Assessing the Effect of Batterer Program Completion on Reassault: An Instrumental Variables Analysis

The main objective of this paper is to investigate the utility of using the instrumental variables (IV) method to estimate batterer program efficacy, i.e., the program effect among batterers who complete batterer programs. This method takes account of possible confounding due to unmeasured traits of compliers and non-compliers. A structural model is used to estimate the impact of program completion on reassault using instrumental variables (IV) regression. Data on 640 batterers enrolled at three batterer programs are used. Results obtained from IV regression are compared with those obtained from a more traditional regression analysis. The results indicate that usual regression methods yield estimates of program effect that may be biased due to confounding by unmeasured batterer characteristics. Unfortunately, IV estimates may be unreliable due to failure of some of the assumptions on which they are based. If equations are adequately identified by the non-linear functional form used to estimate them, then IV results indicate that among a very select group of batterers, program completion significantly reduces the probability of reassault. The implications of confounding due to program non-compliance, program non-enrollment and attrition for future evaluations of batterer programs are discussed.     

Time-Varying Risk Factors for Reassault Among Batterer Program Participants

This study uses longitudinal data to identify risk markers for reassault among batterer program participants. Data are from 308 men and their partners collected at five, 3-month intervals. Time-varying situational and behavioral risk factors, as well as time-invariant individual characteristics, are examined. The most influential risk markers, in terms of relative risk and level of statistical significance, were time-varying: 2 measures of the man's drunkenness during the follow-up interval in which the reassault occurred (OR: 3.5-16.3; p > .0005). Other included time-varying batterer characteristics had no significant effect on reassault. Two significant time-invariant batterer risk factors were (1) severe psychopathology and (2) a history of non-domestic-violence arrest, both measured at intake. Results suggest that batterers' drinking behavior after program intake may provide an important and easily observed marker for risk of reassault and that prediction of reassault with individual risk factors at program intake remains problematical.     

Nonphysical Abuse Among Batterer Program Participants

Nonphysical abuse of women is receiving increased attention, but research with clinical samples of batterers has not substantially addressed the risk markers of nonphysical abuse. A multisite sample of batterer program participants (n = 840) with a longitudinal 15-month follow-up was used to identify risk markers. Logistic regressions were computed with batterer characteristics for 4 categories of nonphysical abuse (i.e., control, verbal, threats, combined) reported by the batterer's female partners during the follow-up. The only substantial and consistent risk markers were nonphysical and physical abuse prior to program intake and program dropout. The programs appear to help reduce the abuse. Other significant risk markers varied across the categories of nonphysical abuse, suggesting that the categories do not form a continuum or hierarchy of abuse. Recurrent abuse, moreover, continues to be more difficult to predict in clinical samples than in the general population.     

Predictors of Underreporting of Male Violence by Batterer Program Participants and Their Partners

Self-reports on domestic violence inventories remain the basis of court and clinical decision-making and program outcome evaluations, but previous research questions their reliability and validity. Accurate prediction of underreporting would help practitioners and researchers adjust batterer and victim self-reports. We develop prediction equations of underreporting on the Conflict Tactics Scale, using a multi-site database of men admitted to batterer programs and their female partners (n = 840). First we use variables measured at program intake to predict female and male underreporting of male violence at program intake. Second, we use variables measured at program intake, as well as measures of program participation, to predict male-female disagreement (male underreporting) at 12-month follow-up. Several variables were predictive of underreporting, both at intake and follow-up, but overall prediction was marginally better than chance. The findings suggest that men and women underreport based on situational factors (such as relationship characteristics) and rational reasons, rather than based on personality traits or social desirability. However, the ability to predict underreporting is too weak for adjustment of self-reports by clinicians and program evaluators.     

Outcomes of Case Management for African-American Men in Batterer Counseling

Case management for additional referrals has been recommended especially for African-American men in batterer counseling programs. Additional services addressing “at risk” needs may help to improve batterer program outcomes. To test this expectation, a quasi-experimental evaluation of a case management project was conducted for both “intention-to-treat” and “received-treatment.” The case management included brief assessment at batterer program intake, referral to relevant services, and follow-up calls from batterer program staff. Re-assault and re-arrests during a 12-month follow-up, along with program dropout from the 16 required sessions of the batterer program, were compared for 202 African-American program participants under case management and a sample of 482 African-American participants previously in the batterer program. In both bivariate and confirmatory multivariate analyses, neither the case management nor actual service contact significantly improved outcomes. However, the small portion of men contacting drug and alcohol treatment did tend toward better program outcomes. Poor implementation of the case management procedures may have contributed to the overall weak effects.     

