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Batterer Intervention- Program Approaches and Criminal Justice
Strategies
Chapter
2
Chapter 4
Chapter
3:
Pioneers in Batterer Intervention: Program Models
This chapter provides an overview of program services and procedures in five
communities visited for this report. The chapter's primary focus is on larger
mainstream batterer interventions. The following chapter, "Current Trends
in Batterer Intervention," discusses smaller specialized interventions in
detail (see box, "Selection of Programs Studied," and appendix B, a
listing of individuals interviewed at each site).
No mainstream program approach or curriculum has yet been proven to be more
effective in reducing recidivism than any other.[1] As a result, many program
directors and criminal justice professionals stress structure over content; they
believe that regardless of a program's philosophy or methods, any responsible
intervention that requires weekly contact can help contain batterers' abuse
through close monitoring of their behavior (see chapter 5, "Criminal
Justice Response").[2] According to Andrew Klein, chief probation officer
for the Quincy, Massachusetts, District Court, "If only appropriate clients
are referred -- people who know they did wrong, have some motivation to change,
are under external pressure to change, and are sober -- if the program monitors
behavior, not attitude, and if the program lasts long enough, then the content
doesn't matter. . . . To be considered effective, the program must stop the
battering and keep offenders from battering again for at least one year."
Program Procedures
The following discussion draws on program practices at the five sites with
special emphasis on issues of common concern.
Intake and Assessment
The batterer's first contact with the program occurs when he arranges for an
intake interview. At this time, the client signs release forms that give the
program permission to contact his probation officer and his partner. The program
then notifies the probation office that the client has chosen it for treatment.
(See appendix D for sample intake and assessment forms.)
The first step of the intervention is the intake assessment, a process that can
span one to eight weekly sessions.[3] The initial session may be done as an
individual interview or as part of a group orientation. Intake sessions serve
several purposes:
o to get the client to agree with the terms and conditions of treatment and to
sign the program contract;
o to begin to assess the nature and extent of the -- batterer's abusive
behavior; and
o to screen for other problems such as substance - - abuse, mental illness, and
illiteracy.
In addition to specific questions about domestic violence, the assessment
typically includes questions about the batterer's family history, propensity for
violence outside the family, and substance abuse. Ideally, the session begins to
foster rapport between the clinician and the batterer, in addition to initiating
the actual intervention. For example, details about the nature of the abuse are
often gleaned through questions regarding the first, the most recent, and the
most severe battering incidents. Describing this behavior in detail can increase
the batterer's awareness of the extent of his violence, and this can form a
foundation for later, more in-depth discussions of the abuse and its
consequences. Similarly, programs usually ask about a range of behaviors that
are psychologically or sexually abusive. This questioning helps the batterer
broaden his definition of abuse.
Programs vary in how clinical their assessments are and to what extent they
measure the batterer's psychological makeup in an effort to identify other
problems that could interfere with the intervention. Some programs screen for
possible problems by using simple checklists and then referring the client for
formal psychological evaluation if a substance abuse or mental health problem is
suspected. Other programs, such as AMEND and The Third Path, use standardized
instruments like the Millon Clinical Multiaxial Inventory (MCMI) to do clinical
assessments themselves. The director of one of the AMEND programs4 explains,
"We use the MCMI both as a diagnostic tool and a treatment planning tool,
and to start thinking about the majority of our clients who have personality
disturbances as falling along a continuum from mild personality dysfunction to
more pronounced conditions."
Programs may refer batterers who are found to have other psychological problems,
like clinical depression, elsewhere for psychiatric treatment or individual
counseling. However, referrals are not considered a substitute for the batterer
intervention program. Rather, psychotherapy is delivered concurrently with the
batterer intervention, as is also typically the case when substance abuse is the
problem. Programs try not to screen out batterers with multiple problems as long
as they comply with the concurrent treatment. For example, batterers who are
clinically depressed may continue in the program as long as they take their
psychiatric medication, while batterers with substance abuse problems must
remain sober and submit to random urine screenings or breathalizer tests. In the
Quincy, Massachusetts, District Court, for example, batterers must take weekly
urine tests. The batterer pays $5 per test, but the probation office will pay if
the offender cannot.
Many programs do deny services to certain batterers. One of the most common
reasons for turning batterers away at intake is if they are part of a cultural
or language group that another program can serve better. While established
programs are striving to develop the culturally sensitive methods discussed in
chapter 4, "Current Trends in Batterer Intervention," other programs
have chosen to develop alliances with grassroots organizations serving specific
cultural communities, such as non-English-speaking immigrants. Family Services
of Seattle, for example, refers Spanish-speaking batterers to a local
organization formed to serve Hispanic immigrants, and it refers batterers in
same-sex relationships to a local gay and lesbian counseling agency. EMERGE, on
the other hand, offers special in-house groups for African American male
batterers and for lesbian batterers, and it has Latino and Asian American
counselors on staff to serve batterers from these cultural groups.
Another common reason for rejecting clients at intake is unwillingness or
inability to pay. Intake fees may be $50 or more. Rather than pay, many clients
prefer to return to probation or the court to request a change in their
conditions. To get batterers past this initial barrier to treatment, Sid Hoover,
supervisor of Seattle's Municipal Probation Domestic Violence Unit, offers
"especially worthy" batterers a limited-time discount coupon to reduce
the cost of intake from $45 to $25. Family Services of Seattle, one of several
local interventions that receive city funds to reduce the cost of providing
services to indigent clients, allows the probation office to designate which
clients will be offered reduced- rate intake. (See chapter 4, "Current
Trends in Batterer Intervention," for a discussion of program fees and
indigence.) According to Hoover, "Getting people into intake is half the
hurdle; if you can get them into the intake, their fear about the whole
enterprise starts to decline. Their comfort level goes up because they've been
in there. They've seen the people, they realize that it's relatively painless,
and the program people aren't dehumanizing them."
Some programs consider a batterer inappropriate for treatment if he
unequivocally denies that he committed any violence. A probation officer in
Seattle noted batterers' difficulty in adjusting to their new roles as
court-mandated clients: "We're kind of breaking the news to them -- you're
going to a DV treatment program -- so they can start to turn themselves from
defendants into health care consumers. They've got to switch hats from fighting
the system to taking responsibility for their life." At intake, the
batterer has just been referred from the criminal justice system where, in the
role of defendant, he was expected to insist on his innocence. Now that he has
agreed to a plea bargain, it is no longer appropriate for him to deny his guilt.
The batterer may not have much time to make this adjustment -- some courts give
the defendant less than a week to make contact with the program. The lack of
time to change his mindset, combined with the batterer's tendency to minimize
and deny his violence, forms the first obstacle to treatment. Apart from
information gathering and initial indoctrination to program rules, overcoming
this obstacle is the primary task of the intake session. In Des Moines, the
intake counselor uses the police report to confront the batterer with the facts
of the case. Other programs postpone confronting batterers until treatment
begins.
Victim Contacts
A number of States require that batterer programs contact partners (see appendix
A, "State Standards Matrix"). At a minimum, partner notification is
needed at four points:
o when the batterer begins attending the program;
o if and when he has been terminated from treatment -- for noncompliance;
o when he has completed the program; and
o if an imminent threat to victim safety arises (seebelow).
Programs with a strong advocacy policy will typically contact the partner every
two to three months as long as the batterer remains in the program.
