Program Descriptions

EMAP: Emotionally Intelligent Mindful Acceptance-Based Program

Previously titled, Emotionally Intelligent Batterer Intervention, EMAP is a comprehensive, trauma-informed treatment program for intimate partner violence. With a strong emphasis on compassion, curiosity, and accountability, EMAP promotes self-acceptance, mindfulness skills, and impulse control.  This participant workbook can be adapted for all levels of care, from 24 to 52 week programs. For female group treatment, use Mindful Workbook for Women, and anger management group treatment, use  Emotionally Intelligent Anger Management. For more information on program implementation and bulk purchase orders, go to facebook.com/treatment.program/

Mindful Workbook for Women

Mindful Workbook for Women

Mindful Workbook for Women is an acceptance-based, cognitive behavioral participant workbook adapted from the Emotionally Intelligent Batterer Intervention program. This comprehensive treatment manual is also a self-help guide for high-conflict couples. Research shows that shame is highly correlated with domestic violence. Many individuals enter treatment overwhelmed and defeated by shame. With a strong emphasis on compassion, curiosity, and accountability, Mindful Workbook for Women teaches self-acceptance, empathy, and impulse control. Accountability is a tool used to strengthen self-esteem and regulate emotions. Given that the vast majority of domestic abusers suffer from a history of trauma, Mindful Workbook for Women is a trauma-informed treatment program. Participants learn to identify and override harmful thinking patterns while healing old wounds. Individuals become vulnerable, transparent, and authentic as they develop an internal locus of control through powerful cognitive restructuring techniques. Readers express feeling grounded and empowered as they learn to slow down through mindfulness training. Mindful Workbook for Women promotes healthy boundaries, assertiveness skills, conflict resolution, emotional intelligence, empathy, and responsible parenting throughout the program.This workbook can be adapted for domestic violence treatment programs ranging in length from 16 to 48 weeks. For male or co-ed groups please see Emotionally Intelligent Batterer Intervention.  For more information on program implementation visit facebook.com/treatment.program/

 

 

Emotionally Intelligent Batterer Intervention

Emotionally Intelligent Batterer Intervention is a comprehensive participant workbook for domestic violence groups. This cognitive behavioral treatment manual is also a self-help guide for high-conflict couples. Research shows that shame is highly correlated with domestic violence. Many individuals enter treatment overwhelmed and defeated by shame. With a strong emphasis on compassion, curiosity, and accountability, Emotionally Intelligent Batterer Intervention teaches self-acceptance, empathy, and impulse control. Accountability is a tool used to strengthen self-esteem and regulate emotions. Given that the vast majority of domestic abusers suffer from a history of trauma, Emotionally Intelligent Batterer Intervention is a trauma-informed treatment program. Participants learn to identify and override harmful thinking patterns while healing old wounds. Individuals become vulnerable, transparent, and authentic as they develop an internal locus of control through powerful cognitive restructuring techniques. Readers express feeling grounded and empowered as they learn to slow down through mindfulness training. Emotionally Intelligent Batterer Intervention promotes healthy boundaries, assertiveness skills, conflict resolution, emotional intelligence, empathy, and responsible parenting throughout the program. Emotionally Intelligent Batterer Intervention exceeds the standard level of care for domestic violence treatment programs ranging from 16 to 52 weeks in length. For more information on program implementation visit facebook.com/treatment.program/

 

Alternative Behavior Choices Batterer Intervention Program

The evidence-based Alternative Behavior Choices group curriculum is appropriate for both voluntary and court-mandated individuals, and meets the requirements of California PC 1203.097 for batterer intervention programs. The curriculum can easily be adapted to a 16-week or 32-week format.  Topics include:  The nature of violence, emotional management, gender roles, socialization, power and control, the impact of domestic violence on children, and communication and conflict resolution skills.

A review of the empirical evidence upon which it was based, can be found at: http://www.domesticviolencetrainings.org/wp-content/uploads/Hamel-(2016)-Int.-DV-Handbook.pdf

To order the workbook, go to www.johnhamel.net and click on the link at the bottom of the page, or go directly to: ABC.MarketingFlier
https://www.domesticviolencetrainings.org/evidence-based-batterer-intervention-program-client-manual/

Achieving Change through Value-Based Behavior (ACTV)

Achieving Change through Value-Based Behavior (ACTV) seeks to reduce offender recidivism and domestic violence re-offenses while helping participants use respectful, adaptive and healthy behaviors in their relationships. ACTV is a 24 week program for men or women who have been court mandated to complete a Batterers Education Program following a domestic violence conviction. Each group session takes 90 minutes.

