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Domestic violence is physical abuse or threats of physical abuse by an adult family or household member against another adult family or household member. Practitioners expand this definition to include violence in intimate relationships where partners may never have lived together, such as dating relationships. This includes physical, emotional, and sexual battering as well as destruction of property and pets. Pushing, pinching, slapping, punching, choking, burning, and shooting are forms of physical violence. Sexual violence includes acts such as making degrading sexual comments, forcing sex, assaulting breasts or genitals, and forcing a partner to have sex with a third person. Some examples of psychological battering include making threats of violence, forcing a battered women to do degrading things, controlling her activities, abusing her verbally, frightening her or threatening suicide, and using children as leverage to get desired results or behavior. Destruction of property and pets may include destroying a partner’s prized possessions, destroying property of her relatives, or killing or injuring pets (Ganley, 1981).
However, domestic abuse is not limited to physical, psychological, and sexual abuse or easily visible overt behavior. It “is controlling behavior to maintain an imbalance of power between an abuser and a battered woman, including any act that causes the victim to do something she does not want to do, prevents her from doing something she wants to do, or causes her to be afraid” (Adams, 1988a). Ways of gaining power and control include economic abuse, using male privilege, using the children, minimizing, denying or blaming, and using isolation and intimidation (Pence and Paymar, 1990).
While domestic violence is not confined to any socioeconomic, racial, ethnic, religious, sexual orientation or age group, research shows that 95% of the victims are women (Murray, Strauss, Gelles, and Steinmetz, 1980; U.S. Department of Justice, Bureau of Justice Statistics, 1983). An estimated 2.1 million women are beaten by their partners at least once during an average 12-month period. The Bureau of Justice Statistics estimates a woman is beaten in her home every 15 seconds (1986). In the United States, more than 50,000 known women were killed by partners between 1980 - 1990. Since a study by Hotaling and Sugarman (1986) did not find any characteristics or psychological differences that distinguish battered women from non-battered women, all women are at risk for becoming targets of domestic abuse (Hart, 1990).
Battered women stay in abusive relationships for many reasons, including fear, love, and hope that her abuser will change. She may stay for the children, for religious reasons, or for economic reasons. The economic reality for many women is to face a choice between continued violence or assured poverty for themselves and their children. Jann Jackson, Associate Director of the House of Ruth in Baltimore, sums up the reasons women stay this way:
Physically injured, psychologically intimidated, isolated from families and friends, and threatened with death if they leave, it is remarkable that so many battered women have reached out for help. We have failed to realize that to leave means facing catastrophic personal losses of everything that is familiar to them. To leave means increasing the risk of violent retaliation by the abuser. To leave means negotiating multiple social systems that fail to meet her needs, that blame her for her victimization, and that often endanger her. To leave means coming to an unknown environment, living with strangers and exposing the most vulnerable, shameful and humiliating experience of her life. To leave means the risk of failure to make it on her own and having to return to her abuser for further subjugation (Update, 4/90).
In the early 1970’s, services for battered women and their children emerged. The first shelter for battered women was started in England in 1971 and the idea quickly spread to the United States. These programs provide safe space, advocacy, counseling, information, and referrals to battered women and their children.
As programs for battered women developed and grew, researchers and program staff began analyzing batterers. They found that batterers are not out of control when they abuse, are not angry, nasty men, and do not suffer from lower self-esteem than non-batterers. Rather, a batterer believes:
Services for batterers started as early as the mid-1970’s. Some programs started directly out of the shelter movement as battered women’s programs began receiving calls for help from batterers. In 1976, the first systematic approach for working with abusers was started by the Victim’s Information Bureau of Suffolk County in New York (Jennings, 1987). Over the past 14 years, the number of programs has grown tremendously across the country.
Critics of state funding believe that battered women’s programs do not currently receive adequate funding and that ensuring safety and providing accessible services for all battered women and their children should be the first priority. Furthermore, there are many who feel that the cost of abuser education/treatment cannot be justified considering its low rate of success when compared to the unmet need for crisis services for battered women and their children. Critics feel abuser education/treatment programs can and should charge fees and be self-supporting. Other critics of state funding are concerned that funding would lead to state standards that would not allow for individualized treatment methods and plans. Programs for batterers are controversial for many reasons.
Proponents of abuser education/treatment programs argue the only way to end domestic violence is to change the behaviors and attitudes of perpetrators. Many battered women stay in violent marriages and those who do leave often return. Studies have shown that about one-third of the battered women who seek shelter return to their abusers (Gondolf, 1988). Abuser education/treatment can offer a means of protection for women who have opted to remain in a relationship with an abuser who will not seek help voluntarily (Dutton, 1986). Even if the relationship ends, many women continue some form of contact with their abusers if they have children in common (Ganley, 1987). Batterers may also begin new abusive relationships with other women. For these reasons, proponents believe working with abusers to change abusive behavior and attitudes is an important part of ending domestic violence.
Passage of the mandatory arrest law in many states has increased the number of referrals from the courts to services for abusers. Court referrals to programs for batterers have increased because judges often prefer sending an abuser to an education/treatment program as a sentencing alternative, as is done with drunk driving, shoplifting, and other crimes. Many battered women support mandated education/treatment because they are often more interested in seeing their partners get help than simply terminating the relationship.
However, not everyone is enthusiastic about batterers’ programs. Critics are concerned about the vast differences in philosophy, education/treatment methods, and orientations of providers of abuser services. They are concerned that not all programs support ending violent, abusive, and controlling behavior as the primary goal of programs for batterers. They worry that abusers may not be held accountable and taught to be responsible for their violence. They are concerned about the potential for a negative effect of programs for abusers on battered women and their children. And they are concerned about the varying degrees in which programs for batterers are involved in community interaction and social action. They also are concerned that these programs may not be effective in changing the abusive behavior of batterers.
These areas of concern have merit. However, by examining each more closely we will see there are remedies to some of these difficulties. The third section of this paper will examine the first four concerns about abuser programs (ending the violent, abusive, and controlling behavior; holding abusers accountable for their behavior; evaluating the effects on battered women and children; and analyzing the importance of community interaction and social action). The fourth, fifth and sixth sections of this paper will discuss differing philosophies, education/treatment methods and orientations and show how some philosophies, methods, and orientations deal with each of these four areas of concern as a way to measure if some approaches to abuser education/treatment are better than others. The seventh section of this paper will examine the effectiveness of abuser education/treatment in changing batterer behavior and attitudes. Section eight will discuss states’ policies regarding funding and standards. The final sections will draw conclusions and provide recommendations.