Since batterers typically minimize or deny their abusive behavior, assessments
and ongoing monitoring often involve separate interviews with the victim to gain
additional information about the relationship. As part of the client contract,
batterers may therefore be required to sign releases that permit counselors to
contact current and past partners. (Some States, like Iowa, avoid the need for
consent by exempting counselors from ordinary client confidentiality
requirements when it comes to victim contacts.) A trained victim liaison usually
interviews victims by telephone for reasons of safety and efficiency. The
liaison assures the victim of absolute confidentiality; nothing she says will be
repeated to her partner or his counselor without her consent. At EMERGE, the
victim liaisons make it clear to victims that the program's primary concern is
the safety of victims and their children. If the victim is willing to discuss
the abuse, the advocate may also ask about the duration, frequency, and severity
of the abuse in order to assist in the batterer's treatment. However, liaisons
make clear that furthering the batterer's treatment is only a secondary goal of
the victim contact. A victim liaison from AMEND expressed a similar view:
When I first started working here, we were getting more background on the
batterer from his partner, such as what his childhood was like. That was helpful
for the therapist in treating him, but at the same time I don't think it was so
helpful for her to have to dredge up all that information about him. So we've
moved away from that in our conversation and started talking more about the
victim and her plans and trying to educate her about domestic violence.
In addition to helping with safety planning, the victim liaison can describe to
the victim the basic features of the batterer intervention program as well as
its limitations (see below).
Victim liaisons (many of whom are called "advocates") interviewed for
this report expressed surprise that most of the partners they contact have never
sought services from a battered women's agency. These victims come to light only
as a result of legal intervention with their abusers; they may not even be aware
that services are available to them. Contacting the partner when the batterer
enters the program therefore offers the opportunity to raise the victim's
awareness of her situation and to begin to help her think about her own and her
children's safety. As the director of battered women's services in Des Moines
added, "For every batterer who gets arrested, his victim will have some
sort of contact from battered women's services, whether it's legal advocacy,
like warning of his release from jail or explaining pretrial hearings, or basic
safety planning."
Because this contact may be the first chance the victim has ever had to tell her
story to a helping professional, it is crucial that the contact be handled
sensitively by another woman who has experience working with battered women. The
EMERGE partner pamphlet lists the following examples of questions to ask the
victim:
o Are you always trying to second-guess your partner to avoid an argument?
o What does your partner do when he loses his temper?
o Do you have holes in your walls or broken possessions from times when your
partner lost his temper?
o Has he ever hurt you physically or threatened you?
o What would it take for you to get away?
o Do you know that there are many other women -- who have experienced what you
are going through - - and that help is available?
The House of Ruth in Baltimore invites victims to a separate open house to
discuss the program's goals and methods and to provide an opportunity for
victims to learn more about the House of Ruth's victim and children's services,
including legal counseling and referral to other service agencies. The following
two sections highlight program techniques for working with victims.
Raising Victim Awareness
In order to develop rapport with the victim, the victim liaison must affirm the
victim's experiences and communicate respect for the victim's right to make her
own decisions. The victim liaison shows concern for the victim's safety by
speaking to her when the batterer is not present and assuring her complete
confidentiality. Victim advocacy starts by offering support, assuring the victim
that other women have also faced similar circumstances. "Mainly we try to
focus the conversations on her, try to reach her that way," one liaison
said. "We ask her what she'd like us to address -- whether it's the kids,
or continued abuse, or drug and alcohol issues." The victim liaison makes
sure that the victim knows that services are available to her and tells her how
she can contact the local battered women's shelter and support group. While
stressing that the interview is voluntary, the liaison asks if the victim is
willing to describe the incident that resulted in her partner's entering the
program. The victim liaison tries to learn all she can not only about the extent
of the physical violence but also about any emotional and sexual abuse. Just as
the intake worker tries to broaden the batterer's definition of abuse, the
victim liaison attempts to help the victim become aware of the broader context
of the abuse. She lets her know that other victims have reported similar
experiences of being humiliated, berated, threatened, or intimidated into
complying with their partner's wishes.
Some program group leaders have difficulty convincing some victims from other
cultures that they have a right to live without violence and to be treated as
their husband's equal. An Asian counselor described the dilemma of being an
Asian immigrant and a victim: "For Asians, the family is the most important
thing, not the individual, as it is for most Americans. The Asian culture
believes that talking to someone outside the family about private matters shames
the family." For those coming from countries with strong patriarchal values
that completely disempower women, programs take pains to educate the victim
about American laws and cultural norms.
Another important reason to contact the victim when the batterer enters
treatment is to guard against false hopes that the program can make him change.
The program stresses that it is up to the batterer to take responsibility for
his violent and controlling behaviors, and acknowledges that many batterers are
not willing to stop being abusive. The liaison tells the victims (just as
counselors tell the batterer) that there is no quick fix -- change takes a long
time and requires a genuine commitment by the batterer. Victim liaisons assure
the partner that she is in no way responsible for making him stop and that the
responsibility to change is the batterer's and his alone.
Making independent contact with the victim also ensures that she gets accurate
information about the program's goals and methods. Particularly during the first
few weeks of treatment, batterers often use the program to manipulate the
victim, distorting what has been said in group to blame her for the abuse. For
example, one victim liaison from AMEND recalls, "The therapist got into
describing what bipolar is. Then these guys go home and say to the victim 'My
therapist said you're manic depressive,' allowing the focus to shift to the
victim rather than remain on his behavior." In explaining the general goals
of the intervention and the standard techniques the batterer will be taught, the
liaison can circumvent the batterer's distortions beforehand. Victim liaisons
also warn the victim that batterers often use their entry into treatment as a
justification for pressuring their partners to stay in the relationship and that
such pressure is another sign of continuing nonphysical abuse.
Ongoing Advocacy and Safety Planning
The victim liaison has the difficult task of balancing cautions against false
hopes with respect for the victim's right to make her own decisions. Should the
victim decide that she wants to remain with the batterer, the liaison needs to
respect that choice but still help her plan for her safety. One victim liaison
usually tells the victim, "Well, you know we can't guarantee he's going to
change. . . . So what are you going to do just in case he doesn't change?"
The liaison advises the victim to identify the absolutely essential items she
would need if she suddenly had to leave home. Then the liaison helps her develop
a plan to have these things available, preferably through a trusted neighbor,
relative, or friend. For instance, the victim might plan to give someone an
extra set of her car keys, copies of her and her children's birth certificates,
and the originals of other important documents and prescriptions.
Safety planning can also be more long term. Victim liaisons may continue to
support the victim over the course of the batterer's treatment, and this support
may help her to prepare to leave him. On the advice of the victim liaison,
programs like EMERGE, AMEND, Family Services of Seattle, and Zegree, Ellner and
Berrysmith all agree that they sometimes maintain a noncompliant batterer in
treatment in order to give the victim extra time to leave safely. In addition,
batterers are also occasionally retained in treatment as a form of supervision
and monitoring intended to increase victim safety. For example, a liaison at
AMEND noted, "There are cases we have kept on that we felt we could have
terminated because we knew that there was going to be no success in
rehabilitating the batterer. But it was better -- for victim safety -- for us to
have some containment, because at least we knew then what was going on with
them."
While all the programs visited for this report had some form of contact with
victims over the course of the batterer's treatment, some victim liaisons oppose
this blending of batterer and victim services. A battered women's advocate in
Seattle suggested that "the 'victim informant' position is difficult for
victims. If the victim gives [the program] information about the batterer's
abuse or other lapses, the batterer may retaliate against her. Her abuser may
then see it as her fault -- not his -- that he has to keep going to the
program." Other victim advocates and liaisons agree that contacting victims
can be a delicate matter, as an AMEND liaison explained:
A lot of times we get information that we can't confront him on -- for example,
the victim will call and say, "He's been drinking, but I don't want you to
confront him on it. I just wanted you to know." So then we tell the
therapist, and the therapist tries to figure out how he can incorporate this
information into the guy's treatment without violating her confidentiality and
safety. And some therapists can do that better than others, finding a back way
of confronting him and getting it to come out another way.
