Therapeutic Alliance with Perpetrators of Intimate Partner Violence: The Roles of Childhood Interpersonal Trauma and Attachment Insecurity

Intimate partner violence (IPV) represents a major global health concern with devastating consequences. Many perpetrators seek treatment to stop their violent behaviors, where a strong therapeutic alliance (TA) could support their progress. This study's first aim was to examine how individual or cumulative childhood interpersonal trauma (e.g. sexual abuse, neglect) and attachment insecurity (anxiety, avoidance) reported by IPV perpetrators predict the quality of TA reported by their therapist. The second aim was to assess whether childhood interpersonal trauma interacts with attachment insecurity in predicting TA. The third aim was to explore whether the number of therapy sessions moderates these associations. A sample of 349 men entering treatment for IPV completed admission questionnaires and their therapists assessed the quality of TA at the end of treatment. Results revealed that childhood interpersonal trauma and attachment insecurity did not predict TA directly, but that TA was worse when men reported childhood physical neglect with high attachment anxiety. The number of sessions moderated the links between TA and physical abuse, exposure to parental psychological IPV, and attachment (anxiety and avoidance). By documenting predictors of TA among IPV perpetrators, this study highlights the importance of trauma history, attachment insecurity, and of promoting longer treatment duration.