Feminist-Cognitive-Behavioral and Process-Psychodynamic Treatments for Men Who Batter: Interaction of Abuser Traits and Treatment Models
Saunders, Daniel G., Violence and Victims
At a community-based domestic violence program, 218 men with a history of partner abuse were randomly assigned to either feminist-cognitive-behavioral or process-psychodynamic group treatments. The treatments were not hypothesized to differ in outcome. However, men with particular characteristics were expected to have lower recidivism rates depending on the type of treatment received. Treatment integrity was verified through audio-taped codings of each session. The partners of 79% of the 136 treatment completers gave reports of the men's behavior an average of 2 years post-treatment. These reports were supplemented with arrest records and self-reports. Rates of violence did not differ significantly between the two types of treatment nor did reports from the women of their fear level, general changes perceived in the men, and conflict resolution methods. However, interaction effects were found between some offender traits and the two treatments. As predicted, men with dependent personalities had better outcomes in the process-psychodynamic groups and those with antisocial traits had better outcomes in the cognitive-behavioral groups. The results suggest that more effective treatment may occur if it is tailored to specific characteristics of offenders.
Since the 1970s treatment programs for men who batter have proliferated, but tests of their effectiveness have not kept pace. Evaluations rarely include adequate comparison or control groups. For example, of the 26 studies reviewed by Hamberger and Hastings (1993) and Tolman and Edleson (1992), only 7 had comparison groups and only one of them had a true experimental design. Moreover, the posttreatment follow-up periods have generally been brief and do not always rely an reports from the men's partners, which are the most reliable sources of information. These studies and the problems with their methods have been carefully reviewed elsewhere (Hamberger & Hastings, 1993; Holtworth-Munroe, Beatty, & Anglin, 1995; Rosenfeld, 1992; Tolman & Edleson, 1995; Saunders & Azar, 1989).
The most commonly evaluated method is cognitive-behavioral, primarily in a men's group format and usually combined with gender role resocialization and methods to reduce male dominance. Only one study could be founded which experimentally compared this approach with another approach. Edleson and Syers (1990,1991) compared: (1) a minimally structured self-help model with a peer facilitator and professional consultant, (2) a structured educational model (cognitive-behavioral) with regular readings and assignments, and (3) a combined model that presented material in less detail than the educational model and allowed more time for work on individual problems. Reports from 52% of the partners, or 8% of the men 6 months after treatment, nonsignificantly favored the education and combined groups. At 18 months posttreatment, reports from 46% of the women or the men showed even less difference among treatment approaches. Other studies used quasi-experimental designs or had small samples (e.g. Dutton, 1986; Harrell, 1990; Stosny).
In the study reported here, I attempted to improve on previous evaluations by obtaining a higher rate of response during follow-up and by ensuring that the treatments were applied according to their stated goals. The study also tested more theoretically distinct treatment models than the Edleson and Syers comparison. Risk factor research on domestic violence, which supports a number of theoretical explanations for domestic violence (Van Hasselt, Morrison, Bellak, & Hersen, 1988) suggested two different approaches for comparison. This research consistently shows that boys who witness violence between their parents or who are abused themselves are more likely to be spouse abusers when they grow up (Hotaling & Sugarman, 1986). Psychological abuse of boys by their parents also seems to be a risk factor (Dutton, van Ginkel, & Starzomski, 1995). However, different theories can be used to explain the intergenerational transmission of violence. …