Evaluating the effectiveness of a court sponsored abuser treatment program

The literature on abuser treatment programs reveals the following problems: (1) the dominance of shelter-related abuser programs, (2) little understanding of the effectiveness of such programs, and (3) low recruitment and high attrition rates in shelter-related programs. This study attempts to deal with some of these difficulties by an evaluation of a court mandated abuser treatment program. The sample used in this study includes a treatment group of 120 court-referred abusers and a control group of 101 nonreferred abusers. The research was designed to deal with problems such as differential participation in the treatment sessions and self-selection bias. Results indicated that the relationship between treatment attendance and recidivism was not linear. Only those defendants who attended 75% of the treatment sessions or more have decreased recidivism; others showed no impact. Some policy implications are also discussed.     

Spouse abuse: An integrative-interactional model

Although spouse abuse is a psychosocial problem and needs to be addressed from an ecological perspective, many clinicians confront this family issue daily. Outlined are some practical suggestions on how to deal with the abuser and the couple when one or both are clients. This work emphasizes the importance of contracts that are related to the level of work being done. Suggestions are made regarding the important considerations in the first few meetings when working with groups of men in the community. Interventions are derived from a broadly conceived cognitive-behavioral-systems perspective.     

Elements Needed for Quality Batterer Intervention Programs: Perspectives of Professionals Who Deal with Intimate Partner Violence

Batterers intervention programs (BIPs) constitute a primary intervention for perpetrators of intimate partner violence (IPV). There is little understanding as to what elements are necessary for a good intervention program. We conducted 36 individual semi-structured interviews with professionals working with BIPs. Our results yielded three thematic categories: (1) optimal BIP structure—group size and program duration should foster change and interaction, (2) facilitator characteristics—co-facilitation is ideal, and facilitators should have IPV training, and (3) program approaches–programs should challenge their clients on their behavior, promote an environment of safety and openness, and strive to adapt to clients.     

Predicting Attrition From Treatment Programs for Abusive Men

Attrition in male battering treatment programs is a serious problem. To keep clients in treatment, it is crucial to understand why they drop out. The current study examined the contribution of both client and program characteristics in predicting dropout from treatment programs for abusive men. Data were collected at intake from 306 abusive men who sought treatment at four different sites. The rate of preprogram attrition (from intake to the first treatment session) was higher in the program that had a lengthy waiting list (46%) than in the other programs amp lpar3%-13%). In-program attrition was more highly related to client characteristics than program characteristics (all programs had rates between 36% and 42%). Those men who dropped out after starting treatment tended to have unstable lifestyles (e.g., substance abuse problems, criminal history, unemployment) and to have inflicted more severe abuse than those who completed treatment. Results also supported a significant interaction between verbal aptitude and structure of program; men with low verbal aptitude were the most likely to drop out of an unstructured program. Possible strategies for preventing attrition are discussed.     

A Theoretical Model of Drug/DUI Courts: An Application of Structural Ritualization Theory

Past studies of Drug/DUI courts primarily focused on outcome evaluation and policy-driven issues, but lacked an effective theoretical framework for understanding drug court programs, in particular the interaction between the program and clients. In this study, we apply structural ritualization theory (SRT) to the Drug/DUI program and argue that such programs serve two key functions, to disrupt clients’ old rituals (e.g., drug/alcohol abuse, committing crimes), and to help lay a foundation for building new abstinent and noncriminal ritualized practices for clients both in and after the drug court program. We further argue that the effectiveness of drug program functions and services at the organizational level and the success of clients’ transformation at the individual level can be empirically measured and studied by four elements of SRT, including salience, repetitiveness, homologousness, and resources. Policy implications are drawn based on the contribution of SRT.     

Reducing public expenditures for physician services: the price of paying less

The purpose of this paper is to examine how physicians respond to changes in payment levels from government insurers. Our analysis focuses on two issues: controlling overall program expenditures, and assuring full access to care for program clients. We review evidence from natural experiments in which payment levels were increased, frozen, or decreased. These studies show that freezing or reducing payment levels is not effective in controlling program expenditures, because physicians responded by increasing the quantity and complexity of services provided. Furthermore, when government programs freeze or reduce their payment levels, physicians are less likely to treat the clients of these programs. We conclude that policymakers must seek alternative strategies for controlling program expenditures.     

Taking Action to Stop Violence: A Study on Readiness to Change Among Male Batterers

The Transtheoretical Model of Change (TTM) predicts that matching interventions with a person’s readiness to change should improve treatment outcomes. This cross-sectional correlational study examined characteristics that affected self-reported readiness to change abusive behavior among a sample of 109 men in a 52-week batterer treatment program. Participants completed measures of anger/hostility, readiness to change, manipulative parenting, and self-esteem. Results indicated that contemplation of the impact of abuse has the highest unique relationship with self-reported taking action to stop violence. Moreover, physical aggression and manipulative parenting account for significant variance in the scores associated with self-reported taking action to stop violence as well. These findings suggest that interventions aimed at moving clients into contemplation, and reducing physical aggression and manipulative parenting styles, may increase the likelihood that batterers will take action to stop violence.     