Injuries and Health Care Use in Women with Partners in Batterer Intervention Programs

Objective:To characterize injury frequency, injury patterns, and health care seeking behavior in women with intimate partners enrolled in batterer intervention programs. Methods: A standardized telephone interview was conducted on a sample of women with male partners enrolled in batterer intervention programs in four U.S. cities. Information on prior injuries and the utilization of health care services was sought. Results: Four hundred and eighty eight of the 648 women (75.3%) reported a history of prior injury as a result of abuse. Contusions were the most common injury. Of the women reporting contusions, 233 (51.4%) reported contusions as their only injuries. Another 220 women (48.6%) reported other injuries in addition to contusions. In the majority of cases (63.2%) the contusions were to multiple body parts. When the contusion involved only one anatomical region, it was mostly to the face. A total of 192 of the 488 injured women (39.3%) reported ever seeking medical care for injuries caused by their intimate partner. Twenty-three women (4.7% of the injured cohort or 3.5% of the total cohort) reported having ever been hospitalized for injuries sustained from abuse.     

Battered women's perceptions of risk versus risk factors and instruments in predicting repeat reassault

This study partially replicates and expands on a previous study that showed women's perceptions of risk to be a strong predictor of reassault among batterers. The current study employed a larger and multisite sample, a longer follow-up period of 15 months, and multiple outcomes including "repeated reassault" (n = 499). According to the multinomial logistic regressions, women's perceptions of risk improved prediction with risk factors (ROC area under the curve improved by.04 and sensitivity of repeated reassault increased 12 percentage points). In comparison to simulated risk instruments, women's perceptions by themselves were better predictors than the K-SID, similar in predictive ability to the SARA, and almost as strong as the DAS. The best prediction of repeated reassault was obtained using risk markers, including women's perceptions (ROC AUC =.83; 70% sensitivity) or by using the DAS and women's perceptions together (ROC AUC =.73; 64% sensitivity).     

Adulthood animal abuse among women court-referred to batterer intervention programs

The substantial increase in the enrollment of women in batterer intervention programs (BIPs) over the past 30 years has greatly outpaced research on women who perpetrate intimate partner violence (IPV). As a result, it is unknown whether existing programs, which were originally designed to treat male perpetrators, are effective at preventing recidivism among women. Recent research shows that men who perpetrate IPV may also aggress against nonintimate partners, children, and animals, and that the reach of their aggressive tendencies has implications for treatment. Conducting similar investigations on women who perpetrate IPV may help to inform treatment delivery in BIPs. This study examined the prevalence of adulthood animal abuse perpetration and its association with psychological and physical IPV perpetration in a sample of women arrested for domestic violence (N = 87). Seventeen percent (n = 15) of the women committed at least one act of animal abuse since the age of 18, in contrast to the 0.28% prevalence rate reported in the general population. The overrepresentation of animal abuse in this sample was consistent with that of men arrested for domestic violence. Furthermore, women who reported committing animal abuse as an adult showed moderately higher rates of psychological aggression and physical assault perpetration against their partners, relative to women who did not report animal abuse. Implications for future research are discussed.     

Outcomes from Referring Batterer Program Participants to Mental Health Treatment

A quasi-experimental study was conducted to investigate the impact of referral to supplemental mental health treatment for batterer program participants who screened positive for mental health problems. The principal outcome measure was re-assault reported during a periodic 12-month follow-up with female partners (n = 308). Batterer program completion and other abuse indicators were also considered. Mandatory court referral to mental health treatment produced no significant improvement in batterer program completion, re-assault and other abuse indicators. These results may be influenced by the low compliance to the referral, since the select number of men who did comply with a mental health evaluation (n = 48 of 148) and those who received treatment (n = 28 of 148) did better than those who did not. Simplified referral procedures or integrated treatment services might prove to be a more effective approach.

