Forensic psychology: Part 4: Chapter 8: Assessing offender populations
Chapter 8
Psychological Practice Guidelines for the Assessment of Family Violence
by Marilyn Van Dieten, Ph.D., C. Psych.Footnote 1
and Jill Rettinger, M.A., Psych.Footnote 2
General principles of family violence assessment
Research in the area of family violence has only recently achieved attention despite the acceptance that violence against women is a widespread social problem. This may be explained in part by the fact that relatively few acts of violence have been dealt with through the criminal justice system. Wifebeating was permitted by law in the United States until the late 19th century, and it has only been in the last fifteen years that the courts have recognized wife abuse as a crime.
The first attempts to increase knowledge in the area of family violence were initiated by women's advocates in the 1960s. Drawing from the personal experiences of victims, intervention programs for abusive males were developed and closely monitored by the women's shelter movement. Since then, women's advocates, victims, and service providers have collaborated closely to develop guidelines for working with abusive men. Essentially, the personal safety of women and children are considered to be as important as the interests of the abusive male.
"To ensure the interests of potential victims are sufficiently addressed..., all procedures and practices must be evaluated from the perspective of whether they advance or endanger the safety of battered women and children" (Hart, 1988, p.235).
The recent increase in arrests and convictions has permitted researchers to systematically identify factors which contribute to abuse. A number of characteristics of men who abuse women have appeared in the literature. This paper will draw on specific criteria advanced by women's groups and from the existing literature to develop guidelines for the assessment of abusive men.
Practical and theoretical issues
When working with abusive men, it is critical for the practitioner to have a very clear understanding of the theoretical models proposed to explain family violence. To date, the most well-validated and dearly presented are social-psychological (social learning) and social-cultural (feminist) theories. A brief overview of these models is presented below (for a more detailed discussion see Edelson & Tolman, 1992).
Social-cultural theories view woman abuse as a common event, supported in all cultures that promote male domination of women. Dobash (S.. Dobash (1979) suggest that "men who assault their wives are actually living up to cultural prescriptions that are cherished in Western society — aggressiveness, male dominance and female subordination — using physical force as a means to enforce that dominance" (p.24).
Advocates of social learning theory view biological factors, observational learning and reinforced performance as the main origins of abuse. Dutton (1993) provides a comprehensive overview of the literature to support the major tenants of social learning theory. First, he suggests that men are predisposed toward aggressive responses because their greater physical size is likely to produce the desired effect and hence, reward the performer. Second, although not all men who abuse women have witnessed parental violence, there is empirical evidence that male children who witness the abuse of their mothers are at greater risk for perpetrating acts of violence in their own relationships. Furthermore, consistent with social-cultural theory, it is suggested that exposure to television portrayals of violence and stereotyped responses to conflict situations also contribute to an aggressive response pattern.
Finally, Dutton (1993) provides evidence to suggest that when men rely on abusive behaviours they are rewarded through: "(1) regaining control or dominance; (2) feeling expressive or acting out and taking charge in a male sex-role consonant fashion; and (3) terminating an aversive state of arousal or upset." Also, if he is not punished for using violence, the likelihood increases that a man will use these actions again in a similar conflict situation (p.200).
Both social learning and feminist theory recognize that violence has a useful purpose and that it is used to gain power and control. According to Edelson and Tolman (1992), "violence is an intentional behaviour that serves to systematically enhance a perpetrator's coercive control over others in his world. Thus violence may be viewed as a behaviour that serves a power-enhancing function for the perpetrator" (p.22).
To end family violence, changes must be made at both a micro and macro level. That is, intervention programs for abusive men are seen as one part of a broader strategy to eliminate violent behaviour. More importantly, this change is necessary to ensure that criminal sanctions are imposed for the perpetration of violent acts, and that women and children are regarded as equally valuable members of the community.
