Upload
others
View
0
Download
0
Embed Size (px)
Citation preview
RWV: Dr. R. Bierman 5-06 SEPI 1
Reduced Violence AfterRelating Without Violence
(RWV)Therapy Groups for Emotional &Relational Change in Domestically
Violent Incarcerated MenDr. Ralph Bierman, Psychologist, 2006©
RWV: Dr. R. Bierman 5-06 SEPI 2
There’s a Lot at Stake Here
“Domestic violence inflicts immensedamage to society in terms of physicaland psychological injury to victims,deaths, health care costs, prenataldamage to infants, and physical andpsychological damage to childrenexposed to violence in their homes.”
-US Department of Justice
RWV: Dr. R. Bierman 5-06 SEPI 3
Statistics 1
, “Nearly 5.3 million intimate partnervictimizations occur each year amongU.S. women ages 18 and older. Thisviolence results in nearly 2 millioninjuries and nearly 1,300 deaths (CDC,2003).”
RWV: Dr. R. Bierman 5-06 SEPI 4
Statistics 2
“experts tend to agree that there arebetween one and four million men whoassault, batter, and/or sexually assaulttheir partners each year. … husbands,ex-husbands, or boyfriends kill some1,200 women each year (Gelles, 1998in U.S. Department of Justice, 1998).’
RWV: Dr. R. Bierman 5-06 SEPI 5
Statistics 3
“Every twelve seconds, twenty-four hours aday, every day of the year, a woman ispunched, kicked, slapped, or worse.” Theauthor goes on to note that every decademore women die as a result of domesticviolence than the total number of Americanswho died in the Vietnam War, and twothousand American children are beaten andstarved to death every year. (Solomon inCohen and Hossein, eds., 1999)
RWV: Dr. R. Bierman 5-06 SEPI 6
Outline of This Presentation
Participant selection & characteristicsTheory re emotional processes fueling
domestic violenceThe RWV integrative treatment programEvaluating changes in emotional processes
& in abusive behavior Pre-Post 3 Year Follow up Recidivism
RWV: Dr. R. Bierman 5-06 SEPI 7
II: PARTICIPANTSELECTION
Institutional ScreeningGroup Process ScreeningParticipant Characteristics
RWV: Dr. R. Bierman 5-06 SEPI 8
Phase 1 of Candidate Selection is byInstitutional Screening of Treatability
After several months in OCI's milieu treatment, (seehttp://www.hometown.aol.com/ocibrampton/info.html)
Incarcerates interested in RWV complete application formsto meet criteria of acknowledging violent behavior andtaking responsibility
Residential unit staff recommend selected applicants:– perceived as ready to look at themselves– not psychopaths– functionally literate
Chiefs of Psychology and of Social Work select 12-14 menfor Orientation to RWV
RWV: Dr. R. Bierman 5-06 SEPI 9
Phase 2 of Candidate Selectionis by Group Process Screening
Introducing each other by expressing “How violence has been destroying my life and the
lives of those I love” (Can they own responsibility?) “What I want to get out of RWV”
Receiving information about RWV content,methods & time requirements; Discussing fears,concerns, misgivings: trust issues come out front
Sampler Session: Deciding whether to participateafter sampling cognitive & experiential processes
RWV: Dr. R. Bierman 5-06 SEPI 10
The participants in OCI’sRWV groups
The menmean age: 30 yearslength of stay at O.C.I. before beginning RWV:
mean of 4.6 monthshistories of physical, sexual or psychological
assaultusually 12-14 men start each group, 2 drop out
The leaders: RB co-leading with a woman34 groups conducted since 1988
RWV: Dr. R. Bierman 5-06 SEPI 11
III: WHAT’S GONEWRONG?