Pre-program attrition in batterer programs

The outcome of batterer programs has become a topic of research and clinical concern in recent years. There has been little assessment, however, of the input of these programs and its implications. This study analyzes the records of 200 inquirers to a batterer program during 1989–1990 to determine the attrition rates based on the initial number of inquirers. The attrition from inquiry to intake is 73%, from inquiry to counseling attendance is 86%, and from inquiry to 12 counseling sessions is 93%. Only 1% actually completed the contracted 8 months of counseling sessions. The only background and protocol variable significantly associated with intake attrition was marital status. Those inquirers referred from informal referral sources and paying high monthly fees were more likely to attend over 12 counseling sessions. The 1990 inquiry-to-counseling attrition rates were higher than the program rates in the early 80s and higher than a comparable program with no separate intake session. The implications of these findings for pre-program protocol are discussed.     

Evaluating programs for men who batter: Problems and prospects

The uncertainty and controversy that surround batterer programs beg more systematic evaluation of program effectiveness. The current national surveys and limited evaluations of batterer programs point to several methodological improvements that include comparisons of program modalities, observation study of the group interaction, and more sensitive measures of abuse. Therefore, suggestions for future evaluations are posed, and continuing problematic areas, such as access to the victim, sensitized responses, selectivity of clients, and community context, are discussed.     

Effects of Motivational Enhancement on Immediate Outcomes of Batterer Intervention

This article presents results of a quasi-experimental trial of a 6 week motivation enhancing intervention for batterers highly resistant to intervention. One hundred and forty one (29%) highly resistant batterers were identified from a consecutive sample of 486 men referred to a large batterer intervention program. Resistant batterers attended either standard intervention (16 weeks) or a specialized 6 week motivation enhancing group followed by 10 weeks of standard intervention. Observation of counselor behaviors confirmed significant differences in rates of confrontation across groups. Analyses of immediate program outcomes provide some support for the value of motivation enhancing intervention. Resistant batterers who attended specialized intervention completed intervention at a significantly higher rate (84.2%) than both resistant clients in standard intervention (46.5%) and non-resistant clients (61.1%). Differences were maintained even after controlling for demographic and lifestyle related predictors of attrition. Advantages of specialized intervention did not extend to counselor-rated success at meeting core treatment goals. Discussion focuses on the implications of these results for the use of motivation enhancing intervention strategies to improve attendance at batterer intervention programs.     

To leave or to stay?: Battered women's concern for vulnerable pets

Consistent with previous research, almost half of a sample of 41 pet-owning battered women reported that their partners had threatened or actually harmed their pets, and over a fourth reported that concern for their pets had affected their decisions about leaving or staying with the batterer. Differences between rural and urban women were not significant, although higher proportions of rural than urban women reported that their partners had threatened or harmed their pets and that concern for their pets had affected their decisions. For the sample as a whole, logistic regression analyses showed that women whose pets had been threatened or harmed were significantly more likely to report that concern for their pets had affected their decisions about leaving or staying. The findings suggest that service providers should inquire about battered women's concern for their pets and should include arrangements for animals in safety planning.     

Predicting batterer recidivism five years after community intervention

The purpose of this study was to examine batterer recidivism rates 5 years after community intervention and to determine differences that discriminate between recidivists and nonrecidivists. Of the 100 men included in the sample, 40% were identified as recidivists because they were either convicted of domestic assault, the subject of an order for protection, or a police suspect for domestic assault. A discriminant analysis was conducted using a variety of background and intervention variables. Five variables were selected that significantly discriminated between recidivists and nonrecidivists and correctly classified 60.6% of the cases. Men who had been abusive for a shorter duration prior to the program, court ordered to have a chemical dependency evaluation, in chemical dependency treatment, abused as children, and previously convicted for nonassault crimes were more likely to be recidivists. Variables relating to intervention did not significantly predict recidivism. Implications for community intervention programs are discussed.     

A meta-analytic review of court-mandated batterer intervention programs: Can courts affect abusers’ behavior?