Practice guidelines: Information gathering
i) Defining abuse
The psychologist should begin with a definition of "abuse." Until recently, researchers have tended to focus exclusively on physical violence and to ignore more subtle forms of abuse. Increased knowledge of the consequences of abuse suggests that psychological/ emotional and sexual abuse, though not lethal, have an equally devastating impact on the victim (Gondolf,1988; Edelson & Tolman,1992).
A working definition of family violence, developed through federal and provincial consultation, is as follows:
"Family violence represents a serious abuse of power within family, trust or dependency relationships... Family violence is a serious social and criminal problem that can result in the death or disablement of its victims. It can involve killing, physical and sexual assault. It also involves other forms of abusive behaviour, such as emotional abuse, financial exploitation and neglect. Family violence has long-lasting psychological effects on its victims. The primary victims are women, children and seniors. In most cases, the offenders are males. It is estimated that no fewer than one in 10 Canadian women is assaulted by her husband or partner; that family violence accounts for over 60% of female homicides; that 25% of girls and 10% of boys are sexually abused before age 16; and that at least 4% of elderly persons are victims of some form of significant abuse...
Family violence is a societal problem. It reflects such attitudes as sexism, ageism and tolerance of violence. Family violence affects all age groups, all socioeconomic groups, all cultures and all geographic regions. It challenges traditional approaches in the areas of prevention, protection and treatment. Assisting the victims cuts across many service systems and institutions, demanding a co-ordinated response to a complex need" (National Clearinghouse on Family Violence, 1992).
The following definitions were taken from materials released by the London Family Court Clinic (Suderman, Jaffe & Haistings, 1993).
- Physical abuse can include slapping, kicking, hitting, pushing, shoving, the use of a weapon, and other forms of physical assault.
- Sexual abuse is unwanted, forced sexual activity.
- Psychological/emotional abuse includes undermining a person's self-esteem, selfconfidence, or sense of well-being by using some or all of the following means:
(i) Verbal abuse: put-downs, name-calling, abusive language.
(ii) Threats: abusers may threaten to take the children from their spouse, to harm the victim or children, and/or to commit suicide. Extreme fear and anxiety in the victim can result.
(iii) Intimidation: abusers may frighten victims by actions, gestures, use of a loud voice and/or destroying property.
(iv) Extreme controlling behaviour: those who abuse their wife or partner are often extremely controlling of their partner's activities. They permit few contacts outside the home and allow little or no freedom of choice/action.
(v) Economic domination: to ensure economic dependence, abusers may assume complete control of family finances and/or may discourage the victim from working outside the home. Isolation: to render the victim even more vulnerable, many abusers isolate their partners from friends, extended family and community contacts.
(vii) Undermining parental role: abusers often sabotage their partner's relationship with their children and usurp their authority to discipline.
ii) What measures should be used in the assessment process?
Screening and detection
A comprehensive assessment battery
Several investigators, including Edelson 67- Tolman (1993) and Dutton (1993), have attempted to integrate the research literature and call for a comprehensive assessment framework. This includes historical, individual and environmental variables which have been found to characterize abusive men.
A list of risk markers, as well as recommended assessment tools are presented in Appendix A. The various measures used in CSC's family violence database and those most frequently cited in the literature are presented in Appendix B.
Special considerations for test selection
(1) Behavioural indices
The most widely used measure to determine a reliance on abusive behaviour is the Conflict Tactics Scale (CTS; Straus, 1979). The CTS is a checklist of acts ranging from "discussed issue calmly" to "used a knife or gun." The respondent is asked to note how frequently these behaviours occurred during conflicts with a spouse within the last year. Dobash, Dobash, Wilson & Daley (1992) provide a compelling argument which specifies the disadvantages of using this measure and other similar behavioral indices.
