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Intervention and Recurrence the Effect of Therapy on Domestic Violence Recidivism
Research Paper Rough Draft
Dr. Eric Brownlee
Research paper submitted to the Faculty of
Gannon University in partial fulfillment of the requirements for the degree of
It has long been the case that one in four American women will suffer domestic violence in their lifetime. There can be little doubt that America is suffering from an epidemic of violence within intimate relationships, but what is being done to reduce those figures? One theory is that men who are found guilty of abuse need to receive therapy and counseling that helps retrain them, so that they do not return to abuse in their new relationships. By reducing recidivism, you can also reduce the number of women who are abused. This study attempts to examine what impact court ordered therapy programs have on the reduction of domestic violence recidivism. It does so through a literature review of scholarly articles on this topic, and through a case study examining the individual outcomes of mandated therapy in Washington State, and comparing those results to other state’s programs and outcomes.
Cover Page 1
4. Research Question.5
5. Review of Related Literature 5
5.1 History and Background 5
5.2 What is Domestic Abuse 7
5.3 Causes of Domestic Violence 8
5.4 What is Treatment..10
5.6 Effect of Treatment on Recidivism14
6. Proposed Methodology 20
7. Proposed Findings21
8. Suggestions for Future Research 22
It is clear that there is a crisis in America. The current national culture is failing to prevent, or effectively treat the growing number of men and women who are victims of domestic violence each day. In fact according to the National Domestic Violence Hotline, domestic violence effects the lives of more than 12 million American’s each year (2014). Despite the growing cry for change, it has been hard for America to work past the stereotype that says domestic violence is a personal family matter, and until recently, the court system could not charge those guilty of domestic violence with more than a misdemeanor offense.
In the U.S. today, over 60% of those found guilty of domestic violence that go without treatment reoffend, but very little research has been done to discover how many fewer reoffend with treatment. The need to reform is repeatedly sought by activist groups, who understand that the decline in domestic violence has slowed in recent years, and more needs to be done to close the gap (Babcock, 2012), but their lobbying is ineffective because it seems that no one knows what the “right” thing is. In order to effectively reform the current legal model and reeducate violent domestic partners one must understand what kinds of rehabilitative therapy actually reduce domestic violence, and why the currently used treatment models are, or are not, effective.
Today the criminal justice system is increasingly joining with social services and health care providers to require counseling for offenders. It is believed that these treatment programs can reduce the risk of recidivism, or the number of repeat offenders, by teaching anger management, modifying behaviors, and increased accountability. The question is which of the programs currently being used as mandatory therapy for offenders are actually effective in reducing violence? Have studies consistently shown that providing violent offenders with rehabilitation and psychological support can help them overcome their violent tendencies so that they do not offend again in the future?
The purpose of this study is to determine what effect mandatory treatment has on recidivism among those found guilty of domestic violence, with specific interest in the state of Washington. The aim is to determine whether or not certain aspects of or styles of mandatory treatment programs have more of a positive effect than others on the number of domestic violence offenders who go on to have deescalated relationships. Do these treatment programs actually rehabilitate violent offenders, or just serve as a means of punishment?
History and Background
Domestic Violence was not recognized as a public issue in the United States until the 1970s. Historically it was a personal matter, but a wave of feminism in the 1960s led to the Battered Women’s Movement, which resulted in slow policy changes during the 1970s, including the founding of the Women Against Abuse organization, the grand opening of the first shelter for battered women, and the establishment of the first domestic abuse hotline. Today, that hotline fields more than 10,000 calls per year from battered women, and offers 24-hour crisis planning for those in need (WAA, 2014). Unfortunately, it was not until 1989 that most jurisdictions began to recognize domestic violence as a misdemeanor office, which allowed law enforcement to arrest violent domestic partners (Erez, 2002).
Today, arrest rates for domestic violence are near 100%, thanks to mandatory arrest laws, but, according to Erez, the real challenge for the criminal justice system is finding an effective response to domestic violence, and a solution that actually reduces recidivism among violent offenders (2002). According to research conducted by the SAVE movement, there are more than 1,5000 state laws designed to protect violence by domestic partners, but not all laws are equally effective (2014). South Carolina, Alaska, Oklahoma, Delaware, Arizona, Tennessee, Idaho, West Virginia, Louisiana, and New Mexico have a significantly higher number of female murders that are the direct result of domestic violence than other states, with a homicide rate ranging from 1.62 to 2.54 per 100,000 women (2013). Other states like Illinois and Delaware, have numbers significantly below 1 per 100,000, placing them nearly 20% below the national average (See Figure 1). But, how do states’ policies and required treatment programs relate to the number of domestic partners who go on to perpetrate increasingly violent offences?