Critics argue that abuser education/treatment may not change violent, abusive, and controlling behavior of batterers. Different programs, philosophies, methods, and orientations have a wide variety of goals including strengthening individual personality traits, improving the couple’s relationship, ending or reducing physical violence, or ending violent, abusive, and controlling behavior. Some of these goals may not lead to ending domestic abuse. For example, strengthening individual personality traits can promote more flexible role behavior, decrease isolation, improve self-esteem, and teach anger control. Or the goal of saving a couples’ relationship can lead to better communication and relationship skills. While these goals may produce changes in individuals or couples, they may actually further enmesh a battered woman in an abusive relationship and do nothing to end the violence.
Goals such as ending physical violence or reducing violence also have problems. Focusing on the physical violence alone ignores the other issues such as emotional abuse, threats, and power and control. If the physical violence lessens or ends, but a battered woman is still living in constant fear and is required to alter her behavior to accommodate a batterer’s wishes, education/treatment has not been successful. In short, critics of programs which focus solely on ending or reducing the physical violence while ignoring an abuser’s need for control, state that such programs make abusers better abusers. They claim the message to abusers is that “you can get what you want without being physically violent,” while teaching them more socially acceptable tools to use to control their partners. Their basic need to control has not been addressed or challenged, thereby leaving partners with a better skilled although perhaps not physically violent batterer. In fact, most outcome studies show that while physical violence may be reduced or eliminated for some men, emotional, psychological and other forms of abuse continues or increases. Therefore, to address the concerns of critics that differing program goals may not change abusers behavior and attitudes, the primary goal of abuser education/treatment should be to end violent, abusive, and controlling behavior.
Critics are concerned that abusers in some programs may not be held accountable for their violent behavior. Accountability is a process whereby a batterer behaves responsibly in his interactions with significant others. It calls for a reckoning of behavior, taking responsibility for his behavior and assures responsible future conduct (Hart, 1988b). Research has shown that it is common for batterers to minimize or deny their violent behavior (Ganley, 1981; Sonkin, Martin, Walker, 1985). It is typical for a batterer to say “She bruises easily” or “I only pushed her” without stating that he pushed her down the stairs. Minimization or denial may be due to guilt or shame and because it is in abuser’s best interest (Sonkin, Martin, Walker, 1985). For education/treatment to be meaningful, batterers must acknowledge that the violence occurred and must become aware of the pain it causes their partners and children.
Another common strategy for abusers is to blame their partners. Batterers often describe violent incidents in terms of what their partners did to cause the problem. They may say things like “If only she had or hadn’t done this, I wouldn’t have had to hit her” (Sonkin, Walker, Martin, 1985). Abusers must learn to take responsibility for their violent responses, no matter what the situation. They must also learn that violence is never an appropriate reaction to another person’s behavior.
Some abusers say they lost control and do not remember what occurred during the attack. However, battered women report that batterers know exactly what they are doing. “They report that an enraged husband does not just slap, he uses his fists and generally aims his blow at places that do not show. Targets include breasts, the stomach (even during pregnancy), the base of the spine, and parts of the head where bumps and bruises are hidden by hair” (Martin, 1981).
Another argument some abusers use is that they were drinking or taking drugs before the abusive incident. Batterers say things like “I was drunk and didn’t know what I was doing.” By blaming the alcohol or drugs, they shift the responsibility for their behavior away from themselves and onto the chemical substances. They may believe that if they would stop using drugs and alcohol, they would stop being abusive. Studies indicate that about 50 percent of abusers have alcohol problems but there is no evidence to indicate a cause-effect relationship or that ceasing to use alcohol or drugs ends violent and abusive behavior (Tolman and Bennett, 1990).
These excuses need to be confronted before an abuser can begin to accept responsibility for his behavior and begin to change. Philosophies, education/treatment methods, orientations and programs that do not confront abuser minimization and denial may reinforce a batterer’s belief that his behavior is acceptable or even appropriate under certain circumstances.
Critics argue that abuser education/treatment may be dangerous to battered women. A woman may continue to stay in a dangerous relationship or think she is no longer in danger because her abuser is in counseling. She may believe that education/treatment is guaranteed to change him and that the domestic violence will certainly end. Gondolf (1988a) interviewed 6,612 battered women who were residents in 50 Texas shelters at intake and discharge to determine what factors influenced whether they returned to their abusers. He found 53% of the women with batterers in counseling planned to return to their abusers, in contrast to 19% of women whose partners were not in counseling. “Even after provision or acquisition of child care, personal income, or transportation, a woman is likely to be drawn back to her batterer by the fact that he is in counseling” (Gondolf, 1988).
Because many battered women do not initially indicate their first choice is to end the relationships, but rather to have the violence end, batterers programs should provide partners of batterers with information about domestic violence, legal and social service referrals, and information about what the offender will learn in education/treatment. Additionally, partners should be told that the offender may still be abusive during or after completing the program (Hart, 1988a). By providing this information, a woman can make better informed choices about remaining in the relationship and can develop a safety plan based on a clear understanding of what her options are if the violence continues.
Critics of programs for batterers are concerned that programs may work in isolation from other agencies that serve abusers and victims. Abusers come in contact with many other agencies that may give different messages about domestic abuse. Ideally, programs for batterers should work closely with other social services agencies and help make the criminal justice system aware of its responsibility to hold men accountable for their violence (Adams, 1988a).
Battered women’s programs are also concerned about competing for funding with abuser education/treatment programs within their own communities or on a state level. Some funding agencies may believe that they are helping end domestic violence by supporting abuser education/treatment without realizing the important role victim services play in ending violence and changing community attitudes, in addition to providing crucial safety and support services for victims and children.
To prevent this from happening, programs for batterers are encouraged to work cooperatively with their local battered women’s program in a manner that is consistent with the goals and philosophy of the battered women’s program. As part of this cooperative effort, abuser education/treatment programs should consistently affirm the primary importance of safety for battered women and their children and having shelter and support services for women available in their community. Other examples of working together include encouraging battered women’s programs to review program materials, monitor abuser groups, and provide on-going consultation. (Adams, 1988a).
