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Treatment Programs for Wife Batterers: Assessment of the DOSE Program
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Proposal for a study on the effectiveness of a treatment program designed to prevent spousal abuse. Includes a literature review & methods section.... More...
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Paper Abstract:
Proposal for a study on the effectiveness of a treatment program designed to prevent spousal abuse. Includes a literature review & methods section.
Paper Introduction:
Introduction
In several speeches in 1989, the United States Surgeon General indicated that over 2 million women are physically assaulted by their spouses or partners each year (Geffner & Rosenbaum, 1990). The O.J. Simpson trial, despite its many sideshows, managed to place the issue of domestic abuse more firmly on the center stage of public discourse. The growing awareness of the seriousness of the domestic abuse problem has resulted in the legal system taking such cases more seriously. In addition to increased incarceration and punishment, many judges have begun referring men who abuse their partners in domestic abuse intervention programs. However, few studies have been made to assess the effectiveness of such programs. Those studies that have been conducted have only drawn weak
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Anger and oppression in men who batter:Empiricist and feminist perspectives and their implications for research.Victimology: An International Journal, 1 , 311-324. Safety for women: Monitoring batterers' programs.Harrisburg: Pennsylvania Coalition Against Domestic Violence. Interspousal reliability ofreports of marital violence. As time passes by,extraneous, often unknown, variables are experienced in different degreesby the participants. The first of these is known as history. Once the batterer is able to identify his owncues that precede his violent behavior, he then can utilize a variety ofdifferent strategies to avoid violence. 3. The battered woman. (1988). Columbus, OH: Charles E. NewburyPark, CA: Sage. 2-23). Dutton, D.G. Thescale has been demonstrated to differentiate between both men and women inabusive and non-abusive relationships. The most common form of treatment is the group psychoeducationalapproach. (1964). However, research has shown the method to be ineffective in the reductionof violence. While the longer periods are of the most interest, and the mostvalid measures, long follow up periods typically present other threats tovalidity. Gender differences in reportingof battering incidences. To increase each member's understanding of the causes ofviolence by examining the belief systems in our culture which support men'suse of violence. In additionto increased incarceration and punishment, many judges have begun referringmen who abuse their partners in domestic abuse intervention programs.However, few studies have been made to assess the effectiveness of suchprograms. An analysis of risk markers inhusband to wife violence: The current state of knowledge. Are individuals in physically abusive relationshipspathological, non-pathological, or both? While early studies (e.g., Devore &Schlesinger, 1987; Gordon, 1964) focused on the causal influences of classand ethnicity in abusive relationships, more recent studies have noted thatsuch factors should also be taken into consideration when devisingintervention or prevention strategies (e.g., Lum, 1986; Pinderhughes,1989). & Tolman, R.R. Because the originators of the ABI noted differences between victimand offender reports of abusive behavior (victims report both greaterfrequency and greater severity), each hypothesis will be measured utilizingboth forms of the ABI, resulting in a set of secondary hypotheses: H1a: Partners of individuals who have been sentenced to the DOSEprogram but who have not yet attended the program will be significantlymore likely to report physical abusiveness than partners of individuals whohave completed the program. Edleson, J.L. (1992). To increase each member's willingness to change abusive behaviorby examining the negative effects of that behavior on his relationship. (1973). Length of timesince treatment will be measured by whether the offenders have completedthe program within one month, within approximately six months, or withintwelve months. The third major focus of such causative studies examine the roles ofethnicity and class in determining abusive proclivities. Dates and times were scheduled to interview each participant viatelephone. In order to assess thestability of effects for the DOSE program, a second set of hypotheses isproposed: H3: Program graduates will engage in increased physical abuse overtime. (1985). However, no study has included a cohortthat has been convicted of battery, but has not yet begun treatment. & O'Leary, K. Mortality is especially threatening instudies of batterers because, as Edleson and Tolman note, "nonparticipantsin follow-up are more likely to be abusive, and therefore success ratesbased on program completers may be