This article was originally written in 2004 and updated in 2018. In 2018 the opening 14 paragraphs of the article were updated to address non-traditional batterers (women and LGBTQ populations for example), given that men are not the only population to batter others. The opening sections now include more recent literature and research discussing a wider variation of batterers in the general population, along with links to resources for population specific treatment options and limitations. The remaining original article follows the updated paragraphs for those clients wishing to learn more about group batterer treatment program ideas with a discussion of what a male heterocentric treatment paradigm looks like, with examples given using a prototype format. Clients seeking batterer services individually (male, female and LGBTQ) are encouraged to read the updated sections below before scheduling.
—-Kurt LaRose MSW LCSW CHT CSW SUPERVISOR LICSW
Men who are arrested for battering their partners make up a relatively small percentage of the overall population; arrests do not accurately indicate prevalence for domestic violence, however the arrest numbers are higher for male batterers and for those considered to be in a minority group (such as men of color). Most batterer and domestic violence intervention models are based on the heterocentric world view, focusing on men as perpetrators and women as victims.
Heterosexual males are generally treated using the Duluth based model rooted in concepts such as the cycle of violence, the power and control wheel and the inequality wheel. Increasing literature and treatment models are emerging for women batterers and for batterers in the LGBTQ community, addressing the unique needs and variables at play for this minority group of batterers (see Wexler), because heterosexual males are not the only ones who perpetrate violence (and heterosexual females are not the only victims of domestic violence).
Men compared to women do have an advantage in what could be coined a biological power difference, largely because of muscle variations between the anatomy of males and females. Men generally (not always) in domestic violence relationships can and will overpower their female partners, as the batterers.
Batterers, whether they are male, female, straight, or LGBTQ batterers, often need specialty counseling services which are generally outside the scope of simple conflict resolution, assertiveness matters, boundary confusion, couples counseling, and basic improved communication tools.
Batterers usually should first be seen individually to assess what type of treatment is needed (the Duluth based model or a more contemporary Wexler based model) which includes research and literature that addresses non-conventional batterers, such as women who are violent and LGBT populations). The assessment would include a substance use disorder evaluation, given that there is a very high correlation between the use of substances and domestic violence, as well as a general mental health evaluation that also considers co-occurring mental health conditions. Financial matters, relationship history, stress and anxiety are other factors when conflicts result in battering.
Battering behavior invokes the emotions of victims who often enter mental healthcare with anxiety and depression like symptoms, along with PTSD and other presenting problems. Victims and perpetrators are both often reluctant to report violence due to their fears that counselors will have to report it (most do not, given the risks of reporting can lead to serious injury and even death to the victims). Too, there are clients who do self report or disclose violence, but because counselors may refuse to treat batterers or the counselor over reacts when a client first discloses, the batterer exits care.
When couples enter care for couples counseling, whether straight or LGBTQ, consideration for domestic violence and battering behavior must be included in the treatment trajectory. Here, it must be decided if individual sessions are indicated, if couples contracting and third party referrals are necessary, and whether the batterer can be treated as male, female or LGBTQ client anywhere near the community in which they live.
Batterers present treatment practitioners with a near insurmountable task. To treat the batterer and deem that they are no longer a threat to others is almost as difficult as it is to understand how a man chooses to abuse those he espouses to love. It is arguable as to whether or not the efficacy of batterer programs can really be determined, and once determined the most critical question becomes whether or not the assessments of batterer intervention programs are scientifically reliable and valid.
The definition of battering varies from state to state. For example in Colorado battering falls under the definition of domestic abuse and includes physical acts of violence, threatened acts of violence as well as psychological and emotional aspects of abuse (Corry, 2002). In Florida the statutes (as recently as 2004) were more limited in that there was no mention of psychological or emotional aspects of domestic abuse and the component of threats were not delineated (see Fla. §§ 741.28). On a national scale the Department of Health and Human Services (DHHS) and the Centers for Disease Control (CDC) define domestic abuse and battering, in a context that is closer to the Colorado interpretation including broader dynamics of battering such as coercion (DHHS, 2003). DHHS and the CDC estimates the cost of intimate partner violence at $5.8 billion per year with $4.1 billion being spent on medical and mental health services (DHHS, 2003).
It is reported that once in every nine seconds a woman is beaten in the U.S. (Koppelman, 1996 as cited in Olson, 2004). The incidence of male battering ranges from 1.8 million cases (Straus & Gelles, 1990) to 5.3 million cases ("National Center for Injury Prevention," 2003). There were 136,000 men arrested for male battering in the United States and 86% of them were court ordered into counseling programs (Hagen, 1998). The numbers on male victims are difficult to locate, even in 2018, and the numbers on LGBTQ populations are similarly hard to locate—in part due to under reporting; there is believed to be continued bias in arrests also such that even arrests are not accurate tallies.