Finally, critics of abuser education/treatment are concerned that some abuser programs focus exclusively on the individual and are not active in promoting social change or community education. Most abusive men in batterers programs will continue to socialize with and have contact with people who condone their violent behavior. Hart (1990) points out:
Batterers live in a community context that has tolerated, condoned and even encouraged violence against women. Each time the batterer leaves his education/treatment program, he returns to a community that gives him support either to continue or to eliminate his practices of terrorism. He needs to hear that his family, co-workers, fellow parishioners, neighbors, friends and other people he respects reject violence in intimate relationships. He must hear that these significant others believe that there is no excuse or justification for tactics of violence, are committed to victim safety, offer him support to change, but are resolved that if a choice must be made between the battered woman and the batterer, they will stand with the battered partner. If he does not hear these messages, he will likely return to violence.
Ongoing work to change attitudes in communities is an essential companion to individual work with abusers. Ideally, a program for batterers can act as a deterrent to those it never sees and prompt other men to work to end domestic violence (Gondolf, 1987b). The batterer’s program can help make the community more aware of the responsibility men have for their violence against women. It can help build public awareness regarding the need for preventive education and help eliminate sexist and racist institutional practices that hinder women’s abilities to avoid and escape violence while actively supporting social change efforts to promote equal rights for women (Adams, 1988a).
Due to widely differing philosophies, methods, and orientations, critics are concerned that not all abuser education/treatment programs: focus on ending the violent, abusive and controlling behavior as their primary goal; hold abusers accountable for their behavior; provide safety for battered women and their children; and work within their community for a coordinated response to domestic violence and promote social action and community education. This section has outlined the problems and offered possible remedies to these criticisms. Throughout this paper, these four areas of concern will be used as measures to rate differing philosophies, education/treatment methods, and orientations. Focusing on one or two areas is not enough; comprehensive, effective programs and approaches must be strong in all four areas. The next three sections will define and compare the various philosophies, education/treatment methods, and orientations and draw conclusions about their effectiveness, based on these four areas of concern.
How the problem of domestic violence is defined often determines the method and orientation of intervention used. Four education/treatment philosophies of domestic violence are: insight model, interactional or systems theory, cognitive behavior theory, and sociopolitical theory. Proponents of the insight model generally choose individual therapy for batterers. Couples counseling or couples groups are generally used as the primary intervention mode by systems theorists. Groups for batterers are the preferred method for those who adhere to the cognitive behavior theory and/or the sociopolitical theory. Insight, interactional, and cognitive behavior philosophies are generally adopted in a social service setting. Those adhering to sociopolitical theory are usually oriented to a grassroots or coordinated community response approach.
According to the insight model, the cause of violent behavior is intrapsychic problems probably resulting from early developmental difficulties. Batterers are seen as fragile individuals in need of nurturing. Their problems include “poor impulse control, low frustration tolerance, fear of intimacy, fear of abandonment, dependency, underlying depression, and impaired ego functioning” and may be diagnosed as “obsessive-compulsive, paranoid, borderline personality, passive-aggressive and pathological” (Adams, 1988b).
The purpose of insight therapy is to make an abuser more aware of how his childhood and past are affecting his present behavior. According to insight theory, if the abuser can resolve his past injuries, he will no longer need to abuse others. Therapy does not specifically address violent behavior but instead looks at childhood experiences and works on building self-esteem (Adams, 1988b).
Most research and literature does not support the view that battering is exclusively an intrapsychic problem nor does evidence support the theory that psychological problems cause violence. Tolman and Bennett (1990) conclude from their literature review that while there is a significant population of batterers with identifiable psychological problems, wife abuse is not limited to men with such problems. Research indicates that not all batterers show signs of psychopathology and among abusers with such symptoms, no pattern of a certain type of psychopathology exists. Therefore, while some wife abuse may be linked to pathology, this is informative only if linked to other social variables (Bograd, 1988).
Systems theorists believe couples and family relationships are cyclical; the behavior of each individual is contingent on the behavior of the other. Battering is believed to be the result of repeated interactions between family members in an effort to maintain the relationships (Bograd, 1988). Acts of violence are symptoms of other problems, such as communication problems where both partners are trying to coerce and incite each other (Gelles & Maynard, 1987).
According to interaction theory, if “one part of the system is disturbed, the other parts have contributed to this disturbance” (Eisikovits & Edleson, 1989). Since both parties maintain the context within which the violence may occur, neither should be held solely responsible for the violence (Flemons, 1989). There are no victims or offenders; each partner is equally culpable for every interaction. In cases of domestic violence, terms such as abuser and victim are replaced with violent couple, conjugal violence, battering pairs, and abusive system. Assigning responsibility to the abuser or victim is considered counter-productive. If the male is confronted, the victim will demand punishment or retribution. If the woman is confronted, she will suffer from learned helplessness and believe she deserves to be beaten (Neidig, 1985).
Systems theorists generally see the couple together because they believe “it truly does take two to quarrel” (Deschner and McNeil, 1986a). The goal of therapy which uses the systems theory is for each partner to identify and change how he or she contributes to problems, including the violence, in the relationship (Adams, 1988b). It is the job of the therapist to challenge family interaction patterns and have the couple or family look beyond the violence to examine the rules that govern family interactions (Gelles & Maynard, 1987).
Cognitive-behavioral models are derived from social theory where violence is believed to be learned behavior. This behavior can be learned in several ways. Abusers who grew up in violent families and witnessed or were victims of violence as children may have learned that violence is a form of power and control by observing what happened in their own families. Or violence as a tactic is reinforced if an abuser finds there are no adverse legal or social ramifications for battering. Once he has used violence and the behavior has been reinforced and found effective at producing his desired results, characteristically violence will be used again (Stordeur, 1989). This model also views violence, in part, as a skill-deficit, stress management, or anger control problem.
Since violence is seen as learned behavior, cognitive behaviorists believe abusers can learn to behave non-violently. Education/therapy is used to show abusers the consequences of their behavior and to teach alternative skills. Skills include monitoring responses, using anger logs and self talk, and training techniques of assertiveness, anger management, conflict containment, and stress control. Therapy also challenges irrational and rigid thought patterns (Adams, 1988b).