Because of these concerns for the victim, some State standards prohibit or
discourage batterer programs from contacting the victim directly.
Orientation
Established programs have adapted their interventions over the years to continue
the assessment process during the initial phase of group intervention. New
clients meet together for one or more orientation sessions during which the
reeducation process begins; at the same time, counselors use the sessions to
make a more accurate appraisal of the extent of the batterer's violence and
substance abuse than may have been possible during intake.[5] For example, the
Arapahoe County, Colorado, chapter of AMEND requires that its clients be
alcohol- and drug- free during the entire six-week orientation period as a test
of their sobriety. Batterers who do not comply with the abstinence rule are
placed in special groups for substance-abusing batterers. The group leaders,
certified both as batterer group leaders and chemical dependency counselors,
provide drug counseling, such as relapse prevention techniques, in combination
with the standard AMEND intervention. The program typically requires random
urine screens and the use of Antabuse.
AMEND also added alcohol education to its orientation curriculum because some
clients have drinking problems that neither their probation officers nor the
intake assessment has brought to light. As one of AMEND's co-directors explains,
"Because a lot of our people have alcohol and drug problems, we'll go
through a basic kind of alcohol education [during everyone's orientation]. . . .
One of our goals that first four to six weeks is to find out who has a problem
and get them dried out."
Besides improving the program's ability to assess the client, the orientation
serves to establish rapport between participants and counselors. Staff who
conduct orientation seek to reduce the batterers' initial defensiveness. As one
program director put it, "We try to reassure them that we're here to help
them, not to beat them up. We try to form an alliance with each person . . .
suggesting that maybe there are things he can learn here to improve his
relationships with his partner and kids."
The session then turns to the program goals and the rules for participating in
the group. Some of the rules relate to attendance, punctuality, and payment of
fees; others are related specifically to the group process, such as
confidentiality, abstaining from alcohol and other drugs 24 hours before each
group session, and participating constructively in group discussions. Other
rules may prohibit sexist or degrading language and insulting or intimidating
counselors or other group members, and require waiting in turn to speak.
Finally, the program explicitly states the expectation that batterers will
refrain from all violent, intimidating, or threatening behavior toward their
partners.
In addition to indoctrinating new members about program rules, orientation
sessions are used to teach batterers the underlying assumptions of the program.
o Counselors establish a broad definition of abuse that includes psychological
and sexual abuse.
o To motivate batterers to change, counselors highlight the consequences of the
batterer's abusive behavior for his children -- often the best motivation to
change.
o Counselors also begin to build empathy for their partners among batterers by
discussing the consequences of abuse for the victim.
o Depending on the treatment approach, these sessions may also cover societal
beliefs and norms that support violence, place physical abuse along a continuum
of other controlling behaviors, or focus on the batterer's typical thought
patterns preceding an abusive incident.
Two of the eight beginner classes, as they are called, of EMERGE are devoted to
demonstrating that there is no "quick fix" to domestic violence.
Batterers learn to acknowledge the long-term effects of their abuse on their
partners and the strategies they have used to keep her in the relationship. The
codirector of EMERGE notes that group members can readily list such quick-fix
strategies as apologizing, buying her gifts, and even enrolling in a treatment
program, but they are less able to offer longer-term solutions that require them
to take responsibility for their own violence and respect their partner's
wishes.[11]
Orientation sessions tend to be more like didactic classes than later sessions,
which may take on a more therapeutic tone. One reason for the lecture- type
format is to maintain order among new members who would sidetrack group
discussions by turning attention away from their own behavior with complaints
about their partner or the criminal justice system. Another, more subtle, reason
for the structured format is to firmly establish norms for how to participate in
group discussions before members graduate to more informal groups. The sessions
also set a tone of active participation, making clear that clients will not be
allowed to attend class without really participating in group discussions.
Finally, the orientation phase -- especially if it is extended over a number of
weeks -- can also serve as a screening device for the more therapeutic ongoing
groups. By requiring attendance at six to eight intake group sessions as a
prerequisite for continued participation, programs like Family Services of
Seattle and EMERGE of Quincy weed out more disruptive clients, who would
eventually drop out regardless of the intervention. Remaining in the orientation
sessions demonstrates a commitment to a long-term solution to their pattern of
abuse.
Most of the programs visited require that each batterer admit to his violence by
describing to the group the abusive incident that led to his enrollment. As one
program director explains, "If a man insists that he has been falsely
charged, I will send him away saying, 'If you haven't done anything wrong, you
need a lawyer, not a batterers program. This program is for men who have a
violence problem, not a legal problem.' "
If the batterer refuses to admit wrongdoing, or shows patterns of disruptive or
resistant behavior during class, he is usually dropped from the program at that
point. The requirement that he admit to his violence, combined with mandatory
attendance at multiple orientation sessions, sets a minimum standard that all
participants must meet in order to continue in the program as a member of an
ongoing group.
Leaving the Program
Batterers may leave programs because they are requested to terminate program
attendance due to noncooperation, violence, nonpayment of program fees, or other
failure to follow program rules; because their probation has been revoked; or
because they have met the program's completion criteria. Some programs offer
aftercare for program graduates.
Penalties for Noncompliance
Clients can fail a program in a number of ways. The most common is a failure to
attend group regularly. Another is by violating crucial program rules -- like
being disruptive or aggressive in group or coming to group under the influence
of alcohol. If the client was identified in the assessment as having a substance
abuse problem, failure to follow through on a referral for alcohol or other drug
treatment (or continued use of substances) would be another serious infraction.
Of course, violating a restraining order or repeating any form of violence could
also be grounds for termination. (For a full discussion of program communication
with probation officers and the courts, see chapter 4, "Current Trends in
Batterer Intervention.")
Programs may take a range of actions against a client who has failed. Before
resorting to terminating the client, the program may issue a warning or require
the batterer to begin the program again. For the majority of clients whose
treatment is court-ordered, the program reports failure to attend or a
resumption of violence to their probation officer. For batterers with a
substance abuse problem, another reportable violation condition may be failure
to maintain sobriety. For these clients, AMEND staff report directly to the
probation officer any indications of any use, whether from random urine testing
or the client's or victim's reports. With the cooperation of probation and the
courts, the client's time in treatment may be extended.
A victim advocate from AMEND emphasized the importance of support from the
probation officer in court-mandated cases: "When we want to restart them,
sometimes [probation officers] aren't real supportive of that, and that really
hampers our decision-making process a lot. Or, I know that this probation
officer may not be able to extend treatment because the judge isn't going to
back up the probation officer, so we have to terminate the batterer." By
contrast, when batterers reoffend in Massachusetts, State standards require a
six-month extension of treatment. Even if the infraction is less serious than
repeated abuse, the violation can be used to restart the treatment clock. A
court-ordered client of the Des Moines DAIS program who has too many absences
(missing 4 sessions in a 12-week period) is required to start the program over
again.
Programs are cautious about terminating a batterer because of the danger it may
pose to the victim. However, they must send a clear message that clients are
required to make constructive use of treatment in order to remain.12 Program
staff are also concerned that the victim not be lulled into a false sense of
security if the batterer attends groups but does not try to change. Nonetheless,
programs ideally consult with the victim before terminating a client. Programs
may also need to terminate a batterer who poses a threat to staff. At AMEND, one
batterer (who had been arrested for holding his wife hostage and attempted
murder) turned his threats and anger on program staff and the victim liaison
when his wife informed him that she had reported continued physical and sexual
abuse to an AMEND victim advocate. The batterer was terminated, and program
staff helped the victim to move out-of-state.