biased" (8 ). Periods have been reported as between a few weeks to severalyears. Most studies instead use self-reports through surveys or interviewsof abusers. The ABI is a 3 -item scale developed to the frequency of a range ofabusive behaviors. The ABI was designed for use as a research interview instrument,originally administered in face-to-face interviews. (198 ). It is a group therapy approach intended to change personalbehavior and to prevent future occurrence of domestic violence.Analysis Data will be analyzed by the Statistical Package for the SocialSciences (SPSS), version 5. H2: Individuals who have been sentenced to the DOSE program but whohave not yet attended the program will be significantly more likely toengage in psychological abusiveness than individuals who have completed theprogram. (1986). & Sugasman, D. Geffner, 1989 Geffner & Rosenbaum, 199 Gondolf, E.W. There is some evidence that suggests that such methods tend tounderreport incidence as well (e.g., Edleson, & Brygger, 1986; Jouriles, &O'Leary, 1985). & Brygger, M.P. Edleson and Tolman note that these concerns include"definitions of abuse, sources of data, and follow-up periods" (79). Rollins, B. (1977). H3a: Partners of program graduates will report increased physicalabuse over time. In the first category, mostof the studies utilize social learning theory to discover or explain thecauses of battery. Roy (Ed.), Battered women (pp. The DOSE program is an alternative to incarceration or other forms ofpunishment. Family Relations, 35, 377-382. (1992). A theory of power relationship inmarriage. Theauthors report the instrument to be reliable, with a given Chronbach'salpha of .7 to .92 for various groups (295). High correlations forconstruct, criterion, and factor validity are also reported (296-3 1). Fourcohorts will be surveyed at various times, one before the treatment andthree at one, six, and twelve months following treatment.Subjects Eighty residents of Wake County, North Carolina served as voluntarysubjects in this study. (1988). Subsequent studieshave also administered the survey via telephone, and some researchers(e.g., Petrick, Gildersleeve-High, McEllistrem, & Subotnik, 1994) in factrecommend that battery victims be interviewed by phone at a time and placeseparate from their partners (3 9). Rosenbaum, A. & Campbell, J.A. However, emergence ofpsychological abuse often remains evident (Petrick, Gildersleeve-High,McEllistrem, & Sibotnik, 1994; Syeis, 1991). & Dobash, R.P. The third and most serious methodological problem is the differingconceptual definition of abuse. Edleson and Tolman (1992) note that most historical reviewsof the subject are sketchy, touching on some ancient Roman writings, a fewexamples from early Judeo-Christian writings, and primarily works from thiscentury. Each respondent, male and female, were to be surveyed in theirhomes at a time when their partner was not present. These cues may bebehavioral (shortening of temper, verbal snapping, making a fist, grittingteeth), emotional (feelings of depression or frustration), or physiological(Geffner & Rosenbaum, 199 ). Eachwill be measured through the use of the Abusive Behavior Inventory (ABI).The ABI consists of 3 items in a five point Likert scale which measureboth physical and psychological abuse. G. However, only a minority ofstudies use such sources. (1988). Follow up studies of two years after the programs show alow or zero frequency of physical abuse. The men then were placed into four cohorts: Those who had beensentenced to attend the program but who had not yet begun it, those who hadcompleted the program within the last month, those who had completed theprogram approximately six months past, and those who had completed theprogram approximately twelve months past. (1989). Family power: The assessment of a decade oftheory and research. By measuring both the physical andthe psychological aspects of abusive behavior, and by assessing both victimand perpetrator reports, the research hopes to acquire a better measure ofthe true effectiveness of this prevention program and to make suggestionsabout improving its overall effectiveness.Hypotheses Following from previous research, it is to be expected that thereshould be measurable differences between those who have completed the DOSEprogram and those who have not. Other studies have shown that this is partof a vicious circle, as most batterers and abusers were themselves abusedas children (e.g., Rosenbaum & O'Leary, 1987), representing a sort ofongoing, dysfunctional procreation of a battering class. . The DOSE program is a six month long program,meeting weekly for twenty-six consecutive weeks. Paper presented at the meeting ofthe American Psychological Association, Atlanta, GA. New York: VanNostrand Reinhold. One study suggests that the mere presence of battered womenin such therapy sessions has a "blaming the victim" effect (Boyrad, 1984).Methodological Concerns Over the past decade and a half, several studies have been conductedto assess the effectiveness of various types of group therapy programs.Edleson and Tolman (1992) provide a table displaying the key features andfindings of nineteen such studies. 