Batterer intervention providers, anger management counselors, mental health professionals, and research scholars dedicated to evidence-based practice worldwide.
I would need more info with specifically what you are asking about as this is a pretty complex and broad topic. I can tell you a few tidbits about how our program interfaces with local services and some of the issues we face.
First, in our county, all police responses to DV or Domestic dispute calls for service are handled with a Lethality Assessment Protocol [LAP], a derivation from the Maryland, US model, itself a shorter version of Jackie Camppbell’s Danger Assessment [DA]. Police responding implement the LAP questionnaire and when the score is at a certain threshold, advocates are called 24-7 to engage in safety planning over the phone. The police literally have special phones for just this effort. Our approx. 40 person county agency which provides services to sexual and domestic violence victims (adults and children) and victims of human trafficking and stalking, DV offenders, shelter services and the public (community education and prevention) all work 18-24 hour shifts on this LAP hotline including all the staff of our 4.5 person BIP. So that is one touch point.
With respect to clients entering our BIP, we now have another unit in our office who now complete the “partner calls”…these calls are made by DV advocates, not the staff doing intakes and group work with offenders. These staff have several tools to use including the full Danger Assessment, the shorter LAP assessment and ODARA. Prior to this new protocol introduced last month, BIP staff were calling partners directly and using the Ontario Domestic Assault Risk Assessment ODARA with partners who were willing (13 item questionnaire). Until just this past month, BIP staff were the ones calling partners and using ODARA.
It should be noted that ODARA was designed primarily as a risk assessment instrument…..it answers the question, is the offender likely to re-offend vs. a lethality instrument such as the DA or LAP which is addresses the possibility of homicide. In our program we have felt both types of tools are appropriate with different folks at different times. I think lethality assessment is important for 1st responders and for victim advocates meeting with victims while risk assessments like ODARA are suited for individuals in tx. That being said, one could easily make the counter-argument. Indeed ODARA was designed like the Maryland LAP for use by first responders (police). When one delves a bit further there is some research that even speaks to each of these tools being fairly decent at the “other function”. In other words, ODARA seems to have some ability to function as a lethality assessment as the LAP and DA can have some ability to predict re-abuse.
Clearly BIP staff can use their clinical knowledge and experience and while I value these things as a supervisor I am also aware that in terms of risk or lethality assessment such knowledge really doesn’t seem to result in better predictive power. In fact I have seen studies that show clinical hunches about lethality are only accurate in the low 40% range which is less powerful than flipping a coin. Tools like the DA, ODARA get you in the high 60’s to mid 70’s which is certainly better than clinical hunches or chance.
Moral of this story….use a tool and preferably use it with partners or individuals when the data is likely to be solid-fact based or “actuarial”…this is one of the strengths of a tool like ODARA….the questions are yes/no and the data exists in actuarial format….example, Has client ever been charged with a domestic related offense in the past”. Secondly practitioners should have a protocol to offer safety planning to victims. We know that victims of DV, do have hunches and these often have better predictive power than other data. I think ultimately risk and lethality would be assessed at multiple points with individual, community and system responses and safety planning at each step.
Every community is different however and sometimes good lethality and/or risk assessment can be compromised by system blockages. One of the things we experience which many BIPS do not…is that we actually don’t get any referral information from probation or police. I know crazy right! So when we sit down to do an intake with a new client, “their story” is typically the “only story” we have access to. We don’t have the police report. And while we used to call partners we found asking them “what happened” wasn’t always helpful as we weren’t able to use that information in treatment of the abuser….unless of course the partner report matches what the primary client states. Usually the stories aren’t the same. We have learned this is okay. Usually later in tx, when clients have made self-change and learned ways of regulating their emotions and behavior, their stories are much more accurate. This goes along with self-responsibility. But clients don’t typically share the full and accurate blow by blow in a first intake meeting. Never underestimate the power of shame.
Now that we have arranged for another unit of workers in our office to make partner calls, we believe that the calls are more productive, better information is shared and the BIP staff are not put into situations where they know things they can’t do much with. We are still experimenting with the information sharing from the staff advocates making the calls and what if any information should be shared back with myself as the program leader or the staff group leader. That’s a work in progress. Suffice it to say, lethality and risk assessment and partner contact and community supervision/probation are all complex issues. Hopefully this is a useful place to start and other BIP pros can weigh in…..