Cognitive-behaviorist therapy provides tools to stop abusive behavior immediately and shows the abuser he can control his actions. Proponents of cognitive behavior theory point to preliminary research which supports the theory that abusive men are more likely to feel angry in conflict or anxiety-producing situations than men who are not violent. (Tolman & Bennett, 1990). Cognitive-behavior and anger-control techniques are criticized when they are used exclusively without dealing with issues of sexism and power and control.
The cognitive-behavior model has provided many useful insights and interventions for battering behavior. It has identified some of the self-reinforcing aspects of violence and also recognized the need for stronger social and legal consequences. This approach is weakest when its practitioners fail to integrate adequately a political understanding of battering that identifies and confronts its sexist underpinnings.
The sociopolitical model addresses male power and control in society by examining why men oppress and subjugate women. Proponents of this model seek to understand when men use force against women and how this serves society rather than looking at one man abusing one woman (Stordeur, 1989). They see domestic violence as one form of oppression along a continuum which includes other forms of violence by a more powerful class against a less powerful class (e.g., racism, homophobia, etc.). Sociopolitical theory is based on the belief that wife beating “is controlling behavior to maintain an imbalance of power between an abuser and the battered woman” (Adams, 1988b). Domestic abuse is a coherent pattern of coercive controls including but not limited to physical, psychological, economic, and sexual abuse as well as social isolation.
Violence is any act that causes the victim to do something she does not want to do, prevents her from doing something she wants to do, or causes her to be afraid. It need not involve physical contact with the victim, since acts of intimidation, such as punching walls and making verbal threats, can achieve the same results (Adams, 1988a).
The goal of therapy is to “challenge sexist expectations and controlling behaviors that often inhibit men and motivate them to learn to apply newly learned skills in a consistently non-controlling manner” (Adams, 1988b). Program curriculum generally includes education and cognitive behavior techniques to identify and eliminate controlling behavior. Later intervention deals with sexist expectations and attitudes.
Based on the four measures outlined here, the sociopolitical philosophy is the strongest approach in all four areas. Domestic abuse is seen as more than physical acts and includes issues of power and control, gender and cultural values. Abusers are held accountable for their behavior and the safety of battered women and their children is a high priority. This model also recognizes the need to change institutions and community attitudes and promotes active community involvement, social action and community education. Insight and interactional theory may not have ending violent, controlling, and abusive behavior as their primary goal. Abusers may not be held accountable for their violence and the safety of battered women and their children may be in jeopardy. Neither philosophy promotes community interaction or social action.
Three education/treatment methods used when working with batterers are individual counseling, couples counseling, and groups for batterers. This section will define each type of counseling, discuss why each method is used, and show how the method deals with ending the violence, accountability, effects on battered women, and community interaction and social action.
Individual counseling is rarely discussed in the literature or by experts in the field. When it is mentioned, it is seen as a method used simultaneously with group sessions, for men who cannot attend group meetings, or for men who are not seen as appropriate for group counseling usually due to other emotional problems. When individual counseling is used based on insight theory, it has all the problems insight theory has in meeting the four areas of concern. A general concern of practitioners with regard to individual counseling relates specifically to accountability. Denial and minimization are more readily addressed in groups than in individual sessions because group members often come to recognize minimization and denial in other members and hold each other accountable. In contrast, one danger of individual counseling is that a therapist may be seduced by the batterer into accepting some of his rationales for his behavior and as a result not hold him accountable for his violence.
Programs that use couples counseling as a primary education/treatment method see couples individually or in couples groups. These couples are seen as “woefully unprepared and inadequate to handle stress inside their relationship or in the external world” (Mack, 1989). Therefore, the goal of therapy is for each partner to identify and change how he or she contributes to the circular problems in their relationship (Adams, 1988b). Couples counseling generally uses interaction or systems theory and varying degrees of cognitive-behavior approaches. Most programs teach couples how to observe cues of violence and stressors in their lives and techniques such as how to use time-outs and stress reduction, and ways to improve assertion, communication, self-talk, and problem-solving skills. (Eisikovits & Edleson, 1989).
Few studies have been done on the effectiveness of couples counseling with abusers and battered women. Eisikovits and Edleson conclude from their literature review that “the research on intervention with couples is, at present, inadequate. Given the shortcomings in the existing research, additional studies will be needed before couples intervention will have proven itself as a viable intervention tool with men who batter and their victims” (Eisikovits & Edleson, 1989).
Proponents of using couples counseling as the primary education/treatment method argue that many couples want to stay together and eliminate the violence from their relationship (Neidig, 1985). Another advantage is that both partners know exactly what the other is learning. The abuser may be more open to participation if his partner is involved (Saunders & Azar, 1989). However, most advocates of conjoint therapy acknowledge couples counseling is inappropriate for “severely” violent couples and families (Eisikovits & Edleson, 1989). Taylor (1984) sees “only couples with mild to moderate levels of abuse by physical degree and frequency.” Gelles and Maynard state that in severe life threatening cases, it is “clearly inappropriate and extremely dangerous to use conjoint or systems interventions” (Gelles & Maynard, 1987).
Critics of conjoint therapy believe that couples counseling is dangerous if used before an abuser has dealt with and ended his violent, abusive and controlling behavior. They recommend that the batterer complete group education/treatment and remain nonviolent for a period of time before beginning therapy as a couple. Willbach, a family therapist, states that “when a potentially actively violent abuser and abused person are in the same family, family therapy may be generally contraindicated” (Willbach, 1989).
The problems with using couples counseling as the primary education/treatment method are the same problems discussed with using systems theory. Ending the violence may not be as important as saving the relationship. Focusing on only the physical violence ignores the issues of power and control. Abusers are not held accountable when there are no victims or perpetrators. And battered women may be blamed for contributing to the cyclical nature of the violent relationship. Therapists using couples counseling may not believe in working for institutional and cultural changes. However, there are additional problems that are specific to couples counseling.
Abuser education/treatment groups for men have become the preferred method of education/treatment by most experts in the field. Due to numerous methodological problems, researchers’ best estimates of “success” in ending physical violence range from 53 to 85% for those who complete the program. Groups are significantly less successful in ending controlling and abusive behavior. A lower percentage of success occurred with lengthier follow up and reports from battered women (Tolman & Bennett, 1990).
