Policy and Politics / News

National Partnership to End Interpersonal Violence Across the Lifespan

My colleague, Shelly Wagers, has reminded me about the recently-completed report from the National Partnership to End Interpersonal Violence Across the Lifespan.  I have read it and I plan on endorsing it.  Here is the link to the web location to see the National plan and endorse it:
https://www.npeiv.org/a-national-plan

Here is the link to NPEIV’s home page to learn more about our organization.  https://www.npeiv.org/

John Hamel, Ph.D., LCSW

Evidence-Based Domestic Violence Intervention Policy: A Research Guide

Individuals convicted of domestic violence in the United States are typically mandated to attend a course of treatment in lieu of, or in addition to, incarceration.  The type of treatment, also known as batterer intervention, is determined and regulated by each state.  In most states, it takes the form of a weekly psycho-educational same-sex group, from 1.5 to 2 hours per session, and for a duration of 16-52 weeks, with the average around 26 weeks.  While standards usually allow individual counseling in special cases, couples therapy is expressly forbidden in all but a few states. A majority of programs take a gendered perspective of domestic violence.

The most methodologically-sound research suggests that these programs are minimally effective in reducing domestic violence.  A primary reason is that unlike interventions for other social problems (e.g., substance abuse), domestic violence treatment policies have not been sufficiently informed by the body of empirical research.  A consensus has emerged, that for treatment to be effective it needs to be tailored to client needs, based on a sound assessment, in contrast to the standard “one-size-fits-all” models currently in existence. Below are some useful resources for anyone wanting to promote evidence-based policies in the field of domestic violence:

  1. Visit the website of the Association of Domestic Violence Intervention Programs (ADVIP) at www.battererintervention.org. Click on the link at the bottom left section of the home page (“click here for full articles and summaries”), or go directly to: http://www.domesticviolenceintervention.net/advip-2016-world-conference-findings/
  • Look for: Domestic violence perpetrator programs: A proposal for evidence-based standards in the United States.  Researched by 17 renowned domestic violence scholars, this is the most comprehensive review of the domestic violence intervention literature.  If time is an issue, read the summaries.
  • Also look for: A survey of domestic violence perpetrator programs in the U.S. and Canada: Findings and implications for policy intervention. This article, by John Hamel and Fred Buttell of Tulane University, reports on a recent survey of batterer intervention programs in the United States and Canada, and provides valuable insights by experienced clinicians.
  1. Read the excellent article by Canadian researchers Lynn Stewart and Claire Slavin-Stewart, Applying effective corrections principles (RNR) to partner abuse interventions. The RNR model is the gold standard for evidence-based interventions with incarcerated populations and general criminal recidivism.  The article was originally published in the peer-reviewed scholarly journal, Partner Abuse, Volume 4, Number 4, in 2013, but is now available on the ADVIP website.  Click on the “Research” link, and then “Articles,” or go directly to:
    http://www.domesticviolenceintervention.net/wp-content/uploads/2014/02/Stewart2013.pdf
  1. A thorough and up-to-date review of the literature on risk assessment instruments can be found in the article, Assessment in intimate partner violence: A review of contemporary approaches, by Tonia Nicholls and her colleagues. This is also available in the research section of the ADVIP website, and can be accessed directly at:
    http://www.domesticviolenceintervention.net/wp-content/uploads/2014/02/Nicholls.etal2013.Manuscript.pdf

Also useful is:  Inventory of spousal violence risk assessment tools used in Canada,  available at:
http://www.justice.gc.ca/eng/rp-pr/cj-jp/fv-vf/rr09_7/rr09_7.pdf

  1. Two states have already demonstrated the effectiveness of domestic violence intervention policies based on risk assessment – Colorado and Florida.
  • For information about research on the Colorado model, read: Gover, A. (2011).  New directions for domestic violence offender treatment standards:  Colorado’s innovative approach to differentiated treatment.  Partner Abuse, 2 (1), 95-120.
  • To read about research on the Florida model, read: Coulter, M., & VandeWeerd, C. (2009). Reducing domestic violence and other criminal recidivism:  Effectiveness of a multilevel batterers intervention program.  Violence and Victims, 24 (2), 139-152.

