Do Anger Management and Batterers’ Do Anger Management and Batterers’

Treatment Programs Work?Treatment Programs Work?

Stephen E. Doyne, Ph.D.Stephen E. Doyne, Ph.D.

San Diego Certified Family Law San Diego Certified Family Law Specialists Spring Seminar Specialists Spring Seminar

April 15, 2010April 15, 2010

Types of TreatmentTypes of Treatment

Anger Management GroupsAnger Management Groups Absence of violent behaviorAbsence of violent behavior Treatment of shorter durationTreatment of shorter duration

Domestic Violence Treatment GroupDomestic Violence Treatment Group Violent/aggressive behaviorViolent/aggressive behavior Often Court-ordered of 52-week durationOften Court-ordered of 52-week duration

Psycho Educational Duluth ModelPsycho Educational Duluth Model The power and control wheel is used to illustrate the The power and control wheel is used to illustrate the

pattern of abuse that includes intimidation, male pattern of abuse that includes intimidation, male privilege, isolation, emotional and economic abuse.privilege, isolation, emotional and economic abuse.

Types of TreatmentTypes of Treatment

Cognitive-Behavioral Group TreatmentCognitive-Behavioral Group Treatment Adopts a social-learning information processing Adopts a social-learning information processing

perspective that violence occurs because it is perspective that violence occurs because it is functional for the user and because the perpetrator functional for the user and because the perpetrator has cognitive and behavioral distortions and deficits. has cognitive and behavioral distortions and deficits. A variety of skills training programs that focus on A variety of skills training programs that focus on communication, assertiveness, anger management communication, assertiveness, anger management techniques (e.g., time outs, relaxation techniques, techniques (e.g., time outs, relaxation techniques, cognitive restructuring, self-instructional training and cognitive restructuring, self-instructional training and relapse prevention) are employed.relapse prevention) are employed.

Features of Treatment Features of Treatment with Battererswith Batterers

The most appropriate treatment modality for The most appropriate treatment modality for physically abusive males are “men only” specialized physically abusive males are “men only” specialized groups operating within coordinated community groups operating within coordinated community response networks. This promotes mens’ accountability response networks. This promotes mens’ accountability for changing violent behaviors, developing non-violent for changing violent behaviors, developing non-violent resolution skills and receiving specialized services resolution skills and receiving specialized services such as treatment for substance abuse.such as treatment for substance abuse.

The recommended duration of intervention ranges The recommended duration of intervention ranges from twelve to fifty-two weeks with group intervention from twelve to fifty-two weeks with group intervention the format of choice.the format of choice.

Couples therapy is deemed inappropriate or engaged Couples therapy is deemed inappropriate or engaged in with caution. There is concern that women’s in with caution. There is concern that women’s disclosures in the presence of parties may lead to later disclosures in the presence of parties may lead to later retribution or imply that she is at least partially to blame retribution or imply that she is at least partially to blame for the victimization. for the victimization.

Assessing the Degree Assessing the Degree of Changeof Change

Has he (or she) made full disclosure of his history Has he (or she) made full disclosure of his history of physical and psychological abuse?of physical and psychological abuse?

Has he recognized that abusive behavior is Has he recognized that abusive behavior is unacceptable?unacceptable?

Has he recognized that abusive behavior is a choice?Has he recognized that abusive behavior is a choice? Does he show empathy for the effects of his actions Does he show empathy for the effects of his actions

on his children?on his children? Can he identify his pattern of controlling behaviors Can he identify his pattern of controlling behaviors

and entitled actions?and entitled actions? Has he replaced abusive with respectful behaviors Has he replaced abusive with respectful behaviors

and attitudes?and attitudes? Is he willing to make amends in meaningful ways?Is he willing to make amends in meaningful ways? Does he accept consequences for his behavior?Does he accept consequences for his behavior?

Female BatterersFemale Batterers There is research to indicating that for females who There is research to indicating that for females who

have a history of conduct disorders, the female have a history of conduct disorders, the female partner has been found to initiate and contribute to partner has been found to initiate and contribute to mutually aggressive partner episodes. One-half of mutually aggressive partner episodes. One-half of violent episodes reported to intimate relationships violent episodes reported to intimate relationships involve men and women being mutually aggressive. involve men and women being mutually aggressive.

Don Dutton, Ph.D. estimates half of all intimate Don Dutton, Ph.D. estimates half of all intimate partner violence is caused by women.partner violence is caused by women.

A majority of women abusers are abused by men A majority of women abusers are abused by men and are using violence to get them to stop.and are using violence to get them to stop.

Female BatterersFemale Batterers Men victims are less likely to report than women Men victims are less likely to report than women

due to shame, mechanisms of fear of humiliation due to shame, mechanisms of fear of humiliation and/or retribution.and/or retribution.