Most groups have become a mix of cognitive-behavior techniques and sociopolitical philosophy. Group length, size, and content can vary significantly from program to program. In Wisconsin, groups range from 1 day to 14 months and may have 4 to 25 members.
Groups are generally run by a team of therapists or a therapist and a paraprofessional. Some groups are run by former batterers. Some experts believe that batterer’s groups should be run by men for men. They believe that men should be responsible for helping men so women can use their energy to work with battered women. They believe seeing two men working cooperatively rather than competitively will provide good role models and that men are more likely to disclose violence, especially sexual violence, only in the presence of other men (Stodeur, 1989). Others strongly advocate for a male/female team because the facilitators can model good male/female interaction. Also, a woman may pick up on sexist remarks and gestures more quickly than a male (Bernard and Bernard, 1984). Having a female present also forces group members to practice communication skills with a woman and shows them a strong female role model.
Many groups begin with an intake interview and an assessment process. Most groups provide instruction on some of the following topics: the different types of violence, the cycle of violence, safety plans, assertiveness training, relaxation and time-outs, issues of power and control, rigid sex role ideation, and denial and minimization of abusive behavior (Eisikovits & Edleson, 1989). Groups may be educational, therapy oriented, or a combination of the two.
An example of an educational format, often referred to as the Duluth model, is the curriculum developed by Michael Paymar and Ellen Pence of Minnesota. Many programs throughout Wisconsin and around the country use this curriculum or portions of it. In Duluth, the 24 week educational program examines eight themes in three week segments. The eight themes are from the power and control and equality wheels. The themes are: Intimidation; emotional abuse; isolation; minimizing, denying and blaming; using children; using male privelege; economic abuse; and coercion and threats. During week 1 of the 3 week segment, participants define the theme and analyze abusive behavior from videotaped vignettes. In week 2, the focus is on understanding participants’ personal patterns of abuse and control and week 3 is used to explore and practice non-violent alternatives and behaviors. Supporters of an educational model, such as the Duluth curriculum, believe highly structured groups avoid collusion with batterers, hold abusers accountable and keep the focus away from victim blaming while men examine their power and control issues.
Groups that are therapy-oriented focus more on family of origin, relationship issues, and communication. Those groups are generally more loosely structured to meet the needs of the members and are often run by degreed professionals. Some proponents of this method adhere to the insight philosophy of domestic abuse but prefer to deal with these issues in a group format.
The majority of groups for batterers combine educational and therapy methods. They mix educational content with looser group process time. Some programs meet twice a week with one session of education and the other therapy/support group. Other programs offer the educational portion first and a therapy component later.
Another group format is self-help. An example is Batterers Anonymous, which allow participants to set the agenda much like Alcoholics Anonymous. Critics of the self-help model argue that if left unsupervised, men may reinforce their sexist attitudes and violent behavior (Gondolf, 1985a). Another problem with this format is that domestic violence may start to be seen as an illness and an episode of physical violence seen as a “slip” (Pence and Paymar, 1990). Jennings (1987) argues in support of this format stating that the same topics will emerge in structured groups through the natural course of discussion when the men are ready to learn. He claims this increases their motivation to change. Jennings contends that batterers are generally rigid and controlling, but that by feeling a part of the process they learn flexibility and tolerance.
In 1989, the Domestic Abuse Project (DAP) of Minneapolis studied three types of groups: education, self-help, and combined education and therapy, each for 12 or 32 sessions. The DAP study found the educational formats tended to be more effective in reducing violence and terrorist threats after a six month follow-up. The self-help formats are least effective for both 12 and 32 sessions.
Proponents of groups state they are important because they break down isolation, a significant problem for abusers. Groups provide emotional support and an opportunity for mutual self-help. Many men find it easier to be open with peers than a counselor. There is an opportunity to practice communication techniques that are being taught through interaction with other group members. Groups also help break down denial and minimization of abuse. Groups expose men to a variety of opinions, models, and techniques. They also can provide role models of other men who have been abusive and are learning and practicing other behaviors (Eisikovits & Edleson, 1989; Bernard & Bernard, 1984). Finally, groups are the least costly method of education/treatment.
Based on the four measures outlined in Section 2, working with abusers is most effective when done in a group setting. Individual counseling may be appropriate for some abusers. Couples counseling is never recommended as the primary method of education/treatment. While programs vary, generally groups, especially those with a sociopolitical perspective, have ending the violent, abusive and controlling behavior as their primary goal. They hold men accountable, especially benefiting from using confrontation by other group members. They may provide support and information to battered women and their children and may be involved in community interaction and social action.
Individual counseling has the problems of insight theory although it may be appropriate for some individuals who may be unwilling to open up in a group setting, would be too disruptive for group, or who have schedules that do not allow attendance at group meetings. Couples counseling as the primary treatment method is contraindicated because of problems with saving the relationship as the primary goal, holding abuser and battered women accountable for the violence, and possibly jeopardizing the battered woman’s safety.
The question of whether programs for batterers are effective is a difficult one to answer. To date, researchers have not found any conclusive or compelling data to prove that programs for batterers are effective at ending violent, abusive, and controlling behavior. Two problems with the current research are the limited number of studies done in the field and the methodological problems with some of the studies that have been completed. This section will discuss the limitations of the current body of research before discussing some findings on recidivism and attrition rates. The next section will look at the research on the possibility that there are different types of abusers. Since program effectiveness should also be judged based on how well a program meets the needs of special populations, the fifth section will provide some information about these groups. The final discussion will look at whether the length of treatment makes a difference in attrition and recidivism rates.
Problems With the Research on Abuser Education/Treatment
Within the past ten years, programs have begun to study the effectiveness of their education/treatment methods in changing the violent behavior of abusers. Since the field of abuser education/treatment is still in its infancy, there are a limited number of studies that have been completed in this area. Due to a number of methodological problems with the research, it is difficult to make an accurate assessment of whether or not the programs for batterers are effective in ending violent, abusive and controlling behavior. These problems include how success is defined, who is evaluated and by whom, when follow-up occurs, and what other variables are examined.
