A consumer's perspective on domestic violence interventions

Journal of Family Violence, VoL 8, No. 3, 1993

A Consumer's Perspective on Domest ic Violence Interventions

El izabeth A. Sirles , 1 Eve Lipchik, 2 and Kate Kowalsk i 3

The current study takes a consumer perspective to examine the impact of legal and mental health systems on couples who are experiencing problems with domestic violence. Unfortunately, their thoughts and wishes are rarely considered when planning for change in their lives. The study asks couples what they think happens to cause abusive episodes, what happens to them when someone finds out about the abuse, and what their thoughts are about the interventions they receive. The specific interventions in this study were a pro-arrest policy and solution-focused brief therapy.

KEY WORDS: violence; domestic; consumer intervention.

INTRODUCTION

Intervening with spouse abuse is a very complex and controversial matter. Multiple systems are involved in taking action to end the cycle of violence in homes. Both the criminal justice system and mental health pro- fessions are called on to ameliorate the problem. Unfortunately, it remains unclear if these two systems are successful either on their own or in working together.

Many different things can happen to couples when the violence be- comes known outside the home, depending on the community they live in. Usually the police are contacted to break up the disturbance and have the discretion to choose informal mediation, an order for the bat terer to leave the home temporarily, or arrest of one or both partners. Sometimes victims are referred to a shelter for emergency housing where they gain access to

1University of Wisconsin-Milwaukee, Milwaukee, Wisconsin. ZPrivate Practice, Milwaukee, Wisconsin. 3Eastwood Family Therapy Centre, Sidney, Australia.

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0885-7482/93/0900-0267507,00/0 �9 1993 Plenum Publishiing Corporation

268 Sirles, Lipchik and Kowalski

treatment and services that help them examine the situation from a position of safety. Frequently batterers are court ordered or referred to treatment intended to help them learn more appropriate anger control and gain insight into the significance of their behavior. Only rarely are couples referred for counseling as a couple to help them resolve their problems together. In other words, the decision-making process that goes into selecting interventions is made by professionals, and the partners in the relationship usually become pawns of the system with very few choices.

In recent years there has been a tendency toward increasingly more aggressive intervention by the criminal justice system. Pro-arrest policies are giving way to mandated arrest laws to assure that every batterer is re- moved from the home and comes to the attention of the legal system. The intention is to provide immediate safety for victims and prevent recidivism through punitive action. Preliminary results indicate this is an effective way of deterring further violence (Sherman and Berk, 1988). Arresting abusers during abusive episodes appears to temporarily decrease the amount of violence they engage in.

The results of this legal intervention are very encouraging and warrant continued study (Sherman, 1990). However, we must also keep in mind that while it is the unquestionable priority of all interventions to stop violence, this behavior usually occurs in the context of a love relationship between two people. We need to know how the reporting of battery and subsequent arrest impact on the couple and their ability to relate to each other. Therefore, the arrest may add a critical dimension to the clinical intervention provided in these cases. If we do not extend our studies to include this information we may find ourselves inadvertently guilty of con- tributing to the unnecessary break-up of families.

For mental health practitioners, intervening with domestic violence is very complex. Individual characteristics, interpersonal dynamics, socioeco- nomic pressures, legal problems and many other issues present themselves with these cases (Gelles and Maynard, 1987). Numerous efforts have been made to develop intervention strategies that address these problems. Treat- ment approaches have included individual (i.e., Sonkin and Durphy, 1982), group (i.e., McKain, 1987), and couple therapies (i.e., Margolin, 1979). Pro- grams have begun that incorporate elements of several approaches, attempting to provide more comprehensive interventions for domestic violence (i.e., Mantooth et al., 1987; Neidig et al., 1985). Unfortunately, all these approaches and models are "clinician driven," with treatment plans and goals being dictated by the treatment providers. There is too little em- phasis on the goals of the clients, who ultimately determine their own responses to intervention strategies.

A Consumer's Perspective 269

The more traditional strategies of separating couples, criminally prosecuting offenders, and working individually with victims to help them become autonomous have only been minimally successful at stopping the problem. Although the shelter movement has made it possible for women to find safety temporarily, the majority of victims and batterers return to their relationships or enter new relationships that are similarly abusive. Research has determined that between 50 and 75 percent of domestic violence couples remain together (Feazell, Mayers and Deschner, 1984; Purdy and Nickle, 1981). The individual approach has failed to recognize the relationship component of domestic violence and strengths within relationships that make some couples want to stay together (Weidman, 1986). The treatment plans and goals tend to focus on individual deficits such as dependence, self-esteem, and anger management (Pirog-Good and Stets-Kealey, 1985), neglecting interpersonal skills that could promote safety in the relationship.

