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Designing a Gold Standard Intervention Program for Female Perpetrators of Intimate Partner Violence: Treatment Providers Perspectives

Robyn Yaxley – Clinical Psychologist; PhD Candidate Applied Research in Crime and Justice Conference 13 February 2020

robyn.yaxley@ utas.edu.au

The Problem

• IPV refers to physical, sexual, financial and/or psychological abuse of a current or former intimate partner.

• Females accounted for 18% of all domestic and family violence related offences recorded in Australia in 2017-2018 (ABS, 2019)

• That’s 4888 individuals in NSW up by 305 on the year before.

• Protection orders issued by Queensland Courts increased from 20.81% to 22.36% in the five years to 2018; and

• Incarceration rates for breach of protection orders increased from 162 to 353 in the same time period (Queensland Wide Inter-linked Courts, 2019).

Current Treatment Approaches for Female Perpetrators

• Focus on their victimisation & safety planning

• Add gender specific material to a male perpetrator program

• Use a gender inclusive framework

• Abusive behaviours are not gender-specific, though there may be gendered effects

• Abusive behaviours vary widely in frequency, harm and direction

• Victim and perpetrator roles can be fluid

• Use a gender-neutral framework with both partners

Treatment Efficacy

Partner Abuse - State of Knowledge Project

• Largest IPV research database in the world

• Mixed evidence for the effectiveness of perpetrator interventions

• No female intervention programs evaluated to date

• No one approach better than another

• No justification for prescriptive or restrictive approach

• Recommended broadening range of interventions beyond the typical and traditional

Characteristics of Female IPV Perpetrators

• Childhood Trauma: Physical, sexual, and emotional abuse • Family of Origin Dysfunction: exposure to IPV, parental substance abuse • Victimisation in Past and/or Current

Intimate Relationship(s) • Complex Trauma Symptoms • Compulsive, Histrionic, or Borderline

Personality Traits • Mood & Anxiety Disorders

• Previous Suicide Attempts • High rates of Head Injury • Hormonal Conditions: PMS & Menopause • Attachment Problems • Avoidant Coping Strategies • Active & Defensive Motivations • Poor educational and employment

attainment • Substance Abuse Problems • Moderate Risk-High Need • Pre/Contemplative

Methodology

• An email invitation was sent to IPV service administrators and providers identified via an internet search

• 110 completed an online survey about female IPV perpetrators and how best to respond to their treatment needs

• Participants were typically asked to rank their responses and could offer qualitative responses

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Participants

Sex

Male

Female

Location

Canada

Australia

UnitedKingdom

UnitedStates

Educational Attainment

Highest Qualification

Masters

Doctorate

Bachelors

PGCert/DipCert/Dip

Discipline

Psychology

Social Work

Other

Sociology

Criminology

Position and IPV Experience

Position

ProgramManager

Therapist/Clinician

ProgramFacilitator

Other

Years of Experience

0-5

6-10

11-15

16-20

20+

Primary Treatment Population and Approach

Treatment Population

Females

Males

Males &Females

Adolescents

Treatment Approach

CBT

Other

Feminist Based

Mi-CBT

Solution Focused

DBT

Organisational Features: Where and When

DV Service

Private Practice

Community HealthService

Mental Health Service

Other

Correctional Service

Before CJS Contact

Upon CJS Contact

Condition of CBO

Pre-Sentence

Pre-Plea

Condition of FVOrder

DuringImprisonment

Duration

• Weekly sessions of 1.5 – 2 hours

• Program Length - Diverse Opinions

• 4 weeks to unlimited access to treatment

• 12 mths most common closely followed by 6 mths (N=18 vs 15)

• The influence of current practice and/or state standards many of which arbitrarily stipulate program durations of 12 months unclear.

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Who and How

Mandatory Attendance

Yes

Sometimes

No

Coed Groups

Yes

Sometimes

No

Clinical Features: Theoretical Underpinning

• Cognitive-behavioural theory received the most support

• Social learning theory rating second in overall popularity

• Feminist based perspectives received some support despite the lack of feminist theory to explain female IPV perpetration

• Criminological perspectives such as the RNR model received little support

The Risk Principle

Risk/Treatment Matching

Yes

No

Sometimes

Don't Know

Mixing Risk Levels

Yes

No

Sometimes

Don't Know

Treatment Modality

Rank 1 Overall Endorsement

Cognitive-Behavioural Therapy Cognitive-Behavioural Therapy

Feminist Based Approaches Mindfulness Based Approaches

Mindfulness Based Approaches Motivational Enhancement

Therapy

Motivational Enhancement Therapy

Narrative Therapy Feminist Based Approaches

Contraindicated Treatment

Rank 1 Overall Endorsement

Anger Management Psychodynamic Therapy

Feminist Based Approaches Anger Management

Psychodynamic Therapy Feminist Based Approaches

Solution Focused Therapy Solution Focused Therapy

Interpersonal Therapy Interpersonal Therapy

Essential Content

• Trauma recovery treatment

• Emotional regulation skills

• Communication skills

• Cognitive restructuring

• Functional analysis

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Program Evaluation

Recidivist Rates

Participant Feedback

Pre/Post TestMeasuresPartner Feedback

Implications

• There is a pressing need for programs; and education and research to inform their development and evolution

• Service providers and the evidence base support the use of CBT based intervention programs with a focus on:

• motivational enhancement strategies

• trauma resolution

• emotional regulation skills

• substance abuse

Future Directions

• Enhance program efficacy via:

• Development of evidence-based program standards and policies to guide clinical practice

• Better dissemination of the research evidence to service providers

• Incorporating principles of effective correctional programing into training programs for service providers

• Program audits to ensure adherence to program standards

• Ongoing program evaluations and outcome studies

Questions?

For further information email:

robyn.yaxley@utas.edu.au Applied Research in Crime and Justice Conference 13 February 2020 utas.edu.au