Completion
While some programs use attendance as the sole criterion for successful
completion, Washington State requires that each program have specific exit
criteria. Family Services' exit criteria require the batterer to write a
"responsibility letter" and an "empathy letter."
o The batterer pretends he is writing the responsibility letter to his partner
and children (if any), accepting full responsibility for his abusive behavior
and -- identifying and acknowledging the painful consequences to them.
o In the empathy letter, the batterer writes as though he were the victim,
describing his feelings (as the victim) about the abuse.
o The batterer then reads the letters aloud to the group, although he decides
whether to share them with his family.
AMEND also makes a distinction between having completed treatment by attendance
only and a more successful discharge. If a batterer has attended a minimum of 36
weekly sessions, he has fulfilled his sentence and is dismissed with an
"administrative" discharge. If, however, he has accomplished his
treatment goals, remained sober, and respected his partner's wishes for no
contact, if applicable, the client receives a successful or "clinical"
discharge. While either way the court- mandated client is no longer required to
attend further treatment, the program's final report to probation will indicate
whether or not the therapist believes the client has worked successfully with
the program. If the client receives only an administrative discharge and later
reoffends, the court may sentence him to jail rather than allow him to enter
treatment again. Follow-up
Some programs offer follow-up or aftercare in the form of ongoing support groups
for clients who complete the program successfully. Washington State standards
require a full year of contact with the program, but only 26 weekly sessions, so
that programs offer monthly meetings as a separate follow-up phase to the
standard treatment. Although not required to by State standards, the Des Moines
DAIS program offers a weekly support group for men who have successfully
completed its 16- or 24-week program. The program director is committed to
providing aftercare so that batterers who have completed the program have the
opportunity to meet with other men who are recovering from violence, to get
support for maintaining a nonviolent lifestyle, and to continue to practice the
conflict resolution and anger management skills the program taught them. One
program director voiced concern, however, that most men are not being trained to
deal with the hypothetical "ultimate situation" that could trigger
relapse for them: "Batterers need to be prepared, to know 'What would you
do? Who would you call for help?' " Relapse prevention and support for
former batterers is important, according to AMEND director Rob Gallup, because
"often the perpetrator is as isolated as his partner."
Program Content: Established Interventions Using Weekly Groups
The group modality is the intervention of choice in dealing with batterers for
several reasons.[13]
o The group combats the implicit social approval of abusive behavior that many
batterers perceive from family and friends. By sending consistent messages that
do not condone any form of abuse and encourage nonviolent alternatives, the
group serves as a healthy support system for batterers who wish to change.
o Successful group members can serve as role models to batterers who are just
beginning to confront their own violent behavior, helping to break through a new
member's minimization of his abuse.
o By providing a new source of support, the group reduces the batterer's
excessive dependence on his partner to meet all his emotional needs.
However, group leaders must be alert and ready to intervene when batterers try
to commiserate with one another, forming unhealthy bonds that excuse abusive
behavior. As one set of group leaders advised, "Be vigilant about male
bonding -- batterers love to stick up for each other against their
partners."
Some programs are strictly structured, such as those using the Duluth curriculum
(described below), prescribing the order in which topics are to be addressed.
Other programs give discretion to group leaders to choose from a range of
program content, while confronting batterers' behavior more directly. Program
directors warned that some leaders may resort to a more flexible approach
because they lack the skill to keep group discussions focused on the planned
curriculum. It is important, therefore, to distinguish between a flexible
curriculum and uncontrolled digressions from the set discussion schedule.
Whatever the structure or treatment approach, each group session typically
begins with a round-robin style check-in, followed by the selected topic or
educational piece for the meeting, ending with goal setting and check-outs.
Check-ins are a way to introduce new members to the group and reinforce the
program's focus on the batterer's behavior. They can be brief (each person
states his name and one of the rules of the group) or more lengthy (each member
describes his most recent or severe abusive behavior). In more therapeutically
oriented programs, the check-ins can lead to discussions that take up the bulk
of the session. For example, the group may discuss possible solutions to
conflicts recounted by group members. For more educational programs, the check-
ins are followed by a more structured presentation from the curriculum.
Regardless of emphasis, at the end of the session programs typically assign
homework that is designed to encourage each client to apply the session's topics
directly to his life. Check-outs help participants summarize what they learned
and clarify their behavioral goals for the coming week.
Accountability as the Foremost Goal
Most batterers deny or avoid accepting responsibility for their actions -- that
is, they refuse to view battering as a choice. As a result, one of the main
goals of all reputable batterer intervention programs is to get the batterer to
become accountable for his abusive behavior.[15] The challenge of the
intervention is to force the batterer to acknowledge his violence in terms of
the full range of abusive acts he has committed, thereby broadening his
understanding of what constitutes unacceptable behavior.
Program staff have divided the most common tactics batterers use to avoid
accountability into three categories:
o denying the abuse ever happened ("I didn't lay a hand on her; she made
the whole thing up");
o minimizing the abuse, either by downplaying the violent acts ("It was
just a slap") or underestimating its effects ("She bruises
easily"); and
o blaming the abuse on the victim ("She drove me crazy"), drugs or
alcohol ("I was drunk, I don't remember anything"), or other life
circumstances ("I was at the end of my rope 'cause I was working 16 hours a
day").
Because these tactics are so common, group leaders in nearly all programs watch
for them and confront batterers whenever they try to use them. For example, some
facilitators will use the police report of the attack to bring the severity of
the batterer's actions into perspective. Group leaders also guard against what
they call "sidetracking," referring to batterers' attempts to turn the
discussion away from their behavior by complaining about their partner, the
criminal justice system, or racial or social injustice (see chapter 4,
"Current Trends in Batterer Intervention"). As one group leader
suggested, "Don't get sucked into their stories; only give them attention
when they talk about their behavior." Whatever the treatment approach,
batterer interventions keep the focus on the batterer's behavior and its
consequences.
Cognitive-Behavioral Techniques
The majority of programs visited for this report incorporated
cognitive-behavioral techniques into their group interventions. As discussed in
chapter 2, "The Causes of Domestic Violence," a common intervention is
to offer the batterer specific tools that help him see that his acts of violence
are not uncontrollable outbursts but rather foreseeable behavior patterns he can
learn to interrupt. Cognitive-behavioral techniques help the batterer recognize
how he stokes his own rage through irrational "self-talk," the
internal dialogue that the batterer uses to build himself up to an abusive
incident.[16] Examining the thoughts and feelings that precede the abuse helps
the batterer to realize that he did not just "lose his temper."
Rather, he felt that his partner had disappointed him in some way, began telling
himself negative things about her, and then used that negativity to justify his
violence. If she is ten minutes late coming home from work, for example, he may
tell himself, "She is seeing another man, she is a slut, she's made a fool
out of me." He may have negative thoughts about what his partner is saying
or doing ("She's like a broken record") or think of ways to blame her
for his violence ("She's really asking for it now"). The batterer
repeats these negative thoughts to himself until he no longer thinks of her as
his wife or girlfriend; she becomes an object that failed to perform as
expected, and so violence becomes justified in his own mind.[17]
In brief, cognitive-behavioral techniques target three elements:
o what the batterer thinks about prior to an abusive incident;
o how the batterer feels, physically and emotionally, as a result of these
thoughts;
o what the batterer does, such as yelling and throwing things, that builds up to
acts of violence.[18]
The group helps members to recognize and interrupt these thought patterns and
the anger associated with them. The batterer learns to use his negative thoughts
and feelings as cues to prevent future violent episodes. When he notices himself
beginning the pattern -- thinking negatively about his partner and starting to
feel angry -- some programs teach him to take a "time-out." This gives
him a chance to interrupt the internal dialogues and substitute reality checks
and positive coping statements. At the same time, he is taught to reduce his
state of physiological arousal through relaxation techniques (e.g., deep
breathing exercises, biofeedback) or noncompetitive forms of physical exercise
such as walking or bicycling. However, rather than use time-outs to reflect on
their self-talk and reduce their anger, some batterers misuse them as an excuse
to interrupt an argument. Victims advocates point out that this is a good reason
to have ongoing contact with victims, to learn about and confront such
distortions illustrated by a batterer who himself reported, "We have
time-outs. They're going great. She sits on the couch when I tell her to."