Systemic strategies of intervention are being tested for their effectiveness in helping with domestic violence (i.e., McKain, 1987; Taylor, 1984; Weidman, 1986). These relatively new approaches have been very controversial because they work with the couple together, to help both members of the dyad develop skills that will prevent further episodes of violence (Taggart, 1986). Opponents to this approach are concerned that abused women will be further endangered by sharing the truth with the counselor in front of the batterer, and victimized by an ideology that conceptualizes the problem as an interactive dysfunction rather than the individual pathology of the batterer (Willbach, 1989). As the result of these concerns, systemic therapists are struggling for methods of intervention that help couples stay together if they want to, while being sensitive to the issues of safety, individual responsibility, and interactive dynamics (Walters et al., 1988).

The current study examines couples' perceptions of both the individual and interactive elements of the violence they experience; their understanding of, and reaction to the pro-arrest policy; and their feelings about the solution-focused brief therapy they participated in.

Solution-focused brief therapy (de Shazer, 1982, 1984, 1985, 1988) is a treatment model based on the work of Milton Erickson. It has a systemic foundation which conceptualizes problems arising, and being maintained in the interactions between people rather than as a result of the pathology of an individual. At the same time, it recognizes that the individual characteristics and strengths of each member of a relational system make the system unique.

One of Milton Erickson's greatest contributions to the field of psy- chotherapy was how he used clients' resistance to their advantage. He demonstrated that by joining with, and accepting the clients' unique point of view, rather than imposing a diagnosis and treatment goal, clients were

270 Sides, Lipchik and Kowalski

more motivated to change and found the resources to do so within themselves. Since then, studies have indicated that when clients define their own goals for treatment they achieve them faster and maintain them longer (Gurman and Kniskern, 1981).

The solution-focused brief model is particularly suitable for treating resistant clients who have been ordered into treatment because of the em- phasis on self-motivation. In this model the therapist interacts with clients for the purpose of constructing solutions with them. This is a process which emphasizes what has to happen in the present to eliminate the problem in the future, not why the problem existed in the first place. It also focuses on exceptions to the complaints, and on existing and potential strengths and solutions, rather than on the details of the problem. For domestic violence cases, this can mean examining methods the couple have used to successfully avoid violent episodes and solve conflicts satisfactorily. In this joint process the therapist's acceptance of the clients' view of the problem, and their goals, helps to create and maintain a climate in which they can avoid being de- fensive and want to risk doing something different.

It is this accepting therapeutic climate which allows for the discussion of the future without the danger of increased violence or inappropriate blaming of the victim. While it is always clear that further violence is un- acceptable, the therapist focuses on the positives in both the individuals and the relationship, and respects the needs and goals of both partners as part of that relationship. This models a different interactional process which is individually empowering and conducive to the acceptance of responsibility for behavior.

Solution-focused therapy is often practiced as a team approach, with the primary therapist conducting the interview and one or more colleagues behind a one-way mirror observing. The team participates in the interview by phoning in questions or using an intercom system. Near the end of the interview, the therapist consults with the team behind the mirror and together they compose an intervention message consisting of compliments about what the clients are already doing that appears positive, as well as recommending a task to be completed between sessions. The therapist de- livers the message to the clients and ends the session. Generally, clients are seen between four and ten times.

METHOD

Subjects

Domestic violence clients were interviewed in the current study to determine their understanding of the dynamics involved in the violence in


their relationships, and the effects of the outside help they received. The subjects were all in live-in or marital relationships, and had experienced domestic violence within that relationship. All batterers in the study had been arrested when a report of the abuse had been made, in compliance with the pro-arrest policy of the county they resided in.

Forty couples were referred for couples therapy at the Brief Family Therapy Center. Of those eighty individuals, forty-two agreed to participate in the study. Twenty-two were individuals who had been arrested as the result of a report to the police, twenty were partners of someone who had been arrested for domestic violence. We received information from 15 intact dyads or couples, with 7 additional batterers and 5 victims who did not have partners involved in the therapy. All of the arrested subjects were male, 90% of the partners were female. Two men were subjects whose wives had been arrested, but the wives did not participate in the research. The average age of the arrested men was 33 years old, the partners averaged 31 years of age. Approximately half of the subjects were black (58%), a third white (28%) and a small percentage of mixed racial origin (14%). The majority of subjects were married (87%) and had an average of two children in their families. Two thirds of the arrested subjects were employed with an average annual income of $16,000 (ranging from 2,000 to 45,000). One-third of the partners were employed, with an average annual income of $14,000.

