Conducing Batterer Intervention Groups During COVID-19 Crisis
Here in the Greater San Francisco Bay Area, most batterer intervention programs have been suspended, at least for the next 3 weeks, due to the Corona virus epidemic. We providers are all scrambling to figure ways to serve our clients, keep victims safe, and stay healthy during this difficult time. Some of us have started, or are about to start, videoconferencing. Others are continuing to hold groups in person, when there are less than 10 per group, and taking preventative steps such as having clients wash their hands before coming to group, etc.
How are the rest of you coping with this crisis?
Mar 21, 2020 @ 01:52:18
I have been conducting individual telephone counseling sessions. The clients appreciate it very much and I plan to continue providing this service for the foreseeable future.
Mar 21, 2020 @ 02:14:22
I am continuing to do intakes via phone, but I have ended face-to-face group classes. I don’t have the citation and haven’t looked deeply into it, but at a recent telehealth training the presenter noted that there is almost no research on the effectiveness of group telehealth and that at least one study has found that safety, cohesiveness, and delivery to be compromised in group telehealth. As such, I am very hesitant to do BIPP groups online, especially with people new to class. However, I have several participants who need to be done by May and others with only one or two classes left. As such, I am going to offer these clients an online group option that is limited to 5-7 participants. If anyone will be or has already started groups online, I would love to know your plan and what seems to work and what doesn’t. Thanks!
Mar 21, 2020 @ 04:31:07
I am prepared to facilitate using “ZOOM” however, the program’s I work for have not advised me to begin. Zoom charges a monthly fee for unlimited use. I have tested it out with family members and it was fairly easy for them to join the meeting for their first time.
Mar 21, 2020 @ 12:48:54
Hi all,
Until the virus decided to become a nasty pandemic, my office would have taken over Catholic Charities programming in June. As it stands, we are on hold. Probation offices and the courts in Wisconsin are closed down until May. No one is progressing toward the end of their probation until they open back up. Unfortunately for some of the men who would be done the first week of May. I wanted to make calls and check-in with the men individually, but have no access to my email at work.
I think the zoom idea is great if everyone is on board with it. However, I thought the individual calls would be more appropriate so members get individualized communication. Sometimes in group formats, they lose the ability to be heard so potentially, the phone calls may help them feel validated as someone who has needs, not just education toward a non-violent lifestyle. ~Pamela
Mar 21, 2020 @ 17:38:30
We are not currently running groups but offer individual telephone support.
Mar 21, 2020 @ 20:42:41
I think everyone has been trying to be resilient and find rapid solutions, which is certainly commendable. People have been pretty quick to jump on the telehealth model, but it is very much uncharted territory. While there are multiple services that are setup to provide online group functionality, anyone who has actually used such systems know that they are subject to challenges associated with the weakest link: typically the group member with the slowest or least stable bandwidth. Melissa Scaia and John Hamel have been piloting a program prior to this crisis but even they are very cautious and suggest NOT jumping into online groups. They have been working with some researchers that have shared several things that must be considered beyond simply whether it is physically possible to gather humans into an online call, including:
1) efficacy and safety has not been assessed.
2) hardware issues are not insignificant (device used, bandwidth, etc.)
3) they have observed less intra-group communication and more client focus on the facilitator (which is problematic for those of us whose interventions depend on using group critical thinking and “challenge” as part of the intervention)
4) group feel/style shifts and will have to reckon with why people may pop in/out and how this would be addressed practically and as a matter of providing credit for attendance.
Those who are used to a more psychoeducational/lecturey style might find online an easy shift, though it does not address whether this has any efficacy or hidden safety issues. For those who carry licenses, there are also significant issues that need to be addressed, associated with conducting this in a way that satisfies ethical criteria and/or HIPAA issues for privacy. Again, not all platforms will certify their product as HIPAA compliant and some may not actually want someone conducting such an intervention using their platform (e.g. if someone gets injured/killed, will the platform be dragged into litigation, etc.)
Obviously, this is uncharted and caution and much research seems the best course.
Peace,
Gil
Mar 22, 2020 @ 00:05:58
Only yesterday, our agency was informed by the probation department in one of the counties in which we operate that we are not allowed to conduct any BIP groups via teleconferencing. They are saying that doing so would violate California state law, which mandates face-to-face 2 hour same-sex groups. On the other hand, they are fine allowing us to suspend the groups indefinitely, and not marking as absent any of our clients during the crisis period, which could last several more months. I pointed out to them that California state law only allows three absences per year, for whatever reason, so aren’t they already violating the law? My point is, this is an emergency, so why not think outside the box and not worry too much about legal constraints – at least for now. I agree with Gil that teleconfrencing brings up a lot of issues, such as privacy and efficacy, that have to be addressed. Certainly, intra-group interactions would be limited, especially in a more discussion/therapy type of group. I get that. A bigger problem, however, is that while many of our group members no longer live with their victims, and/or no longer pose a risk to them, some of them do, and I worry that if they are not getting some kind of treatment their victims might be in danger. Maybe something is better than nothing? Does anyone know anything more about the legal issues related to teleconferencing?
