Modalités d'une intervention systémique en matière de violences conjugales dans une unité de médecine et prévention de la violence

In the interdisciplinary unit of violence medicine and prevention, based within the teaching hospital of Geneva, our clinical experience with the persons confronted with intimate partner violence, and coming on the voluntary mode, led to us to resist, at first, to the treatment of the couple “appointed as patient” without consideration of the individual, as person victim and\or author of violence. Indeed, it can be dissuaded to engage a process of couple therapy when there is intimate partner violence and the existence of violence would moreover be systematically detected before a couple therapy for another motive than this violence. We suggest dealing in a way differentiated in the time and settings, the present characteristics in these situations: the psychotraumatic dimension, the impact of violence on global health at short, average and long term, the responsibility of acts, protection and relational commitment in couples and families. We also defined the indications and the contraindications of couple therapy in these situations. We discuss the implication of these characteristics and the conditions predefined for couple family therapy in this perspective of the complexity and with this ethical point of view.