First, the CTS focuses almost exclusively on physical violence while ignoring more subtle forms of abuse. Secondly, it omits the context (motivation) behind violence, the events precipitating violence, and the sequence of events by which it progresses. This has led to many erroneous interpretations of the data, including for example, that male and female violence is similar in frequency and type. Studies employing more intensive interviews and detailed case reports addressing the context and motivations behind abuse, consistently show gender differences in the use of violence (i.e., Edelson & Brygger, 1986; Van Dieten, Rettinger, & Graham, 1993). More specifically, women almost always employ violence in defence of self and children, whereas men use violence to control their victim. Finally, the reliability of the data is highly questionable. Despite the popularity of this instrument, inter-spousal reliability is typically not reported or indicates that concordance rates between partner reports is highly discrepant.
Dobash et al. (1992) recommend that the use and interpretation of behavioural indices be treated with extreme caution. They suggest that "it is crucial to establish the pattern of who is violent to whom, to thoroughly describe and explain the overall process of violent events within their wider contexts, and to analyze the reasons why conflict results in differentially violent action by women and men" (p. 15). Minimally, the use of behavioural indices should be accompanied by an extensive interview where all acts of violence, including psychological and sexual abuse, are addressed.
(2) Attitudinal measures
Social learning and feminist theory suggest that rigid adherence to sex-role expectations may be a causal factor in woman abuse. To date, a number of attitudinal questionnaires have been developed to assess the importance of this factor. However, there is no evidence to suggest that these measures discriminate between abusers and non-abusers. Dutton & Strachan (1987) suggest these measures tend to be transparent and to elicit socially acceptable responses. They recommend examining the motivation rather than the attitudes behind violent acts.
(3) Interview measures
Perhaps the most popular method used to assess abusive men is the clinical interview. A number of instruments have been developed and are currently available to practitioners (see Appendix C for a sample interview). However, the content of each instrument tends to vary. In order to conduct a comprehensive assessment, it is recommended that the following information be included:
- Assessment of the client's resistance and compliance: motivation for seeking help (i.e., court, family, personal interest); and consequences associated with the violent and abusive behaviour (i.e. divorce, separation, reconciliation, access to children, fines, legal proceedings, condition of probation/parole).
- Assessment for dangerousness to women and children, and determine if the female partner is to be actively involved in the intervention process: determine the current relationship of the abuser to recent or potential victims; determine potential losses or stressors; determine the number of children, their ages, and the client's accessibility to them (many cases of woman abuse also involve child abuse); and gather knowledge about parenting practices.
- A comprehensive history of the client's experience with abuse and violence: determine developmental history related to violence and abuse in the client's family of origin, including victimization and witnessing experiences; determine the client's reliance on abusive behaviours; and determine frequency, chronicity, severity, types, injury inflicted, and targets of abuse as both perpetrator and victim.
- An examination of individual's vulnerability factors: behavioural deficits; hostility/anger; substance abuse; suicidal ideation, depression; educational background; and psychopathology.
- A comprehensive assessment of client's attitudes toward women: the interviewer should ask the offender for details concerning his behaviour and motives, and be alert and cognizant to comments that reflect antisocial attitudes, including "flag words" or phrases that are consistent with:
i) takes responsibility for his partner (I let her, allow her to, want her to, I expect her, she should, etc.);
ii) takes little or no responsibility for his actions, and blames others, especially his partner (she made me, she really pushes my buttons, if only she would ... I would, etc.);
iii) is morbidly jealous (worries constantly about what she is doing, who she is with, what she wears, where she goes, and screens her friends and phone calls, etc.); iv) is egocentric and non-empathic regarding conflicts;
v) espouses traditional gender roles (she should stay at home, she should take better care of house/kids, I expect a meal on the table, women's work/man's work differentiation);
vi) is overprotective (intervenes on partner's behalf without permitting her to take action — she needs me, she couldn't survive without me, etc.);
vii) attributes violence to something outside himself (I just saw red, I lost control, it wouldn't have happened if I hadn't been drinking, things are bad at work, this is the only way I know — I'm just like my dad, etc.).
6. A comprehensive assessment of environmental factors: current living situation; social network; and external stressors (i.e., risk/ needs assessment).
