Violence against women: The state of batterer prevention programs

Approximately 2.1 million women are physically assaulted and/or raped every year in the United States. Of these assaults or rapes, 1.5 million are perpetrated by intimate partners: current or former spouses, boyfriends, or girlfriends, including heterosexual or same-sex partners. Regrettably, women are victimized by their intimate partners repeatedly. Women who are physically assaulted by an intimate partner report an average of 3.4 assaults every year, while those who are raped report an average of 1.6 sexual assaults every year. In all, intimate partners perpetrate approximately 4.8 million physical and/or sexual assaults annually.

Women are not the exclusive victims of intimate partner violence (IPV): 834,700 men are physically assaulted and/or raped by intimate partners in the United States every year. However, not only is the rate of victimization among men significantly lower than among women, but the differences between women's and men's rates of physical and/or sexual assault victimization become greater as the severity of assault increases.' For example, women were two to three times more likely than men to report that they had been pushed, shoved, or grabbed. However, women were seven to fourteen times more likely to report that intimate partners had beaten them up, choked them, threatened or actually assaulted them with weapons, or attempted to drown them.2 As a consequence of severe intimate partner violence (IPV), women are more likely than men to require medical attention, to take time off from work, and to spend more days in bed as a result of their victimization. The psychological consequences for victims of IPV include depression, suicidal thoughts and attempts, lowered self-esteem, alcohol and substance abuse, and post-traumatic stress disorder.3 Women who are experiencing ongoing IPV report deteriorating physical and emotional health over time.4 Nonlethal IPV has been conservatively estimated to result in financial losses of approximately $150 million per year.5 Medical expenses accounted for approximately 40% of these costs, property loss for another 44%, and lost pay for the remainder.

Although women are the primary and direct victims of IPV, children of battered women suffer similar consequences. Each year, more than ten million children witness IPV within their families, and witnessing violence has been shown to increase the risk for the development of acute and long-term physical and emotional health problems.6'' Further, violence against women by an intimate partner is a significant risk factor for child abuse.8,9

The high prevalence, incidence, and consequences and costs of intimate partner violence have galvanized various disciplines to develop programs to help victims recover from abuse and live abuse-free lives. However, equally important is the prevention of violence against women. Interventions targeting perpetrators and wouldbe perpetrators are key in the prevention of violence against women. To this end, male batterers are frequently mandated to participate in treatment programs to reduce future battering. State laws may certify specific programs that batterers must attend in order to have completed their mandated treatment. But research evidence suggests that there may not be significant differences in the outcomes among available treatment programs. Further, some research suggests that different types of batterers may respond differently to existing programs. Accordingly, it is not clear that all batterers should be mandated to the same type of treatment program or that some programs should be excluded from the pool of potentially helpful interventions.

This article reviews scientific data on the effectiveness of batterer intervention programs and discusses the legal and policy implications of those data. It also attempts to provide answers to certain questions. Have specific programs been shown to be effective or ineffective? What dimensions of programs are related to program effectiveness? Are certain kinds of programs more effective for certain individuals? What is the current status of state-certified programs? On what basis do states certify programs? What do the data suggest about the dimensions upon which states should certify programs? What is the relationship among scientific research, advocacy, and policy related to programs for batterers?

An Analysis of Standards in Batterer Intervention and Prevention Programs

Two national surveys and analyses of standards for batterer intervention and prevention programs conducted by Juergen Dankwort and Juliet Austin exist. The surveys were produced and administered under a contract with the U.S.based National Resource Center on Domestic Violence, a project of the Pennsylvania Coalition Against Domestic Violence, with additional funding from the Office of Community Projects, University of Houston. These surveys examine the standards that exist in the United States and Canada to regulate the practice of working with domestic violence offenders-perpetrators of domestic violence. An explosion of programs to address domestic violence over the last two decades has occurred. With that explosion have come growing concerns about what is being done with the offenders. The source of many of the expressed concerns has been advocates who work with the victims of domestic violence.10-12

The history and development of standards used in the various domestic violence programs to treat batterers are generally uniform. In the United States, committees comprised of battered women's advocates, facilitators of batterer programs, criminal justice personnel, and mental health professionals developed standards or guidelines in the 1980s. State domestic violence coalitions driven by strong feminist ideology often played a central role in the development process. Many of these standards are relatively similar, with those developed in one state often having served as models for other states. The rationale in support of the standards was generally identified as a need to maximize safety for domestic violence victims in view of rapidly proliferating batterers' programs with varying, and, in some cases, divergent approaches to batterer treatment interventions.