Figure 1. Incidents of Domestic Violence Related Deaths among Females. This figures shows the incidence rate women killed as the result of domestic homicide between 2003 and 2012.
Simply assuming that treatment programs work, and are in the best interest of both offenders and victims is not enough. It appears that some of the most relied upon methods are actually correlated with the poorest rehabilitated outcomes, and while this could simply reflect a number of local issues, it could also reveal a major flaw with the current system. It would appear that more information needs to be presented in order to gain a full understanding of the effects residential treatment has on those who perpetrate domestic violence (POP, 2014).
What is Domestic Abuse?
Often. people think of domestic abuse as simply the act of one intimate partner striking the other, but According to the National Domestic Violence Hotline, Domestic Abuse (2014) can be defined as:
a repetitive pattern of behaviors to maintain power and control over an intimate partner. These are behaviors that physically harm, arouse fear, prevent a partner from doing what they wish or force them to behave in ways they do not want. Abuse includes the use of physical and sexual violence, threats and intimidation, emotional abuse and economic deprivation. Many of these different forms of abuse can be going on at any one time (para. 5).
In short, abuse has been considered any act taken by an intimate partner that limits, threatens, injures, or causes fear in their partner. All abuse has been designed to maintain control over, or exert power over an intimate partner. It is a means of maintaining an unhealthy sense of hierarchy in the relationship, and often escalates the longer it is allowed to go on. This means that sometimes, it is hard to identify subtle abuse at the beginning of the relationship. Domestic abuse, therefore was not limited by gender, race or socio economic group. According to The American Academy of Experts in Traumatic Stress, Domestic Abuse occured in heterosexual relationships and homosexual relationships, and intimate partners of either gender can be the perpetrators of the abuse (2014).
A common misconception that affects the understanding and treatment of abuse is the belief that domestic abuse only occurs when the abusive partner “snaps,” or loses control, but this is not the case. Rather, every instance of domestic abuse is actually a calculated and intentional means to exert control over the other person. It is purposeful, and moves to reach one of three goals: to intimidate, to humiliate, or to harm (National Domestic Abuse Hotline, 2012).
Types of Domestic Abuse
According to the Women Against Abuse Advocacy Group, there are nine recognized forms of domestic abuse: physical, emotional financial, sexual, technological, and immigration related (2012). Physical Abuse is incurred when the abuser physically attacks, or acts aggressively toward his victim. The severity ranges from slight bruising to murder, and is one of the areas where escalation of abusive behaviors is most obvious (WAA, 2012). Emotional abuse includes verbal and emotional battery. This might include name calling, placing blame, unfounded jealousy, intimidation, shaming, socially isolating, and other socially or emotionally controlling behaviors (WAA, 2012).
Sexual abuse is often a physical attack that culminates in a sexual act. This includes forcing sexual acts, pursuing sex with an unconscious person, physical assault during sexual intercourse, and other intimate abuses (WAA, 2012). Sexual abuse can also include reproductive coercion, though some research groups, like the National Domestic Violence Hotline consider it a separate form of abuse. Reproductive coercion means abusively putting an intimate partner at risk of an unplanned pregnancy, including refusing to use condoms, breaking or removing condoms during intercourse, lying about or denying access to other forms of birth control, and otherwise forcing an unwanted child on a sexual partner (2014).
Technological abuse is controlling or stalking a partner through the use of modern devices. For example, technological abuse includes hacking email and social media accounts, putting tracking devices on a victim’s cell phone, recording or filming conversations without the victims consent, especially conversations with someone else, and otherwise violating privacy through technology (WAA, 2012).
Financial Abuse includes taking action that controls or limits the partner financially, or with regard to their career. Common forms of financial abuse include putting the victim on an extremely restrictive allowance, and controlling the finances in such a way that they have no financial power, causing the partner to lose a job, damaging the partner’s credit score, withholding transportation, and harassing the victim at work (WAA, 2012).
