In psychotherapy, when a person works on change rather than harm reduction, it is often referred to as abstinence-based treatment, transformational change, or simply behavioral change. The exact term depends on the therapeutic approach and the context. Here are some examples of how it might be framed:

1. Abstinence-Based Approach: In addiction treatment, this involves completely stopping a harmful behavior (e.g., substance use) rather than moderating it.

2. Transformational Change: This focuses on deep, lasting changes to core beliefs, behaviors, or identity, aiming to eliminate harmful patterns altogether.

3. Skill-Building and Growth: Many therapy models, like Cognitive Behavioral Therapy (CBT) or Dialectical Behavior Therapy (DBT), focus on building new skills and changing behaviors rather than simply mitigating harm.

4. Self-Actualization or Personal Growth: In humanistic or positive psychology frameworks, this involves striving for higher levels of functioning and fulfillment rather than just avoiding harm.

For instance, a person working on changing their anger management might focus on developing healthier emotional regulation skills (change) rather than just avoiding physically harmful outbursts (harm reduction).

In psychotherapy, when a person works on change rather than harm reduction, it is often referred to as abstinence-based treatment, transformational change, or simply behavioral change. The exact term depends on the therapeutic approach and the context. Here are some examples of how it might be framed:

1. Abstinence-Based Approach: In addiction treatment, this involves completely stopping a harmful behavior (e.g., substance use) rather than moderating it.

2. Transformational Change: This focuses on deep, lasting changes to core beliefs, behaviors, or identity, aiming to eliminate harmful patterns altogether.

3. Skill-Building and Growth: Many therapy models, like Cognitive Behavioral Therapy (CBT) or Dialectical Behavior Therapy (DBT), focus on building new skills and changing behaviors rather than simply mitigating harm.

4. Self-Actualization or Personal Growth: In humanistic or positive psychology frameworks, this involves striving for higher levels of functioning and fulfillment rather than just avoiding harm.

For instance, a person working on changing their anger management might focus on developing healthier emotional regulation skills (change) rather than just avoiding physically harmful outbursts (harm reduction).

In the context of psychotherapy addressing domestic violence, a focus on change rather than harm reduction involves moving beyond strategies that aim to minimize immediate risks (e.g., avoiding physical altercations) to addressing the underlying causes and dynamics of abusive behaviors or victimization. Here’s how it might look for both parties:

For the Perpetrator of Violence:

1. Harm Reduction:

   • Strategies might involve teaching anger management techniques to reduce the frequency or severity of violent outbursts.

   • Safety planning to de-escalate potentially volatile situations.

2. Change-Oriented Approach:

   • Accountability-Based Interventions: Programs like batterer intervention programs (BIPs) focus on helping perpetrators understand the root causes of their behavior, take responsibility, and develop nonviolent relational skills.

   • Transforming Belief Systems: Challenging and changing harmful beliefs about power, control, and entitlement that perpetuate abusive behavior.

   • Skill-Building: Developing empathy, emotional regulation, and healthy communication to replace the reliance on violence as a conflict resolution tool.

For the Survivor of Violence:

1. Harm Reduction:

   • Safety planning to ensure immediate physical safety (e.g., identifying escape routes, contacting support networks).

   • Learning coping strategies to reduce the psychological impact of abuse.

2. Change-Oriented Approach:

   • Empowerment Therapy: Working on self-esteem, boundary-setting, and recognizing red flags in relationships.

   • Trauma Recovery: Addressing trauma responses, such as learned helplessness or hypervigilance, to rebuild a sense of agency.

   • Rebuilding Identity: Focusing on long-term goals, personal growth, and life skills to move beyond the cycle of abuse.

Key Therapies Used in Change-Oriented Work:

• Cognitive Behavioral Therapy (CBT): Helps both parties identify and modify harmful thought patterns contributing to the cycle of abuse.

• Trauma-Focused Therapy: For survivors, this helps heal the emotional wounds caused by the violence.

• Motivational Interviewing (MI): Supports the perpetrator in finding intrinsic motivation to change.

• Systems-Focused Approaches: Examines family dynamics or cultural factors contributing to abuse.

Change in this context often involves dismantling the abusive cycle entirely, fostering healthier patterns of behavior, and ensuring long-term safety and emotional well-being for all involved.

Therefore

John and Julie Gottman’s research distinguishes two primary types of domestic violence: situational domestic violence (SDV) and characterological domestic violence (CDV). Situational domestic violence arises from escalated conflicts between partners, typically in the context of stress, poor communication, or inability to de-escalate tension. It is often mutual or reciprocal and may occur sporadically rather than as a pervasive pattern. This form of violence is not rooted in a desire to control or dominate the partner but rather stems from a breakdown in emotional regulation and communication. The Gottmans highlight that SDV can occur in otherwise healthy relationships and is not predictive of ongoing abuse if the underlying conflict patterns are addressed.

In contrast, characterological domestic violence is deeply rooted in an abuser’s personality structure and is characterized by intentional efforts to dominate, control, or harm the partner. It is often unidirectional, with one partner exerting power over the other through a sustained pattern of physical, emotional, or psychological abuse. This type of violence is linked to personality disorders, attachment trauma, and a deeply entrenched sense of entitlement or insecurity. Unlike SDV, CDV is not situational or reactive but a chronic and systematic pattern of behavior. Victims of CDV often experience isolation, fear, and diminished self-esteem due to the persistent nature of the abuse. The Gottmans emphasize that CDV is far more damaging and requires interventions that prioritize victim safety and often involve legal or systemic responses.

The treatment approaches for these two forms of violence differ significantly. For situational domestic violence, the Gottmans recommend therapeutic interventions that focus on improving communication, conflict resolution skills, and emotional regulation. Couples therapy, particularly Gottman Method Couples Therapy, can help partners learn to de-escalate conflicts and foster healthier dynamics.

However, for characterological domestic violence, couples therapy is not appropriate or safe. Instead, treatment focuses on protecting the victim and addressing the abuser’s patterns through individual therapy, accountability programs (such as Batterer Intervention Programs), and legal intervention if necessary.

The Gottmans stress the importance of accurately identifying the type of domestic violence present to ensure that treatment prioritizes safety, healing, and long-term relational health.