Begun in 2010, this program was adapted from an evidence-based behavior therapy called Acceptance and Commitment Therapy (ACT; Hayes, Strosahl, & Wilson, 1999). My dissertation served as pilot data (see Zarling, Lawrence, and Marchman, 2015). The curriculum was designed in collaboration with the Iowa Department of Corrections and District Departments of Correctional Services. The program guides participants in behavior change using the principles of ACT, and includes learning skills such as defining their own personal values, becoming aware of their emotions and thoughts, noticing the consequences of their behavior, and learning new ways to respond to emotions and thoughts. The facilitators work with the members in a collaborative and compassionate manner, modeling the supportive respective behavior they are trying to teach. They do not offer advice, engage in problem-solving or provide extensive direct instruction. Instead they help group members come to realizations on their own and develop intrinsic motivations to change. These new skills are taught through metaphors and in-session experiential exercises. Session content focuses on five categories: The Big Picture, Barriers to Change, Emotion Regulation Skills, Cognitive Skills and Behavioral Skills.

I conducted an evaluation of 3,696 men arrested for domestic assault in Iowa who were court-mandated to treatment from 2011-2013. This analysis showed that participants in ACTV had half the recidivism rates for domestic assault and two-thirds less violent charges than those who participated in treatment as usual (a combination of Duluth and CBT). In addition, ACTV participants who were re-arrested had significantly fewer charges than those in treatment as usual. The results held for both people who completed the ACTV program and those who left before completion. Anecdotal evidence also shows increased job satisfaction for facilitators as well.

Initial funding for the program came from a Violence Against Women Act grant from the Iowa Judicial Branch. Currently ACTV is funded through state appropriations. Additional funding sources are being sought for quality improvement and further evaluation.

Zarling, A., Lawrence, E., & Marchman, J. (2015). A randomized controlled trial of acceptance and commitment therapy for aggressive behavior. Journal of consulting and clinical psychology, 83(1), 199.

For more information, email me at azarling@iastate.edu

 

 

 

 

The STOP Program: For Women Who Abuse

It used to be that, when we trained mental health professionals, probation officers, victims’ programs, attorneys, and correctional officers all over the world, we had to convince people there was such a thing as female domestic violence.

But over the past decade, the landscape has shifted—and instead we hear pleas everywhere for a quality treatment program for women who abuse that is specifically targeted to women’s issues.

So, after years of pilot group testing, integrating rapidly emerging new research trends, and borrowing from the tremendous success of “The STOP Program for Men” (now in its Third Edition, published by Norton in 2013), this new treatment program was hatched: “The STOP Program: For Women Who Abuse” (Norton, 2016), focusing on innovative strategies for women who abuse their partners.

Like the men’s manual, this new program integrates contemporary interventions and client-centered guidelines to successfully treat domestic violence offenders—who happen to be female.

This program is timed to address the rapidly increasing awareness of female domestic violence and need for quality treatment services. Developed and field-tested for over twenty-five years among military and civilian populations internationally, this program offers therapists, social workers, and other counselors a new level of sound, psychologically-based interventions that actually reach the very women who often seem so unapproachable in a treatment setting.

Presented in a 26-week or 52-week psychoeducational format, “The STOP Program: For Women Who Abuse” is packed with updated skills, training exercises, articles, video clips, handouts, homework, and other resources–that push participants to examine the complex roles of trauma, emotional dysregulation, self-esteem deficits, and history of personal victimization in their relationship problems. And the program gives them new tools to manage these unique issues.

This manual includes many of the same sessions as the original STOP Program for men, with appropriate changes in pronouns, vignettes, and examples. We also have developed and integrated new material specifically dealing with issues that contemporary research and our clinical experience indicate are especially relevant for female offenders: victimization (and rationalization) issues, assertiveness vs. aggression issues, shame, grief and loss, parenting and co-parenting, boundary violations, emotional self-management and dysregulation issues, jealousy, self-esteem issues, gender rules and gender roles, and need for social support.

We are offering training workshops in this new model throughout the world. COME JOIN US IN OCT 2016 FOR THE TWO-DAY “STOP PROGRAM: FOR WOMEN WHO ABUSE” CONFERENCE IN SAN DIEGO. For more info, go to www.RTIprojects.org

And if any of you are doing similar work, please let us know so we can all share and learn.