What shall I do now? Released offenders' expectations for supervision upon release

In an outcome evaluation of recovering addicts who participated in a prison-based therapeutic community, 39 clients (a nonrandomized subsample) were interviewed about their rehabilitation and reintegration experience. The study focused on participants' perceptions of how essential the continuum of treatment and supervision after release was. Whereas many studies have shown that participating in prison-based drug treatment programs reduces likelihood of recidivism, clients in this study suggested that other factors might be equally important-in particular, the importance of the continuum of treatment after release and/or being supervised in the community. Findings are discussed in regard to inmates' expectations, confusion upon release, and formal support mechanisms; suggestions for further research are made.     

How the Framework of Implementation Science Guided an Evidence‐Based Dependency Parenting Program Initiative in Florida

In Florida, like most states, many of the parenting programs that are being utilized with families in the dependency system are non‐evidence based, and fail to provide quantifiable data on parent progress during and after completion of the programs. Providing pertinent information in court on parents’ progress in a parenting program, as opposed to simply monitoring attendance, is a growing need voiced by dependency judges and child welfare case management professionals. Clear, reliable information related to parenting skills acquisition and insight can help to ensure that families involved in the child welfare system have access to quality services that improve outcomes for their children. The purpose of this paper is to detail how a statewide initiative to increase the number of Florida circuits providing evidence‐based parenting programs to their clients utilized implementation science to guide their process, and the degree to which the participating circuits achieved full implementation of evidence‐based parenting programs.     

Rural Versus Urban Victims of Violence: The Interplay of Race and Region

This paper examines individuals who were victims of domestic violence in Illinois between 1990 and 1995, comparing the traits and service needs of those who received assistance in an urban county over the 5-year period with those who were served by domestic violence programs in rural areas. Analysis focuses on the demographic characteristics of clients in each region, their relationship to the abuser, type of abuse, referral source, and need for both concrete and supportive services. In addition to looking at variations by region, analysis examines differences between African American and White clients within and across geographic areas so that the interaction of race and location is highlighted. Results indicate that apart from demographic differences related to race, there is little difference in the circumstances of abuse when victims in the urban region are compared to rural victims of violence. However, those in rural environments regardless of race, have more service needs. Differences in service needs also exist in relation to race, and for some services, both race and location are important. The implications of these findings for policy, practice, and future research are examined.     

Intervention

When a child is sexually abused there are two immediate and strong reactions; the abuser must be punished, the child must be helped. If the abuser is a stranger, there is no problem. The child and her family can be worked with and the abuser can be sent to prison with no one else hurt, except of course for the abuser's own wife and children. But if the abuser is a parent of the child, a choice may have to be made. Either treat the child or punish the abuser, usually not both. If the abusing parent is put in jail, the abused child will feel guilty, a parent who may be otherwise a valuable member of the family is gone, the family loses a paycheck, its standard of living tumbles, the abused child may be blamed by the rest of the family. The best treatment requires the whole family, the abuser and the abused, the mother who may be an enabler, the other children who are necessarily involved. Without the abuser, the treatment circle is not complete, the problems cannot be fully resolved, the children may yet grow up to be abusers themselves. If, as is usual, the abuser is part of the family constellation, a policy decision must be made, and early: to punish the abuser or to have adequate treatment. The sooner treatment can be started, the more effective it will be. Conversely, the sooner the abuser is jailed and charged, the fresher the evidence will be.     

An evaluation of a private alternative probation and counseling program: Predicting program outcomes from client characteristics

The purpose of this evaluation was to determine if client characteristics affected selected program outcomes. The sample consisted of 475 clients admitted into a for-profit, private alternative probation and counseling program between November 1, 1998 and February 28, 1999. Multiple regression analyses identified race, previous alcohol and drug treatment, and employment status as significant predictor variables of client compliance. Being able to target client characteristics that are associated with successful program outcomes can help programs fulfill their goals of diversion and costeffectiveness, thus making the most effective use of scarce resources.     

Core Consensus,Strategic Variations: Mapping Arts Management Graduate Education in the United States

This study is the first comprehensive curricular comparison of graduate arts management programs in the United States. Its principal finding is that there exists considerable curricular convergence among arts management programs and that their differences may be exploited strategically. Through extensive curricular analysis and in-depth conversations with faculty, this study makes both conceptual and methodological contributions to the field—conceptual because it provides an empirical basis for the definition of arts management as a formal academic discipline in its own right and methodological because it proposes a framework to effect a systematic comparison of arts management program curricula.     

