Domestic Violence/Partner Abuse Treatment

Whenever a battery/domestic abuse case in brought in front of a court, mandated treatment is usually part of the sentence in every jurisdiction of the United States (Dankwort & Austin, 1999). The most common model of treatment in state-sanctioned programs is called the Duluth model.

It is a 12-52-week mandatory intervention following arrest that presumes battery to be a male offense influenced in large part by patriarchal values. The offenders are also forbidden from participating in conjoint therapy with the victims, at least until they have completed the mandated treatment.

Current Treatment and Assumptions

Even though the Duluth model is dominating the world of domestic abuse interventions, its effectiveness has not been empirically substantiated (Chalk & King, 1998). In fact, several studies have found the model’s treatment results unimpressive.

One study concluded that the intervention offers little advantage of the effects of the arrest (Babcock, Green, & Robie, 2004), another noted that dropout rates are high despite court referrals and this can pose a great risk to the victims (Daly & Pelowski, 2000).

Moreover, those with the highest risk to repeat offense, that is, younger, unmarried, unemployed people with a history of violence in the community, are the least likely to complete treatment (Rondeau, Brodeur, Brochu, & Lemire, 2002). Also, failed treatments are sometimes worse than no treatment, because it creates a false sense of security in victims that exposes them to continued risk.

The Duluth model rests on the following six assumptions that contribute to its limited results:

1. All partner abuse is battery

Even though most acts of abuse are relatively minor and non-recurring, the model uses the term battery in its interventions and refers to the most extreme manifestation of abuse in all cases (Felson, 2002). A narrow interpretation of abuse can lead therapists to overreact to some forms of abuse while missing others.

It also prevents victims from reporting more minor forms of abuse, as they fear institutional overreactions. It is important to adopt an approach that recognizes the many forms of abuse, including mild to severe physical violence, threats and intimidation, verbal assault, enforced isolation, and economic dependency.

2. All abusers are male

Contrary to the popular belief that men are responsible for all partner abuse, studies have found that women are just as likely to commit some form of verbal or physical abuse as men (McCarroll, Thayer, & Liu, 2000).

Although the level of injury suffered by women is vastly different in magnitude, it does not justify ignoring acts of abuse committed by women. Therapists should be equally sensitive to the perpetration by and victimization of both men and women.

3. Patriarchal attitudes adequately explain partner abuse

The idea that men have the right to control their women used to be a widely-accepted explanation for domestic violence (Pleck, 1987). However, if that was the case, women would not be perpetrators of abuse. Considering the many forms of abuse and characteristics of abusers, only a multifactorial model can begin to encompass the complexity of partner abuse.

4. Arrest is always a deterrent

Although arresting a perpetrator is usually beneficial because it halts the abuse in the short-term, the longer-term effects are not necessarily positive. It seems that getting arrested may decrease the likelihood of re-offense by married, employed, socially connected abusers, but not by unmarried, unemployed and socially disorganized high-risk perpetrators (Campbell et al., 2003). Furthermore, these high-risk individuals may be more likely to injure their partners following arrest (Dugan, Nagin, & Rosenfeld, 2001).

Sometimes arrest also has a negative effect on those it seeks to protect. It can add to victims’ feelings of powerlessness, it leads to court backlogs and delayed prosecution, lower rate of conviction, and lower rate to report the abuse (Buzawa & Buzawa, 2003). Therefore, many victims actually prefer to get orders of protection without filing criminal charges (McFarlane et al., 2004).

5. Standardized, group therapy is universally relevant

As mentioned before, typical treatment for partner abuse is 12-52 weeks of intervention. Anger management training and CBT are common components of most programs (DiGuiseppe & Tafrate, 2001).

Because it is assumed that all perpetrators will benefit from the same approach, these interventions are administered in group format and provided by service providers with brief training who lack professional degrees (Dankworth & Austin, 1999). Successful treatment needs to take individual needs and characteristics into account.

6. Conjoint intervention should either be avoided completely or at least delayed

In most jurisdictions, conjoint therapy sessions are explicitly forbidden (Lipchik, Sirles, & Kubicki, 1997). Even when conjoint sessions are allowed, the victim is rarely invited in order to be protected from further abuse (O’Leary, Heyman, & Neidig, 1990).

While it is true that conjoint sessions are contraindicated in relationships where the victim could be subjected to further abuse, in other cases it can help clinicians understand the dynamics of the situation in which the abuse occurred and be the fastest route to change.