Effects of Abusive Power RelationshipsMan-WomanParent-Child
At macro cultural level & at micro family andindividual level
RWV: Dr. R. Bierman 5-06 SEPI 12
The Men’s Emotional Damage1: Theory re Shame-Rage CyclePainful boyhood memories breeding shame:
Traumatic experiences: abuse / neglect / life threateningevents
Contempt, humiliations, especially by fathersParental failures of empathic attunement
Destructive defenses for shameAvoidance: substance abuse; hedonism; dissociationAnger-Out: Rage at others who trigger shame experience
Shame-Rage LinkageShame: fearful anticipation of others’ contemptSo aversive that it is masked by rage. Rage = response to
perceived attack on self Vs. anger = response to frustration
RWV: Dr. R. Bierman 5-06 SEPI 13
The Men’s Emotional Damage2: Posttraumatic Stress DisorderRe-experiencing: sudden, vivid memories
with painful emotions, flashbacksAvoidance: avoiding situations associated
with the trauma; emotionally numb,disconnected from life
Hyperarousal: irritable; angry, poor sleep,poor concentrating
Impaired day to day functioning
RWV: Dr. R. Bierman 5-06 SEPI 14
IV: What Happens In RWV?
Program StructureTherapy Outline
Emotional Change ProcessesRelationship Change Processes
RWV: Dr. R. Bierman 5-06 SEPI 15
RWV Program Structure
Time: weekly for 13 weeks– 3.5 hours in group– 1.5 hours individual– 1 hour homework dyad + readings & videos
Major Modules weekOrientation, Sampling & Contracting 1-2Therapy for Emotional Change: 2-7Therapy for Relationship Change 8-12Closing & Sharing Assessed Changes 13-14
RWV: Dr. R. Bierman 5-06 SEPI 16
RWV Therapy Outline
Emotional Change Self-Experiencing and
Empathizing , inmutual helping dyadsand in group sessions,for processingchildhood shame thatfuels rage and violencein the man-womanpower struggle
Relationship ChangeDialoguing to resolve
conflict, reducedistancing, empathizewith abuse victim andto meet each other’sneeds instead of beinglocked in the man-woman powerstruggle.
RWV: Dr. R. Bierman 5-06 SEPI 17
THERAPY FOR EMOTIONALCHANGE:Basic Processes
Processing emotional distress via Shared Self-Experiencing:– Learn & practice “Experiential Focusing” skill– Process & talk out Vs. avoid & act out distress
Communicated empathy with one another– Skilled Listening & Understanding Vs. Fixing– Respect Vs. Dominating, Controlling
Processing trauma via EMDR
RWV: Dr. R. Bierman 5-06 SEPI 18
EMOTIONAL CHANGE:FOCUSING
Experiential Focusing: attending to the bodily feltsense of a problem; a series of steps toencourage interaction of the felt sense withsymbolic awareness
recovering feelings and associated inner-childmemories
letting go of the armored male mystique,becoming a vulnerable human being
working through childhood trauma and shamefueling rage
completing unfinished business in imaginarydialoguing with their own abusers
RWV: Dr. R. Bierman 5-06 SEPI 19
Gendlin's 6 Focusing Steps
1. Clearing a Space 2. Finding a Felt
Sense 3. Getting a Handle
4. Resonating 5. Asking
6. Receiving
RWV: Dr. R. Bierman 5-06 SEPI 20
RWV 10 Focusing Steps: 1-4
1) Relaxing and thought quieting 2) Getting the bodily felt sense of a life
issue 3) Getting a “handle” for the felt sense by
identifying where it is bodily felt anddescribing the quality of the feeling
4) Accepting the felt sense, adopting acaring, interested attitude
RWV: Dr. R. Bierman 5-06 SEPI 21
RWV 10 Focusing Steps: 5-7
5) Immersing oneself in the bodily feltsense, losing the mind-body duality andbecoming one with the felt experience
6) Receiving words and images from thefelt sense
7) Regressive experiencing, receivingwords and images of when this bodily feltsense first happened (“Float back technique”)
RWV: Dr. R. Bierman 5-06 SEPI 22
RWV 10 Focusing Steps: 8-9
8) Unfinished business imaginarydialoguing
9)Accessing internal resources forrelating to oneself in new ways --self-nurturing to fulfill unmetaffectional and self-regard needsinstead of oppressing oneself as didthe hostile introject
RWV: Dr. R. Bierman 5-06 SEPI 23
RWV 10 Focusing Steps: 10
10) Closing -- surfacing, processingthe experience, and receivingresonance from fellow therapy groupmembers.
RWV: Dr. R. Bierman 5-06 SEPI 24
Treatment Example of RWVEmotional Processing
3 volunteers read aloud from handout. One asT (Therapist), one as P (Participant), andone reading explanatory text.