11-26). Journal of Marriage and the Family, 42, 841-854. This study will seek toadvance the state of research in two ways. Thesepower theories borrow heavily from the feminist theories of thedifferential in power distributions between the genders. As Edleson andTolman (1992) note, "not only do ethnicity and class influence power withinrelationships, they also play an important role in how society responds toviolent men and their victims" (21). Dobash, R.E. The second methodological concern is the source of data for manyprevious studies. Such an instrument,the Abusive Behavior Inventory (ABI), is now available.The Abusive Behavior Inventory Recognizing both the wide variety of abusive behaviors and the need toadequately measure that behavior, Shepard and Campbell (1992) developed theAbusive Behavior Inventory (ABI). The instrument consists of 3 items, ten of whichmeasure physical abuse and twenty of which measure psychological abuse.Additionally, the instrument consists of two forms, identical to oneanother except that one is worded to the batterer and one is worded to thevictim. In one such study, some of the more disturbingimplications of spousal abuse were found by Walker (1979), who discoveredthat 53% of batterers examined in the study had also sexually or physicallyabused their children as well. The partners of these men wereplaced into similar cohorts. Journal of Marriage and the Family, 38, 619-627. The spouses of the men were placed in four similar cohortsof ten subjects each. Devore, W., & Schlesinger, E. A variation on this approach, couple counselling, in which both theabusers and the victims are treated together, has had mixed success. Developed within the perspective offeminist theory, the ABI recognizes the psychological component factor inabusive behavior. 4. Thus, use of the ABI allows the researcher to address two of thethree major methodological criticisms of previous studies, definition ofabuse and sources of data.Purpose of Study The present study is designed to replicate past studies that examinethe effects of psychoeducational group treatment programs for men who havebeen charged with battering their partners through an examination of WakeCounty, North Carolina's Domestic Offender Sentence Education (DOSE)program. Yllo &M. The group approach utilizes the example and discussions contributed bygroup participants. There is no consistency in the length of follow up periods in paststudies. Spitzer, J. & Bahr, S. The participants are taught toidentify the cues that precipitate violent behaviors. Ten were men who had completed the program within amonth of the survey. Assisting the group member to understand his acts of violenceand abuse and their relationship to issue of power and control. Many of these group programs employ a cognitive-behavioral approachthat show partial success in terminating or reducing the violent behaviorof participants. Jouriles, E. New York: National Federation of Temple Sisterhoods. From this table, it is evident thatpositive results from the programs are relatively consistent, with successrates between 53% and 87% reported in each study. The outcome of court-mandated treatment for wifeassault: A quasi-experimental evaluation. Before anyreduction in such activity can be adduced to a treatment program, such apossibility must be controlled for. To gain practical information on how to change abusive andcontrolling behavior by exposing non-controlling and nonviolent ways ofrelating to women. Journal of Family Violence, 3(2), 91-1 4. Davidson, T. However,feminist theory holds that psychological abuse can be nearly as severe.Most previous studies define successful outcomes as the reduction ordisappearance of physical violence (Edleson & Tolman, 1992, 79). (1986). The best sources for data are either female (victim) self-reports, or combined male-female reports. Edleson, J.L. 2. H4: Program graduates will engage in increased psychological abuseover time. Specifically, although physicalviolence can disappear or be reduced, levels of assertiveness, locus ofcontrol, self-esteem, anxiety, depression, and hostility remain unchangedwhile narcissism tends to increase (Faulkner, Stoltenberg, Cogen, Nader, &Shooter, 1992). However, it is alsoevident that there are a number of methodological concerns in past researchon the topic. All subjects were given guarantees ofconfidentiality.Materials The Abusive Behavior Inventory (Shepard & Campbell, 1992), or ABI, isa 3 -item scale developed to measure the frequency and range of abusivebehavior on a five-point Likert scale (1=never to 5=very frequently). Gordon, M. MethodThe method to be employed will be quasi-experimental survey research. Treatment received will be measured by whethersubjects, or their partners, have completed the DOSE program or whetherthey have been sentenced to DOSE but have not yet attended. American Journal of Orthopsychiatry, 54, 558-568. Additionally, many of theprograms teach anger management skills. New York: Harper & Row. Otherresearchers focus on power theories (e.g., Bograd, 