Several programs have developed rules that are also explained to the partner to
make sure the batterer uses standard time-outs constructively.[19] Rules include
limits on the length of the standard time-out, revisiting the issue at stake at
a mutually agreeable time later, and not watching television or using alcohol or
other drugs while taking a time-out.[20] At EMERGE, time-outs are not taught
because, according to co-director Susan Cayouette, "Time- outs are still
abusive to women -- they tell her, 'If I stay with you, I will be abusive.'
"
The Duluth Curriculum: Issues of Power and Control as Primary Targets
Many batterer intervention programs adhere to, or borrow from, a
psychoeducational and skills- building curriculum that is a component of the
Duluth model. Developed in the early 1980's by the Domestic Abuse Intervention
Project (DAIP) of Duluth, Minnesota, the model emphasizes the importance of a
coordinated community response to battering and places battering within a
broader context of the range of controlling behaviors illustrated in the
"The Power and Control Wheel" (see exhibit 1-1).[21] The wheel depicts
how physical violence is connected to male power and control through a number of
"spokes" or control tactics: minimizing, denying, blaming; using
intimidation, emotional abuse, isolation, children, male privilege, economic
abuse, and threats. According to the Duluth model, the batterer maintains
control over his partner through constant acts of coercion, intimidation, and
isolation punctuated by periodic acts of violence.
The curriculum is taught in classes that emphasize the development of critical
thinking skills around eight themes: 1) nonviolence, 2) nonthreatening behavior,
3) respect, 4) support and trust, 5) honesty and accountability, 6) sexual
respect, 7) partnership, and 8) negotiation and fairness. Depending on the total
length of the program, two or three sessions are devoted to each theme. The
first session of each theme begins with a video vignette that demonstrates the
controlling behavior from that portion of the wheel. Discussion revolves around
the actions that the batterer in the story used to control his partner; the
advantages he was trying to get out of the situation; the beliefs he expressed
that supported his position; the feelings he was hiding through his behavior;
and the means he used to minimize, deny, or blame the victim for his actions. At
the close of each session, the men are given homework: to identify these same
elements in an incident when they exhibited similar controlling behaviors.
During subsequent sessions devoted to the theme, each group member describes his
own use of the controlling behavior, why he used it, and what its effects were.
Alternative behaviors that can build a healthier, egalitarian relationship are
then explored.
Putting the Duluth curriculum into practice requires considerable skill on the
part of group leaders. One group observed for this report strayed dramatically
from the evening's agenda, as members succeeded in sidetracking the discussion
away from their behavior onto complaints about the curriculum and about their
partners. Even when the agenda is adhered to, the classroom-style format can
allow some members to sit back and not participate in discussions or even
reflect on their behavior. Group leaders have to be vigilant against both the
active and passive ways batterers avoid taking responsibility for their abuse,
both inside and outside of group. Furthermore, directors of several programs
noted that the tenor of the group intervention varies substantially depending on
the style of the group leaders and how they view their role (e.g., as educators
who teach new skills or as therapists who confront the men's inappropriate
behavior).
EMERGE and AMEND: More In-depth Group Counseling
Two other programs stand out for their longevity and model reputations, EMERGE
of Quincy, Massachusetts, and AMEND of Denver, Colorado. However, unlike the
Duluth model, both programs include more in-depth counseling in addition to
reeducation and skills building. Similarly, the director of the DAIS program in
Des Moines expresses particular concern that its Duluth-style program may not be
enough to reform or deter more high-risk or chronic offenders. In fact, the Des
Moines DAIS worked with the local domestic violence coalition to secure a
special waiver from the State standards so that it could pilot test a more
therapeutic model with high-risk offenders.[22]
The director of EMERGE argues that any treatment that fails to span at least 4
to 6 months runs the risk of never breaking through the batterer's facade of
compliance.[23] Many batterers, often known for being manipulative and
intelligent, can readily adapt to a short-term intervention, quickly learning to
"talk the talk." If the intervention is too short, it may end during
this "honeymoon" phase, leaving the provider satisfied with a job
seemingly well done but with the abusive behavior fundamentally unchallenged and
unchanged. As a result, the EMERGE program lasts a minimum of 48 weeks
(including orientation). The founders of AMEND believe chronic offenders may
require from one to five years of treatment to genuinely change the abusive
behavior,[24] with their 36-week program constituting the minimum period of time
necessary. However, preliminary findings from a multisite evaluation currently
under way for the Centers for Disease Control (CDC) do not support the notion
that longer is better: graduates from a 3-month intensive program fared as well
as those who completed 9 months of treatment in terms of reoffenses at a
12-month follow-up.[25]
The founders of both EMERGE and AMEND also argue that psychoeducational
approaches alone do not address the true nature of the problem. If the
batterer's problem were simply a deficit in skills, he would be far less
functional in the broader world outside the family. The director of EMERGE
argues, "Batterers know how to get along with their bosses, for instance;
they just don't use these same social skills in their intimate
relationships."[26] Focusing solely on the batterer's thoughts, feelings,
and reactions -- by teaching anger management techniques, for example -- can
inadvertently reinforce the batterer's egocentric view of the world. As a
result, EMERGE and AMEND strive to balance cognitive-behavioral techniques with
confrontational group process to force the batterer to accept responsibility for
his abusive behavior and its consequences.
While it is important to give batterers specific tools to interrupt their
abusive behavior patterns, they need more than new skills. Like the Duluth
model, EMERGE and AMEND believe that batterers need resocialization that
convinces them they do not have the right to abuse their partner, a process
AMEND refers to as "habilitating" the batterer.[27] For AMEND, this
means redressing batterers' maladaptive moral development. For EMERGE, as
explained below, the focus is more on the abusive relationship and the emotional
consequences of the abuse for the victim.
The EMERGE Approach
Batterers who successfully complete the program's orientation phase of eight
didactic and skills- based sessions, and admit to at least some form of domestic
violence, graduate to an ongoing group (see exhibit 3-1, "The EMERGE
Model"). The groups blend cognitive-behavioral techniques with
"accountability-focused group therapy," which is more flexible and
interactive than programs that adhere strictly to a preset curriculum, such as
the Duluth model. The ongoing groups use confrontation and feedback.
New members introduce themselves to the ongoing group through a so-called
"long check-in." First, the new member describes the incident that
brought him to the program, typically the most recent abuse. The batterer has to
focus on his own behavior, without talking about what his partner did to
supposedly provoke the abuse. One group facilitator interrupts batterers'
attempts to sidetrack the issue with phrases like, "Right now, I just want
to know what you did. . . . I'm not interested in what you think she did wrong
before you hit her. . . . Your behavior is the reason you're here."
Through the long check-in, which may last ten to twenty minutes, the new member
has to admit to his violence in front of the group. The group facilitator asks
close-ended questions to elicit details about which specific acts of violence
were committed, such as:
o Did you punch her with your fist?
o Did you knock her down?
o Did you have anything in your hand when you hit her? Any kind of weapon?