RWV: Dr. R. Bierman 5-06 SEPI 25
EMOTIONAL CHANGE 2a:Guided Focusing Exercises“What Is a Bodily Feeling?”
attending to the bodily felt sense of a problem
Parent Dialogue
completing unfinished business with their ownremembered childhood physical, sexual oremotional abusers
RWV: Dr. R. Bierman 5-06 SEPI 26
EMOTIONAL CHANGE 2b:Guided Focusing ExercisesCritic Dialoguereplacing destructive self-shaming self-talk, characterized by
degrading their worth as persons, with a constructive styleof confronting their hurtful behavior. “You cannot treatother people better than you treat yourself”
Re-parenting & Self-Nurturingnurturing their own internal hurt child. Giving themselves the
care they never received as children.
RWV: Dr. R. Bierman 5-06 SEPI 27
EMOTIONAL CHANGE: EMDRfor Overcoming Traumatic Stress
Eye MovementDesensitization &Reprocessing
Discovered and developed byDr. Francine Shapiro
Meta-Analysis of all treatmentsfor PTSD: “EMDR is effectivefor PTSD, and that it is moreefficient than other treatments”
EMDR on APA’s Division ofClinical Psychology list of“empirically validatedtreatments,” as “probablyefficacious for civilian PTSD”
RWV: Dr. R. Bierman 5-06 SEPI 28
EMOTIONAL CHANGE -EMDR : What a client does images a distressing life event, with associated
bodily felt sense & negative thoughts about selfwhile following an object with their eyes as it
rapidly moves from side-to-side or hearing tonesin one ear and then the other or being tapped onone knee then the other
shares new feelings, thoughts and images thatarise after each set of bilateral stimulation;keeping these in mind while...
repeating sets of right-left stimulation untilexperiencing the big relief of “It’s over!”
RWV: Dr. R. Bierman 5-06 SEPI 29
THERAPY FORRELATIONSHIP CHANGE
Dialoguing skill to resolve conflictsTime-OutsClosing Exits: reducing relational
avoidanceVictim Empathy via “My Partner’s Issues
with Me” dialogues:– Impact of my verbal abuse– Impact of my physical abuse
RWV: Dr. R. Bierman 5-06 SEPI 30
From Abusive Fighting toConstructive Conflict Processes
Emotionally abusive fightingDesired conflict processesDialoguing guidelines
In-Session change to desired conflictprocesses: transcript & tape
RWV: Dr. R. Bierman 5-06 SEPI 31
Emotionally Abusive Fighting
Accepting her influence & acceding to herrequests represents a loss of face. Batterersrespond with:
Contempt: insulting, demeaning– “fat cow” “ugly bitch” “piece of shit” “good for nothin.” “dummy”
“stupid idiot” “Why are you being such a bitch?” “Are youemotionally dead?” -- not thinkin at the time that it's fear.
Domineering: suppressing, squelching– “Shut up” “Enough. That's it.” She tries to talk to me and I storm
off. I'll break something that she likes. I once threw the cat througha window. “Beat it! Get out of my face.” “Fuck off!”
RWV: Dr. R. Bierman 5-06 SEPI 32
Squelch!
RWV: Dr. R. Bierman 5-06 SEPI 33
Desired Conflict Processes
1. Delineate the issues
2. Identify the negative interaction cycle
3. Access underlying unacknowledged feelings
4. Redefine the problem(s) in terms of the underlying feelings
5. Promote identification with disowned needs and aspects of self
6. Promote acceptance by each partner of the other partner'sexperience
7. Facilitate the expression of needs and wants to restructure theinteraction
8. Establish the emergence of new solutions
9. Consolidate new positions
RWV: Dr. R. Bierman 5-06 SEPI 34
Dialogue Guidelines
EXPRESSING AN ISSUE OPEN A TALK TIME
– Appreciate a positive EXPRESS YOUR BEEF
– “I feel...when you do...”– Describe your bodily felt
sense EXPRESS UNDERLYING
CHILDHOOD WOUND SWITCH TO HEAR
PARTNER’S SIDE SAY WHAT YOU DO
WANT INSTEAD
RECEIVING PARTNER’SBEEF
“I'M READY TO LISTEN.”– Assume active listening
position PARAPHRASE, CHECK IT
OUT, ASK FOR MORE SUMMARIZE VALIDATE: “I understand
you and you make sense tome.”
