Unit 4: Working with People Who Use Violence and Coercive Behaviors Against Partners

Learning Objectives

Chapter 1: Your Feelings, Expectations, Role, and Safety

One of the most important aspects of working with people who use violence against partners is careful and consistent attention to your own feelings, expectations, and role. Although this is true when working with survivors (and anyone, really), there are many reasons why it is essential when working with people who use violence.

Feelings

You may find that you have very strong and automatic gut-level responses to people who are abusive to their partners: rage, anger, disgust, fear, sympathy, and/or compassion.

Feelings of anger and a desire to punish might be particularly acute when the person denies or minimizes their abusive behavior. However, it is important to understand that minimization and denial are normal responses when asked to admit to engaging in violent and cruel behavior toward others, especially an intimate partner. It is important to remember that such revelations occur over time and after building trust.

You might also be tempted to dismiss or marginalize the person directly (e.g., refuse to work with them, believe they can't change).

• Sometime this is sound clinical practice (if you are feeling threatened or at risk).

• Sometimes it's because you or someone you love is a survivor of domestic violence.

• And finally, sometimes it's a result of not knowing how to proceed in a way that is safe for yourself or others.

You might also be tempted to marginalize them indirectly.

For example, if you're working with a survivor, you might make disparaging or dismissive comments about their abusive partner to show support or validate their feelings. Although your intentions are good, doing so can really backfire on your efforts to build a relationship.

Finally, feelings of confusion might arise when you work with people who use violence and coercive behaviors with partners - especially when the work is ongoing.

In cases of people who are particularly coercive and manipulative, you might find yourself pulled into - and start believing - the person's rationales for using violence, which often include blaming the survivor.

Or, you might find it difficult to imagine that the person you're working with is capable of being violent because of how they act when they are with you. Falling into these situations can be dangerous. For example, you might end treatment prematurely or make recommendations that could harm the survivor and others.

For all of these reasons, it is essential to seek consultation, attend to your own feelings and biases, and consider your own physical and emotional needs so that you can effectively engage with people who use violence and coercive behaviors.

Expectations

It is important to be aware of your expectations and stereotypes regarding people who use violence. Three common expectations are described below.

Expectation: A clear dichotomy between "victim" and "perpetrator"

One expectation you might have is that survivors never use violence and that people who use violence are never victimized. This dichotomy is true in some cases, but not always.

First, research and practice wisdom indicates that female survivors use a variety of strategies to protect themselves and their loved ones, and that some of these strategies involve violent behaviors - as is often the case with anyone protecting themselves from an assault (see Hamby, 2014 for a review). As described in Unit 1 of this training, these behaviors typically constitute "violent resistance," one of several types of domestic violence distinguished by who is using coercive controlling tactics (Johnson, 2008).

Second, there are also situations in which survivors use violence toward their abusive partners as an act of retaliation (Hamby, 2014; Swan, 2002; Larance & Miller, 2016) and sometimes toward their children (Peled, 2011). Although these behaviors warrant attention, they do not negate the person's status as a victim.

Finally, many people who use violence and coercive behaviors against partners have been victims themselves at some point, be it by a family member (e.g., child abuse, exposure to domestic violence; Anda et al., 2006), peer (e.g., bullying; Miller et al., 2013), neighbor (e.g., community violence; Powell, 2008), or society (e.g., racism, homophobia; Al’Uqdah, Maxwell, & Hill, 2016; Burnette, 2015; Edward & Sylaska, 2011; Powell, 2008). These experiences do not excuse the perpetration of domestic violence; however, they do make it difficult to maintain that "victims" are totally distinct from "perpetrators" (for more on this topic, please go to Chapter 3 of this unit).

Expectation: A "typical" presentation

You might expect that you can identify the primary aggressor just by certain visible indicators such as their physical size, how they act in front of you, or their level of success and status in other domains (e.g., school, workplace, friend circles).

This, however, is an erroneous assumption. For example, size can be particularly tricky when assessing domestic violence in gay and lesbian relationships. There is a tendency to assume that the larger, more “manly” partner is the one being abusive; however, there is no evidence to support that assumption (Baker, Buick, Kim, Moniz, & Nava, 2012).

Similarly, some people are very skilled at targeting their abusive behaviors toward their partners only; and, thus, keep the abuse a secret from friends and colleagues (Jacobsen & Gottman, 1998; Holtzworth-Munroe & Stuart, 1994). They often present in public as charming, successful, and – in some cases – more “together” than their partners (whose physical, mental, and economic heath has been eroded by the violence they’ve endured). Such a charming presentation can be particularly effective when the person also has multiple layers of privilege at their disposal (e.g., male, white, educated).