Minority of female perpetrators batter for the same Minority of female perpetrators batter for the same reasons as men.reasons as men.

Treatment programs are best as “women only” Treatment programs are best as “women only” groups. Completers are less likely to be passive-groups. Completers are less likely to be passive-aggressive (provocative) or use physical force on aggressive (provocative) or use physical force on their partner.their partner.

ComplianceCompliance Anger management programs have better Anger management programs have better

compliance than domestic violence groups due to compliance than domestic violence groups due to shorter duration and less sociopathic population.shorter duration and less sociopathic population.

There is a high drop out rate from batterers’ There is a high drop out rate from batterers’ treatment programs even among Court mandated treatment programs even among Court mandated batterers. There is a need to focus on retention batterers. There is a need to focus on retention techniques and on motivational interviewing techniques and on motivational interviewing procedures that are designed to increase the procedures that are designed to increase the batterers’ participation and investment. batterers’ participation and investment.

Men who complete the batterers’ treatment program Men who complete the batterers’ treatment program tend to be more educated, more likely to be tend to be more educated, more likely to be employed, married and Caucasian and less likely employed, married and Caucasian and less likely to have a criminal record.to have a criminal record.

ComplianceCompliance

Completers have a higher stake in social conformity Completers have a higher stake in social conformity and are “socially bonded,” not isolated and have and are “socially bonded,” not isolated and have something to lose. something to lose.

Battering treatment programs need to be one Battering treatment programs need to be one component of a coordinated community response component of a coordinated community response that involves police response, prosecution and that involves police response, prosecution and probation as well as treatment options.probation as well as treatment options.

Outcome of Treatment Outcome of Treatment with Batterers with Menwith Batterers with Men

Approximately two-thirds of men who complete group Approximately two-thirds of men who complete group intervention programs for domestic violence remain intervention programs for domestic violence remain non-violent in their intimate relationships. However, non-violent in their intimate relationships. However, some twenty percent of men continue to be severely some twenty percent of men continue to be severely violent in intimate relationships. These men tend to drop violent in intimate relationships. These men tend to drop out of treatment and have substance abuse problems.out of treatment and have substance abuse problems.

Treated batterers have a forty percent chance of being Treated batterers have a forty percent chance of being successfully nonviolent. But non-treated batterers have successfully nonviolent. But non-treated batterers have a thirty-five percent chance of maintaining nonviolent a thirty-five percent chance of maintaining nonviolent behaviors. behaviors. There is only about a five percent increase There is only about a five percent increase in success rate attributable to treatmentin success rate attributable to treatment. .

There are no significant differences between various There are no significant differences between various forms of batterers’ treatment programs (e.g., Duluth forms of batterers’ treatment programs (e.g., Duluth model versus Cognitive Behavioral Intervention). model versus Cognitive Behavioral Intervention).

Duluth Power and Control WheelDuluth Power and Control Wheel

Can We Improve the Efficacy of Can We Improve the Efficacy of Treatment Programs?Treatment Programs?

Choose carefully who goes to treatment – whether it Choose carefully who goes to treatment – whether it is anger management or domestic violence groups.is anger management or domestic violence groups.

Exert more effort on pre-intervention preparation. Exert more effort on pre-intervention preparation. Use motivational interviewing procedures and work Use motivational interviewing procedures and work

on developing and maintaining a therapeutic on developing and maintaining a therapeutic alliances.alliances.

Have close monitoring of treatment, non-compliance Have close monitoring of treatment, non-compliance and legal sanctions for non-adherence.and legal sanctions for non-adherence.

Can We Improve the Efficacy of Can We Improve the Efficacy of Treatment Programs?Treatment Programs?

Target specific examples of batterers (e.g., different Target specific examples of batterers (e.g., different types of batterers: family only, Borderline Personality types of batterers: family only, Borderline Personality Disorders who have a history of victimization and Disorders who have a history of victimization and Antisocial Personality Disorder/generally Antisocial Personality Disorder/generally violent types).violent types).

Tailor interventions for diverse ethnic minorities.Tailor interventions for diverse ethnic minorities. Assess need for concurrent treatment such as Assess need for concurrent treatment such as

substance abuse and trauma-focused interventions.substance abuse and trauma-focused interventions. Maintain close coordination with other mental health Maintain close coordination with other mental health

practitioners for the family or agencies.practitioners for the family or agencies.

““I and the public knowI and the public knowWhat all school children learn,What all school children learn,Those to whom evil is doneThose to whom evil is doneDo evil in return.”Do evil in return.”

– – W.H. AudenW.H. Auden