Finally abuse with regard to immigration is defined as any act that uses a partner’s immigration status as a controlling factor or as leverage. This might mean reporting an undocumented immigrant to the authorities, when in an intimate relationship with that person, tampering with immigration documents, limiting a partner’s ability to learn English and other immigration related actions (WAA, 2012). In order to protect domestic partners from any and all forms of abuse, society must try to find ways to prevent, and rehabilitate abuse. Most experts agree that doing this begins with providing treatment.
What is Treatment?
There are a number of treatment programs currently used to try to reduce the recidivism of domestic violence offenders but they all have one thing in common. They hold the perpetrator solely responsible for their action, allowing none of the blame to be placed on their victim (Babcock, 2012).
The two most common methods are anger management treatment and the Duluth method. Anger management assumes that most violent attacks in intimate relationships occur as the result of anger, and work to prevent recidivism by giving offenders other ways to manage their anger, and express their feelings. Similarly, the Duluth method uses the power wheel to define eight types of abusive behavior, assuming that all abuse are efforts to maintain power and exert control. The Duluth program then works to teach offenders non-violent strategies for dealing with the emotions or behaviors that cause them to be abusive (See Figure 2).
Figure 2. Wheels of Equality and Power Control. These wheels are used in therapy to describe violent behaviors and their nonviolent counterparts, or alternatives.
According to the POP center, research has demonstrated that single method approaches, like anger management are less effective at treating domestic violence offenders than combination approaches like the Duluth method. It attributes this advantage to the complexity of the domestic violence issue, saying “an offense as complex as domestic violence is unlikely to be prevented by a single measure (2014).” However, the same study notes that there is not a single method that has been shown to be most effective, rather traditional retraining systems like the Duluth method seem to be no more effective than less tradition, goal and faith oriented programs. In all, the study concluded that not enough is known about what works and why, and that overall “greater refinement in assigning batterers to appropriate programs could improve results. (POP, 2014).”
In short, experts across the field agree that all domestic violence offenders needs help coping with the underlying causes of domestic violence, and encouraged (or forced) to seek treatment for their issues, but what treatments work best, and why is relatively unknown. More research needs to be done to discover how addressing the underlying causes of violence reduce reoffending, and how to decide which kinds of treatment are most appropriate for specific types of violent offenders.
Recidivism is the rate of recurrence, or the number of domestic violence offenders who will engage in domestic violence again after legal action and rehabilitation. According to a 2000 study of criminology with respect to domestic violence, 41% of those that are arrested for domestic violence and introduced into a Batterer Program, will commit re-assault within the first 30 months, with 2/3 of those committing the re-offence within the first 6 months (Gondolf 2000). A more detailed study from 2004 revealed that up to 35% of program participants likely engaged in some form of abuse while still in the mandated program period. This study found that overall, when studied “from the moment of arrest to two years post release 62% of all defendants were rearrested” for domestic related offences (Puffett & Gavin, 2004)
Perhaps most interesting however, is how Babcock’s work seems to contradict that of the POP center. Babcock claims that research indicates that roughly 60% of offenders will re-abuse both with and without treatment. Similarly, when the National Institute of Justice reviewed the effectiveness of Batterer Intake Programs in California, they found that there was no statistical evidence to support their use (MacLeod, 2009). This has led some to believe that treatment programs in no way help to reduce the number of domestic abuse cases seen each year, and are instead used as a complex and costly form of punishment for the crime of intimate battering.
The Effect of Treatment on Recidivism
A number of both criminologists and psychologists have engaged in peer reviewed studies that specifically looked at the effect of treatment on domestic violence recidivism. A Study by the Oregon Division of Administration of Justice specifically looked at the methods that have been used to study recidivism, noting that prior reviews of the syudy have had conflicting conclusions about the effectiveness, perhaps in large part because they have been based on qusi-experimental methodologies, and a failure to control significant variables (Feder, 2005). This will be essential to avoid in the research conducted, and is an important lens through which to view all other peer review studies available on the topic.
Perhaps one of the most conclusive studies, conducted by the Washington States Institute for Public Policy (WSIPP) completed a research task designed to study domestic violence offenders, and look at the effectiveness of interventions to reduce recidivism (2013). The WSIPP group specifically studied the criminal history database in both the United States and Canada to look at the number of domestic violence cases filed which resulted in mandatory therapy, and then analyze the re-offending behaviors of those in the system, and the recidivism of offenders over an eight year period after treatment. Do these treatment programs have an impact on domestic battery recidivism over time, or is it simply a way to punish the offender, without any real value as a rehabilitation method?