A major problem with many studies is how success is defined. Most studies use ending physical violence as the criteria for success and do not measure whether there have been changes in emotional abuse and power and control issues. Some studies have looked for changes in interpersonal relationships, depression, or other psychological measures which do not indicate whether or not the violence has ended (Gondolf, 1987b). Some experts in the field believe success should be measured based on improvement in the life of the partners of the batterers. If the circumstances of her life have not improved — if she is not less isolated, terrorized, or has no more autonomy than before her abuser began education/treatment — then the program should not be seen as successful (Eisikovits & Edleson, 1989; Hart, 1988a; Gondolf, 1987b).
Who is evaluated and by whom are also factors that can skew research results. Although attrition is a major problem for this population, most studies base recidivism statistics on persons who complete. The success rates drop off sharply if dropouts or no-shows are counted in the evaluation (Gondolf, 1987b).
Recidivism rates may also be affected by whether they are based on police reports, self-reports, or partner reports. Follow-up rates based strictly on police reports indicate that the police were not called again—not whether or not the violence in the home has ended. Self-reports may not be accurate because abusers may continue to minimize and deny their abusive behavior (Gondolf, 1987b). Since several studies have found that in most cases battered women report more frequent and severe abuse than their abusers report, victim reports are generally seen as the most accurate but may be understated if a battered woman fears retaliation (Edleson & Brygger, 1986; Saunders, 1988b).
Timing of follow-up studies also creates problems. Some evaluations are done only at the beginning and end of programs, which does not give any information about long-term change. Some studies do follow-up after six months. However, if the base rate of violent behavior was relatively low (once or twice a year), abuse may not have occurred within a year after education/treatment (Saunders, 1988b). Yet having longer follow-up periods brings the additional difficulty of not being able to locate the respondents. Most response rates from follow-ups done after six months are very low, with the most successful usually around 50%. Recidivism rates for the 50% that were not found may be very different from the group that the researcher was able to locate (Gondolf, 1987b).
A final question: Is it the education/treatment program that causes abusers to change their behavior and attitudes or are there other variables involved? Most research does not use a control group for ethical reasons because of the potentially dangerous and lethal behavior of the population being treated (Saunders, 1988b). Therefore, recidivism rates stating how many men are no longer violent are meaningless without baseline data to show how many men may have ended their violence without education/treatment. “In fact, it has been estimated that as many as 30% of batterers may recover through spontaneous remission, that is, through factors not related to education/treatment” (Dutton, 1986).
It is also possible that other variables such as friends, family, church, AA, or contact with the legal system may have had an impact on ending the violence (Gondolf, 1987b). Tolman and Bennett (1990) conclude from their literature review that change in batterers behavior is probably due to multiple factors such as police and criminal justice system involvement and/or disapproval from friends or relatives.
Finally, lack of violence may be due to lack of contact with his partner. If she had ended the relationship or was in a shelter, success may be based on fewer opportunities to abuse rather than on a change in behavior. The abuser may have ended the violence due to strategies taken by his partner or action taken by the shelter, such as providing legal or financial information and support (Gondolf, 1987b).
The current body of research has examined behavior changes in individual abusers. Few studies have looked at whether the impact of the arrest and other systems’ involvement is in part responsible for ending abusive behavior. While the use of coordinated community response is increasing around the country, few studies have been done on its effectiveness or the effectiveness of community education about domestic violence in producing change in an individual abuser’s behavior and attitudes. Eisikovits and Edleson (1989) point out
While most experts acknowledge the need to trace the causes of spouse abuse to the cultural level (e.g., norms and values concerning women’s position in society), it is seldom acted on in a systemic way. It may be easier and less threatening to society to target individuals and families for change rather than norms or values that are part of an intricate web of social order.
Most research in this area indicates that some abusers become less physically violent but that programs have little or no success in ending emotional battering and controlling behaviors (Hamberger & Hastings, 1987; Saunders & Azar, 1989; Edleson, 1989). Success rates for ending physical violence range from approximately 53 - 85 percent (Tolman & Bennett, 1990). However, many studies, like one done by the Minneapolis Domestic Abuse Project, have found that after treatment most men continued to use emotionally abusive tactics, such as stomping out during arguments, insulting partners, restricting liberty, or threatening to the leave the partner (Edleson, 1989).
Currently, no one has conducted comparison research examining which method, individual, couples or group treatment is the most effective with batterers (Hart, 1990). Research on treatment methods has found no empirical evidence to support individual or couples counseling for batterers. Current literature reviews reveal that no outcome data is presently available on individual treatment of men who batter. Only a handful of studies have been done on couples counseling. These studies have many of the problems cited in the previous section. At present, couples counseling has not been proven a viable option due to the shortcomings in the existing research (Eisikovits and Edleson, 1989)
Most of the evaluation literature on batterers has examined the effectiveness of groups. Success rates vary widely. At this point little information is available about how batterers change as a result of groups, whether these changes keep abusers from using violence in the future, how group treatment aids in the change process, or what other factors may also contribute to an abuser’s changes in behavior and attitudes (Eisikovits & Edleson, 1989).
Attrition rates are an important part of determining whether or not abuser treatment programs are successfully ending domestic abuse in a community. Unfortunately, attrition is a major problem for most programs for men who batter. One survey indicated that one-third to one-half of the batterers dropped out after the first session. The AMEND program in Denver reports a 75% dropout rate after one or two sessions. The RAVEN program in St. Louis reports treating about 950 men during its 10-year span of activity—less than 2% of the estimated batterers in its vicinity. An evaluation study of the Second Step program in Pittsburgh shows that over five times as many men inquire about the program as enroll in it, and about 30% of those who enter its 12-week program drop out before the program is completed (Gondolf, 1987a).
Several studies on attrition rates conclude that dropouts may be younger or minority men, with less education and lower incomes than other men in the group (Tolman & Bennett, 1990). DeMaris (1989) studied court-ordered men and found that unemployed men and men with lower incomes were more likely to drop out of education/treatment, but found no connection with level of education. Younger men, those with younger partners, a history of prior arrest, and those with relatively low motivation to reform were more likely than others to be dropouts. In addition, men who drank or had been in trouble because of their drinking were more likely to be dropouts. In summary, men with a history of problematic adjustment in areas such as work, relations with the legal system, or alcohol consumption seem to be those who are unable to complete programs for batterers. “For some individuals, dropping out is part of a general pattern of low achievement in socially valued areas” (DeMaris, 1989).