Long check-ins are repeated with any member the therapist suspects of using
violence again based on something the batterer has said in group or the partner
has reported to the advocate. After the check-ins from new members, each ongoing
group follows with short check-ins for regular members centering on their
interactions during the past week, particularly situations involving conflict or
tension with their past or current partners. Group therapists may probe for
information regarding other controlling behaviors, verbal abuse, or alcohol and
drug use, as well as any positive principles the client may have practiced.
Members are reminded to concentrate on their own behavior rather than their
partners'.
After check-ins are completed, a member may ask for a turn, or the group
facilitator may call on a member, to follow up on something he disclosed during
check-in. Typically, the person taking the turn describes the recent conflict or
incident in detail, focusing on his thoughts, feelings, and actions. Other group
members are taught to give appropriate feedback that avoids
"quick-fix" advice. Appropriate feedback includes listening
attentively, asking questions that determine the sequence of events, and
confronting the person when he tries to avoid accepting responsibility for his
behavior. Once the facts of the event are clear, the group turns to
brainstorming alternatives to how the person behaved with his partner, and he
then evaluates the usefulness of the options proposed. The turn concludes when
the person practices the alternative he thinks will work best, sometimes in
role-play with another group member. Each session concludes with goal setting
for the coming week and check-outs.
The EMERGE approach focuses on the broader relationship between the batterer and
the victim, addressing other concerns of the partner in addition to stopping the
physical violence. To build empathy, the therapist may instruct the client to do
a special check-in involving the narrating of an abusive incident as though he
were his partner. Clients are instructed always to refer to their partner by her
first name (rather than as "my wife" or "my girlfriend" or
"the wife") as a reminder not to think of the women as possessions or
objects. To address broader concerns in the relationship, follow-up questions in
a client's turn may center on the partner's thoughts and feelings during the
conflict, with the group leader balancing learning about the broader context of
the conflict against being sidetracked by complaints about her behavior. To
maintain this balance, the therapist asks questions about the batterer's
responsibility for his behavior and the feelings the victim has expressed about
his actions.
Group therapists also incorporate the partner's concerns, as expressed to them
or the victim liaison, in establishing the client's individual treatment goals.
In addition to the standard goals of no physical or sexual abuse toward the
victim or the children, each client develops behavioral goals that address his
favorite control tactics. For instance, the partner may have expressed concerns
about a client's extreme jealousy. The group would then help the client develop
specific behavioral goals, such as: "I will not ask jealous questions of my
partner when she gets home late," or "I will not call to check up on
my partner while she is at work." The goals would also incorporate positive
alternatives, such as: "The next time I catch myself thinking jealous
thoughts, I will use positive self-talk," or "Instead of checking up
on my partner, next time I'll take a walk." The main features of the goals
are that they continue to direct attention to the client's behavior and that the
partner is in agreement with them.
The AMEND Approach
The designers of AMEND share the commitment to longer-term treatment with the
founders of EMERGE. AMEND also aims to establish accountability, increase
awareness of the social context of battering, and build skills. Group therapists
at AMEND use the Duluth "Power and Control Wheel,"
cognitive-behavioral techniques, and other anger management tools. However, the
AMEND model uses therapeutic group process to address psychological factors.
But, whereas an ordinary therapy group might try to support the client and help
him express his feelings, AMEND group leaders are "moral guides" who
assume more directive, value- laden positions -- in particular, taking a firm
stand against violence and confronting the client's behavior as unacceptable and
illegal.
AMEND identifies four stages in the long-term therapeutic process of recovery
from violence: crisis group, advanced group, self-help/support group, and
political action group. Most men do not continue past the first two therapeutic
stages.
o Stage I (Crisis Group). The first 12 to 18 weeks of group therapy are devoted
to breaking through the batterer's denial. Through education and confrontation,
the batterer begins to accept some responsibility for his violence.
o Stage II (Advanced Group). After four or five months of group therapy,
assuming the client has been actively engaged in reflecting on his patterns of
abuse and in practicing anger management techniques, his cognitive distortions
begin to decline and his denial breaks down. The batterer begins to -- recognize
his own rationalizations. He will still try to minimize and deny his violence
(or blame his partner for it), but when confronted in group, he will begin to
admit the truth -- that he chose to be violent to get what he wanted from his
partner. The director of AMEND noted how often batterers might admit during this
stage, "The funny thing is, I wasn't even that mad. I just wanted to show
her who's boss." These
periodic breakthroughs define the second stage of recovery.
However, the work of the group does not stop there; batterers continue to
vacillate between accepting and avoiding responsibility for their behavior. They
may have learned to "talk the talk," but they may also continue to be
manipulative or verbally abusive to their partners. They may also present a good
face to the group, reporting only what went right during the week. Unless the
therapist can totally break through the batterer's facade, the risk of relapse
remains. This is one of the reasons ongoing partner contacts are important to
the AMEND intervention. Through victim advocates, therapists can learn about
verbal abuse or other intimidating or threatening behavior and then confront the
batterer about these more subtle forms of abuse.
The final phase of recovery for those in the advanced group is the beginning of
genuine, profound personal change. The batterer in this phase has reformed
outwardly; he no longer tries to control his partner through violence or
intimidation. This is a painful and frightening time for clients because they
begin to feel long- suppressed emotions, such as those from childhood traumas.
Group therapists at AMEND call this time "the tunnel" because clients
are midway through the change process: they do not know whom they are changing
into, but they do not want to return to the person they used to be. The group
process shifts to a warmer and more supportive tone at this stage, more akin to
conventional insight or client-centered therapy. In addition, the therapist
continues to teach more sophisticated skills like relaxation techniques and ways
to manage conflict.
Those who choose to continue in therapy may become overly attached to the
therapist, so that setting and maintaining boundaries become especially
important. (For example, one group leader mentioned that clients might want to
continue the discussion after group or feel that it was appropriate to follow a
facilitator home to talk further.)
As the client prepares to end therapy, he is encouraged to develop a
responsibility plan that includes a support network that will help him continue
to practice healthy communication skills and avoid future violence (Stage III,
Self- Help/Support Group). A few men will go beyond self-help groups to become
more involved in community service and political action aimed at ending domestic
violence (Stage IV, Political Action Group).
Implementation Issues
The more in-depth approaches of EMERGE and AMEND require more sophisticated
group therapy skills than, say, psychoeducational programs that adhere strictly
to the Duluth curriculum. The designers of the EMERGE approach recommend that
groups be led by a male-female team to model nonabusive interactions between the
sexes and to guard against more subtle male bonding or victim blaming, which a
male group leader alone might inadvertently encourage. Because batterers can be
such difficult clients, the codirector of AMEND also recommends close clinical
supervision of all group leaders. For example, the Arapahoe County, Colorado,
chapter of AMEND devotes a two-hour staff meeting once a week to case reviews
with therapists and victim advocates to ensure the quality of the intervention.
Conclusion
The programs discussed in this chapter represent mainstream approaches to
batterer intervention. All the programs share a common interest in assuring the
safety of the victim and stopping violent behaviors by the batterer. The
question of how best to achieve nonviolence is critical from a criminal justice
standpoint. While confrontational approaches are appropriate as a reminder to
batterers that violent behavior is illegal and socially unacceptable, less
punitive approaches, such as those advocated by psychologists, may produce
greater retention in treatment and lower rates of recidivism. Until more
evaluations are available, however, all batterer interventions can promote
criminal justice goals by intensively monitoring the behavior of mandated
batterers and reporting violations of probation conditions or any imminent
threat to the victim to the proper criminal justice authorities.