David B. Wexler, Ph.D.
dbwexler@gmail.com

The Needs ABC Model – Supportive Challenging & Responsibility-Taking

There are strong reasons why men who batter would be resistant to treatment through group therapy.  Domestic violence involving physical injury is legally defined as a punishable behavior.  Because many batterers are implicitly required to participate in treatment groups through their involvement with the legal system, group work may be seen by them as a form of punishment.  Jenkins (1990) posits that men who batter externalize responsibility and therefore minimize the importance of treatment.  Indeed, batterers frequently hold their partners accountable for “provoking” the violence and are often puzzled as to why their partners are not also in treatment.  Thorne Finch (1992), in discussing the social construction of masculinity, suggests that society has so legitimized violence against women that batterers might perceive treatment groups as ludicrous.  Gondolf (1993) and Star (1983) describe a consistent profile of batterers as men with low self-esteem and insufficient knowledge of social skills; feelings of inadequacy might cause these men to fear exposure in a group setting. Many batterers request individual treatment, reflecting this anxiety.

Further, writers generalize that many men perceive group work in a negative way.  Sternbach (1990) writes that long standing patriarchal constructs of masculine autonomy and competition have traditionally made disclosure, emotional expression and vulnerability among men in a group difficult.  Strauss and Gelles (1992) in their research also point to autonomy and control as important aspects of men’s modus vivendi; group work challenges these precepts.  Goldberg Wood and Middleman (1992) describe the resistance to changing one’s world view as a constant struggle for men in treatment groups.  World view refers to one’s perception of self in relation to others and one’s meaning in society; it is one’s personal philosophy, and it mandates one’s behavior.

A logical progression from the above notions is that many men who batter perceive entry into a treatment group as: 1) punishment to be either avoided or stoically endured; 2) a threat to their masculine identity and world view, which may include having a dominant role in a relationship or family; and 3) an attack on their already diminished capacity for self-worth.  It could be imagined that batterers contemplating entry into a treatment group stand at a cross roads. On one side lies the desire for a “second chance” through learning new ways to behave, but on the other side lies a vision of being mortified in the presence of a group of men through coerced humiliating admissions of failure and inadequacy.

Because the consequences of domestic violence are so serious, very often brutal, and sometimes irreparable, treatment for batterers requires an environment where clients feel reassured enough to talk casually but candidly about themselves.  Effective treatment engages these men in non-defensive conversations about their behaviors and life experience.  The Needs ABC Model creates and maintains an environment in which men and women can consider more productive problem-solving options.

(https://www.amazon.ca/Needs-ABC-Acquisition-Behaviour-Psychotherapies/dp/1861770537/ref=sr_1_2?ie=UTF8&qid=1466977323&sr=8-2&keywords=tom+caplan).

S.A.F.E. Counseling Program, Inc.

John Anthony Bochnowicz, SAFE Director, entered the field of DV counseling for victims and perpetrators in 1982 in Kings Beach, California. SAFE was founded in 1994, first named Supportive Alliances for Family Empowerment (SAFE). SAFE’s office is located in Langhorne, Pennsylvania. Serving court referred and self-referred men, women and families in the Greater Philadelphia Area – primarily Bucks County – 40 min north of Philadelphia and 2 hours south of New York. Since 1994 SAFE has been affiliated with the Peace Center, a non-profit peace education and violence prevention organization in Langhorne.

 

SAFE is a BIP provider for male and female offenders and victims in gender specific groups. SAFE’s services are a part of a coordinated community response to IPV. Recently implemented local standards strictly and explicitly prohibit providers of DV offender programs from reaching out to participants’ victims. SAFE holds the controversial position that is confirmed by recent social sciences and neuroscience research, that there are characteristics that parties in conflict share in common. SAFE has narrowed these down to 10 core areas in common for DV partners. Establishing a secure relationship with the facilitator is central in the intervention, along with using motivational interviewing as an approach to enroll the clients into their treatment. SAFE employs CBT Techniques to challenge and reframe client’s beliefs, biases and cognitive distortions and teaches self-awareness and self-regulation as the basis of safe practices to build the client’s ability to experience and express empathy, genuine interest, and insight into the emotional world of others. SAFE teaches an emotional healing process, and uses Gestalt Therapy Principles of being in the present to facilitate attunement and synchronicity with each group participant during each session.