Mar 22, 2020 @ 19:54:54
We are all shut down here as you can imagine. We were not encouraged to try to work over the net since the face to face “vibe” would be lacking. Courts, etc. also closed down so not one seems to be too anxious about their court cases (if they have them). It’s been difficult to sit back and be patient but we are looking at this as a learning experience. It also helps us with patience when we return to the live groups – “listen and learn” from our clients – then make the intervention. We will be processing this shutdown with our students once we are “back in business.”
Best wishes to all and stay healthy!
Mar 22, 2020 @ 20:05:07
Here in Florida, we have not been instructed to isolate or quarantine, unless we have symptoms or have been diagnosed with covid-19. We have been limited to groups of no more than 10. I have been careful to instruct my group members that they should not attend if they have been exposed or have an underlying condition or if they feel sick in any way. They must wash hands prior to entering the group room, I have been sanitizing doorknobs, etc.
Hippa enforcement is being relaxed to allow healthcare professionals to provide telehealth through otherwise non-hippa compliant apps (see link below). I have created a doxy account but haven’t used it yet (will need to get releases, etc. to do so). I’ll have to cross that bridge if and when our governor tells me I must.
I appreciate reading others’ experiences using telehealth technology, specifically for batterers groups, so please keep sharing. Thanks
HHS.gov link below:
https://www.hhs.gov/hipaa/for-professionals/special-topics/emergency-preparedness/notification-enforcement-discretion-telehealth/index.html
Mar 22, 2020 @ 23:05:48
Hello, We are also shut down and moving forward with the possibility of using ZOOM for online “face to face” groups. We have received a “YES” from one side of the court. We need to hear from Probation and the Judge before moving forward yet we are preparing to support our clients to complete. We will focus on our most senior advocates, with 40+ weeks, since they have been consistent and dedicated to the process of stopping their violence. The laws may change here in California as this State of Emergency unfolds. Nothing changes if Nothing Changes! Please be safe!
Mar 23, 2020 @ 21:54:55
We have been running online community based domestic violence/domestic abuse intervention groups for about 1.5 years on Google Hangouts and they work really well. Note, these are not court-mandated BIPs or group counseling sessions, but rather peer-based community groups similar to AA, NA, or Celebrate Recovery that are specifically focused on the issue of intimate partner violence and abuse.
We’ve found that participants are attentive and surprisingly vulnerable, likely because we intentionally create conditions to foster opening up. Being online and just using first names allows them to remain anonymous if they wish. As the group facilitator, I share my own stories of perpetrating violence and abuse, as well as what I learned to change, which signals that they are not going to be judged. And of course we are welcoming, respectful, and encouraging.
Our groups are voluntary, but that also means that they don’t have to be arrested to get in, so we can include individuals whose partners don’t want to press charges and those who are causing harm via non-criminal, emotional abuse. The feedback we’ve received from other providers is our groups are a great supplement to and reinforcement of the work they are doing with their counseling or BIP group.
The group is free to participants and they can sign up at https://www.ananiasfoundation.org/groups/. It could be a good stopgap while the COVID-19 virus disrupts us.
Mar 27, 2020 @ 00:21:20
Our program in Alameda County and our program in San Quentin State Prison is shut down until at least the first week in April if not longer. I have been getting calls from clients and potential clients looking for an online alternative. I did direct one potetial client to Michael Clark’s site. I have been checking in with my clients by text, and phone calls just seeing if they need to talk. Some of the men have been very welcoming of the phone call and a chance to check in with someone who is willing to talk to them about some of their struggles during this Covid 19 ordeal. Many of the men I have spoken to are anxious to return to the groups. I have also continued to create progress reports for my clients who have requested them, based on their participation up till our last class which was held on 3/14/20. At this time we have no plans to do an online group but that may be the only way to hold groups if the order to shelter in place extends past mid April or into May of this year. Until then I am going to continue to check in with my clients to let them know that I am here if they need to talk during the day. I am interested in seeing what happens with Daniel’s program in Sacramento County and if the courts and probation allow online groups. I hope that Alameda County probation continues to communicate with our BIPs with any changes or updates.