Grusznski and Carrillo (1988) found dropouts to have less education, lower employment levels, fewer children, and to have used more threatening behavior. They were also less likely to have witnessed abuse as a child in their family of origin but more likely to have been a victim of child abuse. They did not find a connection between legal mandates for education/treatment and completing education/treatment.
Hamberger and Hastings (1989) found that dropouts were younger, had lower employment levels, and had higher pretreatment levels of police contact for AODA offenses and other offenses (not violent offenses). Personality data indicated greater borderline and schizoidal tendencies. While court-mandated participants were less likely to drop out than voluntary clients, nearly one third of court-mandated clients still dropped out.
Saunders and Parker (1989) studied whether court-mandated clients completed education/treatment more often than voluntary clients. They found for younger, non-college educated men, mandated referral was related to completion. For men who did not report severe violence, voluntary referral was more highly related to completion. Minority men were more likely to drop out.
Increasing evidence indicates that batterers are a heterogeneous population (Fagan, 1989; Hamberger & Hastings, 1989; Tolman & Bennett, 1990). Several studies indicate there may be different categories of abusers that may require different treatment methods.
Hamberger and Hastings (1988) found eight subgroups of types of batterers based on three factors: borderline or schizoid personality disorders, narcissistic or antisocial personality disorders, and passive-dependent or passive-aggressive personality disorders. The profile of group 1 is withdrawn, moody and hypersensitive, and volatile with a tendency to overreact. These abusers may exhibit a Jekyll-and-Hyde personality and their violence is likely to be impulsive and explosive.
Group 2 abusers are self-centered individuals rigidly forcing others to live by their rules and values. They believe they are superior to others and are entitled to be treated well. This group is less likely to express aggression by anger but rather to punish others when their needs and expectations are not met.
Group 3 abusers are tense, rigid individuals who lack self-esteem and need one or few significant others in their lives. Their aggression is best understood as a response to frustration and dependency needs.
The other groups are combinations of the first three groups. Group 4, is a combination of groups 1 and 2, extremely aggressive, explosive and classically a “psychopathic” personality. Group 5 is a combination of group 1 and 3, moody, with intense dependency needs and mood swings. Group 6 has the narcissist, manipulative qualities of group 2 and the dependent qualities of group 3. These men are gregarious, and superficially charming. They have strong dependency needs and react with sudden hostility when threatened. Group 7 is a combination of groups 1, 2, and 3. They show high dependency needs, are filled of anxious needs for support, have fears of separation and episodes of moodiness and dejection. Group 8 is low on factors in all 3 groups and does not show any clear pathology (Hamberger & Hastings, 1988).
Saunders (1990) found three types of abusers: “Generally Aggressive,” “Family Only,” and “Emotionally Volatile.” “Generally Aggressive” abusers are the most severely violent. They were most likely to have been severely abused in childhood and tend to be aggressive in and out of the home. They may abuse alcohol and drugs more than the other groups. Abusers in this group may have rigid sex role attitudes and high levels of anger, depression and jealousy, anti-social and narcissistic traits. They may require the most treatment including dealing with past family issues and AODA treatment.
“Family Only” are the least severely violent and are violent only in their own homes. They report little abuse in childhood and abuse alcohol only occasionally. They have more liberal sex role attitudes and have compulsive and conforming personalities. Abusers in this group may benefit from short-term treatment including assertiveness training and learning to deal with their emotions (Saunders, 1990).
The “Emotionally Volatile” group is the most psychologically abusive to their partners. They report high levels of anger, jealousy, and depression and are most likely to have attempted suicide. They may be violent outside their homes. Abusers in this group may need to be checked for borderline or depressive symptoms and would benefit from relaxation training and cognitive restructuring (Saunders, 1990).
Programs for batterers must meet the needs of special populations of abusers. Since special populations have unique issues that may contribute to higher drop-out rates, it is important to discuss some of the obstacles some abusers may experience in education/treatment programs. Articles specifically addressing issues of special populations are difficult to locate, so much of the information in this section is based on conversations with researchers and program personnel. The special populations to be discussed in this section include men of color, older men, gay men, AODA-affected men, men with limited literacy skills, women arrested as abusers and lesbian batterers. Other groups not included here that may require special consideration include the physically challenged, mentally ill, Vietnam veterans, and refugees.
A common issue for all of these groups is that they often represent a small proportion of the overall group makeup and therefore may feel isolated and different than other abusers or the facilitator(s)/therapist(s). This may cause them to be resistant and uncooperative. Discussing this openly and, when working in a group setting, finding areas of commonality among group members to show ways that members have similarities may be helpful. It is also important not to discount the significance of the additional barriers and stresses a person from a special population may feel due to societal pressures and prejudices. In groups, having more than one person from a special population, when possible, may diminish some feelings of isolation.
Other suggestions for working with special populations include encouraging facilitators to learn more about different cultures and lifestyles by attending sensitivity training and connecting with other community resources that work with these populations. When possible, staff should be from diverse backgrounds. In addition, having materials in languages other than English, considering transportation issues if certain populations live far away from the agency, portraying a culturally diverse environment in the agency, and having people of different backgrounds as guest speakers or part of videotaped presentations may help to create a more comfortable and relevant environment.
A final note on special populations: programs working with court-mandated clients should keep in mind the institutional racism and classism of the legal system. Clients may bring examples of discrimination to the education/counseling process and believe they were treated unfairly. To avoid perpetuating racism and classism, agencies should examine their own policies and practices to ensure that they are not discriminatory (Ganley, 1987).
Ideally, this section would be broken down into different ethnic groups but there is not enough information available to write about different groups separately. Instead, listed below some generalizations based on conversations with program personnel.
Racism may be a major issue for men of color. These men may feel isolated if they hear or feel racist undertones from other group members. Such comments should be considered inappropriate in groups and dealt with directly.
Some populations, such as Asian groups are not being seen in most Wisconsin programs for batterers. Program facilitators felt one reason may be the strong sense of community within some Asian communities and that these communities may be resistant to help from outside. For some Asian groups, there may be language barriers. Also, in some cases, there may be strong cultural differences regarding patriarchal family structure, domestic abuse, and taboos regarding discussing family issues outside the family or group.