In Canada, the development of standards emerged in the late 1980s through initiatives jointly undertaken by counselors of batterers' programs and representatives of provincial governments, with some variance by virtue of the additional involvement of other interested parties. These standards were developed through designated committees. The rationale for the Canadian development of standards was identified as a need for accessibility and accountability of programs that entered into contractual agreements with government funding agencies and the need for program uniformity, improved coordination with collateral domestic violence services, and victim safety.

Two basic categories of standards exist: (a) mandatory standards, with and without accompanying legislation; and (b) voluntary standards, some of which are adhered to by many programs and others of which are not commonly referenced because there is little inducement for program compliance with them. Programs are required to commit to following mandatory standards as a condition of being funded and licensed to operate. On the other hand, while programs are not obligated to adhere to voluntary standards, voluntary standards in some cases seem to be followed more often than mandatory standards, perhaps because particular voluntary standards may be very well known. It is important to note, however, that the fact that some standards are mandatory does not ensure that they will always be followed in practice.

In the United States as of 1997, 17 states had mandatory standards for domestic violence intervention programs for offenders, 12 states had voluntary standards, 8 states had standards in a draft stage, and 11 states had standards in development. In Canada, just over half of the provinces and territories had such guidelines in place, several of which were obligatory for programs to follow as a condition of funding. As of 1997, only 3 states (Mississippi, Arkansas, and Idaho), 5 Canadian provinces, and 1 Canadian territory had not yet begun to develop standards.

To obtain their data for the two national surveys and analyses concerning domestic violence program standards, Dankwort and Austin used telephone surveys of domestic violence coalitions and other organizations. After collecting the information and analyzing it, they created categories. For purposes of analysis, the elements of standards were summarized in seven broad categories and then broken down into identified themes within these categories. The broad categories include: (a) Philosophy of Standards; (b) Purpose and Procedures of Standards; (c) Protocol for Programs; (d) Staff Ethics and Qualifications; (e) Intake Procedures; (f) Intervention: Format, Mode Content, and Duration; and (g) Discharge Criteria. The elements do not necessarily reflect the contents of an actual standard, but instead are categories created to organize the information collected. For example, a theme within Philosophy of Standards is "Patriarchy", seen as causing and/or maintaining men's violence against women. "Abuse" is conceptualized as the use of coercive control over anoter, socially reinforced through sexist attitudes, etc. The category of staff ethics and qualifications incorporates some requirements that program facilitators must be violence free, must not abuse alcohol or drugs, must seek to rid themselves of sexist attitudes, and should have training specifically in domestic violence issues.

The findings of this research provided information about the contributions and limitations of batterer program standards. Additionally, the research made it possible to identify the concerns that preoccupy some key participants and stakeholders who are engaged and invested in ending domestic violence. The research found that the contributions of standards in domestic violence program included (a) promotion of a priority on victim safety and batterer accountability; (b) facilitation of a process by which those with varying interests and particular mandates can work together to end domestic violence; (c) promotion of consistency among programs and the existence of accountability to the community; (d) the existence of consumer education by virtue of publicizing the content of programs along with program limitations; (e) acknowledgement of expertise from victims' advocates; (f) encouragement of a coordinated community response to stopping domestic violence; (g) emphasis on the social dimensions of domestic violence; (h) exertion of influence for existing programs to develop new programs and facilitate the development of standards in other regions; and (i) legitimization of the need for specialized knowledge, training, and intervention approaches in relation to work with abusers.

The findings also revealed the limitations of existing standards. These limitations include the fact that (a) standards sometimes lack specificity or fail to explicate their rationale; (b) standards do not discuss how to intervene with gay men and lesbian offenders who have been charged with domestic violence; (c) mandatory standards may turn into a form of unwanted control if access to revise or modify them is lobbied away from grassroots interests; (d) compliance with standards is complex and may be problematic on various levels-for example, standards may obtain a superficial acquiescence without real commitment by practitioners to implement their underlying purpose, or there may be no action if the standards are not mandated; (e) standards may be infrequently monitored and/or unfunded; (f) standards may be inadequate if their only requirement is attendance by batterers of a required number of sessions in order to complete a program; and (g) standards may have been developed without researchers' input, without the inclusion of mental health professionals, without a scientific research basis, and without a requirement that batterers' counselors possess academic degrees or professional licenses, as some professionals and scholars in the mental health community in the United States have charged.

