Greek) https://lahers.hmu.gr/%CE%B9%CF%83%CF%8C%CF%84%CE%B7%CF%84%CE%B1-%CF%86%CF%8D%CE%BB%CF%89%CE%BD
Stake, R. Ε. (2006). Multiple Case Study Analysis. The Guilford Press.
Stalikas, A., Triliva, S., & Roussi, P. (2012). Psychometric Tools in Greece. Pedio. (In Greek)
Stephenson, K. R., Sullivan, K., & Christensen, A. (2016). Couple Therapy. In H. S. Friedman (Ed.), Encyclopedia of Mental Health (2nd ed., pp. 368-376). Academic Press. https://doi.org/10.1016/B978-0-12-397045-9.00176-2
Stith, S. M., McCollum, E. E., & Rosen, K. H. (2011). Couples Therapy for Domestic Violence: Finding Safe Solutions. American Psychological Association. https://doi.org/10.1037/12329-000
Stith, S. M., McCollum, E. E., Rosen, K. H., Locke, L. D., & Goldberg, P. D. (2005). Domestic Violence-Focused Couples Treatment. In J. L. Lebow (Ed.), Handbook of Clinical Family Therapy (pp. 406-430). John Wiley & Sons, Inc.
Swan, S., Gambone, L., Caldwell, J., Sullivan, T., & Snow, D. (2008). A Review of Research on Women’s Use of Violence with Male Intimate Partners. Violence and Victims, 23, 301-314. https://doi.org/10.1891/0886-6708.23.3.301
von Schlippe, A., & Schweitzwer, J. (2008). Handbook of Systemic Therapy and Counseling. University Studio Press. (In Greek)
White, M. (2008). Externalizing the Problem and Rewriting Life and Relationships. Metalogos, 13, 82-118. (In Greek)
Wiebe, S., & Johnson, S. (2016). A Review of the Research in Emotionally Focused Therapy for Couples. Family Process, 55, 390-407. https://doi.org/10.1111/famp.12229
Wiebe, S., Johnson, S. M., Burgess-Moser, M., Dalgleish, T., Lafontaine, M., & Tasca, G. (2017). Predicting Follow-Up Outcomes in Emotionally Focused Couple Therapy: The Role of Change in Trust, Relationship-Specific Attachment, and Emotional Engagement. Journal of Marital and Family Therapy, 43, 213-226. https://doi.org/10.1111/jmft.12199
Wiebe, S., Johnson, S., Lafontaine, M.-F., Moser, M., Dalgleish, T., & Tasca, G. (2016). Two-Year Follow-Up Outcomes in Emotionally Focused Couple Therapy: An Investigation of Relationship Satisfaction and Attachment Trajectories. Journal of Marital and Family Therapy, 43, 227-244. https://doi.org/10.1111/jmft.12206
World Health Organization/WHO. https://www.who.int/health-topics/violence-against-women#tab=tab_1
Yin, R. K. (2003). Case Study Design and Research: Design and Methods (3rd ed.). Sage Publications.
Zimmerman, T. S., Prest, L. A., & Wetzel, B. E. (1997). Solution-Focused Couples Therapy Groups: An Empirical Study. Journal of Family Therapy, 19, 125-144. https://doi.org/10.1111/1467-6427.00044