Mar 30, 2020 @ 15:11:09
Hi everyone,
Here are some news from BIPs in the Province of Quebec (Canada).
In Quebec, BIPs are recognized by the state as essential services, so they are open in the actual context. However, beyond general public health guidelines, there are no specific guidelines for them from the government. The Quebec association of BIPs, à cœur d’homme, which brings together 29 organizations providing BIPs, does not provide guidelines neither. Her president, Valérie Meunier, gave me a certain portrait of actual practices.
The majority of BIPs has interrupted groups, but some of them have replaced them by online groups, using Skype or Zoom for example.
Face-to-face meetings are still possible in some BIPs: in this case, public health guidelines applies. Phone interventions are however favored. Some organizations have extended their opening hours. So far, organizations are observing a positive answer from men.
Reflections are still in progress to stay in touch with men, in order to limit IPV risks.
Apr 03, 2020 @ 22:11:36
This discussion is very helpful and demonstrates how controversial this issue can be. To me the ethics of providing alternative and less than optimal services when unable to do so in the typical manner are most at play. I don’t think anyone is saying that telehealth groups are as effective as live groups and I don’t think that this is even a fair comparison at this time as we are more likely facing the issue of providing some type of telephonic check-in (which almost everyone can do) vs. telehealth vs. nothing at all. For me it comes down to this ethically, I believe that providing a modicum of support and an opportunity for our clients to connect to therapeutic agents (Us) to learn and practice safe ways of regulating their thoughts, feelings and behavior (IN A SUPPORTIVE, AFFIRMING MANNER) is far less likely to produce negative outcomes than doing nothing at all. I could be wrong but I think we will help more families weather the storm that we are now in, with safety. With so many individuals losing their jobs, their savings, having kids at home in some cases with little structure is fraying our families’ abilities and capabilities to cope. If you check in with your clients as we are doing, they will tell you that they are stressed and we know what happens when coping capacities are stressed, so how could we abandon our clients at this time? Have our licensure, state and national BIP codes and guidelines caught up? Not yet! And if we wait for those changes, we may lose people and not due to a virus. That is why some regulatory bodies are calling for relaxation of the typical codes.
I understand that in WWII, we had a shortage of officers for the armed services and instead of a two-to-four year training, we reduced it to two weeks…..but that was the action that was needed. Was it optimal? No. But did it save lives……I bet it did.
In Virginia, BIP providers need to be licensed mental health practitioners unless they are working in exempt settings such as county governments under licensed staff but the counseling and social work boards have not specifically made exceptions for exempt settings for telehealth yet. Additionally programs that receive federal funding via VAWA may also be subject to more stringent regulations that impact BIPs that may come under the agency/program’s direction. Thankfully our state BIP Certification board just reached out to providers to ask us how we are working to provide intervention whether through individual support or telehealth solutions and heck, even alerted members to this site (Awesome job–Shout Out VA BIP Certification Board).
From a mental health point of view, I don’t know of any research that shows any patient population that can’t benefit from telehealth but in domestic violence there is this nagging concern that our clients will use such tools as instruments of coercive control. I think if there is any possibility of that for a program or client, I wouldn’t suggest providing such services, but I think the opposite effect is actually more likely if the service is genuinely positive, helpful and supportive. If we approach our clients with the care and concern that brought us to this field, they will deeply appreciate it and may be “all ears” as we use our skills to help them learn to better regulate themselves. In this sense I don’t think that if we provide group telephonic or teleconference style using a tool such as WebEx/GoToMeeting/FaceTime/Zoom we can do it in the same way we would provide in-vivo services. From what folks have said, there are even some unique benefits for some clients but the work is harder for practitioners. I have heard that the tech issues are an issue, whether the client can be home with partner/children (perhaps depends on type of violence and client hx/motivation and environmental variables), how if homework is used, what device is used, the group rules/expectations, use of individual 1:1 brief telephone sessions between telehealth groups, etc.
Our plan in ADAPT is to continue weekly check ins and if and when we get clearance to implement telehealth, we will probably use Zoom for Healthcare, shorten the session length but add the commensurate time to individual check ins for homework, make the groups smaller, consider moving to open vs. closed (or a hybrid of 4 weeks of closed feeding 14 weeks of open for example) and consider how to choose membership in a more planful manner but provide an option for clients who are not ready or appropriate for group telehealth.
In any case, I look forward to hearing how others are thinking about and redesigning services in the wake of what might be months of home segregation. Take care everyone.