Sam Bachman
Jun 20, 2017 @ 16:16:15
I would need more info with specifically what you are asking about as this is a pretty complex and broad topic. I can tell you a few tidbits about how our program interfaces with local services and some of the issues we face.
First, in our county, all police responses to DV or Domestic dispute calls for service are handled with a Lethality Assessment Protocol [LAP], a derivation from the Maryland, US model, itself a shorter version of Jackie Camppbell’s Danger Assessment [DA]. Police responding implement the LAP questionnaire and when the score is at a certain threshold, advocates are called 24-7 to engage in safety planning over the phone. The police literally have special phones for just this effort. Our approx. 40 person county agency which provides services to sexual and domestic violence victims (adults and children) and victims of human trafficking and stalking, DV offenders, shelter services and the public (community education and prevention) all work 18-24 hour shifts on this LAP hotline including all the staff of our 4.5 person BIP. So that is one touch point.
With respect to clients entering our BIP, we now have another unit in our office who now complete the “partner calls”…these calls are made by DV advocates, not the staff doing intakes and group work with offenders. These staff have several tools to use including the full Danger Assessment, the shorter LAP assessment and ODARA. Prior to this new protocol introduced last month, BIP staff were calling partners directly and using the Ontario Domestic Assault Risk Assessment ODARA with partners who were willing (13 item questionnaire). Until just this past month, BIP staff were the ones calling partners and using ODARA.
It should be noted that ODARA was designed primarily as a risk assessment instrument…..it answers the question, is the offender likely to re-offend vs. a lethality instrument such as the DA or LAP which is addresses the possibility of homicide. In our program we have felt both types of tools are appropriate with different folks at different times. I think lethality assessment is important for 1st responders and for victim advocates meeting with victims while risk assessments like ODARA are suited for individuals in tx. That being said, one could easily make the counter-argument. Indeed ODARA was designed like the Maryland LAP for use by first responders (police). When one delves a bit further there is some research that even speaks to each of these tools being fairly decent at the “other function”. In other words, ODARA seems to have some ability to function as a lethality assessment as the LAP and DA can have some ability to predict re-abuse.
Clearly BIP staff can use their clinical knowledge and experience and while I value these things as a supervisor I am also aware that in terms of risk or lethality assessment such knowledge really doesn’t seem to result in better predictive power. In fact I have seen studies that show clinical hunches about lethality are only accurate in the low 40% range which is less powerful than flipping a coin. Tools like the DA, ODARA get you in the high 60’s to mid 70’s which is certainly better than clinical hunches or chance.
Moral of this story….use a tool and preferably use it with partners or individuals when the data is likely to be solid-fact based or “actuarial”…this is one of the strengths of a tool like ODARA….the questions are yes/no and the data exists in actuarial format….example, Has client ever been charged with a domestic related offense in the past”. Secondly practitioners should have a protocol to offer safety planning to victims. We know that victims of DV, do have hunches and these often have better predictive power than other data. I think ultimately risk and lethality would be assessed at multiple points with individual, community and system responses and safety planning at each step.
Every community is different however and sometimes good lethality and/or risk assessment can be compromised by system blockages. One of the things we experience which many BIPS do not…is that we actually don’t get any referral information from probation or police. I know crazy right! So when we sit down to do an intake with a new client, “their story” is typically the “only story” we have access to. We don’t have the police report. And while we used to call partners we found asking them “what happened” wasn’t always helpful as we weren’t able to use that information in treatment of the abuser….unless of course the partner report matches what the primary client states. Usually the stories aren’t the same. We have learned this is okay. Usually later in tx, when clients have made self-change and learned ways of regulating their emotions and behavior, their stories are much more accurate. This goes along with self-responsibility. But clients don’t typically share the full and accurate blow by blow in a first intake meeting. Never underestimate the power of shame.
Now that we have arranged for another unit of workers in our office to make partner calls, we believe that the calls are more productive, better information is shared and the BIP staff are not put into situations where they know things they can’t do much with. We are still experimenting with the information sharing from the staff advocates making the calls and what if any information should be shared back with myself as the program leader or the staff group leader. That’s a work in progress. Suffice it to say, lethality and risk assessment and partner contact and community supervision/probation are all complex issues. Hopefully this is a useful place to start and other BIP pros can weigh in…..
Vera Tzenova-Bochnowicz
Jun 25, 2017 @ 14:50:45
Thank you for the detailed response, Sam! Very helpful to hear from you.