Subjects were all clients who had been referred for therapy to the Brief Family Therapy Center in Milwaukee, a private, outpatient, family therapy clinic. Milwaukee is a major metropolitan city, with a large and diverse mi- nority population. Referrals were nonrandomly made by the prosecuting attorney, subsequent to an arrest for domestic violence. The prosecutor independently determined who should be referred to the clinic for therapy, based on the perception that therapy might be a useful intervention. All domestic violence referrals to the center were potential subjects for the study. Eighty percent of the subjects in the study were ordered to treatment by the prosecutor, while the others were voluntary clients. Clients were asked to voluntarily participate with no remuneration. Only two clients refused.

Procedure

Couples were seen together in therapy, individuals whose partners refused therapy were seen alone. The therapists were Masters level clinicians who were trained in the solution-focused brief therapy model. This model was used to help clients develop individualized goals, and to draw upon their individual and interpersonal strengths. Teams of colleagues and trainees were behind one-way mirrors to participate in the treatment process.


Upon completing treatment, subjects were interviewed over the phone regarding their perceptions of the violence in their lives and the impact of the interventions they received. Questions were asked using a structured questionnaire developed for this study. Content areas included a ranking of possible individual and interpersonal issues that contribute to the violence, information about the violence itself, perceptions of the utility of reporting the violence, and a brief history of prior abuse experiences. Ad- ditional questions were asked to assess their satisfaction with the therapy, and plans for the future. The interviewer was a graduate student, but not the therapist for the clients.

RESULTS

Perceptions of Violence

The batterers ranked money problems as the most important variable related to the violence, followed by alcohol abuse problems, jealousy, disagreements about children, sexual problems, rejection by their partners, and drug related problems (listed in declining order of importance). Arrested men acknowledged they started the argument about one third of the time (33%), but felt the majority of arguments started as mutual disagreements (40%) or were started by their partners (27%). They also reported they usually hit first (69%), with their partners beginning the violence approximately 30% of the time. The couples reported an average of five abusive episodes occurring in their relationships, ranging from one to twenty-four.

When asked about their past, only two batterers revealed they had been physically abused as children. Two had been arrested in the past for violence, and twenty percent indicated they had been violent in previous relationships. Only one man admitted he had been violent with his children before.

The victims reported slightly different perceptions of the problems leading to the violence. They ranked alcohol abuse as the most important variable, followed by money problems, jealousy, fear of their partners, rejection by their partners, disagreements about children, drug related problems, and sexual problems (presented in declining order).

Three women reported they had been physically abused as children, and three women indicated they had been physically abused in prior relationships.

These results indicate some insight into individual problems and interactive elements of domestic violence. Financial pressures, excessive drinking, and numerous marital issues resulted in mutual disagreements that precipitated violent episodes.


Utility of Reporting Law

Two-thirds of the arrested men were not aware of the pro-arrest law prior to being abusive. Slightly over half (55%) of the victims were also un- aware their mates would be arrested as the result of a report to the police. The majority of reports were made by the victims (87%) with a few cases being reported by neighbors. The arrested men spent an average of 9 hours in jail (ranging from 5 to 72 hr). Various charges were filed, ranging from assault and battery to disorderly conduct. Most victims did not want their mates to be prosecuted (71%), and in fact, only 20% were prosecuted. The low prosecution rate could be the result of uncooperative victims making it difficult to gather evidence or gain testimony. Most of the arrested men indicated the pro-arrest law would deter them from violence in the future (62%), although they generally felt the law was enforced unfairly.

The victims were mixed in their impressions of the effectiveness of the law. Many felt the law was useful for deterring violence, with comments ranging from "in the past I was afraid when the police left because they would just talk to him and leave him home with me there, now I feel safe because they will take him away" to "something had to be done to make him be responsible for his actions". Despite numerous comments expressing dissatisfaction with the legal system, and a new awareness that reports result in arrests, most of the victims indicated they would report violence if it occurred again (84%).