Apr 08, 2020 @ 17:18:31
My colleague, Shelly Wagers, who is one of the Associate Editors for the journal, Partner Abuse, recently wrote an article on the apparent rise of intimate partner violence during the COVID-19 pandemic. I am not surprised. This is why we must continue to work with our clients, even if we cannot always arrange to see them in person. The link to the article is at: https://theconversation.com/domestic-violence-growing-in-wake-of-coronavirus-outbreak-135598
Jun 03, 2020 @ 02:44:24
I appreciated the article by Shelly. I knew the increase would take place. My agency was limited in providing services, and my actual job at another organization was terminated on June 1, 2020. I finally have access to my past clients. They had to wait from March 10-June 1 to hear from me ‘legally’ as I was told to not discuss anything with them. However, my agency was certified in WI and was given permission to begin groups. Once the agents began referring clients to me I started a Zoom program where we have a powerpoint presentation of vital topics pertaining to domestic violence and the issues at hand: stress, emotion regulation, and what counts as violence, and Radical Acceptance and DV. I created the PowerPoints to meet a need. So far my groups are manageable with 7 men and all of them participate actively and the group cohesion is amazingly powerful. They have demonstrated accountability. These are some of the same members I worked with for months and the consistency paid off. Now, I have one new member who joined this past Saturday and he caught the same participation momentum. I wanted to share this with you because my desire to help slow the curve of DV potential in my clients was halted, but then started again. Thank you for the amazing support here on ADVIP. I have been blessed to be a part of this organization. ~Pamela, M.S.
Sep 14, 2020 @ 20:32:12
Hi I am Anne and I am new. We have been doing BIP on Zoom for awhile now in Orange and Seminole County in Fl. It is actually going well. I really enjoyed the training and happy to now be a member!
Mar 04, 2021 @ 19:09:59
Hi, I am Suzanne and am a recent member. I am in Louisiana and our domestic violence law requires in person meetings. I got special permission of the referring judges and the assistant DA to conduct groups online due to the pandemic. I conduct the same group online via zoom that I used to conduct in person. Attendance has increased and because we are a close-knit, rural community, group cohesion and participation has not suffered. People can still work and attend group by stepping away to a private place for an hour or so, when they work on boats on the river, when they work the oil rigs offshore, when they go out of town to work or move out of state to live.
I am in the process of asking our legislature to change the “in person” requirement but want to make sure that the online groups are conducted appropriately. Online interventions that allow an individual to log on, watch a video, and then take a test are not sufficient to meet our law nor to bring about the necessary change in attitude and beliefs or break through denial.
I am seeking everyone’s feedback about continuing groups online after the pandemic disappears and how you might word the change to ensure appropriate online interventions. Thanks.
Mar 05, 2021 @ 05:08:40
Suzanne,
In Kansas, action had to be taken to make certain that online groups that were advertising as being in compliance with state standards actually were. Our recommended changes to Kansas law (now being adjusted) requires any certified program to do mostly face-to-face, but can continue doing some virtual, dependent on needs of the participant. If you need additional information, just give me a call 785-409-3773.
Mar 05, 2021 @ 06:07:11
In most of California and in Idaho the programs are now entering a year of using online platforms for their BIP’s (both States have 52-week programs). Since they are using my curriculum I have re-created some of the activities for the facilitators to use Microsoft Office Forms for survey and White Board brainstorming exercises for discussion (good especially for the visual and kinesthetic learners). The facilitators indicate that some of the men actually improved in engagement because of Zoom. Overall, the women’s groups have not been as responsive via Zoom and since most of the groups are smaller they were able to meet in person with masks and social distancing. I was a strong advocate against online BIP’s, but this pandemic has forced the issue and I have been pleasantly surprised that some participants can actually benefit from this option. In one program the men are required to answer three questions after group via email/text 1) What stood out to you from this lesson? 2) What did you learn about yourself? 3) What are you going to do differently as a result of what you learned? The facilitator said many of the men have moved from a few word answers to some of them “writing novels” about their insights and personal applications! Also, because of Zoom I was able to “substitute” lead a group when they were otherwise going to miss 3 weeks due to staff training and holiday schedules. Given that I am in Washington, that would have been impossible for in-person groups. So…I imagine most of us are still learning to think outside the “traditional” box!!
Apr 22, 2021 @ 19:49:59
Nada,
I love what you shared here. I ask the GLAD at the end of my groups. Name a gratitude, something they learned about themselves, something they accomplished, and something they will delight in. The ability for men to find gratitudes, and apply something they learned is like a quick review at the end. Thank you for sharing!
Pamela
Apr 22, 2021 @ 20:04:00
Pamela…I love GLAD– makes it easy to remember. I will revisit ours and find an acronym too–thanks for the good idea 🙂