Court-mandated batterer intervention programs are being implemented throughout the United States to address the problem of domestic violence. Prior reviews of research on the effectiveness of these programs have arrived at conflicting conclusions. This study is a systematic review of the extant research on this topic. Experimental and quasi-experimental studies that used matching or statistical controls were included. The results were mixed. The mean effect for official reports of domestic violence from experimental studies showed modest benefit, whereas the mean effect for victim reported outcomes was zero. Quasi-experimental studies using a no-treatment comparison had inconsistent findings indicating an overall small harmful effect. In contract, quasi-experimental studies using a treatment dropout design showed a large, positive mean effect on domestic violence outcomes. We discuss the weakness of the latter design and raise concerns regarding official reports. The findings, we believe, raise doubts about the effectiveness of court-mandated batterer intervention programs.     

The impact of length of domestic violence treatment on the patterns of subsequent intimate partner violence

Randomized clinical trials (RCTs) have been used for several decades in criminal justice research to assess the benefits of interventions. RCTs have been employed with some frequency in evaluating batterer intervention programs (BIPs); between 1990 and 2005, there were five RCTs of BIPs. While most of these studies failed to find positive findings, one conducted in Brooklyn, New York, appeared to detect a positive effect of a BIP on domestic violence re-offending. Subsequent inspection of the data, however, revealed several complicating factors that led us to reanalyze these data. Our reanalysis focused on whether the intervention temporarily suppresses abusive behavior during the time that offenders are under court control, or whether the program produces lasting changes in offender behavior. With improved data analysis techniques, additional outcome data, and several alternative analytical models, we arrive at an alternative conclusion than is reported in the original publication. While we still find evidence of a reduction in the number of new incidents across a 15-month period due to treatment assignment, we now find that the effect of attending treatment does not likely persist beyond the treatment period once the treatment measure is specified as a time-dependent parameter rather than a fixed effect. This outcome is more consistent with a suppression/supervision explanation rather than a therapeutic outcome explanation. The implications of these results are discussed.     

PARENTAL CONFLICT RESOLUTION

Six-, 12-, and 15-month follow-up data are presented evaluating a program for high-conflict parents. Funded by a grant from Health and Human Services, the program's content reflects an extensive review of research literature, including the relevant literature on personality disorders. Introduced in Phoenix, Arizona in October 1999, the program has served more than 1,000 families in several jurisdictions. Whereas other programs for entrenched, high-conflict cases are typically time intensive, involving 2 to 6 months, this is a one-time 4-hour program. As such, the authors are heartened to report a suprisingly positive—and enduring—response from the parents.     

Stage of Change as a Predictor of Attrition Among Men in a Batterer Treatment Program

This study assessed the contribution of the men's stage of change to the prediction of attrition among men attending a batterer treatment program. As outlined by the transtheoretical model of change, men were classified into the precontemplation, contemplation, or action stage based on their level of change motivation and behavior. It was hypothesized that men in the precontemplation stage would dropout of treatment at higher rates than men in later stages of change. Participants were 308 men who enrolled in a batterer treatment program over the course of 1 year, 61.4% of whom dropped out of treatment. Counselor rated, but not self-rated stage of change significantly predicted treatment completion once traditionally used demographic, contextual, and personality variables were taken into account. Specifically, men identified by counselors as being in the precontemplation stage were 2.3 times as likely as men rated in the contemplation stage and 8.8 times as likely as men rated in the action stage to dropout of treatment. Referral source, age, and history of arrest also made significant contributions to the prediction of attrition. The best combination of predictors led to the successful classification of 72% of the cases, 98% of the dropouts but only 19% of the completers. Discussion focuses on the limitations of current findings and their implications for the use of the transtheoretical model to predict attrition from batterer treatment.     

Extent and characteristics of woman batterers among federal inmates

Efforts to identify men who batter women in clinical settings have increased in recent years, but batterer research in United States federal prisons is lacking; low security federal prisons are logical places to consider batterer screening and treatment given the number of men, the domestic violence "risk markers" associated with these men and the likelihood they will be released and return to female partners. This study examined intake assessment data for 115 low security federal inmates. The inmates evidenced high levels of risk markers for woman battering, one in three (33%) acknowledged recent physical violence against women partners, 1 in 10 (13%) admitted severe violence, and the self-identified batterers showed more substance use and personality problems than other inmates. The findings suggest that batterer screening and treatment may be needed in federal prisons and that more research is warranted with a burgeoning male population that ultimately returns to society.