Battering is not solely a male perpetrated phenomenon, because women batter as well (Stuart, Moore, Ramsey & Kahler, 2004; Henning & Feder, 2004). A much smaller treatment emphasis and a limited training platform exists when women are the batterers, and the same is true when LGBTQ members are the batterers. The limitation in covering all populations who batter is mainly due to educational institutions who continue (in 2018) to focus on the heterosexual males as the perpetrators. It is inaccurate to exclude female and LGBTQ populations from batterer intervention programs and from outpatient care; it is equally inaccurate to exclude males as victims of domestic violence, and limiting access to male victim treatment options. Limited provider competency to treat a varying population of batterers and victims may contribute to its perpetuation and add to its prevalence. There is a wealth of literature that exists related to male victims and women perpetrators of violence dating back many years—even as the provider network and educational dissemination of such information remains somewhat limited.
There are programs in the US that treat women batters and who train providers in treating minority batterer populations (see Wexler for example) To be sure, it is not only an issue for heterosexual relationships; homosexuals are both batterers and battered (Cruz, 2003). Women are victims in 85% of all domestic violence cases (Rennison, 2003).
While the issue of male batterers is a serious social problem with far reaching implications, its prevalence within the overall U.S. population is relatively small. According to the U.S. Census Bureau (2004a) there are nearly 295 million people living in the U.S. Thus 5.3 million cases of domestic abuse represent 1.7% of the population. Seemingly a small problem in numbers, it is not so when looking at dollars. At an annual cost of $5.8 billion, the impact of battering costs every man, woman and child in the U.S. nearly twenty dollars per year.
All batterers and victims generally need supportive care. Most domestic violence programs are provided to women at no cost. Few male domestic violence programs exist in the US, and even fewer for male victims (straight or LGBTQ) are offered for free. Most batterers who are women or who are members of the LGBTQ community will generally need to find treatment in outpatient offices.
MALE BATTERER INTERVENTION TREATMENT SUMMARY AND LIMITATIONS
The demographics of both perpetrators and victims vary. Men who are batterers are likely to have witnessed or experienced physical abuse as children (Rosenbaum & Leisring, 2003); they are more likely to have been admitted to psychiatric emergency rooms or alcohol treatment programs (White, Gondolf, Robertson, Goodwin & Caraveo, 2002); there is a correlation between men who batter and being under the influence of substances (Leonard, 2001); and batterers frequently are living in poverty and/or have lower educational levels (Chase, O'Farrell, Murphy, Fals-Stewart & Murphy, 2003). Just as men who batter are likely to be under the influence of substances, the same is true of women who are the victims (El-Bassel, Gilbert, Schilling & Wada, 2000). Interestingly, there is a greater likelihood of continued battering for university-educated women compared to lesser-educated women (Johnson, 2003).
Research regarding various types of male batterer treatment programs suggests that there is no certain model that is more or less effective than others (Stith, Rosen, McCullom, & Thomsen, 2004; Tutty, Bidgood, Rothery, & Bidgood, 2001). Tutty and colleagues evaluated 15 male batterer treatment groups consisting of interventions based upon social learning theory, the feminist perspective, as well as psychoanalytic and self-help methods. There is some agreement as to the use of individual therapy versus group therapy; group treatment is generally accepted as the preferred method for treating male batterers (Reddin & Sonn, 2003; Tutty et al., 2001).
One model that appears frequently in the literature is the Duluth Model (Pence & Paymar, 1993 as cited in Stith, Rosen, McCullom, & Thomsen, 2004), a feminist perspective in treating male batterers (van Wormer & Bednar, 2002). Duluth is popular, in part, because it can easily be adapted to batterer intervention programs (BIP). Florida's batterer intervention program, which mirrors many components of the Duluth model, encourages men to take full responsibility for their abusive behavior, to become sensitive to how it might feel to be the victim of battering, to see their partners as equals, to realize that battering can stop - for good, and it encourages batterers to confront their own need for power and control ("Program Content," n.d.). And while the state of Florida never clearly says that its BIP mirrors Duluth components, a comparison of the Florida BIP (as governed by Florida's Department of Children and Families) and the Duluth Model supports this supposition. For example, both programs focus aspects of treatment on the "Power and Control Wheel" and the "Equality Wheel" (see "Creating a Process of Change," n.d.; "Wheel Gallery," n.d.; "Declaration of Policy," n.d., Orientation section), and both programs place emphasis on community involvement, social influences, and victim safety (see "Domestic Abuse Intervention Project," n.d.; "Office of Domestic Violence Program," n.d.).