1988; McDonald, 198 ;Rollins & Bahr, 1976), wherein the ability of one partner to actually orpotentially modify or control the behavior of another is the focus. Intervention for men who batter: An ecological approach. Those studies that have been conducted have only drawn weakconclusions, due to their limited sample sizes. (1979). Family systems approaches to wife battering: Afeminist critique. (1985). Ten of the men had been sentenced to the DOSE program, but had not yetbegun attendance. (1984). Participants are requiredto attend all twenty-six sessions and to pay a fee of $66 . (1992). The latter concern will be achieved through the use of ABI asthe primary data gathering instrument. Ten were men who had completed the program twelvemonths prior. Assimilation in American life. Some studies use police reports, which is a poor choicesince many if not most incidents of abuse go officially unreported (Dutton,1986). In K. Edlesonand Tolman (1992) thoroughly review the many such studies that have beendone over the past 15 years and describe the various approaches totreatment. Spousal abuse in Rabbinic and contemporaryJudaism. In addition to this social learning theory of learned domestic abuse,several other theories have been proposed. Methodological issues in marital violenceresearch. In M. Ten were men who had completed the program six monthsprior to the survey. Bograd, M. Hotaling, G. Forty of these subjects consist of men who havebeen charged with spousal battery, forty will be the partners of these men. Some studies (e.g., Davidson,1977; Dobash & Dobash, 1979; Spitzer, 1985) have focused on feministcultural theories, wherein what is claimed to be a Western tradition ofviolence and subjugation of women actively encourages battering. (1976). Violence andVictims, 1 (2), 1 1-124. Permission was askedof these men to contact their spouses or partners to participate as well.Only those men who agreed to the latter condition were included in thestudy. Contemporary studies of the topic fall into two general categories:investigations into the causes and implications of abuse, and assessmentsof various treatment or intervention programs. Hart, B. Violence against wives. If program graduates initially change their abusivebehavior, but regress to their old ways over time, the program may requirethe addition of ongoing or refresher sessions. (1985). A minimum score of 3 would indicate no abuse, themaximum score would be 15 .Procedures Men who had either attended or had been sentenced to attend the DOSEprogram were requested to participate in the study. Merrill. Further, there tends to bea lack of control for history, maturation, lurking variables, and othermethodological concerns. Additionally, each variable is measured by surveying bothoffender's reports of their abusive activity and victim's reports of abusereceived. Items 1 through 6, 8 through 13, 15through 17, 19, 2 , and 22 through 23 are the measurements of psychologicalabuse. This leads to the first two researchhypotheses: H1: Individuals who have been sentenced to the DOSE program but whohave not yet attended the program will be significantly more likely toengage in physical abusiveness than individuals who have completed theprogram. The treatment is described as an ecological model that aids indecreasing the social isolation that abusers often experience (Hotaling &Sugasman, 1986). Newbury Park, CA: Sage. This has providedresearchers with both a large population of offenders and a wide variety oftreatment approaches to examine. Oneway Analysis of Variance (ANOVA) willbe used to determine whether there are significant differences in abusivebehavior between each of the surveyed cohorts. NewYork: Free Press. Generally, programs are mandated by the courts, have strictrules on attendance, and vary in duration from 5 to 5 sessions (usuallyone or two sessions a week at two hours per session). (1987). Otherresearchers report, however, that the absence of physical abuse often doesnothing to reduce the terror that battered women feel (e.g., Hart, 1988;Rosenbaum, 1988). The second major threat to validity in longitudinalstudies is mortality, wherein fewer and fewer participants are available orwilling to continue the study. Journal of Consulting and ClinicalPsychology, 53, 419-421. Syers, 1991 Walker, L. Convicted batterers will be assessed before they enter theprogram, as will three additional cohorts of batterers who have completedthe program within one, six, and twelve months. This study will examine one particularintervention program, controlling for these various concerns, in order toassess both its immediate effectiveness in preventing abuse, as well as thestability and longevity of those effects.Literature Review Just as the social problem of domestic abuse has only lately gainedpublic notice, the scholarly study of domestic abuse is a recentdevelopment. Rosenbaum, & O'Leary, 1987 Shepard, M. However, they note that "it is clear from these reviews, that,for most of recorded Western history, women have been viewed as men'sproperty at worst or as the subjects of their rule at best" (18). Prevention and