Endnotes
1. See Browne, K., D.G. Saunders, and K.M. Staecker, "Process-Psychodynamic
Groups for Men Who Batter: Description of a Brief Treatment Model,"
University of Michigan, January 26, 1996; and Gondolf, E., "Multi-Site
Evaluation of Batterer Intervention Systems: A Summary of Preliminary
Findings," Working Paper, Mid-Atlantic Addiction Training Institute,
October 24, 1996.
2. Lindsey, M., R. W. McBride, and C. Platt, AMEND Philosophy and Curriculum for
Treating Batterers, Littleton, CO: Gylantic, 1993.
3. Edelson, J. and R. M. Tolman, Intervention for Men Who Batter: An Ecological
Approach, Newbury Park, CA: Sage Publications, 1992.
4. AMEND has five sites, each with its own director.
5. An intensive group orientation that supplements individual intake sessions
has also been found to bolster program retention. Tolman, R.M. and L.W. Bennet,
"A Review of Research on Men Who Batter," Journal of Interpersonal
Violence, 5 (1990): 102.
6. Campbell, J. C., "Prediction of Homicide of and by Battered Women,"
in Assessing Dangerousness: Violence by Sexual Offenders, Batterers, and Child
Abusers, ed. J. C. Campbell, Thousand Oaks, CA: Sage Publications, 1995: 96-113;
Hoffnung, P.S., "General High Risk Factors: Likelihood of Serious
Harm," Quincy, MA: EMERGE, n.d.
7. Saunders, D. G., "Woman Battering," in Assessment of Family
Violence: A Clinical and Legal Sourcebook, ed. R.T. Ammerman and M. Hersen, New
York: John Wiley & Sons, 1992: 208-235.
8. Tarasoff v. The Regents of the University of California, 529 P2d 553 (Cal.
1974) (Tarasoff I); reargued 551 P2d 334 (Cal. 1976) (Tarasoff II).
9. See Lipari v. Sears, Roebuck and Co., 497 F.Supp. 185 (D. Neb. 1986) and
Jablonski v. United States, 712 F2d 391 (Ninth Circuit, 1983), which held that
therapists may be liable even when a specific victim is not identified.
10. See Fein, R.A., B. Vossekuil, and G.A. Holden, "Threat Assessment: An
Approach to Prevent Targeted Violence," Research in Action Series,
Washington, DC: National Institute of Justice, September 1995.
11. Adams, D., L. Bancroft, T. German, and C. Sousa, "Program Manual: First
Stage Groups for Men Who Batter," Quincy, MA: EMERGE, 1992.
12. Adams et al., "Program Manual: First Stage Groups for Men Who
Batter."
13. Gondolf, E.W., Men Who Batter: An Integrated Approach to Stopping Wife
Abuse, Holmes Beach, FL: Learning Publications, 1985.
14. Lindsey, McBride, and Platt, AMEND Philosophy and Curriculum for Treating
Batterers.
15. Adams, D., "Treatment Models for Men Who Batter: A Profeminist
Analysis," in Feminist Perspectives on Wife Abuse, ed. K. Yllo and M.
Bograd, Newbury Park, CA: Sage Publications, 1988: 176-199; Lindsey, McBride,
and Platt, AMEND Philosophy and Curriculum for Treating Batterers; Paymar, M.,
Violent No More: Helping Men End Domestic Abuse, Alameda, CA: Hunter House,
1993.
16. Adams et al., "Program Manual: First Stage Groups for Men Who
Batter"; Edelson and Tolman, Intervention for Men Who Batter.
17. Family Services Domestic Violence Treatment Program, "Men's Domestic
Violence Workbook," Seattle, WA: Family Services Domestic Violence
Treatment Program, 1996.
18. Zegree, J., S. Ellner and D. Berrysmith, "Men's Group Manual,"
Seattle, WA: Zegree, Ellner and Berrysmith Domestic Violence Treatment Program,
1995.
19. Ibid., A-11.
20. Family Services, "Men's Domestic Violence Workbook"; Lindsey,
McBride, and Platt, AMEND Philosophy and Curriculum for Treating Batterers;
Zegree, Ellner and Berrysmith, "Men's Group Manual."
21. Paymar, Violent No More; and Pence, E., "Batterers'
Programs: Shifting from Community Collusion to Community
Confrontation," Duluth, MN: Domestic Abuse Intervention Project, 1988.
22. The pilot is being patterned after The Third Path in-depth counseling
program.
23. Adams, D., Course on "Counseling Men Who Batter," a staff training
seminar that fulfills all the requirements for accrediting batterer group
facilitators in Massachusetts.
24. Lindsey, McBride, and Platt, AMEND Philosophy and Curriculum for Treating
Batterers.
25. Interview with Edward Gondolf, October 22, 1996.
26. Adams, Course on "Counseling Men Who Batter."
27. Lindsey, McBride, and Platt, AMEND Philosophy and Curriculum for Treating
Batterers.
--------------------------------
Key Points
o This chapter describes program services in the larger, more well-established
programs visited for this report.
o Specialized innovative programming is discussed in chapter 4, "Current
Trends in Batterer Intervention."
o Common mainstream program procedures include:
-- Intake: First contact with batterer referred by the criminal justice system.
-- Assessment: Client agrees with terms of program and is assessed for
dangerousness, extent of abuse, substance abuse, mental illness, illiteracy, or
other obstacles to treatment.
-- Victim Contact: Partners may be notified about batterer's status in the
program and any imminent danger, and referred to victim services.
-- Orientation: An initial phase of group intervention that may be more didactic
than later meetings.
-- Group Treatment: May involve a set educational curriculum or less structured
discussions about relationships, anger-management skills, or group
psychotherapy.
-- Leaving the Program: Batterers may complete the program, be terminated for
noncompliance, or be asked to restart the program.
-- Follow-up: May consist of informal self-help groups of program graduates or
less frequent group meetings.
o Program content varies, but all the well- established programs discussed in
this chapter include feminist educational approaches that may be combined with
cognitive-behavioral or psychotherapeutic approaches.
---------------------------
Selection of Programs Studied
Thirteen programs in five communities were selected to represent a range of
approaches to batterer intervention.
o Two of the largest and most established programs in the country -- EMERGE in
Quincy, Massachusetts, and AMEND in Denver -- were chosen to represent pioneers
that continue to modify their models in keeping with the most recent trends in
batterer intervention.
o The Domestic Abuse Intervention Services (DAIS) of Des Moines represents one
of the many programs that use the "Duluth model," a popular curriculum
developed by the Domestic Abuse Intervention Project of Duluth, Minnesota.
o Family Services of Seattle, a subsidized provider of batterer intervention to
low-income clients, was founded as an anger management program but shifted its
emphasis to follow the Duluth model.
o The Harborview Medical Center in Seattle, Washington, was chosen to represent
a public health model of batterer intervention. The center runs a self-styled
"eclectic" program for batterers as outpatients in a private hospital
setting that emphasizes psychotherapy.
o House of Ruth, in Baltimore, another Duluth- based intervention, was chosen to
represent programs that prefer "colorblind" interracial groups in
contrast to the current trend toward specialized single-race or culture
interventions that take into account the racial and cultural context of the
violence (see chapter 4, "Current Trends in Batterer Intervention").
o Colorado's The Third Path, founded by Michael Lindsey, was included for its
innovative use of psychological treatment and batterer typology, as well as its
focus on high-risk offenders.
o The Compassion Workshop of Silver Spring, Maryland, was chosen for its
innovative approach to batterer intervention, which uses cognitive restructuring
techniques to prevent violent responses to emotional pain and to cultivate
compassionate, nonviolent relationships.