The Correctional Service of Canada's National Training Strategy (Family Violence Initiative, 1994) has recommended a number of guidelines which should be followed when conducting a clinical interview. These include:
- Interview the offender separately from his partner (if you are interviewing the opposite sex, be sensitive to possible gender-biased offender attitudes).
- If you are aware of abuse in the offender's history, acknowledge it. Be matter-of-fact.
- Even if you don't suspect abuse, take steps to screen it out. Remember that the offender's definition of abuse may be very different from yours. For example, he may not distinguish between physical abuse and "discipline," or may feel it is his right to control other family members. Also, he may not think that putting her down or telling her she's crazy is abuse!
- Assess for all forms of abuse by asking as many open questions as possible about his family relationships.
- Where the risk of abuse is present, state clearly that family violence is never justifiable, he's responsible for his violence, and only he can change his behaviour.
- Avoid colluding with the offender. If you have documented cases of abuse on file, confront him with the facts. Do not provide him with opportunities to minimize, deny, or blame others.
- Encourage the offender to participate in family violence prevention and treatment programs.
iii) From whom should the information be collected?
Self-report information
It is generally accepted in both the research and clinical literature that men will minimize or deny the use of abusive behaviour (i.e., Coleman, 1980; Edelson & Brygger, 1986; Pagelow, 1981). Variation in reporting among family members and between genders has been examined (Edelson & Brygger, 1986; Gully, Pepping & Dengerink, 1982; Jouriles & O'Leary, 1985). Results dearly suggest that women reported higher frequencies of violence than their male partners. Inconsistencies in reporting tended to increase when male and female partners were asked to rate the use of psychological abuse.
The decision to rely exclusively on self-reports of abusive acts must be carefully considered by the examiner. If other sources are not used to validate this information, it is recommended that interview and behaviour checklists be carefully chosen, and that they clearly specify discrete behaviours which characterize the many forms of abuse. Psychological abuse is more subtle and difficult to identify than physical abuse. This may be explained in part by the perpetrators inability to recognize and acknowledge the impact of psychological abuse on the victim.
File information
A reliance on offender file information may prove inconclusive when the review focuses exclusively on past acts of violence. Given that mandatory arrest and prosecution policies that apply to family violence are relatively recent, it is not surprising that many acts of family violence do not appear on the offender's file. This is compounded by the fact that most incidents of family violence go unreported. Dutton (1987) estimated that only 6.5% of wife assaults are reported to police and that only.38% result in convictions. Further, until recently, records of violent offenses did not specify the gender of the victim or the perpetrators relationship to the victim.
File review information has proven useful in identifying federal offenders at risk for perpetrating acts of family violence. Dutton and Hart (1992) began with a composite profile of the male batterer based on descriptions provided by female victims residing in shelters.
These included:
- a history of witnessing abuse or of being a victim of abuse in the family of origin (Dutton & Hart [1992] discovered that almost twice as many offenders reported a history of family violence than their files indicated);
- prior record of violence;
- multiple relationships;
- personality disorders including anti-social personality, narcissism, and borderline personality disorder;
- substance abuse;
- individual characteristics such as low assertiveness, low self-esteem, inability to express feelings, depression, hostility/anger control problems, rigidity in sex roles and attitudes.
Partner-reported information
Given the difficulties in relying on self-report data and file reviews, there is an increased interest by both clinicians and researchers to validate this information with reports from the female partner. In fact, it is commonly accepted that partner data be considered as the most important criterion measure in treatment outcome studies with male batterers.