intervention is the other main category of research.Several different types of programs have been developed based on thedevelopmental and causative models described above, and with increasingfrequency the courts are sentencing batterers to such programs. Itmay well be that the mere fact of getting caught and the shame ofconviction can cause a temporary respite in abusive activity. The Abusive Behavior Inventory:A measure of psychological and physical abuse. Understanding race, ethnicity, and power.New York: Free Press. Feminist perspectives on wife abuse. The instrument consists of two sub-scales, a twenty-item scale measuring psychological abuse and a ten-item scale measuringphysical abuse. Violence and Victims, 1, 163-175. Typically, abuse and battery are treatedinterchangeably, the focus being on actual physical violence. Each item is scored on a five-point Likert scale 1=neverto 5=very frequently. The most common strategy is"timeout." This technique involves the ability of a man to identify thosesituations that are escalating closer to violence and to temporarily removehimself to de-escalate and to prepare to use alternative, more respectfulskills to resolve the conflict. The abusers are also provided with coping skills, models(peers with similar problems), the reduction of stigma, and bolsters toself esteem. An important factor in evaluating the effectiveness of interventionand treatment programs is the durability and stability of the treatmentover a period of time. Petrik, Gildersleeve-High, McEllistrem, & Subotnik, 1994 Pinderhughes, E. Social Work Practice and People of Color. McDonald, G. Therefore, in orderto adequately assess the success of intervention programs, an instrumentthat measures both physical and psychological abuse, and that considersboth victim and offender reports, would be valuable. H2a: Partners of individuals who have been sentenced to the DOSEprogram but who have not yet attended the program will be significantlymore likely to report psychological abusiveness than partners ofindividuals who have completed the program. Theremainder of this discussion will take up each of these concerns in reverseorder. Journal of InterpersonalViolence, 7, 291-3 5. New York: OxfordUniversity Press. This allowed foruniform test conditions and protected against any intimidation that mightbe operative should convicted abusers and their victims be interviewedtogether.Treatment Wake County, North Carolina maintains the Domestic Offenders SentenceEducation (DOSE) program, a psychological education intervention programfor convicted abusers. Faulkner, K., Stoltenberg, C., Cogen, R., Nolder, M., Shooter, G., &Garvin, R. For the present study,each factor will be considered separately as dependent variables. Items 7, 14, 18, 21, and 25 through 3 are the measurements ofphysical abuse. (1986). Abuse, asnoted above, has traditionally been a compound variable which confounds twofactors, physical abuse and psychological abuse. The programs focus on exploring, confronting, andchanging the attitudes and cognitions that contribute to violent behavior.Film and videotape presentations in which abused women share theirexperiences and feelings are often used to develop the abuser's empathy andto redirect their cognitions (Gondoff, 1985). First, the major methodologicalquestions of data sources and follow up periods will each be addressed.Second, the definitional problems surrounding the nature of abuse will beaddressed. Lum, D. H4a: Partners of program graduates will report increasedpsychological abuse over time.Variables There are four dependent variables: Offender's reports of physicalabuse, offender's reports of psychological abuse, victim's reports ofphysical abuse, and victim's reports of psychological abuse. Counselorsrunning the program identify four goals of the intervention: 1. Bograd (Eds.), Feminist perspectives on wife abuse (pp. Wifebeating: A recurring phenomenon throughouthistory. Monterey,CA: Brooks/Cole. References Bograd, M. There are two independent variables: treatment received and length oftime since treatment. Introduction In several speeches in 1989, the United States Surgeon Generalindicated that over 2 million women are physically assaulted by theirspouses or partners each year (Geffner & Rosenbaum, 199 ). Ethnic-sensitive social workpractice. Someauthorities argue in favor of this approach because it allows directcontact with both parties during treatment, which includes role playing andface-to-face discussion of the couple's specific situation (Geffner, 1989). The emergence ofpsychological abuse is consistent with studies that show no change inpersonality attributes after treatment. .2. (1986). Thegrowing awareness of the seriousness of the domestic abuse problem hasresulted in the legal system taking such cases more seriously. There has also been little research into therelationship between physical and psychological abuse. The O.J.Simpson trial, despite its many sideshows, managed to place the issue ofdomestic abuse more firmly on the center stage of public discourse.
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