It is evident from this research that a significant trend to establish standards for batterers' programs is well underway in North America. The conclusions to be drawn from the research suggest future directions that standards might take as they come up for revision or as they are formulated for the first time in those regions where they are presently under development. Existing and developing standards might seek to address whether and how to develop standards for women mandated to attend a batterer's program; how to intervene with lesbian and gay male offenders; how to intervene with various cultural, ethnic, racial, and religious minority groups; how to address some of the divisive underlying controversies raised by the standards, including the matter of diversion intervention approaches and practice methods to address safety issues for victims; how to encourage the justice system to function in a manner more in accordance with the standards; how to develop effective economic ways to monitor program compliance; and how to encourage additional innovative research regarding program impact, the types of desirable curricula, intervention protocols, and the overall effectiveness/impact of standards.

These researchers have recommended that victim safety and batterer and program accountability be the deciding criteria by which any proposed changes to standards are measured. In the absence of conclusive scientific evidence to support the content of existing standards, programs should use knowledge based on experience acquired by the battered women's movement over more than two decades as a reliable foundation for intervention practices.

Batterer Intervention Programs: One State's Experience

Georgia is one of the states that do not have standards and thus no quality assurance for batterer intervention programs. However, in the 2002 session, the Georgia legislature passed legislation giving the commission the jurisdiction to develop such standards. As in many other states, the main rationale for developing standards is victim safety and offender accountability. Standards will outline the minimum requirements as determined by existing national minimum standards.

Extensive solid research in the area of batterer intervention programs is nonexistent. Ed Gondolf I3 is one investigator who has engaged in some sound work. Still, the findings of existing research into batterer intervention programs remain inconclusive and controversial. One of the most controversial areas is whether batterer intervention programs fully address the root of the problem. Certainly it makes sense to standardize such programs if the bottom line is victim safety. However, communities find it hard to accept that batterer intervention programs are not always the answer. While it makes sense to have certification of the programs, it also important for communities to understand the limitations of batterer intervention programs. Part of the reason that intervention programs are not the ultimate answer is that the majority of men who assault women never enroll in those programs. A major issue is how to impact those men who normally do not become involved in intervention programs.

Looking at social structures and cultural norms as an important context in violence against women is critical. In twenty years of working with men who batter, the organization Men Stopping Violence has learned that batterers gain much of their direction about how to relate to women from their cultures. In essence, they learn from their cultures that it is permissible to abuse women. Men receive messages that abusing women is acceptable even from institutions such as churches and other faith communities as well as the judicial system. Hence, batterer intervention programs generally are only as good as the community in which they are functioning. Thanks to the battered women's movement, however, the message that violence against women is unacceptable is beginning to take root in a variety of cultures.

Part of the challenge of efforts to stop violence against women is making an accurate determination of whether victims and potential victims are really safe even after an intervention begins. In research, the only way of knowing is through partner reports, a limitation that researchers must recognize. After all, manipulation is one of the hallmarks of the way batterers relate in the classroom and in the system. While the physical abuse may stop, or the batterer may find creative ways not to enter into the judicial system, verbal assaults and threats can continue to keep the terror alive. The system is not measuring the looks, threats, or emotional assaults-it is merely looking for whether a victim has been assaulted physically. If it is true that victim reports are the only reliable way of knowing whether an intervention program is having an impact, then those data must be put into a broader context when obtained. Also of concern is that many victims' main interest is stopping the present abuse. These victims do not necessarily want to leave or damage the relationship in which the violence is occurring. A victim may modify her reporting, even for a researcher, if she is concerned that reporting the batterer may result in his having to reenter the system.

Batterer intervention programs must therefore be placed in a broader context, with their functions as well as their limitations acknowledged. Men Stopping Violence uses its batterer intervention program to leverage communities and to impact legislators and institutions. The program is really a conduit to communities, rather than the ultimate answer. At the halfway point of the 24week Men Stopping Violence program, a batterer is required to bring in several members from his community, such as his pastor or boss, to witness the work done in the program so that these community members can, in turn, take the information back to the community. In the long run, communities must take responsibility for both the problem of violence against women and for developing the solutions to it.