EMPATHIZE
RWV: Dr. R. Bierman 5-06 SEPI 35
In-Session Desirable ConflictInteractionsSTEPS OF COUPLES EFT
1.Delineate issue2.Identify negative cycle3.Access underlying feelings4.Redefine problem by above5. Identify with disowned
needs6. Accept other’s experience7. Express needs & wants to
restructure relationship8.New solutions
3.ACCESS VIA FOCUSING
a. Attend to felt senseb. Waiting for the unformedc. Unfolding felt sense in all
its components:i body sensationsii emotionsiii life situationsiv symbolsv beliefs about oneself
d. Felt shift
RWV: Dr. R. Bierman 5-06 SEPI 36
In-Session Change to DesirableConflict Interactions
The Transcript Road Map E: = Expresser, R: = Receiver, T: = Therapist Headings indicate the steps of the Couples Dialogue Guidelines which
the men are following.
Footnotes, numbered in bold, describe the desired interactions.
Annotations within the footnotes with brackets and numbers, e.g.[Step 3], refer to steps in the Table of Desired Conflict Interactions.
The annotations and footnotes provide us with markers forrecognizing the men’s changes to desired conflict interactions thathappen during RWV sessions.
RWV: Dr. R. Bierman 5-06 SEPI 37
Treatment Example of DesirableConflict Interactions
RWV: Dr. R. Bierman 5-06 SEPI 38
V: Does RWV Repair theDamage?
Before-After Changes inShame
PTSD
Power & controlAnger & Defensiveness
RWV: Dr. R. Bierman 5-06 SEPI 39
Evaluating Pre-Post Changes:Measures Internalized Shame Scale
Post-traumatic Diagnostic ScaleConflict Tactics Scale, adapted formPersonality Research Form - Form E
State-Trait Anger Expression Inventory::self-perception & staff perception forms
RWV: Dr. R. Bierman 5-06 SEPI 40
Internalized shameshame decreases
0 20 40 60 80 100
ISS Percentile
Internalized Shame
INTERNALIZED SHAME DECREASES DURING RWV
POSTPRE
Toxiclevelof shame withdysfunctionaldefenses
Averagemaleshame
Shame Emotions: Feelings of inferiority, worthlessness, inadequacy, of being diminished,emptiness ...
RWV: Dr. R. Bierman 5-06 SEPI 41
PTSDPTSD symptoms improve
0
10
20
30
40
50
60
Sym
pto
mS
ever
ityS
core
Symptom Severity
POST TRAUMATIC SYMPTOM SEVERITYDECREASES DURING RWV
PRE Severeto
ModeratePOSTModerate
Maximumpossible
Severity of Reexperiencing, Avoidance & Arousal
RWV: Dr. R. Bierman 5-06 SEPI 42
RWV reduces in-prison coercivepower & control behaviorpower & control behavior!
0 1 2 3 4 5 6 7 8 9 10
Negative Conflict Tactics Scores
Abusive, RWV
Abusive, No RWV
Nonabusive, NoRWV
RWV Reduces Coercive Power & ControlSignificantly More Than Other Treatments
After
Before
0 1 2 3 4 5 6 7 8 9 10
Negative Conflict Tactics Scores
Abusive, RWV
Abusive, No RWV
Nonabusive, NoRWV
RWV Reduces Coercive Power & ControlSignificantly More Than Other Treatments
After
Before
RWV: Dr. R. Bierman 5-06 SEPI 43
RWV reduces hostilityhostility!
46 48 50 52 54 56 58 60
Standard Scores on Aggression (PRF)
ABUSIVE, RWV
ABUSIVE, NO RWV
NON-ABUSIVE, NO RWV
RWV Reduces Hostility Substantiallyand Significantly More Than Milieu Therapy Without RWV
After
Before
RWV: Dr. R. Bierman 5-06 SEPI 44
RWV reduces defensivenessdefensiveness!