Essentially, avoid jumping to conclusions based solely on initial observations!

Expectation: Change is impossible

A final expectation or assumption you might have is that people who are abusive can’t change. Although having a healthy dose of realism is important – after all, changing any attitude or behavior is difficult and takes time – remember that each person is unique.

There is a robust literature on the factors that influence and indicate an abusive person’s capacity for change. Specifically, several typologies have been developed, with a primary focus on male perpetrators (e.g., Gondolf, 1988, Jacobsen & Gottman, 1998; Holtzworth-Munroe & Stuart, 1994). A review of typologies indicated that men who use violence differ according to level of risk (low, moderate, and high) and that - within these three types - there are differences according to severity and frequency of violence, criminal history, and level of psychopathology” (Cavanaugh & Gelles, 2005, p, 162).

Thus, because men who use violence are a heterogeneous group, it is important to assess these factors before determining treatment options and capacity for change. Please see the next chapter for more information.

Role

As has been mentioned throughout this training, your role will dictate the settings and ways in which you encounter people who use violence, as well as the strategies and content of your work with them.

For instance, you might be in a program specifically for people who use violence and abuse; in this case, you will quickly get a sense of the person’s level of violence and have clear practice guidelines from your agency. You might be in a mental health, healthcare, or substance abuse program, where the person has sought treatment for a concern other than violence. In these cases, you probably will not know about the person’s use of violence as you begin your work together.

Your task is to establish an empathetic and trusting relationship while evaluating the current risk for serious violence and maintaining a standpoint for non-violence. This is much simpler if the person is distressed about his or her violence and seeking help to become non-violent. It is more difficult if the person is charismatic, manipulative, and/or actively working to get you to join in on blaming the person's partner for the violence.

In settings where violence is not the presenting reason for treatment, it is important to maintain your role, but do not put on blinders or avoid assessing for violence and coercive behaviors. To do so not only overlooks important information that can aid in treatment, but also can be a safety risk to the person’s partner.

Personal Safety

As we have mentioned, it is also important to think about your own safety when engaging with people who use violence and coercive behaviors. (This is particularly true for law enforcement when they are responding to incidents of domestic violence. Please see this helpful resource on effective and safe police response strategies.)

Be sure to take all threats, intimidation, and manipulating behaviors seriously. In some circumstances, people who use abusive behaviors extend their violence beyond partners to anyone they see as a threat to their power and control. It is important to think about this and put in place some measures for your own personal safety. Speaking with the survivor about safety planning can be helpful in understanding the capability and behaviors of the abusive partner.

As is good practice for anyone in a helping profession, be aware of how accessible your personal information is. For example, is your home address listed? Are your social media accounts publicly available? Also, depending on agency policy, you might be allowed to use your personal cell phone to call or text with clients. Before doing so, consider whether that will allow you to maintain appropriate and safe boundaries – advice that applies to working with survivors too.

Finally, educate yourself about the protections that are in place at your workplace. Discuss concerns with your supervisor and co-workers to develop additional safety strategies that can be implemented.

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Chapter 2: Assessment of Risk and Protective Factors

One of the most difficult aspects of working with cases involving domestic violence is assessing risk and living with the uncertainty that is part of this process. Remember that risk assessment is not an exact science!

The risk assessment process should focus on the physical and emotional safety of the person’s partner (former or current), children, and the person you're working with. It is also important to think about your own safety, as we have mentioned.

As discussed in Unit 2, asking questions sensitively and listening with an open mind are essential aspects of successful communication regardless of the person you are working with. Additionally, people who have been abusive are likely to come into the conversation feeling defensive and judged, which can hinder communication and relationship building.

The following strategies can help to counter defensiveness and minimize escalation:

• Speak to the person with respect and remain respectful throughout interactions.

• Set limits by saying things such as "when you do that (e.g., yell, stand up), I can't really engage with you."

• Be conscious of your tone when making statements that may be hard to hear.

• Avoid labeling the person (e.g., you're a "batterer" or "perpetrator").

• Focus on the behaviors, not the person.

• Tune into the whole person, and not just their violence and abusive behaviors.

• Avoid escalating in response to the person's escalation (e.g., their yelling or cursing).

• If the person becomes escalated beyond what is typical for the nature of the content and/or your level of comfort, Mederos (2004) recommends ending the conversation with a statement such as, "It looks like we have gone as far as we can in this discussion. Let's continue it at another time" (p. 48).