 

SAFE has the experience and unique intervention model designed for work with the entire family, and with victims and perpetrators since 1982. SAFE’s intervention model is trauma-informed, resilience-focused, strength-based and client-centered. The emphasis in SAFE’s intervention is on the experiential involvement of each client over didactic instruction, by teaching a set of tools and a specific process to work through whenever an incident or trauma is experienced. The client is walked through this process repeatedly every week to facilitate the development of new neural pathways. The clients are conditioned to have new emotional and behavioral responses to their shames and fears by bringing Love into their lives to alleviate their emotional pain in the form of giving themselves R.U.A.C.A.T. (Respect, Understanding, Acceptance, Caring, Appreciation, and Trust). The repetition as a way of learning new behavior is supported by Dr. Daniel Sonkin’s work with Secure Base Priming. The importance of learning how to give love to oneself as a way of stopping violence is supported by Erin Pizzey’s talk in the Toronto Symposium of 2014. The clients also receive a written text of the course along with weekly reading and homework assignments with exercises that can be personalized. SAFE’s Intervention rationale and approach are consistent with CDC’s Connecting the Dots Study; Attachment Theory; Trauma-Informed Practices and Care; Resilience and Strength Based approaches to healing and behavior transformation; underpinnings of Motivational Interviewing; ACEs study findings and recommendations; neuroscience and social sciences intersections on best approaches to teach empathy, motivate change and transform harmful behavior to others and self; recent social sciences research outlining the risk factors for perpetrating IPV, the psychological and developmental characteristics of the perpetrators, and the categories and dynamics of IPV incidents.

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.

 

Brain change and domestic violence

The goal of any domestic violence prevention program that treats offenders is to help the participants adopt and maintain a set of new behaviors and thought processes. It is relatively easy to educate clients about behavioral alternatives to violence. It is more difficult to have them practice these new behaviors within the group and hopefully in their real life home situations. What is most troublesome., though, is helping clients practice, practice, practice these new actions to the point they become totally familiar, habitual and automatic. Fortunately, our knowledge of how the brain works can help counselors promote real change. That is because real change inevitably involves brain transformation. New neuronal networks must be developed, improved and maintained while older, less desired networks are diminished in size and potency. A fuller description of neuronal networks, along with more information about my treatment program can be found in my upcoming article, “The Utilization of Neuroplastic Change Principles in Domestic Violence Treatment: An Experimental Program,” to be published in the October, 2014 issue of the peer-reviewed journal, Partner Abuse.

Here is an example of how such brain change patterns can be described to clients. Let’s  propose a client decides that one aspect of his tendency toward domestic violence is related to his habit of frequently making critical remarks. Although it would be useless to attempt to describe exactly how and where criticism is located in the brain (in reality, an abstract concept such as criticism will be linked with many overlapping circuits in the brain) it is meaningful to most clients to have them envision their criticism as a single network. Thus, the “criticism network” becomes the target for neural diminishment. The only way to do taht, of course, is by lessening the number of times one makes critical remarks as well as the number of times one even thinks about making such remarks. Here the phrase “use it or lose it” becomes paramount. The first goal for this client becomes not making criticisms so that the strength and interconnectivity of the criticism network will be weakened. Next comes building a more desired network, here entitled the “praise network.” Since “neurons that fire together wire together” it is imperative that the client identify and implement giving praise several times a day to his domestic partner, children, etc. By doing so over a fairly lengthy period (I generally estimate about six months) the client’s praise network will gradually evolve from a difficult, awkward task that requires conscious effort toward one in which the client can quickly and gracefully give praise to others in a natural, almost habitual manner. Thus the principles of long-term potentiation predict that the criticism network will be diminished through non-usage while the praise network will grow stronger and more efficient over time.

Arborization will predictably also affect the client’s behavior. For example, as the praise network grows it literally takes up more space in the brain and connects with other networks. So, for instance, the client might discover that giving praise makes it easier to be connected family members since they are now more likely to stay present and even seek his company. Connection in turn leads to engagement which leads to improved empathy toward the people he no longer criticizes and instead praises.

This last possibility demonstrates one way that brain change plans differ from standard behavioral management rpograms. Brain change in intrinsically evolutionary and therefore somewhat unpredictable. As the targeted network expands it links up with other neural networks in patterns unique to the history, wants and needs of the participant. For example, building a praise network might lead from praise to connection to empathy as above but it could also extend from praise toward self-praise and self-nurturing.