40 42 44 46 48 50 52 54 56 58 60
Defendance Standard Scores (PRF)
Abusive, RWV
Abusive, NoRWV
Nonabusive, NoRWV
RWV with Milieu Reduces Defensiveness Substantiallyand Significantly More Than Milieu Treatment Without RWV
After
Before
RWV: Dr. R. Bierman 5-06 SEPI 45
Staff see men as less angry inangry inprisonprison
0
5
10
15
20
25
30
35
40
STA
XIR
awS
core
s
Trait Anger
STAFF PERCEIVE MEN AS EXPERIENCING LESS ANGER DURING RWV
Max
Pre
Post
Experiencing angry feelings & feeling unfairly treated by others
RWV: Dr. R. Bierman 5-06 SEPI 46
Men see themselves as lessangryangry
40 45 50 55 60 65 70 75
STAXI Standard Scores
Total Anger Expression
Angry Reaction
RWV Reduced Men's Experienced andExpressed Anger
AfterBefore
Trait Anger
Anger Expression Out
RWV: Dr. R. Bierman 5-06 SEPI 47
RWV REPLICATION
CAN RWV RESULTS BE REPLICATEDBY A THERAPIST OTHER THAN
RWV’S CREATOR?
RWV: Dr. R. Bierman 5-06 SEPI 48
RWV Changes ReplicatedAggression
Pre-post Differences for RWV Groups: Bierman (1) &Scapinello (2)
59
62
51
51
0 10 20 30 40 50 60 70
1
2
RW
VG
rou
ps
Standard Scores on Aggression (PRF)
post
pre
RWV: Dr. R. Bierman 5-06 SEPI 49
RWV Changes ReplicatedDefensiveness
Pre-post Differences for RWV Groups: Bierman (1) & Scapinello(2)
59
58
50
50
45 50 55 60
1
2
RWV Grps1
&2
Defedence (Defensiveness) Standard Scores
Post
Pre
RWV: Dr. R. Bierman 5-06 SEPI 50
RWV Changes ReplicatedTrait Anger
Pre-post Trait Anger Differences for RWVGroups: 1 (Bierman) & 2 (Scapinello)
65
67
55
51
0 20 40 60 80
1
2Group 1 &2
Staxi Standard Scores for Trait Anger
Post
Pre
RWV: Dr. R. Bierman 5-06 SEPI 51
RWV Changes ReplicatedAngry Temperament
Pre-post Differences for Staxi-AngryTemperament for RWV Groups: 1 (Bierman) & 2
(Scapinello)
65
68
53
58
0 20 40 60 80
1
2
RW
VG
roup
s
Staxi Standard Scores for Angry Temperament forRWV Groups 1 and 2
Post
Pre
RWV: Dr. R. Bierman 5-06 SEPI 52
RWV Changes ReplicatedTotal Angry Expression
Pre-post Total Anger Expression Differences for RWVGroups: 1 (Bierman) & 2 (Scapinello)
72
66
55
50
0 10 20 30 40 50 60 70 80
1
2
Gro
up
Staxi Standard Scores for Total Anger Expression
Post
Pre
RWV: Dr. R. Bierman 5-06 SEPI 53
Participant NarrativeFeedback “more aware of my feelings ... better able to talk instead of
throwing things or hurt someone ... learned to trust others.”
“I am not filled with hatred.”
“I realized I could get in touch with my feelings. I feel amore caring and understanding attitude.”
“I’m more aware of my feelings, as well as my bodilyfeelings. … if I’m feeling angry I get a stirring insideand a lot of times it’s not always the same thing, it’susually different. Plus I saw that I react to certain thingsbecause of how I reacted to some events in my childhood,and how I grew up knowing no different. And now I canchange that”.
RWV: Dr. R. Bierman 5-06 SEPI 54
Participant Evaluation atRelease
RWV: Dr. R. Bierman 5-06 SEPI 55
Evaluating long term-change:3-year follow up recidivism dataSubjects: 74 men with complete pre-post
data, released at least 3-years whenrecidivism studied
Data from Ontario records of convictionsand dispositions pre and post RWV re:
Measures: Types of offenses; Severity ofoffenses; Sentence length
RWV: Dr. R. Bierman 5-06 SEPI 56
Post-OCI Frequency of ViolentOffences Declined
0.00% 5.00% 10.00% 15.00% 20.00% 25.00% 30.00% 35.00%
Participants Offending Violently
1
Pre OCI
Post 3-years
RWV: Dr. R. Bierman 5-06 SEPI 57
Post-OCI Severity Rating ofOffences Declined
0 5 10 15
1
Median Offense Severity:Higher number = Less severe offense
Pre OCI
Post 3-Years4
10
RWV: Dr. R. Bierman 5-06 SEPI 58
Post-OCI Mean Sentence LengthReduced by 58%
0 200 400 600 800
1
Sentence Length
OCI Offense
Post 3-years
RWV: Dr. R. Bierman 5-06 SEPI 59
RWV: a breakthrough intreatment of domestic violence ?Recidivism indicators all point to substantial
and significant reduction in violent crime afterdomestically violent men completed RWVtreatment groups at the OCI.