In order to make an accurate assessment, it is important to gather information from a variety of sources, such as:

• The person using violence

• The survivor

• Children (biological, adopted, and stepchildren)

• Family and community members

• Other professionals who are involved (e.g., police, probation officers)

• Existing documentation (e.g., criminal records, medical reports, child welfare reports)

Factors in Assessing Risks

As mentioned, risk assessment is not an exact science, nor is there a definitive list of risks that predict whether someone will use violence and controlling behaviors against a partner. Below are several common indicators of perpetration, though please note that they are by no means a guarantee. (For more information and the sources from where these were taken, see Farrell, 2011 and Ganley, 1998).

If the person is your client, and you have reason to believe that he or she poses risk of serious harm to a current or former partner, you might be legally obliged to take action. In such a case, it is important that you seek consultation. See Unit 6 for more information on legal reporting requirements.

Finally, because this is an introductory training, we highly encourage you to receive additional training on risk assessment. The Mederos (2004) resource we've cited throughout this unit is an excellent resource with abundant practical tips and strategies.

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Chapter 3: Oppression and Trauma among People who use Violence

Sensitivity to historical and societal oppression is essential for effective work with people who use violence.

People from marginalized groups who are abusive often have experienced some form of trauma themselves (Mederos, 2004). As mentioned, such traumatic experiences can include, but are not limited to, traumatic family events, exposure to and involvement in community violence, poverty, homelessness, and discrimination due to race, class or sexual orientation.

Although a history of trauma or oppression does not excuse or justify the person's behaviors, it plays an important role in the healing and change process.

For example, it might take longer for people who have endured tremendous violence to stop being violent. Or, it might be that efforts to change are hindered by factors such as a lack of culturally sensitive resources, disbelief by systems that change is possible, continued exposure to trauma, and resistance to engage in services and systems that have harmed them. Again, these factors are not justifications for violence, but should be considered when working with people who use violence.

Understand and recognize implicit bias when working with people who use violence.

This is particularly true when working with low-income men of color (Mederos, 2016). Implicit bias can cause you to make assumptions based on common stereotypes of narratives (e.g., all low-income men of color are dangerous or are "deadbeat" dads [Mederos, 2004; Mederos, 2016; Edin & Nelson, 2013]); these assumptions then affect your interactions with the person (Brandon et al., 2008). For example, before you even know anything about the person, you automatically assume - based on race and class - that he is violent and poses a danger towards you and others (Maxwell et al., 2012; Brandon et al., 2008).

It is important to be aware of these tendencies, acknowledge when you are acting based on assumptions, and work to see the individual as a whole person (Mederos, 2016).

Practice cultural humility.

Cultural humility is essential when working with anyone, but especially when working with people from cultural groups that differ considerably from your own. Cultural humility involves perpetual self-reflection, education about the norms, values, and beliefs of the people you encounter, and honesty about your own limitations and mistakes (Fisher-Borne, Cain, & Martin, 2015; Tervalon & Murray-Garćia, 1998).

Cultural "values" are not an excuse for perpetrating domestic violence.

Although cultures differ in their values and beliefs about gender roles and roles in intimate relationships, domestic violence does not correspond with the ideals of any culture as a whole; but rather, reflects segments of people within. If the person you're working with argues that their behavior is normal in their culture, most likely they are simply hoping that you don't know it's not true or won't try to find out. Or, maybe such overt justifications are more common among some people in their countries or culture.

In mainstream American culture, there are many justifications for domestic violence (e.g., "she made me do it"); they just happen to be more covert than in some other countries due to increased societal and legal sanctions against domestic violence. The point is that justifications exist in every culture, but they do not excuse domestic violence.

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Chapter 4: Interventions for People who use Violence and Coercive Behaviors

In this section, we present common interventions for people who use violence. Some interventions were developed specifically for this population. Others were not, but can be helpful depending on the nature of the person's abusive violence (i.e., occasional violence vs. a pattern of coercive control).

Batterer Intervention Programs (BIPs*)

*Please note that Massachusetts now refers to these programs as "Intimate Partner Abuse Education Programs."

• The main focus of BIPs is to educate abusive partners on power and control with the goal of the member taking responsibility for their actions.

• BIPs work to educate on the effect this behavior has on both the person's partner and their children, operating from the belief that stopping violent behavior is ultimately up to the person using abusive behavior (Mederos, 2004).

• BIPs have traditionally served heterosexual adult men; however, pilot programs for LGBTQ* individuals as well as adolescents are now running in Massachusetts.