Implications for Victims of Intimate Partner Violence

Batterer treatment programs for victims of intimate partner violence must be examined in terms of safety and accountability. One study by Gondolf considered victims' perceptions at the time of entry of their batterers into batterer intervention programs of both short- and long-term duration. The findings indicated that within one week of men's program intake, 95% of victims believed their batterers would complete the program. In fact, the results of that study found that only about half the men actually did complete at least three months. Fifty-nine percent of victims said that the batterer had admitted a violence problem, but another analysis had found that there was really no relationship between admitting the problem of violence and the incidence of re-abuse. Sixty percent of victims said that they felt very safe, and 44% felt that they were unlikely to be assaulted again in the near future. After four years, 47% of the perpetrators had, in fact, re-abused at some point during that fouryear period. Complicating the task of examining the re-abuse issue is that abuse may not have been inflicted on the same partner, but rather could have been inflicted on the same partner, on a new partner, or on both. 13

A study by Heckert and Gondolf looked at predictors of the victims' perception of whether they found themselves to be at risk at the time their batterers entered programs. This study found that the best predictors of a victim's perception of high risk were based on the batterer's previous use of controlling behavior and his previous use of severe physical violence. Being married, not living together, and frequent episodes of the batterer's being high or drunk were also predictors.14

An extended follow up by Gondolf in 2001 looked at how victims perceive their situations after their batterers had completed domestic violence programs. Nearly two thirds of women reported being "better off" after 15, 30, and 48 months following batterer treatment; 85% felt "very safe" and "very unlikely" to be assaulted again at 30 months and 48 months following program treatment; and 12% reported that they felt "worse off." However, 25% of perpetrators repeatedly re-assaulted after program completion."

In her study of women's perceptions of batterer treatment programs, Juliet Austin concluded that victims of perpetrators involved in domestic violence programs reported feeling safer, having enhanced well-being, feeling validated that the abuse was not their fault, and having acquired new knowledge about domestic violence-all positive outcomes of a batterer treatment involvement. 16

Finally, an unpublished manuscript by Ferris on the effects of partner contacts by a batterer intervention program known as Emerge found that 86% of women said that they were satisfied with the program; 81 % said they felt that their confidentiality was protected by the program; 25% said that the contact was their first opportunity to talk about domestic violence (this is critical, given that contact can maximize the ability to capitalize on the opportunity for intervention); 25% said that they felt influenced to end the relationship; 39% said that they felt influenced to seek help for themselves; 10% said that they were influenced to file a child abuse report; 55% said that they believed the program was effective; and 50% said that they experienced repercussions. Though repercussions did not always take the form of physical violence, in some proportion of the cases they did.' While these findings and others reflect a fairly optimistic overall view by victims, a significant factor for all women is that batterer treatment programs can result in repercussions and in a general worsening of situations for them.

In all, research findings have a number of implications. For example, batterer behavior must be monitored closely within the initial three months of entrance to a program. There must also be some provision for follow-up support and safety for victims. To some extent, the violence intervention field must grapple with the issue of how to address what appears to be a somewhat overly optimistic view about the effectiveness of batterer treatment. Certainly, some batterers do not reoffend; yet, the risk of batterers' re-offending must not be denied. In addition, it is very important to victims for programs to offer or refer victims to other services, despite the research suggesting that most victims of batterer treatment program partners do not use other services and that victims report that they do not perceive the need for such services. Another safety issue is that victims should not be coerced into couples' treatments. In addition, victims' and advocates' voices must be included in the discussion about batterer treatment programs, given that they have the longest history with these issues. And as Gondolf suggests, batterer treatment programs need to make sure to incorporate new partners into follow-ups, not merely the index partners; the reason is that many partners separate and some number of new partners are being abused as well, so that contact with the index partners alone is not enough. In some cases, both an index and a new partner are being abused.