Barriers to evaluating the effectiveness of drug treatment behind bars

The delivery of substance abuse treatment within correctional settings marks one of the criminal justice system's primary opportunities to disrupt the drugs-crime nexus. Federally funded residential substance abuse treatment programs were rapidly introduced across the nation, although implementation problems increased their operational variability. This article examines how implementation barriers interrelate with other types of obstacles and multiply to hinder determinations of program effectiveness. Specific barriers were identified from a case study of process and outcome evaluations of the South Carolina Residential Substance Abuse Treatment (RSAT) program. A conceptual framework groups barriers by type into four interrelated domains wherein additive effects and reciprocal consequences that can undermine effective program assessment are illustrated.     

SUPPORTING FAMILY STRENGTH: THE USE OF TRANSFORMATIVE MEDIATION IN A PINS MEDIATION CLINIC

This article describes, and explains the rationales for, the establishment of an innovative program in which a law school and two social services agencies are collaborating in a mediation clinic that uses the transformative model of mediation to serve clients in cases that seem ideally suited to benefit from this approach to practice—so-called "PINS" (persons in need of supervision) cases involving conflict within families, between parents and their adolescent children. The article first describes the evolution of the PINS system and the changing views of its purpose, especially in New York State. It then offers a brief introduction to the unique features of the transformative approach to mediation and explains why that approach in particular is likely to mesh with current understandings of the needs of the families involved in these cases. Finally, the article describes the innovative "Family Solutions Program" and how it uses transformative mediation to help these families and suggests that experience of this program shows how use of the transformative model, in particular, could be valuable not only for clinical education but also for effective volunteer training and supervision in mediation programs generally.     

Wise mind—risky mind: A reconceptualisation of dialectical behaviour therapy concepts and its application to sexual offender treatment

Abstract

This paper aims to introduce a reconceptualisation of dialectic behaviour therapy (DBT), “wise mind–risky mind”, and its application to sexual offender treatment. This reconceptualisation holds some promise in addressing issues around general, affective, cognitive and sexual dysregulation, and may provide an alternative way of thinking about sexual offender treatment. The wise mind–risky mind dialectical construct helps clients and therapists utilise a common language that captures and validates the experiential difficulties that clients go through in effectively managing their risk for sexual offending. The incorporation of DBT principles in standard sexual offender treatment programmes can assist clients in effectively managing problems with dysregulation in various domains. It can also afford a more integrated treatment framework when working with sexual offending dynamics. The authors discuss this new construct and its possible applications within the broader forensic mental health field.     

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.     

Recidivism among spousal abusers: predictions and program evaluation

The relative effectiveness of two interventions for dealing with 200 court-referred spousal abusers is examined. The overall failure rate is 17.5%, with most recidivism occurring during the first 6 months after treatment. Offenders who completed a 14-week group treatment program called SAFE manifest significantly lower rates of recidivism (10.6%) than do offenders who did not complete the mandated treatment (38.8%). Some high-risk clients are referred to a cognitive restructuring treatment program called R&R, and those completing both programs (despite their high-risk status) have a recidivism rate of only 23.5%. Prediction of recidivism is difficult, with the LSI-R scores correctly predicting only 66% of the outcomes, using a cut score of 11.5. The exploration of other predictors is encouraged.     

The Relationship Between Partner Abuse and Substance Use Among Women Mandated to Drug Treatment

This study investigates the relationship between substance use and partner abuse among women (N = 1,025) who entered drug-treatment programs through the criminal justice systems in New York City and Portland, Oregon. Self-report data on substance use and partner abuse indicate that although the rate of partner abuse in both cities is well above the national average, the less substance-involved women in Portland reported more abuse than their New York counterparts. Our analyses suggest that the relationship between partner abuse and substance use during conflicts varies within the population of women offenders who are heavily drug-involved, with women in Portland reporting a greater direct link between partner abuse and substance use. The findings indicate that there is a need for drug-treatment providers to understand their clients' victimization histories and the relationship between partner abuse and substance use in order to engage clients in the treatment process and help them learn how to avoid being victimized in the future.     

Engagement processes in model programs for community reentry from prison for people with serious mental illness

Linking prisoners with mental illness with treatment following release is critical to preventing recidivism, but little research exists to inform efforts to engage them effectively. This presentation compares the engagement process in two model programs, each representing an evidence-based practice for mental health which has been adapted to the context of prison reentry. One model, Forensic Assertive Community Treatment (FACT), emphasizes a long-term wrap-around approach that seeks to maximize continuity of care by concentrating all services within one interdisciplinary team; the other, Critical Time Intervention (CTI), is a time-limited intervention that promotes linkages to outside services and bolsters natural support systems. To compare engagement practices, we analyze data from two qualitative studies, each conducted in a newly developed treatment program serving prisoners with mental illness being discharged from prisons to urban communities. Findings show that the working relationship in reentry services exhibits unique features and is furthered in both programs by the use of practitioner strategies of engagement, including tangible assistance, methods of interacting with consumers, and encouragement of service use via third parties such as families and parole officers. Nevertheless, each program exhibited distinct cultures and rituals of reentry that were associated with fundamental differences in philosophy and differences in resources available to each program.