Academic journal article Journal of Marital and Family Therapy

Developing a Manualized Couples Treatment for Domestic Violence: Overcoming Challenges

Academic journal article Journal of Marital and Family Therapy

Developing a Manualized Couples Treatment for Domestic Violence: Overcoming Challenges

Article excerpt

This paper describes challenges faced in a four-year project to develop a manualized couples treatment program for domestic violence. The couples treatment program is an add-on to a male batterer program where the male partner has perpetrated mild-to-moderate violence, yet both partners want to remain together. The project involved the cooperation of a variety of community agencies and referrals from key domestic violence programs. While some anticipated challenges did not materialize over the course of the project, unanticipated challenges did. Qualitative data collected from therapists and clients throughout the project was used to refine the treatment approach.

The Virginia Tech Domestic Violence Focused Couples Treatment Program began in 1997 with funding from the National Institute of Mental Health (NIMH). The goal of the project was to develop and pilot test a 12-session manualized treatment program for couples who choose to remain together after experiencing mild to moderate male perpetrated violence in their relationship. Solution-focused therapy forms the overall philosophical framework for this integrated treatment program (de Shazer, 1985; O'Hanlon & Weiner-- Davis, 1989). The treatment model, and the rationale for choosing a solution-focused approach, are discussed elsewhere (see Tucker, Stith, Howell, McCollum, Rosen, 2001; Stith, McCollum, Rosen, & Locke, in press). The purpose of this paper is to assist Marriage and Family Therapy (MFT) outcome researchers by describing how we were able to overcome challenges faced in doing outcome research in partnership with community agencies. While this collaboration posed a number of problems, if MFT researchers are to develop clinically relevant treatments, we must work with practitioners and community agencies to do so (Donenberg, 1999; Weisz, Donenberg, Han & Weiss, 1995)

Couples treated in this project were recruited via community domestic violence programs as well as through probation officers, newspaper advertisements, and letters sent to therapists and social service agencies. Couples were excluded if there was severe violence, current alcohol or drug use, threat or use of weapons, possession of guns in the home (and refusal to relinquish those guns), and/or refusal to sign a no violence contract. Male-female co-therapy teams provided all treatment. Conjoint treatment began after the men attended a minimum of six sessions of a male batterer's program. Therapists were graduates of, or advanced interns in, our master's level Commission on Accreditation for Marriage and Family Therapy Education-accredited MFT training program.

All clients and therapists completed post-session evaluation questionnaires at the end of each session to provide feedback on what was and was not helpful about each session. Selected clients and their therapists also completed tape-recorded, qualitative interviews at intervals throughout the 12 weeks of treatment to provide their views about what was, and was not, effective and helpful in the treatment program. Preliminary outcome findings are encouraging. Men in the couples program significantly reduced their levels of physical and psychological abuse over the course of treatment and also report positive changes in their attitudes toward violence against women. At 3-month follow-up, women in the couples treatment program reported that they were significantly less afraid of being abused by their partners than they were at pre-test. A full report of the outcome findings is in preparation.


Compliance with a Treatment Manual

Although all therapists were selected because of their high level of skills, none had ever used a treatment manual. This is consistent with training programs in general. For example, only a fraction of clinical psychology students are trained in the use of manual-based treatments (Task Force on Promotion and Dissemination of Psychological Procedures, 1995). …

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