“ It is unclear at this time whether any of theseprograms are more effective than no treatment“ – from review of “Group InterventionPrograms for Batterers”
“very few of these programs have beenevaluated rigorously to assess theireffectiveness” – CDC, 2004
RWV: Dr. R. Bierman 5-06 SEPI 60
Cautious interpretation of results
Limitations in the data: We have no data on recurrence of
emotional, psychological abuse. The data only show those reported or caught
for criminal behavior. The data are specific to an incarcerated
population. We don’t know the impact of RWV onnon-incarcerated abusers who haven’t been soseverely punished.
RWV: Dr. R. Bierman 5-06 SEPI 61
Further study should address:
Relation of recidivism to key pre-post personalitychanges e.g. reduced shame, aggression. (Inpreparation)
Rate of recidivism comparing RWV graduateswith a matched comparison group of Ontarioincarcerates.(See next set of slides)
Follow up data gathered directly from intimatepartners
RWV effectiveness with non-incarceratedoffenders & violent women.
RWV: Dr. R. Bierman 5-06 SEPI 62
RECIDIVISM
RWVV.
NO TREATMENT
RWV: Dr. R. Bierman 5-06 SEPI 63
RECIDIVISM: COMPARISONSAMPLECreated by the Program Effectiveness,
Statistics and Applied Research Unit ofOntario’s Ministry of Community Safety andCorrectional Services
76 offenders matched for the most frequentlyoccurring offences in the RWV group
An indicator of the potential for spousal violence is thepresence of a “Partner Abuse Flag” in thecomputerized record (Offender Tracking InformationSystem). Nineteen percent of the RWV group and fourpercent of the Comparison group were so flagged withHigh Specific Risk for Violence
RWV: Dr. R. Bierman 5-06 SEPI 64
RECIDIVISM: RWV V. NO THERAPYOVERALL REOFFENDING
RWV V. NO TREATMENT ONOVERALL RECIDIVISM FOR
HIGH RISK
26%
36%
0% 10% 20% 30% 40%
1
RW
Vv.
NO
TREATMENT
% Who Reoffend
NO Treat
RWV
RWV: Dr. R. Bierman 5-06 SEPI 65
RECIDIVISM: RWV V. NOTHERAPY- REOFFENSESENTENCING
64%89%
26%11%
0% 20% 40% 60% 80% 100%
Percent Sentenced
PRISON
PROBATION
RWV V. NO TREATMENT ON REOFFENSESENTENCINGFOR HIGH RISK
No Therapy
RWV
RWV: Dr. R. Bierman 5-06 SEPI 66
RECIDIVISM: RWV V. NOTHERAPY- REOFFENSE CONTACTS
40
32
11
64
89
0
10
20
30
40
50
60
70
80
90
Percent
CS PRO WOC
Type of Recontact
Recontacts for High SPECRISK Offenders
RWV
COMP
RWV: Dr. R. Bierman 5-06 SEPI 67
REOFFENSE CONTACTS
CS = Community Service PRO= ProbationWOC = Warrant of Committal TO Custodial
Sentence There was a differential recidivism rate for high Specific
Risk/Need offenders. Of the RWV group, 26% recidivated;in the COMP group 36% recidivated. Figure 66 shows thatthe recidivists from the RWV group were less likely toreceive custodial sentences for post RWV offences thanthose in the non RWV comparison group. Of the RWVgroup 64% received subsequent custodial sentences vs89% for the COMP group.
RWV: Dr. R. Bierman 5-06 SEPI 68
RECIDIVISM: RWV V. NOTHERAPY- DAYS IN COMMUNITY
422
343
050
100150200250300350400450
Days inCommunity
Group
Days Out Between Episodes
RWV
COMP
RWV: Dr. R. Bierman 5-06 SEPI 69
RECIDIVISM: RWV V. NOTHERAPY- SURVIVAL TIME
S u rv iv a l o f H ig h L S I S P E C R IS K O ffe n d e rs
D A Y S O
2 52 01 51 05 00
CumSu r
1 .