The decision to use this information requires a number of special considerations:
- If a woman (or other family member) indicates a renewal of violence, she must be informed that any information she gives MAY be shared with the offender. A protocol specifying the limits to confidentiality and protection of information must be clearly specified in advance to the female partner, and all efforts must be made to ensure her safety and protection. In cases of family violence, the abused partner may refuse to share information if it will be apparent to the offender that she has provided it. The victim must be given the choice of whether or not she wishes to share this information, and her decision must be respected. As indicated in the CSC National Training Strategy (Family Violence Initiative, 1994) disclosure of information may be withheld from the offender only when such disclosure would jeopardize the safety of the person, the security of a penitentiary, or the conduct of any lawful investigation. If sufficient grounds are established to withhold information from the offender, a detailed summary that excluded any identifying particulars is prepared and shared with the offender.
- A victim may request the release of information about an offender. The Guide for Use and Disclosure of Personal Information about Offenders (CSC, 1994) outlines what information can be shared about the offender. In certain situations, the Commissioner can disclose:
i) the offender's name;
ii) the offence;
iii) start and length of the sentence; and
iv) eligibility dates and review dates regarding temporary absences or parole.
If the interest of the victim clearly outweighs any invasion of the offender's privacy, the victim may also be told:
i) the offender's age;
ii) which penitentiary the offender is in;
iii) the offender's release date for temporary absence, work release, parole or statutory release and the offender's destination from any of these; and
iv) whether the offender is in custody and, if not, the reason why the offender is not in custody. - When conducting assessments in the community, it is imperative that the female partner be assessed separately from the male, and that she is able to speak openly and freely without fear of reprisal or retaliation.
Reporting guidelines
i) Duty to warn The Canadian Psychological Association (1991) has adopted ethical standards of practice which address the psychologist's obligations to potential victims of clients:
"Do everything reasonably possible to stop or offset the consequences of actions by others when these actions are likely to cause serious physical harm or death. This may include reporting to appropriate authorities (e.g., the police) or an intended victim, and would be done even when a confidential relationship is involved" (Standard, 11.36).
If the psychologist reaches the conclusion that there is clear risk or fear of danger to the battered woman and her children, a warning should be initiated. Reporting risk includes advising the victim, the police, the victim's family, etc.
The Correctional Service of Canada is currently developing guidelines which will require federal employees to report all known and suspected family violence incidents. The issue of child abuse is clear. There exists provincial legislation which requires citizens to report, to the relevant authorities, all known or suspected cases of child abuse and, in some cases, elder abuse. With regard to women abuse, the criminal justice system responds to physical assault (including the destruction of property), overemotional assault (intimidation, using coercion and threats) and sexual assault.
Hart (1988) suggests it is incumbent upon the therapist to evaluate carefully the possibility of serious threats posed by the client. She recommends that the following factors be considered when assessing dangerousness:
- threats of homicide or suicide;
- fantasies of homicide or suicide;
- access to, and threats to use, a weapon;
- obsessiveness about partner;
- rage;
- depression;
- drug or alcohol consumption;
- access to the battered woman;
- level of isolation; and
- any changes in family status.
ii) Duty to protect
As previously indicated, one of the primary objectives of intervening with male batterers is to ensure the safety and protection of women and children. To meet this objective, many service providers have assumed a much larger responsibility than that traditionally adhered to in initiating warnings. This includes notifying women of potential danger and implementing protective strategies.
If the examiner feels that there is significant risk to the woman or her children, a warning should be initiated and various protection strategies should be implemented. This includes disseminating information which will assist the victim to assess the risk of physical and psychological danger posed by her partner.
In addition, the victim should be informed of the various services available to her in the community which will permit her to develop a safety and protection plan. Finally, the victim should be given enough information to make an informed decision about whether or not she should stay in the relationship. For example, many women will stay in the relationship if the batterer has been mandated to a treatment program.
The victim should be informed that participation in a program does not guarantee that the batterer will change. Programs for batterers are advised to inform the victim of the male's attendance and general progress in the group. They should also attempt to evaluate the male's progress at home, by requesting information from the partner.