(You can get an electronic copy of either or both articles by contacting John Hamel, LCSW, at
johnmhamel@comcast.net)

  1. One of the most reliable and widely-used risk assessment instrument, the Ontario Domestic Assault Risk Assessment (ODARA), is available from the Waypoint Centre for Mental Health Care. For information and to watch the free training video, go to: http://odara.waypointcentre.ca/
  1. Another reliable and widely-used instrument, the Brief Spousal Assault Form for the Evaluation of Risk (B-SAFER), is available at: http://www.justice.gc.ca/eng/rp-pr/fl-lf/famil/rr05_fv1-rr05_vf1/rr05_fv1.pdf  The B-SAFER is a component of the Colorado risk assessment model.
  1. For an excellent discussion on how couples therapy can be a safe and effective treatment option, read: The trials and tribulations of testing couples-based interventions for intimate partner violence, by the notable researcher-practitioner Julia Babcock of the University of Houston. It is available at:
    domesticviolenceintervention.net/wp-content/uploads/2017/03/Babcock2017.pdf
  2. Two examples of existing evidence-based programs for a psychoeducational group format are the Stop Domestic Violence Program by David Wexler, at: RTIprojects.org; and the Alternative Behavior Choices program by John Hamel, at: https://www.domesticviolencetrainings.org/evidence-based-batterer-intervention-program-client-manual/

 

Evidence based practice – the chicken or the egg – which came first?

The Chicken or the egg, which came first?

Before you can have an evidence based practice you have to have a practice upon which to base your evidence.

If you only have 1 practice there is no opportunity to compare and contrast and establish a better practice. Without a better practice,  there  can never be a best practice and best practice, as a superlative,  is an illusion, it exists only, if at all, in a moment of time.

Our practice is 21 years old and it flies in the face of a great deal of “traditional practice”. We reckon it is pretty damned good although there will definitely be improvements which can and should be made.

Fly in the face number 1

Coming from couple counselling backgrounds we knew much more about couple relationships than we did about the politics. We knew very much more about the interactions between men and women than we ever did about criminals. So although we accepted the UK DV figures of 1994  that only 4.9% of DV was attributable to women our course was designed to work with male abusers but without excluding female abusers.  So, for 21 years we’ve worked with male abusers and female abusers, in mixed gender groups. Internally there have been very few problems with this. Externally you’ll perhaps be able to imagine the troubles! About 1,000 men and 100 women have completed the 36 hours of our programme.

Fly in the face number 2

We went for a closed group. We recognised that when John Doe from family X meets Sheila Oz of family Y  there will be many differences in their expectations – based on what they learnt from their family of up-bringing.   If someone, very reasonably,  only knows their own family then he or she  will tend to believe that all families will run like that.  Meeting people from different families will help him or her  to understand some of the differences.

We want the clients to talk together, as much as possible,  intimately. We want them to exchange as much information as possible about one another. Like women on labour wards, through the sheer intimacy of the situation some of the men and women will make friendships which will last and be mutually supportive.   We felt enormously supported in 2012 when we met Dr Louise Dixon whose very critical paper of RESPECT – the accreditor of perpetrator programmes in the UK – coincided with our practical understanding of their nonsense, and also her conclusions about similar work being needed by females  also matched ours.  (It has also been very refreshing that so many of her ex-students have continued to contribute to the greater reality of the IPV agenda.)

Fly in the face number 3

Emotion drives behaviour, not, in the vast majority of cases, a desire for power and control – read Ellen Pence’s 1999 confession about her notions of power and control ! Duluth and Beyond.

As clients talk about their emotional experiences in their families in a very large percentage of cases what pops up?  Well, yes, you guessed it,  as the research tells us, their own abuse at the hands of their parents, and others.  And what does that “put the client in touch with” ? – Their own sufferings, which when they explore and understand a little also brings their own behaviour, often in front of their children, into stark relief.   Most of the people we work with are seeking to regain (or keep) contact with their children so it is important that they understand the impacts of parental behaviour on their children (as well as their partner). The “emotional wheel”  provides a very much better focus than the power and control wheel:  it is immediately relevant to the clients themselves, their children and their partner.  Clients “take it on board”  with alacrity – rather than having the power and control wheel welded onto them, somehow.   (Our emotional wheel version differs a little from Plutchnik’s; rather arrogantly we think ours is better!  Open to debate!)

Fly in the face no 4

The amount of time and the format. Traditionally counselling runs an hour, 90 mins, 2 hours per week.  We want to run a closed group. Over longer periods of time people fall ill, get conflicting appointments, etc . etc.  A prolonged  closed group would disintegrate with drop-outs! Training for professionals very often occupies full days. The most important course I ever took lasted 4 whole days.  Men work.  Many men work moving shift patterns. You cannot satisfy all the various needs but you do need to be satisfying most.  Men provide.  If you “stop them from working”  you stop them earning and this interferes with many men’s ideas of their roles as providers. So you avoid that as far as possible. We work at weekends, Saturday and Sunday, 2 weekends, about 1 month apart. The results – 90 – 95 % of the people complete all the work.  This year we’ll work 32 of the 52 weekends – that is a very high social cost to us – we feel like martyrs!  – but the real importance is for the clients who can engage, and in the longer run for the benefit of their children and their partners and their future partners, too.  If we ever totalled them up it would seem like a very small cost to us, compared to the benefit to most of them.

