The Rise of Domestic Violence During the Pandemic
One overlooked challenge from the pandemic that continues to unravel, is a significant increase in domestic violence. A systematic review conducted by the National Commission on COVID-19 and Criminal Justice found that reported domestic violence incidents in the U.S. rose by at least 8.1% in 2020 (Council on C.J., 2021).
On a global scale, the U.N. described the situation as a “shadow pandemic” with domestic violence cases surging by 25 to 33% worldwide during andsince the pandemic (Harvard Gazette, 2022).
This alarming trend underscores an ongoing need for enhanced support and resources for survivors. One that emerged is remote teletherapy, which has become an essential tool for mental health providers.
The surge in domestic violence can be attributed to many stressors that were made worse by lockdowns. Factors such as unemployment, food and housing insecurity, and increased childcare responsibilities, heightened the risk of domestic violence. The increased use of alcohol or other substances as coping methods, further contributed to this rise.
The mental health implications are vast, including that survivors of interpersonal violence are three to five times more likely to present with anxiety, depression, and PTSD than non‐survivors (Emezue et al, 2022).
With the goal of improving survivor safety and wellbeing, there is a need for further research to determine long-term outcomes of remote teletherapy for this population. Results so far indicate promising outcomes of teletherapy as an “addition to”rather thana “replacement for” in-person methods (Emezue et al, 2022).
One example in which the outcome of teletherapy may be uncertain is with couples seeking therapy for Situationally Violent or High-Conflict Relationships. These are often defined as having “pervasive negative patterns of interaction” in which both partners can engage in violent behaviors at times (Hoss et al, 2023).
Research suggests these situations need to be assessed carefully, and that at least 50% of couples who seek conjoint therapy have had some type of abuse in the history of their relationship (Greene & Bogo, 2002).
These are common and complicated situations, and may require interventions not covered in this post. For a more detailed discussion of evidence-based practices including Domestic Violence Focused Couples Therapy, please refer to the work of Hoss et al (2023). We will explore additional challenges involved in using teletherapy to address interpersonal violence. However, first let’s take a look at some benefits and what works well.
Why Teletherapy Works: Key Benefits for Domestic Violence Survivors
Remote teletherapy has proven to be an invaluable resource for victims of domestic violence. One of the primary benefits of teletherapy is accessibility. It allows some to receive counseling and support from the safety of their homes, which is especially important for those who may be unable to leave due to isolation.
Teletherapy offers a degree of anonymity, allowing individuals to access counseling in the privacy of their own space. This can encourage more survivors to seek assistance who otherwise might not feel comfortable making the first step.
For those living with abusers, teletherapy can be conducted in more discreet ways; such as audio-only sessions or using safe communication platforms that do not leave traces. This is especially important when the survivor cannot leave the abusive environment.
Remote therapy eliminates the need for travel, making it easier for those with tight schedules, childcare responsibilities, or health concerns. This convenience can be vital for survivors who need consistent, ongoing support as they navigate the trauma associated with domestic violence recovery.
The use of telehealth has been shown to reduce barriers to accessing care, particularly for those living in rural or underserved areas. Research indicates that teletherapy can be effective in treating trauma related symptoms and clients generally report high levels of satisfaction with remote therapy services (Johnson & Miller, 2023).
All of these factors are critical for those who may fear stigma or retaliation from their abusers if they seek help. As well, the use of technology in therapy sessions can facilitate the inclusion of safety planning and other interventions that are crucial for violence survivors. These elements suggest that teletherapy can play a significant role in providing timely support to survivors of interpersonal violence, as well as improving safety and wellbeing. If you or someone you know could benefit from teletherapy, call now to schedule an appointment with one of our compassionate therapists.
Safety Planning for Survivors of Interpersonal Violence
An essential component of teletherapy for domestic violence survivors is the development of personalized safety plans. Safety planning involves creating a detailed, individualized strategy to enhance a victim’s safety in various situations, particularly during a crisis.
The National Domestic Violence Hotline website offers an Interactive Digital Personal Safety Planning tool that is easy to use (2024). https://www.thehotline.org/plan-for-safety/
An effective safety plan can vary widely for each situation. Safety plans can include several key elements:
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- Identifying Safe Spaces: Help the survivor identify a safe room or space they can go to during an incident, ideally with access to an exit and without weapons.
- Establishing a Code Word: Develop a code word or phrase the survivor can use to alert trusted friends or family members when they are in danger and need immediate help. A code word can also be used to alert the therapist of active danger in the home that needs to be reported to ERS.
- Documenting Evidence: Encourage the survivor to keep records of incidents; including photos, text messages, video, or even a journal, which can be used as evidence if they decide to pursue legal action.
- Emergency Contacts and Resources: Compile a list of emergency contacts; including local shelters, hotlines, and legal services, that the survivor can reach out to for support.
- Planning for Children and Pets: Create a plan that ensures the safety of any children or pets in the household; including designating a trusted person who can take care of them in an emergency.