For purposes of accountability, programs must provide feedback and information to victims. The nature of a program and information about its effectiveness, along with program evaluation and termination summaries, are important feedback and information elements. In addition, according to a personal communication from D. Adams, documenting violent behavior is vital for use in court proceedings related to divorce, custody, and/or visitation. Finally, controlled effectiveness and other studies of batterer intervention should include information from victims, not just information about perpetrators in official reports, such as police reports, arrest data, and recidivism data.

Domestic Violence Work in Kentucky: A Legislative Perspective

In 1992, Kentucky passed a bill authorizing probable cause arrests for domestic violence for the first time. Previously, police officers were not empowered to arrest someone for a misdemeanor unless the crime was committed in the presence of the officer. The new legislation authorized police officers called in to a probable domestic violence situation to arrest the suspected perpetrator. In addition, Kentucky put into use the Civil Emergency Protective Order (EPO) as a means of addressing domestic violence. This civil order, which can be effective for as many as five years, mandates that the perpetrator of domestic violence engage in no further acts of violence against the victim, have no contact with the victim, and stay completely away from the victim and the victim's family. Mandated arrest of the suspected perpetrator and use of the EPO have proven to be effective tools for quick and direct intervention by the justice system. Violation of an EPO is currently a criminal offense in Kentucky.

Putting these tools to use in Kentucky required laying a lot of groundwork. One major task was training health care professionals, social service groups, agencies, law enforcement groups, prosecutors, and judges regarding these new tools and the dynamics of domestic violence. The training soon paid off in the form of recognition that domestic violence is a special type of crime. For instance, in 1993, Fayette County elected the first woman to serve as the county attorney. She immediately created a domestic violence division of prosecution-a very important step for communities, because when a prosecutor recognizes that domestic violence is a different kind of crime stemming from a very complicated situation, the special needs relating to domestic violence crime can be handled more appropriately.

Those trained to enforce the new law also learned that a characteristic of domestic violence is the reluctance of some victims to prosecute their abusers. The victim of domestic violence is in an intimate relationship in which the victim often loves and does not wish to leave the batterer. In addition, victims may be reluctant to admit the abuse because of embarrassment. After all, it is very embarrassing to tell a mother, a neighbor, a friend, a police officer, or a victim's advocate that the person who is supposed to be loving and cherishing instead metes out physical and verbal abuse. The dynamic of financial dependence may also play a role in a victim's reluctance to prosecute her abuser. Sometimes, the emotional and financial ties of the victim to the abuser are so strong that the victim violates an EPO by seeing the batterer anyway. Prosecuting domestic violence cases is extremely difficult when the victim either will not testify or violates an EPO and claims that everything is fine.

Successful intervention requires a combination of effective batterer intervention programs and batterer punishment. Kentucky uses both options, because treating batterers is not always possible. Kentucky has established a nine-month batterer treatment plan set up by the Mental Health, Mental Retardation Comprehensive Board. Known as a diversion program, the plan is targeted to younger batterers with little or no criminal history. Those with felony convictions are not considered for the program, nor are older batterers. Typically, an accused young batterer with a relatively minor or no criminal history is offered a plea bargain. Those batterers who accept the plea bargain must attend the diversion program. Upon successful completion of the program, the offender has the charges set aside and dismissed. To ensure that this program works, a multi-disciplinary team made up of the prosecutor, victim's advocates, a sheriff's department representative, a police department representative, a treatment program representative, and sometimes others meets weekly to review and discuss each case.

Unfortunately, the program does not enjoy unalloyed success. In one case, for example, a batterer undermined the program by influencing the other participants in the absence of the counselor by making comments such as, "Why are we here? I work hard. I provide a good living for my wife and my children, and here we are sitting in this group where they are treating us like a bunch of criminals." He was dismissed from the group as a result, and knowing what that dismissal meant to the court, subsequently took his family hostage in what became an eight-hour siege and standoff with the police.

Like many other states, Kentucky has learned that violence in the family is the breeding ground of many ills that our society must pay for in taxpayer dollars-dollars to provide medical treatment for the injuries, to correct the problem, and/or to separate the victims from the perpetrators. Moreover, violence in the family is cyclical. It is known that boys and young men who see their fathers batter are likely to repeat the behavior, and girls in families who see their mothers battered without taking action are more likely to become victims. Battering is culturally reinforced. Accordingly, the messages about the need to stop battering must be taken to the community in which the cultural underpinnings of the practice exist.