.
.
.
.
0 .
G R O U
C oO
RWV: Dr. R. Bierman 5-06 SEPI 70
RECIDIVISM: RWV V. NO THERAPY
RWV – Durability of changes: YES RWV pre-post gains in reduced aggression are
sustained after 3 years.RWV – Better than no treatment: ?
Apparently RWV works better.than no treatment withoffenders flagged as at high specific risk for repeatedviolence. This strengthens the evidence that RWVaddresses the issues fuelling violent behavior and notgeneral criminality
The treatment effect could be strengthened with: (1)follow-up/maintenance/booster sessions, (2) addressingtheir serious addiction disorders
RWV: Dr. R. Bierman 5-06 SEPI 71
VI: RWV FEATURES
Uniqueness & ParallelsIntegrative
Learning Methods
RWV: Dr. R. Bierman 5-06 SEPI 72
RWV & other domestic violencetreatments
RWV Uniqueness 2-tier treatment; progressive
phases Voluntary psychotherapy after
strong sanctions Process Experiential +
Developing “EmotionalIntelligence” skills + Learningprinciples
Reduces Shame & Traumawhich fuel rage, lowers anger
Integrative Focus: both relatingto self & to others; on origins &present
Retains men in treatment
Parallels with Other Approaches Profeminist: egalitarian
democratic man-womanrelationship; control patternaddressed; batterer fullyresponsible for violent behavior
Family: communication &conflict resolution
Psychodynamic: childhoodorigins of shame & trauma
Cognitive-Behavioral:modifying thoughts & behaviorin current situations; “self-talk”;“time outs”; time limited
RWV: Dr. R. Bierman 5-06 SEPI 73
RWV: Integrating ProgramQualities
structured focused time-limited psychotherapy & skill building personal & relational integrating social learning, experiential, cognitive-
behavioral, and psychodynamic therapy principles group, dyadic, & individual modalities
RWV: Dr. R. Bierman 5-06 SEPI 74
RWV: An IntegrativePsychotherapy-1
RWV PROCEDURE Focusing core Focusing “Float-back” Focusing Self-Nurture Empathic responding
by participantsHelper-Helpee dyads
TX APPROACH Experiential, Gendlin Psychodynamic Experiential, EFT Experiential,
Interpersonal Experiential,
Interpersonal
RWV: Dr. R. Bierman 5-06 SEPI 75
RWV: An IntegrativePsychotherapy-2
EMDR
Self-talk guidelines &logs
Imago Relationship
Cognitive-behavioral,Experiential
Cognitive
Psychodynamic,Interpersonal,Experiential
RWV: Dr. R. Bierman 5-06 SEPI 76
RWV Skill Learning Methods
Cognitive/Conceptual learning: reading anddiscussing re basic skills; printed handouts
Graduated Practice of skill components: inGroup; Homework Dyads; 1-1s
Modeling positive communication: tapes;transcripts
Reinforcement: explicit appreciation of skillActive Guiding: prompting, suggesting
RWV: Dr. R. Bierman 5-06 SEPI 77
ADDITIONAL RESOURCES
Bierman, R. (1996-1997). Focusing in therapy withincarcerated domestically violent men. The Folio: AJournal for Focusing and Experiential Therapy, 15,47-58.
Bierman, R. & Cheston, J (1996) Relating WithoutViolence: A Manual for a Treatment Program forDomestically Abusive Men. Program Manual, OntarioCorrectional Institute , 109 McLaughlin Road South,Brampton, Ontario L6V 2P1 Canada.
Wolfus, B. & Bierman, R. (1996). An evaluation of agroup treatment program for incarcerated malebatterers. International Journal of Offender Therapyand Comparative Criminology, 40, 318-333.
RWV: Dr. R. Bierman 5-06 SEPI 78
For further information, pleasecontact ...
Dr. Ralph Bierman, Psychologist
55 Harbour Square - Suite 1612Toronto, Ontario M5J 2L1 Canada
Phone 416-777-1652
Fax 416-777-2518
e-mail: [email protected]
Web: http://www.torontotherapist.com/