Approaches to Perpetrators of Domestic Violence: Dual diagnosis? Monday 1 0 th September 2012

1. Approaches to Perpetrators of Domestic Violence: Dual diagnosis? Monday 10th September 2012

2. Respect We are the UK membership association for domestic violence perpetrator programmes and associated support services. Our vision is to end violence and abuse in intimate partner and close family relationships. Our key focus is on promoting, supporting, delivering and developing effective interventions with perpetrators. Respect is a UK registered charity, number 1141636.

3. What we do… Disseminate best practice and set standards for DV perpetrator work. Respect Accreditation Standard launched 2008 • Women’s Aid • Refuge • Fatherhood Institute • Ministry of Justice • Association of Directors of Children’s Services • Child & Family Court Advisory Support service (CAFCASS)

4. We also… • Run a UK wide helpline for perpetrators and professionals seeking advice • A men’s advice line for men identifying themselves as victims • Have commissioned a 3 year independent research project (the Mirabel Project) to further enhance what we know about effectiveness of programmes

5. Why work with perpetrators?

6. Why work with perpetrators… • Majority of perpetrators do not come into contact with the criminal justice system • Repeat victimisation is common. 44% of victims are involved in more than one incident. No other crime has a repeat victimisation as high. (Dodd et al, 2004)

7. Why do we need to think about gender?

8. Men’s violence is a global problem, manifest at every level of society and is society’s most costly and most urgent problem

9. Every year in England & Wales approximately 150 people (120 women – nearly 50% of all female murder victims & 30 men – nearly 8% of male murder victims) are killed by a current or former partner. (Flood-Page, C & Taylor, J. (eds) Crime in England & Wales 2001/2002, London, Home Office • The evidence from the British Crime Survey consistently shows that the majority (around 75%) of victims of four or more incidents of domestic violence are female. Debbonaire, T. (2012)

10. 40 – 50 years ago there was no such thing as “gender studies” courses at universities • Kimmel (2011) argues that feminism and the women’s movement “…made gender visible” • Privilege (patriarchy) makes gender invisible: E.G Never planning a night out on the basis you might be raped

11. White, men in suits White men in uniform More mixed (race, gender)

12. However, there is often a disconnect… • Kimmel (2011) argues that although the aggregate power of men is clearly one that favours them institutionally – many still feel powerless • This seemingly contrary position is also often expressed by men using IPV when they are on programmes to help them change

13. Kimmel further argues that you need to address this feeling of powerlessness • Arguably this is what certain father’s rights groups & politically racist organisations have been successful in mobilising: “You feel powerless because of women’s rights…” Or “You feel powerless because of immigration…”

14. So why promote gender equalities when addressing men using IPV?

15. Children do better… They do better educationally Less likely to suffer mental health problems Less likely to take recreational drugs Less likely to misuse alcohol Less likely to suffer abuse/be abusive

16. Their partners are happier… Less likely to want to leave Less likely to have an affair Less likely to seek psychiatric support Less likely to misuse drugs and alcohol

17. He’s happier… Less likely to commit suicide Has more sex Less likely to suffer mental health problems Less likely to misuse alcohol/drugs (Coltrane, Adams, Gottman)

18. What work has been done so far with men using violence in their intimate relationships? • Domestic Violence Perpetrator Programmes (DVPPs)

19. Common Aspects of Programmes • Most DV seen as a gendered social historical crime, not a sickness within perpetrators • Men-only group programmes preferred • Cognitive behavioural approach • Most programmes NOT clinically-based • Close relationship with victim advocates, and offer parallel linked support for partners of men in programmes • Limited confidentiality

20. Goals of Intervention • Victim safety and autonomy • Eliminating Perpetrator’s opportunities and inclination to abuse • System accountability and responsibility • Changing the climate of tolerance to violence against Women and Children

21. A tight coordinated response has an impact on compliance and recidivism (Gondolf) 4 yr longitudinal follow-up evaluation shows a clear de-escalation of re-assault and other abuse over time, with the vast majority of men reaching sustained non-violence. At 30 months after batterer program intake, 80% of the men had not been violent to their partners in the previous year, and at 48 months, 90% had not been violent in the previous year (Gondolf, 2000; 2002; 2004) Perpetrator Intervention Programme Effectiveness (USA)

22. What about mental health responses?

23. Explanations… “It’s all a question of controlling their anger – you need to teach him better anger management”

24. “It’s a couples problem” They need couples counselling

25. “It’s about intoxication” You need to stop him drinking & taking drugs

26. “It’s a psychopathology” …he needs therapy/support

27. “It’s a question of biology” Men are predisposed to use violence

28. “It’s a systems issue (homeostasis)” They need family therapy…

29. Then why do they do it? Rather than asking for causes (why?) we propose to look at the intentions / goals of the violence (what for?) Usually, violence is used as an intent to maintain or re-establish the control over the partner, the relationship or oneself

30. What might we consider? Look to develop a clear, shared understanding of what domestic violence is and reflect this in policies.

31. Key Messages Violence is unacceptable & the abuser is 100% responsible for his abuse It is a behaviour with an intent It is a behaviour that is learned It is a behaviour that is systematic

32. Assess Risk • Again have a clear documented approach to risk in DV cases • If you were asking someone to conduct a risk assessment on a man using DV – What would you want to know?

33. Start thinking of work with domestic violence perpetrators as a specialism that requires further training and the development of an adequate skills base.

34. “Expert” Risk Assessment Psychiatric report June 2010 History of severe and life threatening violence including use of knives, threats to kill, and violence whilst his partner was holding their child in her arms

35. Report content… 1. Assessor was a child, adolescent and family psychiatrist. No evidence within his qualifications and experience of experience or expertise within the field of domestic violence. 2. But concluded that although the children have all said they do not wish to see their father, he could see no reason why they should not be “helped to accept” contact with their father. 3. Report concluded “I quite confidently say that R A has been a victim of circumstances and the criminal allegations on him are unlikely to be true”.

36. Other issues to consider: Mental illness is not the primary cause of most domestic violence • Research in the UK and USA has shown that the majority of perpetrators do not have mental health problems (see Edward Gondolf, 2002 & Home Office Findings report 217) • Research reveals that most men can be categorised as having anti-social and narcissistic personalities showing hostile attitudes towards women and inflated sense of self rather than low self esteem

37. Symptoms of mental health problems can exacerbate domestic violence behaviours or vice versa • Depression and threats/attempts to commit suicide or self harm are established risk factors in lethal domestic violence including homicide • Issues of dual diagnosis add to the complexity

38. Perpetrators’ mental health problems can play a role in why survivors remain in abusive relationships • Mental health problems can be used as an excuse for the use of violence and abuse and avoid responsibility • Beliefs that treatment will ‘solve’ the problem of domestic violence can increase risk

39. Tailored responses are needed to respond to service users who are also perpetrating domestic violence • Symptoms associated with some mental health diagnoses mirror behaviours common to many male perpetrators; this can make it particular difficult for practitioners to understand the motivations for violence and how to respond. • Current psychological interventions alone are unlikely to address the complex dynamics centred on power and control issues which underlie domestic violence committed by the majority of offenders. In some cases they can reinforce ‘poor me’ symptom common to most perpetrators

40. However for some men they may need specialised help in deal with the emotional and psychological scars associated with childhood or other traumatic experiences (e.g. military) as the psycho-dynamic model points out • Unclear whether adapting treatment to match different ‘typologies’ of domestic violence offenders has any effect on treatment outcomes.

41. Finally… See yourself as part of a community response to DV that holds perpetrators to account. I will now attempt to demonstrate!