• BIPs emphasize long-term group approaches, which combine psycho-education about power and control with cognitive behavioral techniques and therapeutic interventions. They aim to challenge men's control of the relationship toward adoption of a more equal partnership (Barner & Carney, 2011; Mederos, 2004; Mills, Barocas, & Ariel, 2013).

• BIPs generally seek to broaden the person's understanding of what constitutes abuse, recognize its impact, and accept responsibility for one's abusive actions. This also includes overcoming patterns of minimizing, justifying, blaming and excuse-making, and practicing more respectful and empathetic communication strategies with one's partner (Mederos, 2004; Mederos, 2016).

• Group leaders challenge the implicit, or even explicit, messages another member might receive from their social environment in hopes of changing attitudes that in turn create behavior change (Mills et al., 2013, Barner & Carney, 2011).

• BIPs place partner safety as a major focus (Mederos, 2004). Consequently, the programs attempt to speak with and stay in touch with the partners of the people involved in the program. This serves to monitor the person's behavior outside of group and provide limited support and referrals to partners.

• BIPs are connected to domestic violence organizations throughout the state and inform the survivor on their partners' progress. A list of BIPs, and a great deal of other helpful information, can be found on this website.

If you are working with a survivor whose partner is enrolled in a BIP, it's very important that they continue to develop and follow safety plans. Survivors should be made aware that there is no guarantee that attending a BIP will cause their partner to stop being abusive during the group or resume being abusive once the group ends.

Fatherhood Groups*

Fathering Groups

• Focus on parenting and educate participants on the impact that violence has had in their own lives and on how it might affect their children (Peled & Perel, 2007). Often men who participate in these groups describe wanting to be a good father, but being emotionally or physically distant (Scott, 2012; Peled & Perel, 2007).

• Fatherhood groups provide a space for the men to recognize the trauma in their own lives and the intergenerational effect it can have.

• Another common emphasis of these groups is the importance of ending abusive behaviors against the children's mother in the context that hurting the mother also harms the children. Fathers are taught how these behaviors impact the children and aim to promote healthy relationships between parents (Scott, 2012; Peled & Perel, 2007).

• Fatherhood Groups that specifically target men who use abusive behaviors have become an alternative intervention to traditional BIPs.

Fatherhood-Involvement Programs, Responsible-Fatherhood Groups, and Men's Groups

• These are non-stigmatizing groups that support non-violent behavior, and when available, might be helpful to men who are not systematically violent to their partners.

• These groups typically focus on promoting men's positive involvement with children and family (Edleson & Williams, 2007).

• Although these groups condemn domestic violence, they generally do not address it in any substantive way, and, therefore, do not have the capacity to act as a batterer intervention program (Edleson & Williams, 2007; Roulet, 2003).

*Please note that the fatherhood groups just described are NOT part of the "father's rights" or "men's right's" movement, a socially conservative movement that is increasingly aligned itself with the alt-right (Landsbaum, 2016).

Other Interventions

Substance Abuse Treatment

• This treatment is sometimes mandated for people who are violent and abusive to partners given the overlap of violence and substance abuse. However, substance abuse treatment should not be a substitute for a treatment that directly addresses violence. The best practice is treatment for both substance abuse and violence, either through a specialized batterers' group or by participating in separate treatment programs for addictions and for violent behaviors.

Individual Therapy

• This might be an appropriate intervention, as many people who are abusive to their partners are, themselves, in psychological distress. Conversely, you might discover that clients in treatment for other reasons are, in fact, using abusive behaviors against their partner. The most successful alternative intervention, currently, is a cognitive-behavioral treatment group that focuses on eliminating violence and abuse by focusing on skills training and anger management (Dutton & Corvo, 2007). It is important to note that using abusive behaviors is not, on its own, a psychological condition. Rather, it is a pattern of behaviors (Mederos, 2004).

Interventions to be used Rarely and with Caution

Anger Management Programs

• These programs are not intended for those who are violent and abusive in their intimate relationships. Instead, they are intended for people who are violent to strangers, co-workers, fellow drivers, and - in some cases - siblings (Mederos, 2004). They offer short-term interventions designed to teach people who use violence to recognize the triggers for and signs of anger and to defuse them. Participants are taught different techniques, including relaxation techniques, to control their rage, but they do not address behavior changes regarding patterns of control (Mederos, 2004).

• Critics of using anger management to address domestic violence stress that they: 1) do not address the underlying issues of power and control, and 2) most people who use violence against partners can and do control their anger in most situations; the violence toward their partners might appear to be spurred by anger but is, instead, intentional and strategic (Gondolf & Russell, 1986; Norlander & Eckhardt, 2005; Robinson, 2014).