A number of smaller programs that serve specialized populations were observed in
Seattle. Zegree, Ellner and Berrysmith conducts two therapy groups for batterers
as part of its mental health practice. Anne Ganley, a pioneer in batterer
treatment, directs a program for veterans that utilizes the Duluth curriculum at
the Mental Health Clinic of the Seattle Veterans Administration Medical Center.
Ina Maka, a Native American-operated intervention, uses the context of Native
American cultural lore as part of a family-preservationist model of batterer
intervention. Sexual Minorities Counseling Services targets gay and lesbian
batterers. Women's Refugee Alliance sponsors individual and group batterer
counseling for recent Southeast Asian immigrants. These specialized programs are
discussed in chapter 4, "Current Trends in Batterer Intervention."
--------------------------------
The Impact of State Standards on Intervention Strategies
Each of the five communities visited for this report developed its own response
to domestic violence. The responses were influenced in part by the statutory
standards of care in each State.
The State standards in Iowa, for example, require that the Duluth curriculum be
used in all batterer interventions. As a result, the probation office in Des
Moines finds it easiest to ensure that the Duluth model is being followed by
referring all batterers to a single provider, the Domestic Abuse Intervention
Services (DAIS) program of Des Moines. In constrast, Washington and Colorado
allow providers to implement a variety of treatment approaches as long as they
follow specified procedures related to intake assessment, frequency of victim
contacts, and duration of program participation. This flexibility allows more
than a dozen programs of varying sizes and theoretical approaches to provide
services to cities like Seattle and Denver. Some of Seattle's programs serve
distinct populations using curriculums designed especially for Asians, veterans,
Latinos, Native Americans, gays and lesbians, or recent immigrants (see chapter
4, "Current Trends in Batterer Intervention"). By contrast, EMERGE,
one of two programs that receive referrals from Quincy, Massachusetts, District
Court, provides services to diverse populations under one umbrella agency.
Finally, in Baltimore, where State standards are still being debated, an
established Duluth-style program currently receiving the bulk of referrals will
soon compete with a controversial new program for court referrals.
--------------------------------
Ongoing Lethality Assessment
Victim liaisons and batterer counselors routinely inform clients that all staff
have an ethical and legal duty to warn the victim if they believe she is in
imminent danger of further abuse. While they cannot predict dangerousness,
practitioners are told to watch for signs that a batterer intends to harm
someone. Some of these signs may be revealed during the intake assessment and
the initial partner contact. When either the batterer or his partner indicates
that these signs are present, the counselor must warn the batterer's partner and
probation officer about the potential danger.[6] Warning signs based on the
batterers' previous behavior include:
o the severity of previous injuries to the partner;
o incidents of forced sex with the partner;
o prior threats to kill, especially those involving the brandishing of a gun or
other weapon;
o history of alcohol or drug abuse, or a major mental illness such as
schizophrenia, manic -- -- depression, or personality disorder;
o obsessive jealousy or possessiveness, or stalking behaviors like spying on the
victim; and
o suicide threats, especially if the batterer has attempted suicide in the past.
In addition to considering indicators based on past history, practitioners also
conduct ongoing risk assessments during the intervention, looking, for example,
for any recent escalation of violence or victim expressions of fear for her
life. If, during the course of treatment, the batterer reveals he has or is
developing a plan (as opposed to a fantasy) to harm his partner, the
practitioner has an ethical and legal duty to warn -- and even take steps to
protect -- the potential victim.[7] The batterer can be said to have a plan, as
distinguished from a fantasy, if he has expressed an intention to take concrete
steps to carry out violence (e.g., purchase a weapon, save money toward the
objective) or has actually carried out one or more steps. Counselors' legal duty
to protect potential victims varies by State law and, in some cases, by State
batterer intervention standards or protocols.
In Tarasoff v. The Regents of the University of California,[8] the U.S. Supreme
Court ruled that therapists who have determined -- or should have determined --
that a client is a threat have a duty to use reasonable care to protect an
intended victim by, for example, warning the victim, hospitalizing the client,
and warning police. In the case of batterer program staff, duty to warn may
include the victim, her victim advocate, the batterer's probation officer, the
courts, or police.
Subsequent Federal cases have set even stricter standards.[9] Identifying a
potential threat to the victim allows law enforcement authorities to conduct a
risk assessment, evaluate the situation, and develop a case management plan to
preempt the threat by vigorous prosecution of existing offenses or engaging the
assistance of other mental health or social services staff.[10]
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Advantages of Open-Ended Group Interventions
For practical reasons, group membership is typically open-ended, with new
clients cycling in as other clients graduate. Program administrators argue that
having a new member join ongoing groups offers distinct advantages because new
members:
o benefit from joining a group that has already established norms for
accountability;
o serve as reminders for those who have been attending group of the consequences
of violence; and
o act as mirrors to other members of how much progress they have made since they
entered the program.[14]
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Program Summaries for Three Mainstream Batterer Intervention Models
Program models for the three major program approaches discussed in this chapter
share many similarities, but they also have a few significant differences.
The Duluth Curriculum
Program Structure -- Program length varies by local standards but generally
involves 2 or 3 sessions on each of eight themes:
o nonviolence;
o nonthreatening behavior;
o respect;
o support and trust;
o honesty and accountability;
o sexual respect;
o partnership; and
o negotiation and fairness.
Approach: Each unit begins with a video illustrating the abusive behavior
targeted for change. Discussion is didactic and confrontational. The Duluth
model (which incorporates the curriculum) emphasizes that batterer intervention
must take place in the context of a coordinated community response to domestic
violence.
The EMERGE Model
Program Structure -- 48-week program divided into two stages: 8 weeks of
orientation, and 40 weeks of group work. EMERGE recommends additional time in
the program for approximately one-third of the batterers. Orientation topics
include:
o defining domestic violence;
o negative versus positive "self-talk";
o effects of violence on women -- "quick fixes" (e.g., apologies,
promises) versus long-term solutions (e.g., taking responsibility for their
abuse, developing respect, genuine changes);
o psychological, sexual, and economic abuse;
o abusive versus respectful communication; and
o effects of partner abuse on children.
Second stage groups meet weekly for two hours. Group sessions typically include:
o a short "check-in" for old group members and a long
"check-in" for any new group members. Short check-ins recount any
conflicts during the week; long check-ins detail the last abusive episode and
focus on batterer responsibility;
o longer discussions concerning issues raised during check-in that focus on
alternatives to violence; and
o development of individualized goals based on current and past abuse.
Approach: EMERGE emphasizes the broader relationship between batterer and
victim: it targets not only physical but also emotional and psychological abuse
for reform. Exercises to develop respect and empathy for the victim are used.
Group leaders use confrontation.
The AMEND Model
Program Structure -- Period of intervention is variable, from 36 weeks (the
standard period for batterers mandated to treatment) to five years for the most
difficult cases. AMEND prefers a long treatment period. AMEND takes a
"multimodal" approach to batterer intervention centered on group
therapy, but it may also include some individual counseling or couples work.
Approach: AMEND's philosophy has seven tenets:
o belief in the feminist "power and control" theory of battering is
central;
o intervention with batterers cannot be value- neutral -- violence is a crime;
o violence and abuse are choices, and the victim is not responsible for the
violence;
o counseling has two aims: 1) teaching behavior change to stop violence and
abuse, and 2) addressing the psychological features of the batterer's problem;
o ending violence is a long-term process, from one to five years;
o ending violence is complex and requires "multimodal intervention";
and
o the treatment of batterers requires special skills and training.
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Batterer Intervention- Program Approaches and Criminal Justice
Strategies
Chapter
2
Chapter 4
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http://www.eurowrc.org/
Violent Men