An evaluation of the connection between the recidivism of offenders and behavior treatment programs for domestic violence must be based on a national evaluation of studies on the effectiveness of domestic violence related programs. This study specifically looked at the evidence from the records of offenders in 34 states, who were all receiving mandatory group treatment for domestic violence, and the effectiveness of the states’ programs. 30 of the 34 states had study data on evaluated male-only group treatment, the remaining four programs also relied on couples counseling as an element of treatment for male offenders (Miller, 2013).
Data was collected on all 34 original studies, specifically focusing on a set of data that met the research design criteria (Miller, 2013). The researchers based a study’s merit on the research rigor, so that there could be confidence in the findings. Studies that evaluated or relied on the motivational factors of clients, their personal demeanor or personality characteristics were removed from the data pool, so that there could be confidence that any change seen in participant behavior was caused by the treatment program and not outside influencing factors (Miller, 2013).
The study also removed data from studies that followed both those who completed treatment and those who dropped out before completion. This study wanted to specifically look at those who had successfully completed the treatment program, and the study design was not capable of accounting for outlying factors like unemployment, criminal conduct and severe psychopathology, all of which are more common among dropouts, and which are major risk factors for recidivism. Only by removing those subject to these increased risk factors, and by looking specifically at those who received a full course of treatment could the study designers be confident that their findings reflected only the effectiveness (or ineffectiveness) of the treatment program.
The final study population was only made up of those who were sent to treatment under a court order as the result of a criminal case. This excludes those who may attend the treatment program voluntarily, or as the result of a child custody case or civil case. This allowed the outcome to measure only the criminal recidivism of those found guilty of domestic violence, and mandated to treatment by the court. Data about the population was solely was gathered from official police documents and court records.
Placing these limitations on the data resulted in a significant reduction in the sample size. Of the 34 studies originally considered, nine met the study’s rigorous standards and were included in the final calculations and evaluation. The information collected from those nine studies was used to mathematically calculate the effect size of the study, or a statistical analysis of the effect of intervention on recidivism. The effect size of each study can be reviewed in Table 1.
That study’s findings indicated that the first effect that was studied was the apparent effect size of each study. Of the nine studies, there were a total of 11 study groups, each resulting in a unique effect size (Miller, 2013). Negative effect sizes indicate that a treatment program had a desirable outcome, or that the findings demonstrated that the treatment did reduce recidivism over time. The more negative the effect size, the more effective the treatment program.
Through a comparison and averaging of the effect sizes for the 11 study groups, it was discovered that the average effect size was not statistically significant, or was mathematically equal to zero. This means, that at first examination, the study found that long-term group therapy, as mandated by the court, had little or no effect on recidivism long term. The second stage of analysis in the study broke the therapy down into groups by therapy type, in hopes of determining if a specific style of mandated group therapy was more effective at treating domestic violence offenders and reducing recidivism. To accomplish this, the 11 studies were broken into two distinct categories: treatment methods based on the Duluth model, and other forms of therapy, or therapies that relied on counseling scenarios. This effectively divided the initial 11 studies into one sub-group of six and a second subgroup of five. Each category was then analyzed separately to calculate average effect size.
The second treatment group, however, received much more hopeful marks. When studied individually, each of the programs which relied on counseling or other non-Duluth therapy statistically reduced domestic violence recidivism. Unfortunately, they also have very small sample sizing when taken alone, and so cannot be considered statistically significant, or be classified as research based approaches.
When analyzed as a whole, non-Duluth models have a combined average effect size that is extremely significant. Their measured negative effect is roughly equal to a 33% reduction in re-offence over a period of 8 years. This means that as many as 1/3 less offenders return to using domestic abuse as a tool in their relationship after executing a completed course of treatment.
Unfortunately, when closely analyzing the types of treatment programs that were most effective, two constraining factors are exposed. First some of the most effective treatment programs include substance abuse treatment and rehabilitation. This is not going to be an appropriate treatment style for all domestic violence offenders. However, it may point to the fact that therapy needs to address the underlying cause of the violence rather than the violence itself.
The law in most states also constrains the courts ability to use substance abuse and other similar causal treatment programs in response to domestic violence conviction. Many states have laws that require a Duluth-like program that is aimed at abuse behaviors and anger management. These states will not allow other treatment programs to be used instead of their prescribed model of “minimum treatment program requirements (Miller, 20013).”