• Anger management programs might be helpful for people who are violent to a range of people and when used as a supplement to batterer intervention programs.

Couples Counseling

• This is not recommended in most domestic violence cases for a variety of reasons (Bograd & Mederos, 1999). Most importantly, this modality might increase the risk of harm for the person being abused (Mederos, 2004). For example, a survivor might feel safe in the therapist's office and disclose details about the abuse and/or other information that can be used against them. A partner who has not renounced abusive behavior is likely to retaliate violently at some point, perhaps even as soon as the couple exits the therapist's office (Mederos, 2004).

• Couples counseling can also create a situation in which an abusive partner attempts to negotiate giving up violence and abuse in exchange for unhealthy concessions or compromises from the abused partner (e.g., "I'll stop hitting if you stop disagreeing with me"). Such "compromises" essentially extend that person's control over the survivor and can lead to additional physical and psychological harm.

• Finally, even in cases where couples counseling might be beneficial, the amount of time and energy that needs to go into assessing for risk negates feasibility (Hamby, 2014). There are scholars and practitioners who argue for couples counseling (Stith & McCollum, 2011), stressing that it can be helpful in relationships marked by situational couple violence; that is, low to no levels of coercion, control, and fear (Johnson, 2008).

Criminal Justice System as an Intervention

The criminal justice system can be, to some extent, another intervention for people who use violence. In some cases, fear of involvement – or of re-involvement – with police and the courts can act as a deterrent to future violence, due largely to the range of negative consequences that have been developed to prevent or end the use of domestic violence (Barner & Carney, 2011). Below are some common themes to consider.

Criminal justice intervention also can be a route to other types of treatment.

It is common for the court to mandate attendance of a batterer's intervention program or some other type of treatment. Most attendees of batterer intervention programs are court mandated (Barner & Carney, 2011). The combination of criminal justice interventions and community-based interventions seem to work more positively than criminal justice by itself (Barner & Carney, 2011).

The criminal justice system is often more of an intervention for survivors than for those who use violence.

Arrest and incarceration of an abusive partner can provide some short-term safety for survivors, giving them a chance to think through their next steps, get to shelter, obtain a restraining order, or even just get a good night's sleep. See Unit 6.

Legal system involvement can have unintended negative consequences for survivors and people who use violence.

Examples include, but are not limited to, increased risk of harm to survivor’s safety, loss of family income if the abusive partner is sent to jail, deportation, strain on children, child welfare involvement, and the survivor being re-victimized by the criminal legal system (Amanor-Boadu et al., 2012; Calton, Cattaneo, & Gebhard, 2016; Fleury-Steiner, Bybee, Sullivan, Belknap, & Melton, 2006; Rhodes, Cerulli, Dichter, Kothari, & Barg, 2010).

Survivors of color who do not want to engage law enforcement may legitimately fear greater harm for themselves and their families as a result of criminal justice (e.g., police, courts) or child welfare involvement (Richie, 2012). These challenges are just some of the reasons that survivors might not want to call the police or pursue the arrest and prosecution of their partners.

Because legal system involvement can negatively affect marginalized people, some communities have developed alternative procedures for addressing domestic violence. These alternatives are typically rooted in restorative justice principles and include such strategies as mediation and intimate abuse circles (for a review, see Hampton, LaTaillade, Dacey, & Marhi, 2008).

A Word on Barriers to Treatment

When considering interventions for people who use violence, it is important to be aware of the potential logistical and individual-level barriers that hinder people’s participation. In anticipating these barriers, you can identify creative solutions to circumvent them from derailing progress.

Logistical barriers

Availability of appropriate services is often a challenge, especially for people from marginalized communities (e.g., people of color, LGBQT* individuals, non-English speakers). For example, programs that are culturally or linguistically appropriate may not be offered at an easily accessible time or location.

In addition, most batterer intervention programs receive little or no public funding, but rather charge participants to cover program costs. Some people may not be able to pay this fee and are caught between being court ordered to attend these sessions and not having the financial resources to do so. In Massachusetts, because the Department of Children and Families (DCF) contracts with several batterer intervention programs, some of the people referred by DCF can attend the program for free.

Individual-level barriers

A common barrier is the person’s willingness to participate in treatment and other interventions. As mentioned, someone using abusive behaviors may not acknowledge their behavior and ultimately resist taking responsibility. They might blame it on external factors such as substances or their partner's behavior, or their own psychological troubles. It is also possible they do not see what they're doing as problematic and don't understand the seriousness of their behavior.

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