Fly in the face no 5

In the UK 7 Duluth-style programmes run by 4 Duluth-style projects could scrape together 36 whole male figures on whom to base £1.2 worth of research, MIRABAL. The researchers drew some percentage style conclusions in the executive summary which lead you, if unwary,  to think “Wow  – that’s impressive!”  On page 8 of the fuller report you get the explanation – based on 36 men!

That year, our little organisation completed work with 55 men, 33 of them referrals by social services. So far, 12 months later,  we have heard of 1 man from that cadre that has been violent again.  I would bet that more than 45 of those men would have been willing to undergo the research afterwards. Our annual income?  Less than £15,000.   Buy some research with that!

We have a practice. We have some evidence but nothing like enough. Our independent evidence mainly focusses on the profound changes brought about in 1 client who would have almost certainly been concluded as having a “severe personality disorder”  although those words were not written. The examining psychologist’s remarks – 13 years ago – were:  “That condition is not supposed to change, they’ll have to re-write the text books.” A client who completed this weekend showed many of the same signs of very profound changes (and of course there was another who showed relatively little sign of change. )

Professor Daniel Siegel and many others have been doing just that, re-writing the text books, that is –  and no doubt his definitions of The Mind and emotions and their inter-relationship with the brain and relationships will, no-doubt, earn him a Nobel Prize or some equivalent in the future. For all of us “professionals” who became skilled at applying the various DSM’s diagnoses and, in our training, didn’t get any information about “the mind”, 95% plus of us to all appearances, Siegel’s work is likely to help us develop understandings of what constitutes a healthy mind, as opposed to merely diagnosing an unhealthy mind and then having very little idea about what to do with that to help improve the individual’s situation!

Emotion is a noun but with Siegel’s insights based on his definition he states : “emotion is a verb”. Temper is both noun and verb, more the latter than the former!

Evidence based practice.  Practice is a noun: unfortunately the verb is with an s!   How does evidence based practice practise?  Does it get trapped by attempting to apply a diagnosis without knowing what it is seeking to achieve?

Issues about working with men and women, together

Can I just say what a sheer relief it is to find some constructive dialogues giving potential alternatives to the nonsense that is “Duluth”.  The late Ellen Pence did have the decency to admit in her 1999 book that she got the “power and control” thing wrong”. The trouble seems to me to be that because of the vested interests nobody in the UK  wants to read and understand the implications of that!

Our experience of running mixed groups has overall been very good, although we have of course completed work with 900 plus men and only 100 plus women.  With a maximum group size of 8 there are very often groups with no woman, my co-facilitator apart, but we have also had groups where there have been 3 women and 3 men. We do not, however work with couples in the same group; if both partners need to attend then they attend in separate groups.

As couple counsellors we saw no real problem with this. Our experience suggested that many of the problems faced by a female would be very similar to those faced by males, and in terms of couple relationships there is no reason not to include both gay men and lesbians in that mix although over 21 years we’ve only had two of each.

We were very relieved in 2011 to discover that Dr Louise Dixon’s paper suggested that in her opinion, based on criminological need, there was no academic reason for separate courses. However  the stumbling block we saw in her prolonged format, which we manage to largely avoid in ours, was one of “two emotionally vulnerable people”  being given plenty of opportunity to “get their heads together”, using the course as the alibi for where they were going.   Our format is so compact that although people get to know one another very well the opportunity does not really exist to develop a relationship whilst still on the course. Outside the course those people become adults in their own right.

We could also add that by and large men also need to learn about women, and the differences, woman to woman,  and also, of course, women need to learn about men, man to man. There is no better way I suggest of doing that than having them working together in considerable intimacy. So the last woman we worked with, for example, was able to give first hand experiences of having a baby by caesarian section, very important for two of thee men there.

On the subject of research we’ve found that men are by and large very willing to take part, women have been very much more reticent to talk “publicly” but are willing to talk off the record. I think that the men tend to think they’ve done something very wrong and having addressed their problems they usually feel very much better about themselves and women are not sure that they have done anything wrong and at the end they have become much more aware of the potential damage they have caused, which perhaps links up with a potential “bad mother” private image. So for a researcher in urgent need of data we could quickly find 30 men. I would have thought we should have been able to find 10 women – but as it was only two came through!