Therapy Outcome

The majority of couples were seen together in therapy (93%) aver- aging four therapy sessions (range 1 to 7). Most of the couples reported they attended therapy regularly (92%), although the therapists indicated client rescheduling and cancelling of appointments was common. Approxi- mately half (54%) of the men arrested for violence found the therapy to be a positive experience, indicating they had learned some skills in con- trolling their drinking, arguing, and avoiding potentially violent episodes. One-quarter (23%) were mixed in their response to therapy, and one-quarter (23%) felt the counseling had been a negative experience, indicating they had not learned from it.

The victims were generally more satisfied with therapy, 84% respond- ing they had positive experiences and had benefited from the work. Six percent expressed mixed feelings about the outcome and 11% were dissat- isfied with the services. Subsequent to therapy, 86% of the subjects were still together and planned to remain in their relationships.


During the follow-up interviews, couples fairly consistently remarked they had learned to be cautious during arguments and to leave the situation to calm down if it became apparent they could not readily resolve the issue.

DISCUSSION

The purpose of the current study was to find out what couples who have experienced domestic violence think about their problems and the help they received. There are limitations to the methodology that must be considered before interpreting the results. The subjects that provided opinions for this study are not representative of all domestic violence cases. They are a sample of people who were deemed appropriate for therapy because the prosecuting attorney felt there was hope they could learn nonviolent means of resolving their problems. Although there had been more than one abusive episode, the majority of cases had no prior history of arrests for domestic violence. Therefore, the responses given may not represent the distribution of all domestic violence cases, but a more functional subset of cases. The validity of responses given must also be questioned, as the content of questions asked was sensitive and possibly incriminating to subjects. Thus, the abuse and the reported histories could be other than indicated. Readers are cautioned that the study is not a controlled evaluation of either pro-arrest policies or solution-focused therapy. The results are opinions of a select group of individuals who came to the attention of the legal and mental health systems in a major metropolitan community.

The findings are significant along several dimensions. They are generally supportive of continuing arrest policies and providing mental health services. The services need to be case specific, covering individual and interpersonal issues with couples, batterers and victims. Professionals need to accept that many couples elect to stay together, and work with them to help their relationships be safe and healthy.

Both batterers and victims seemed aware of key issues that contribute to the onset of violence. Money and alcohol abuse problems were cited as the most important stressors they faced. This information gives direction for treatment providers. A number of relationship issues were also identi- fied: jealousy, co-parenting, rejection, sexual problems, and fear of their partners. These interpersonal issues are best addressed in couples work where both parties can work together to develop new strategies for relating and coping with their problems.

The results indicate the violent episodes contain specific interpersonal dynamics that need to be discussed in treatment. Disagreements are healthy


and normal in relationships, but become dysfunctional when they cannot be resolved in a constructive manner. When the violence involves mutual hitting, both members of the couple need to recognize what they are doing and how it contributes to the outcome.

The criminal justice system had an interesting impact upon these cases. Batterers generally felt the arrest laws would deter them from violence in the future, despite the fact that most of them were not prosecuted subsequent to their arrests. They seemed to be influenced by their new knowledge and experiences with the pro-arrest policy and the potential punitive actions that could be brought against them. Victims seemed to be favorably impressed by the fact that their partners would be arrested if they reported the abuse again, and indicated they would contact the police if they needed to. However, their reluctance to cooperate with the prosecution of their partners could diminish the effectiveness of the legal system in stopping the violence.

Opponents to the law were concerned victims would not report domestic violence for fear of retaliation. The findings suggest that some victims will report abuse to stop the current violent episode, but they may fear the consequences of providing evidence or testimony against their partners in further legal action. Many victims indicated they wanted the violence to stop, but they didn't want their partners to go to jail.

Although the treatment was ordered by the prosecuting attorney, solution-focused therapy was generally perceived as a positive experience for the subjects in this study. Many couples were still together after treatment and felt they had learned new ways of dealing with conflict between them. These preliminary results indicate further research is warranted to system- atically test the utility of the model for domestic violence cases.

Domestic violence is a complex problem with legal, social and psy- chological implications. The solution lies in the combination of all these factors. Work needs to be done to improve legal and clinical interventions to protect women and facilitate healthy relationships. As professionals, we have the same goal, to stop the violence, but different roles can result in conflicting interests and methodologies that work at cross-purposes for clients. If the consumers of our interventions are treated as passive rather than active participants in this process, they will not be motivated to make the changes we strive to create.

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A consumer's perspective on domestic violence interventions

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