Approaches to Perpetrators
of Domestic Violence:
Dual diagnosis?
th
Monday 10 September
2012
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.
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)
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
Why work with
perpetrators?
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)
Why do we need to think about
gender?
Men’s violence is a
global problem, manifest
at every level of society
and is society’s most
costly and most urgent
problem
• 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)
• 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
White, men in suits
White men in uniform
More mixed
(race, gender)
Government,
Judiciary,
Royalty, Military,
Media, Finance
Police, Doctors,
Teachers, Social
workers, Clerks
Part-time workers, Service
Industry, Unemployed, Asylum
Seekers, Disabled, Children
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
• 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…”
So why promote gender equalities
when addressing men using IPV?
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
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
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)
• What work has been done so far
with men using violence in their
intimate relationships?
• Domestic Violence Perpetrator
Programmes (DVPPs)
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
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
Perpetrator Intervention Programme Effectiveness
(USA)
• A tight coordinated response has an impact on compliance
and recidivism (Gondolf)
• 4 yr longitudinal follow-up evaluation shows a clear deescalation 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)
What about mental
health responses?
Explanations…
“It’s a couples problem”
They need couples counselling
“It’s about intoxication”
You need to stop him drinking &
taking drugs
“It’s a psychopathology”
…he needs therapy/support
“It’s a question of biology”
Men are predisposed to use
violence
“It’s a systems issue (homeostasis)”
They need family therapy…
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
Colin Fitzgerald, Respect
What might we consider?
Look to develop a clear, shared
understanding of what
domestic violence is and reflect
this in policies.
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
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?
Start thinking of work with
domestic violence perpetrators
as a specialism that requires
further training and the
development of an adequate
skills base.
“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
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”.
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
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
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
• 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
• 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.
Finally…
See yourself as part of a
community response to DV that
holds perpetrators to account.
I will now attempt to
demonstrate!