All in all, the study of both professional literature and peer reviewed study deomstrates that the current body of research provides insignificant evidence to argue for a single standardized body of treatment. Further, and more specific research must be provided, based on scientific research methods rather than quasi-sciences, in order to create a conclusive body of evidence for a single, most valuable treatment method. Both the Deluth Method, and Addiction counceling show promise, and provide an excellent starting point for developing this body of research.
The population of interest in this study is men who have been convicted of domestic abuse, and who have been court ordered into an inhouse treatment program in order to decrease recidivism The population that is accessible is that of all men who have been convicted in the state of Washington only, and who are ideally in treatment within 200 miles of the University, who are willing to travel to the University for screening, testing, treatment, and monitoring, and who have a 24 month probation which will allow for reffective follow up monitoring to determine long-term effectiveness. Those with serious mental illness will not qualify for the study.
The study will track, but will not use as a determining factor, certain demographic of eacb member in the test group. These factors, including participant age, marital status, education, ethnicity, and self-reported recent health events, will allow for correlations to be tracked between demographics and behaviors, in order to determine whether these variable factors effect the outcome of treatment, over the course of the study.
The study participants will be broken into 3 groups, one group will use the Deluth model only, one group will use only addiction counceling, and the third will use a combination of the first two methods. Participants must commit to and complete the full treatment program, and be studied over a 24 month period in order for their data to be included in the study’s findings.
This study hopes to determine the effects of the Deluth method, when identically applied to a group of similar participants, and to guage the effectiveness of addiction treatment, both when used alone and when used in combination with the Deluth method in order to reduce recidivism.
Previous studies have failed to provide conclusive evidence about the effectiveness, and best practices for the Deluth methods use, and by appling a strictly scientific method that eliminates variables and statistically measures a selected study group, hopes to eliminate many of the flaws present in previous studies based on quasi-science.
Further Research Suggestions:
When looking at the previous model by the WISPP group, there could not be conclusive findings on any of the specific treatment models placed in the non-Duluth category because they featured too small a sample size, but when viewed individually many of them showed promise, significantly reducing recidivism. While this study elected to focus in on addiction therapy and the Deluth model, both as stand alone treatments and in conjunction, each of these methods deserves further exploration in a controlled environment, and with a greater population. These models include Cognitive behavior therapy, Relationship Enhancement Therapy, Substance Abuse Treatment, and Group Couples Counseling for Domestic Violence Offenders.
Looking at the success of non-Duluth models, it can be deduced that programs which are tailored to address the specific underlying needs of the abuser, or causes of the abuse, assigned on a case-by-case basis may be more effective than a blanket order for a one-size-fits-all therapy program. Other therapy programs in the initial group of 34, which were not statistically analyzed because they did not meet this study’s criteria, but which might prove effective under the lens of future research include Addressing Psychopathology including: diagnosing and assessing Borderline Personality Disorder and Post Traumatic Stress Disorder, Mind Body Bridge therapy, Moral Reconation Therapy, Interactive journaling, Faith Based offender treatment.
Finally, there is a growing case for researching and analyzing treatments that have nothing to do with counseling and psychotherapy, instead relying on punishment or nutrition. These could be studied more in-depth for a more complete picture of what is useful in reducing recidivism, and for helping offenders learn to be in a committed relationship with becoming physically violent.
In conclusion, the study demonstrated that there is not currently enough research to support the use of any specific treatment program, and the most frequently ordered system, the Duluth treatment system is wholly ineffective at rehabilitating Domestic Violence Offenders, and is not positively impacting the staggering recidivism rate among intimidate offenders. Unfortunately, only a limited sample size was available for each of the non-Duluth methods, so it was impossible to compare data and recommend a specific, scientifically proven form of treatment to assign to domestic violence offenders in order to reduce the number of offenders who revictimize. Further research needs to be done to determine the most effective treatment format, of formats that are effective in treating recidivism, and whether or not treatment needs to be motivation specific.
Furthermore, policy changes should be made to end the overly popular use of the Duluth method as the standard treatment for domestic violence offenders. While it is the single most commonly used treatment program for domestic violence offenders, it has been scientifically proven insignificant in stemming the tide in domestic abuse cases. Judges need to be encouraged to order other forms of treatment, in order to assist in the further study of treatment variables, rather than using therapy as a punishment, rather than a rehabilitative tool, which they go to for a year, and then return from unchanged.
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