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Abuse refers to physical, sexual, or emotional harm to a person perpetrated by a relative, caregiver, or spouse, or others in a social relationship with the abused person. Common forms of abuse include intimate partner abuse, partner or marital rape, and elder abuse. All of these forms of abuse are typically contained within the broad term domestic violence.

In many cases, survivors of sexual abuse, physical abuse, intimate partner violence (IPV), or elder abuse may be referred to counseling and therapy by law enforcement or other professionals, such as medical doctors and nurses, social workers, police officers, and the court. Counselors should be aware that a client may live in the same household with the abuser at the time of referral; therefore, the client may be afraid or ashamed to disclose the abuse because of economic dependency or fear of further physical or psychological harm from the abuser. It is important for therapists working with abused clients to first ensure their physical safety. It is critical to acknowledge that the cause of the abuse resides in the person who abuses rather than in the survivor. Therapists may effectively use techniques from many therapeutic orientations when working with abused clients, as long as they possess sufficient knowledge of the nature of the abuse, consequences of abuse, available services and resources for treatment, and legal issues.

Intimate Partner Abuse

Intimate partner abuse is interpersonal violence that occurs between current and former marital partners, cohabiting partners, separated marital partners, or same-sex partners. Several terms are used to describe violence or abuse between intimate partners. These include marital abuse, spouse abuse, and domestic violence. However, the terms intimate partner abuse and intimate partner violence are more commonly used today. Intimate partner violence occurs among heterosexual and same-sex partners as well as across different racial and ethnic groups. It is estimated that IPV occurs in 10% to 20% of intimate couples in the United States. Some research suggests that the prevalence rate may be higher among some marginalized groups, including couples that cohabitate without marriage, rural populations, disabled individuals, and recent immigrants.

Violence against intimate partners includes physical violence, sexual violence, threats of violence, stalking, and psychological abuse. Each act can be placed on a continuum ranging from mild verbal abuse to severe physical violence and even partner homicide. Men and women are equally likely to be initiators of IPV; however, women are more often survivors of severe violence resulting in injury and death.

In addition to physical injury, negative consequences of IPV include psychological stress and financial costs in lost wages and medical fees for treatment. Survivors of IPV often experience strong psychological stress such as helplessness, fear, anger, and anxiety. Some survivors may develop nightmares, intrusive thoughts, intense anxiety, and fears associated with violence. These are common symptoms of posttraumatic stress disorder. Survivors of repeated violence may develop learned helplessness, a psychological condition in which survivors no longer attempt to escape from a painful situation because of previous failed attempts. These strong emotional Stressors may further impair survivors' cognitive and coping skills and even diminish survivors' abilities to leave abusers.

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