American Indians are seen more frequently in some Wisconsin programs. Several culturally specific programs are located on at least three reservations. Common issues for American Indian men include chemical dependency, difficulty communicating their emotions, and exposure to general forms of violence on reservations. Some Indian men may have been taught as children that men should be in charge and may as children have seen violence everywhere as a way to resolve conflict (EMT, 1989). For American Indians on reservations, program staff recommend incorporating traditional Indian values and rituals, specifically focusing on AODA issues in group, and having at least one facilitator who is a member of the tribe.
There appear to be two types of older men in abuser education/treatment programs. The first type has been abusive all his life and sees no reason to change. He may be set in his ways and beliefs about women and may be resistant to the whole idea of education/treatment. A second group of older men may also have been violent their whole lives but may now be eager to find ways to change. They may be interested in improving their relationships with their partner or children and may fear spending the last years of their lives alone if they continue to drive their families away.
Older men may come to group with more embarrassment than younger men. They may have health issues including not being as strong as they used to be or being on new medication. Many have a history of violence in their childhood that they may never have discussed. Older men may feel out of place in a group with men the ages of their children or grandchildren.
Some program personnel suggest steering older batterers into a smaller group, having a separate group for older men, or encouraging them to participate in an aftercare program. Other ideas include using age-appropriate facilitators, spending more individual time, and including screening for medication as part of the intake process.
MOVE (Men Overcoming Violence) in San Francisco has found the major difference between gay and heterosexual violence is homophobia. At an institutional level, police tend to report mutual combat rather than domestic violence, and restraining orders can be difficult to obtain. Gay men aren’t screened by service providers for domestic violence, so they may not be given information about services that are available to them in their community.
On a personal level, homophobia impacts gay men through internalization. Abusers may threaten to expose their partner’s gay lifestyle to family or friends as a way to keep control. Gay men may feel they have nowhere to turn within the gay community. AIDS has added another dimension to domestic violence. Forced sex or blood from fights can be lethal. Also, partners may stay together longer due to health concerns (EMT, 1990).
Thirteen studies were published between 1980-1988 on incidence of alcohol intoxication and/or alcohol abuse in samples of violent men and their partners. Four studies found 53 - 70% of abusers were intoxicated at the time of the violent incident. The range of chronic alcohol abuse was 24 - 86%, and the mean was 53% (Tolman & Bennett, 1990).
Research indicates that chronic alcohol abuse is a better predictor of woman abuse than acute intoxication. Since studies suggest that approximately 50% of abusers will have alcohol abuse problems, chemical dependency assessment is recommended as part of a batterers program intake. Tolman and Bennett conclude from their literature review that there is no evidence to support the myth that drinking causes woman abuse and there is no evidence to suggest that alcohol and drug treatment will end violent, abusive and controlling behavior. However, AODA treatment is recommended when indicated because the use of drugs and alcohol will probably interfere with the process of changing battering behavior (Tolman & Bennett, 1990).
Many of the men who drop out of programs are younger, uneducated men. Programs with structured reading and writing exercises may be overwhelming for men with limited reading and writing ability. Men with limited literacy skills may be too ashamed to admit that they cannot complete or understand the work required for the group. This population may benefit from using videotapes and role plays, not requiring written homework, taping psychological testing or forms, having the material passed out in group read out loud, and allowing these members to complete the homework orally. Determining reading and writing ability should be a standard component of the intake procedure.
Increasingly, programs for batterers around Wisconsin are seeing women who have been arrested and court ordered to their treatment programs. Most program personnel feel that the majority of these women are battered women and that virtually all of these women have been abused at one time — either in their childhoods, previous relationships, the current relationship, or all of the above. Most programs have found it inappropriate to mix men and women in the same group because the experiences of battering women are markedly different from the men in the group. For abusive men to see women in group may reinforce their beliefs that their partners are equally violent and to blame for the violence. They may hold onto the belief that their partner should be in group too. Women who have been violent can benefit from anger-management techniques and learning about issues of power and control but due to gender difference, should be provided additional information, in a separate women’s only group or in individual sessions. For women who are also battered women, information about domestic violence and services available in the community may also be helpful.
Since few models presently exist for working with lesbian batterers, the first step appears to be to gather more information on the issues of lesbian battering. Michal Osier, founding member of LAVENDAR, hypothesizes that lesbian batterers may fall into three categories: those who recognize that they have a problem and wish to change; those who do not acknowledge they have a problem and exhibit patterns of victim-blaming and denial; and those who have been severely traumatized by early abuse. Each one of these groups may require different treatment techniques and methods although all three may benefit from social-political components that address society’s teachings about violence, women, and being lesbian in our culture (WCADV Newsletter, 6/90).
Length of education/treatment may also impact on attrition and recidivism. Programs vary from one-day workshops to programs running for a year and one-half or longer. Proponents of shorter programs argue that abusers are more likely to complete and therefore benefit from their programs. Critics of short programs argue that abusers need to be in education/treatment at least six months or longer if an abuser is truly going to change because it will take months or years of “learning self-control, eliminating the use of power and control over his battered partner, changing the context of his life to avoid the people, places and things that support his violence, and developing respect for women” (Hart, 1990).
The Domestic Abuse Project in Minneapolis examined program length by looking at three types of models—education, combination of therapy and education, and self-help for 12 sessions or 32 sessions. Initial results after six months indicate that 12 sessions were as effective as 32 sessions in ending violence. However, since the 32 sessions occurred in a 16 week period meeting twice a week, this study doesn’t indicate if education/treatment that last six months or longer is more effective than a shorter program offered twice a week.
Due to the limited amount of research available and the methodological problems with the current studies, no conclusive data is available to support the effectiveness of abuser treatment. Factors to consider when examining research include how success is defined, who is included in the population studied and who reports, and length of the follow-up period. Attrition rates and special populations are important factors in program effectiveness. At this time, it is unclear what role program length, categories of batterers or other variables play in changing an abuser’s behavior and attitudes. Coordinated community response and community education make it difficult to determine their role in abuser education/treatment. Clearly, more research on abuser education/treatment programs is needed.
Source: Department of Health and Social Services
Division of Community Services
Bureau for Children, Youth and Families
Author: Bonnie Brandl
http://comnet.org/bisc/brandl.html
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