Evaluation of a Health Care Provider Training Program to Identify and Help Partner Violence Victims

This study tested four hypotheses about the impact of a 3-h domestic violence training program with 752 health care providers on attitudes and values related to screening and helping partner violence victims. Hypotheses 1, 2, and 3 were that training would be related to: 1) increased self-efficacy to identify and help partner violence victims, 2) increased endorsement of the role of health care providers and settings for helping partner violence victims, and 3) increased comfort making appropriate community referrals to help partner violence victims. Hypothesis 4 was that training effects would be moderated by prior training and by prior experience with helping a victim. Following training, health care providers reported increased self-efficacy, increased comfort making appropriate community referrals, and increased valuation of health care providers and the health care system as having an important role in stopping domestic violence. Hypothesis 4 was also supported. Prior training and/or experience with an abuse victim predicted smaller changes in the dependent variables. These gains held at a 6-month follow-up. Implications for training curriculum design are discussed, in addition to institutional policy implications for determining the benefits versus costs of universal training, including staff who demonstrate prior training or experience with battered victims. Study limitations and future research directions, including the need to measure performance and policy compliance will also be outlined.     

Personality correlates of men who batter and nonviolent men: Some continuities and discontinuities

The present study investigated personality and family-of-origin differences among three groups of domestically violent men and a nonviolent comparison group, matched for age and education. The domestic violence groups consisted of male batterers referred for treatment (agency identified batterers) who were alcoholic (n=38) or nonalcoholic (n=61), and a third group who were identified through community sampling as maritally violent (n=28 community batterers). Multivariate analyses of variance of the Millon Clinical Multiaxial Inventory (MCMI) showed that, compared to nonviolent controls, alcoholic and nonalcoholic batterers showed higher levels of borderline characteristics. Furthermore, alcoholic batterers showed the highest MCMI elevations, followed by nonalcoholic batterers. Community-identified batterers showed no predicted significant differences from the nonviolent controls. On measures of family-of-origin pathology and disruption, only alcoholic batterers differed significantly from nonbatterers on report of both experienced and witnessed abuse victimization.Based on a paper presented in: A. Holtzworth-Monroe (Chair)Research on Marital Violence: What We Know, How We Can Apply It. Symposium presented at the meeting of the Association for the Advancement of Behavior Therapy, New York, November 19, 1988.     

Consistency and Accuracy of Batterer Typology Identification

Researchers in the field of domestic violence have derived “typologies” to better conceptualize the differences found among batterers (e.g., Holtzworth-Monroe and Stuart [1994]. Psychol. Bull. 116: 476–497). Efforts have since been made to evaluate clinicians' accuracy in classifying batterers into subtypes (Langhinrichsen-Rohling, Huss, and Ramsey [2000]. J. Fam. Violence 15: 37–53). The present study investigated the accuracy and consistency with which experienced clinicians could sort profiles into an empirically derived MCMI-based batterer typology (Hamberger, Lohr, Bonge, and Tolin [1996] Violence Vict. 11: 277–292). Seven PhD level psychologists with experience in the field of domestic violence were asked to sort 36 MCMI profiles into three piles. Each pile was represented by each of the three prototypical cluster types described in Hamberger et al. (1996) using the Basic 8 MCMI subscales. Overall, expert raters were able to sort most profiles into the three clusters accurately. However, the expert raters had the most difficulty correctly sorting some of the “nonpathological” profiles, as 40% were placed into the antisocial cluster and (6%) were sorted into the negativistic-dependent cluster. There are a number of possible explanations for the lower accuracy in sorting the nonpathological cluster. Results suggest that psychologists with domestic violence training can accurately sort MCMI profiles of batterers into the main three subtypes derived from empirically-based typology research. Clinical implications for typology assessment are discussed.     

We've had training, now what? Qualitative analysis of barriers to domestic violence screening and referral in a health care setting

The present study assesses barriers to identification and referral of domestic violence (DV) victims by staff at a health care institution following a 3-hr DV training program in which 752 health care providers participated. Focus groups are conducted with staff in hospital departments that serve a high volume of women. Responses to focus group questions identify system-wide and individual hospital department barriers. These barriers have implications for health care organizations trying to implement DV screening protocols through training alone to change staff behavior in diverse clinical settings. Limitations of this study and future research recommendations are also discussed.