- Technology Safety: Advise the survivor on how to safeguard their technology, such as securing their devices with strong passwords or two-factor authentication. Also advise them to be cautious about sharing photos or locations online.
- Emotional Safety: When the abuse hasn’t escalated to physical violence, it is possible to focus on emotional protection. This may include coping skills to help the survivor maintain integrity, self-soothing, positive self-talk, attending support groups (local or online), and finding a quiet place to disengage from verbal or psychological abuse.
Safety planning options can be key in empowering survivors and providing them with practical steps to protect themselves while they work through the challenges of leaving an abusive relationship or manage ongoing risks (Department of Veterans Affairs, 2018).
Challenges and Limitations of Teletherapy
Despite many advantages, teletherapy is not without limitations. One of the most significant challenges is lack of access to technology for some. Not all survivors have access to reliable internet connections or devices, especially when facing financial hardship. This digital divide can exclude some of the most vulnerable populations from receiving teletherapy.
The physical presence in face-to-face therapy sessions can foster a sense of safety and connection that might be harder to achieve in a virtual setting. Body language and nonverbal cues, essential for assessing emotional states, can potentially be compromised through a screen.
Teletherapy may pose risks for survivors if they are living with the abuser. Ensuring privacy can be difficult, especially if the abuser monitors their phone or internet use. Survivors might feel unsafe or unable to speak freely during remote sessions for fear of being overheard.
Technology-perpetrated abuse is also on the rise, including multiple forms of cyber stalking, cyber harassment, location tracking, hidden cameras, or hacking into home security systems. Although this can be assessed somewhat, there is no absolute way to know how much control an abuser has over a client’s technology. (Hoss, et al, 2023)
Finally, teletherapy can be limited in situations that require immediate crisis intervention. Therapists may face difficulty in assessing the severity of a situation or responding quickly to emergencies. The teletherapist may reside outside of the client’s main service area, making it difficult or impossible to contact ERS on behalf of the client.
It could be more effective and helpful to connect the survivor with a domestic violence program in their own community. In such cases it’s possible for the therapist to take on an advocate role, following up to ensure a connection to services is made.
Most regions host some type of domestic violence shelter or program that can provide a broad range of assistance including temporary or permanent housing, transportation, employment assistance, child care, medical and legal advocacy, or referral to addiction recovery services (Emezue et al, 2022).
Occasionally local programs will turn away new cases, due to their own shelters being at capacity. Hopefully they would refer the family to another nearby community. However in such an event, it’s again possible for the teletherapist to advocate and assist with locating a program in a nearby district or region. Additionally, since many domestic violence programs generally focus on short-term assistance, teletherapy may be more suitable for survivors who are no longer in immediate danger and are working through the longer-term process of trauma recovery.
Conclusion: A Promising Addition, Not a Replacement
Remote teletherapy has proven to be a valuable tool for addressing domestic violence with great potential for further development. Its accessibility, flexibility, and safety benefits make it a promising option for many survivors.
The increase in domestic and interpersonal violence since the pandemic has highlighted a critical need for innovative approaches to support survivors. While teletherapy offers many benefits, it also presents challenges that must be addressed.
The limitations indicate it should be considered an addition to traditional therapy rather than a replacement. Further research is essential to evaluate the timing and long-term outcomes of teletherapy in domestic violence cases. Together we can collaborate to refine best practices that ensure both the safety and emotional wellbeing of survivors.
References & Further Reading
Council on Criminal Justice. (2021). New analysis shows 8% increase in U.S. domestic violence incidents following pandemic stay-at-home orders. Retrieved from: [Council on C.J. Website].
C. Emezue, J.D. Chase, T. Udmuangpia, T. L. Bloom. (2022). Technology‐based and digital interventions for intimate partner violence: A systematic review and meta‐analysis. Campbell Systematic Reviews, Sep;18(3):e1271. Retrieved from: [Wiley Online Library]
Greene K, Bogo M. (2002). The different faces of intimate violence: Implications for assessment and treatment. Journal of Marital and Family Therapy, 28(4):455–466. doi: 10.1111/j.1752-0606.2002.tb00370.x
Harvard Gazette Team. (2022). ‘Shadow pandemic’ of domestic violence. Retrieved from: [Harvard Gazette website].
L. Hoss, L. Richardson, A. Axelrod, J. Cravens Pickens. (2023). Clinical Guidelines When Addressing Abuse over Telemental Health. Contemporary Family Therapy, Mar 29 (1–11). Springer Nature – PMC COVID-19 Collection. Retrieved From: [Pub Med Central – National Library of Medicine]
D.M. Johnson, A.B. Miller. (2023). Telehealth-based interventions for intimate partner violence: A review of the literature. Journal of Telemedicine and Telecare, 29(1), 45-57.
National Commission on COVID-19 and Criminal Justice. (2021). Domestic violence increased in the US by 8.1% during the COVID-19 pandemic. Retrieved from: [Global Citizen website].
National Domestic Violence Hotline. (2024). PDF previously available: Department of Veterans Affairs. (2018). Interactive Personal Safety Planning. Retrieved from: [National DV Hotline website]