Professional qualifications
To ensure that services are offered in a responsible and effective manner, professionals must have a certain amount of relevant experience and training in the area of family violence. This includes:
- Knowledge and understanding of ethics and standards of professional conduct as presented in the Canadian Code of Ethics for Psychologists (1991) and the Practice Guidelines for Providers of Psychological Services (1991). It is also strongly recommended that the psychologist have a clear understanding of the duty to warn and protect guidelines, which have been advanced by practitioners in the area of family violence and by the Correctional Service of Canada.
- A clear theoretical understanding of family violence. Given the tremendous contributions made to this field by various disciplines, it is highly recommended that the psychologist have a clear understanding of sociocultural, and socio-psychological explanations of abuse.
- Assessment skills. The psychologist must be sensitive to the various forms of abuse and have extensive knowledge of the causal factors, prevalence, and impact of abuse on both the batterer and victim.
- Skills in crisis intervention (i.e., suicide, selfinjury, substance abuse, etc.). The majority of male batterers present with a variety of clinical needs. Frequently, they will be depressed or suicidal whenever they perceive the loss of their partner or the imposition of criminal sanctions.
- Knowledge of the treatment literature. In recent years, a proliferation of studies have been conducted to examine the effectiveness of treatment with abusive men. Edelson & Tolman (1992), in particular, have identified a number of program characteristics that contribute to successful outcome. There is also consensus by many service providers that certain intervention techniques may prove harmful to the victims of abuse if not closely monitored. For example, programs which focus exclusively on anger management and behavioral change have been criticized. Gondolf (1985) argues against anger control groups because:
- Extensive knowledge of community resources. Know what services (legal, treatment, emergency housing, etc.) are available for men, women and children.
- Awareness of personal attitudes, values and beliefs. Consistent with standard 11.10 of the Canadian Code of Ethics for Psychologists (1991), it is important that the psychologist "evaluate how their own experiences, attitudes, culture, beliefs, values, social context, individual differences and stresses influence their interactions with others, and integrate this awareness into all efforts not to benefit or harm others" (p.15). To ensure that the abusive male is held accountable for hurtful and controlling behaviour, it is necessary that psychologists examine their own attitudes and behaviours, and to challenge any sexist, racist or homophobic beliefs that they may hold. Psychologists must also learn to identify and challenge the various rationalizations held by men who abuse women. Many of these rationalizations are deeply rooted in social and cultural messages which condone inequality between men and women. As indicated previously, many abusive men report incidents of victimization in their personal histories or present as emotionally distressed. At times of disclosure, it is easy for a professional to exacerbate this feeling of victimization or to subtly collude with the client. This tends to absolve the client of responsibility for his own actions and can help him to rationalize the use of behaviours which are hurtful and controlling.
- Resources. A vast amount of resource material on family violence is available through a variety of sources, including family violence programs, the National Film Board, and specialized book stores (i.e., women's book stores). The psychologist should have an awareness of the resource materials available and should be able to critically evaluate them.
i) they imply at some level that the victim did something to provoke violence;
ii) they do not account for the premeditated abusive behaviours of men (i.e., abusive men tend to have strategies for dealing with anger towards colleagues, friends or neighbours, but they do not control their behaviour toward their partner);
iii) they fail to address the normative reinforcements for wife abuse and for violence against women in general;
iv) research has demonstrated that as some men become less physically violent they adopt more sophisticated ways of maintaining control in the relationship. For example, a male might take a "timeout" when he feels he is losing control. However, if he uses this tactic to withdraw from the situation and then "punishes" his partner by staying away, he has simply replaced an old controlling behaviour with a new one (p.3).
An additional example of an intervention approach that may be harmful to victims of abuse is conjoint therapy. A reliance on "couples counselling" in cases of domestic assault has been highly criticized because:
i) it implies, at some level, that the victim is somehow responsible for the event;
ii) it seeks to repair a relationship which may contribute to increased danger for the victim;
iii) an abused woman may not feel it is safe to speak openly in treatment and that anything she says may place her at risk for further retaliation; and
iv) the woman and man are given the implicit message that both share the responsibility for the violence (Edelson & Tolman, 1992).
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