I see another group of members suggesting facilitators should be mental health trained practitioners.   My reading of Dr Dan Siegel’s work suggested that mental health professionals were highly skilled in diagnosis but seemed to have had very little training in what constituted good mental health and how that might be achieved. His long overdue definitions of emotion and the mind and the role and importance of relationships look to me as if they will be a very positive contribution for the next couple of decades.

I was also delighted this morning to find Dr Tonia Nicholls’ Youtube clip.

Secure Base Priming Research Project

Greetings,

The Secure Base Priming Research Project (www.securebasepriming.org) is an independent research study looking at the effects, over time, of repeated secure base priming on a person’s mood, current sense of felt-security, and attachment style. Secure base priming is either the subliminal or supraliminal presentation of words or images that represent attachment security, or the names of real-life security providing attachment figures. It can also consist of guided imagery that involves the recollection of real or imagined experiences of feeling safe, secure, loved or emotionally helped in a close relationship.

These priming procedures have been shown to increase mood, increase openness to new information/experiences, decrease negative stereotyping, reduce aggression and increase compassion and altruism. Additionally, secure base priming has been shown to reduce psychiatric symptoms of depression and anxiety.

Most research have focused on a single administration of primes followed by an assessment/task. Results consistently demonstrate a temporary effect. We are looking at whether using these exercises on a daily basis will result in a more sustained effect. We are also interested in knowing whether there is a decay in effect once the priming has stopped. We are hypothesizing that these exercises can be used to augment the security-enhancing effects of psychotherapy.

Currently we are soliciting subjects through the Internet (Twitter, LinkedIn) and networking with colleagues. Participation requires that participants spend less than 5 minutes a day to complete the exercises for ten days. Days 1, 9 and 10 may take a bit longer since the participants must also complete three assessment questionnaires.

We are currently exploring the idea of conducting a similar study with perpetrators of domestic violence who are in court-mandated treatment.

If you have any questions, comments or suggestions, please feel free to respond here or contact me directly (contact@danielsonkin.com) at any time.

Daniel Sonkin, Ph.D.
Mayté Frias, Ph.D.

Male Victims of Domestic Violence

Hi All,

Our state government in New South Wales (Australia) have recently indicated their willingness to fund services to work with men who are victims of domestic and family violence.

I was wondering if any members had any resources or can recommend any case management frameworks or program interventions for male victims of domestic and family violence?

Thanks

 

Suicidality and Intimate Partner Abuse

I just finished an online CEU course  that was probably one of the best I’ve ever taken – “Suicide – What Every Therapist Need to Know”  through Professional Psych Seminars – Lisa Firestone, PhD., instructor. (I have no affiliation with her or PPS). I took this course because suicide risk is something I always assess for and something that I find a significant portion of my clients have struggled with.

I am an LCSW in Santa Rosa, CA and co-founder of NOVA Non-Violent Alternatives. In addition to my private practice, I facilitate two groups for female offenders and one group for male offenders. My special interest is working with women around their violence. (I wrote a book on my treatment approach because there has been so little available about working specifically with abusive women. My book is “Domestic Violence Treatment for Abusive Women – A Treatment Manual”).

I started out working only with men. Our program was certified based on our willingness to be trained at Duluth and follow their model. What an eye-opener it was when I actually got to know the men in our group AND their female partners! I found that women are truly equally capable of intimate partner violence – sometimes as primary aggressors, sometimes as victims and later aggressors, sometimes in mutually aggressive relationships, sometimes as reflections of their own mental illness. etc. (Of course, all of this has since been borne out by formal research). Clearly, domestic violence is not a one-size-fits-all problem.

Now, we do things very differently than when we first started. While we teach cognitive-behavioral skills for emotional regulation, our program is now based on Attachment Theory, Trauma Theory and Social Learning Theory. I aim to find a balance between compassion and holding clients responsible/accountable for their behavior. I’ve found that clients typically have significant histories of childhood trauma, abuse and neglect – so much so that it is not surprising that they would believe that partner abuse is normal and appropriate – and that they have often struggled with suicidal thoughts/attempts.

We now always do a thorough individual assessment before accepting someone into a group.  During these assessment interviews is when I’ve found how often clients have significant histories of suicide attempts, ideation, self-harm, psychiatric hospitalizations, etc.

I am curious to know from other treatment providers whether they have had clients who have attempted or committed suicide while in treatment.