Planning Effective Interventions

In order to create effective partner abuse interventions, therapists need to consider and work with individual clients’ characteristics, value systems and circumstances. It is also important to examine the exact nature and lethality of the abuse.

Both abuser and victim need to be assessed for their motivation to change and to determine the role each of them should play in the treatment. If substance use played a role in the abuse, abstinence by both partners needs to be a requirement at the beginning of therapy, as all substances tend to create hypersensitivity and overreactions that easily lead to conflict.

Furthermore, treatment needs to be based on theory-driven, empirically supported intervention techniques. There are several areas of focus that can enhance treatment success for partner abuse such as problem-solving, learning empathy, insight aimed at self-understanding, communication and conflict resolution skills, job counseling, etc.

If you’re interested in learning more about characteristics of abusers and victims, please feel free to read the first part of this series below:

Domestic Violence : Characteristics of Abusers and Victims

If you are struggling, know you’re not alone.

If you are someone you know feels unsafe at home, please reach out to the NYS Domestic and Sexual Abuse Hotline or 911 if you are in immediate danger.  Communication is secure, discreet, private, and available 24 hours/day, 7 days/week by:

Text: 844-997-2121

Chat: OPDV.NY.GOV

Call: 800-942-6906

Domestic Violence References

• Stuart, R.B. (2005). Treatment for partner abuse: Time for a paradigm shift. Professional Psychology: Research and Practice, 36, 254-263.
• Dankwort, J., & Austin, J. (1999b). Standards for batterer programs: A review and analysis. Journal of Interpersonal Violence, 14, 152–168.
• Chalk, R., & King, P. A. (Eds.). (1998). Violence in families: Assessing prevention and treatment programs. Washington, DC: National Academy Press.
• Babcock, J. C., Green, G. E., & Robie, C. (2004). Does batterers’ treatment work? A meta-analytic review of domestic violence treatment. Clinical Psychology Review, 23, 1023–1053.
• Daly, J. E., & Pelowski, S. (2000). Predictors of dropout among men who batter: A review of studies with implications for research and practice. Violence and Victims, 15, 137–160.
• Rondeau, G., Brodeur, N., Brochu, S., & Lemire, G. (2002). Dropout and completion of treatment among spouse abusers. Violence and Victims, 16, 127–143.
• Felson, R. B. (2002). Violence and gender reexamined. Washington, DC: American Psychological Association.
• McCarroll, J. E., Thayer, L. E., & Liu, X. (2000). Spouse abuse recidivism in the U.S. Army by gender and military status. Journal of Consulting and Clinical Psychology, 68, 521–525.
• Pleck, E. (1987). Domestic tyranny: The making of American social policy against family violence from colonial times to the present. New York: Oxford University Press.
• Campbell, J. C., Webster, D., Kozloi-McLain, J., Block, C., Campbell, D., Curr, M. A., et. al. (2003). Risk factors for femicide in abusive relationships: Results from a multisite case control study. American Journal of Public Health, 93, 1089–1097.
• Dugan, L., Nagin, D., & Rosenfeld, R. (2001). Exposure reduction or backlash? The effects of domestic violence resources on intimate partner homicide. Final report. Washington, DC: U.S. Department of Justice.
• Buzawa, E. S., & Buzawa, C. G. (2003). Domestic violence: The criminal justice response (3rd ed.). Thousand Oaks, CA: Sage.
• McFarlane, J., Malecha, A., Gist, J., Watson, K., Batten, E., Hall, I., et. al. (2004). Increasing the safety-promoting behaviors of abused women. American Journal of Nursing, 104, 40–50.
• DiGiuseppe, R., & Tafrate, R. (2001). A comprehensive treatment model for anger disorders. Psychotherapy: Theory, Research, Practice, Training, 38, 262–271.
• Lipchik, E., Sirles, E. A., & Kubicki, A. D. (1997). Multifaceted approaches in spouse abuse treatment. In R. Geffner, S. B. Sorenson, & P. K. Lundberg-Love (Eds.), Violence and sexual abuse at home: Current issues in spousal battering and child maltreatment (pp. 131–148). New York: Haworth Maltreatment and Trauma Press.
• O’Leary, D. K., Heyman, R. E., & Neidig, P. H. (1999). Treatment of wife abuse: A comparison of gender-specific and conjoint approaches. Behavior Therapy, 30, 475–506.