Some researchers argue against models that utilize power and control and equality as the central themes to support why it is that men batter and their significance in treating batterers. Power, control, and equality, as presented in the Duluth Model are too simplistic, it is argued, in addressing male batterers' array of issues; the two concepts can be associated with childhood victimization at the hands of caregivers and peers, posttraumatic stress, depression and other psychiatric disorders (Rosenbaum & Leisring, 2003). The male batterer literature, however, suggests that power and control are predictors to abusive behavior (Gerlock, 2001).
The Duluth Model is/are set up in such a way that the batterer is not enabled to use excuses to minimize responsibility for battering. Excuses that are utilized by batterers include lack of anger control and substance use. Research has shown that while substances can be a factor in domestic violence, it is not the cause of it (Forjuoh, Coben & Gondolf, 1998; Leonard, 2001).
Another common factor in providing treatment to batterers, while using Duluth concepts, is promoting equality between partners. Men who see their partners as equals are less likely to abuse them, and batterers who learn to be respectful and supportive are less likely to re-abuse (Gerlock, 2001). Likewise, BIP and Duluth do not focus on conjoint therapy for the batterer and the victim; in fact it is prohibited (likely going against the norm of many therapeutic techniques). The literature indicates that doing so puts women at increased risk of further abuse (Jory, Anderson & Greer, 1997).
One issue that confronts practitioners who must deal with abusive men is that many theories of treatment emphasize the circular relationship between clients and their partners; in essence therapists generally look at all parties in a relationship and treat clients from the didactic or systemic approach (Brogad, 1992 as cited in Jory, Anderson & Greer, 1997). The Duluth Model, on the other hand, requires practitioners to confront batterers and pursue the responsibility issue assisting batterers in assuming full and sole responsibility for battering behavior.
At issue in any treatment program, is efficacy. The literature is contradictory, at best, in regards to what intervention method is most beneficial for male batterers. Many batterer intervention programs have shown significant success rates (a cessation of battering) that are near 60% at thirty months post intervention (Gondolf, 2000). Gondolf (2000) evaluated four different batterer intervention programs, including those that utilize aspects of the Duluth Model, from different regions of the U.S. with a sample of over 600 men. His research indicated that the men were predominantly successful in no longer battering partners, and this finding remained constant whether or not the men were voluntarily enrolled in the programs, or court ordered.
Stith, Rosen, McCollum and Thomsen (2004) argue that there are problems with the Duluth Model, particularly in that it limits the ability of practitioners to develop interventions that meet the specific needs of batterers; treatment is not a "one size fits all" process. Stith and colleagues argue that couples therapy is effective when working with batterers and their partners evaluating a small sample of couples with the use of random assignment and a control group. The other argument against Duluth is that it is based upon an intervention that is rooted in the views and perspectives of the victims and it discounts those factors that cause abusive behavior to be exhibited by a batterer in the first place, such as childhood experiences (Rosenbaum & Leisring, 2003).
To be sure the debate about the preferred and most effective treatment modality for male batterers will not be settled here. But the need for treatment is clear. Last year, in the state of Florida for example, nearly 14,000 people were assisted in domestic violence shelters, and almost 210,000 people were counseled in domestic related matters ("Department of Children and Families," 2004). According to the Office of Program Policy Analysis and Government Accountability (OPPAGA) statistics, in Florida there are 137 different batterer intervention programs, in which 4,376 batterers were treated during the fiscal year of 2002-2003 ("Department of Children and Families," 2004). For next year, OPPAGA reports that the Florida Legislature has budgeted $25.3 million for domestic violence related matters; the cost to Florida's 17 million residents (U.S. Census Bureau, 2004b) will be more than $1.48 for every man, woman and child.
Obtaining data on the success/failure rates for Florida's batterer intervention programs was unsuccessful in the preparation of this report. The lack of data on the batterer intervention programs in Florida may be in part due to BIP's being stopped for a number of years and then re-instated in 1996. Arguably, the data needs to be gathered; it was easy to find the BIP monitoring guidelines, necessary forms for program implementation, fees, and educational requirements for staff that lead, supervise and evaluate batterer intervention programs for Florida. The one assessment of domestic violence programs in Florida that could be found, neglects to address batterer programs and the authors note "the program should collect information to assess whether its services help victims remain safe from domestic violence over the long term" (Stake, Alvarez & Turcotte, 2002). In other words, Stake et al. reveal that supporting data is not gathered. Why the state does not have data on batterer intervention program efficacy is unclear.
Male batterers comprise the largest percentage of perpetrators, and usually the victims are female. Women perpetrate battering behavior as well, as do members of the LGBTQ community. A commonly accepted model for treating male batterers is the Duluth Model, and it's efficacy has been researched on a national level with mixed results. Florida's male batterer intervention programs, and others in the US, are based upon Duluth ideology, however data on program efficacy in Florida is sparse, if it exists at all.
The Duluth Model is not without opposition, and research shows that the model can be problematic for certain batterers. It is dated, yet still it is the model of preference used by many, if not most therapists in the US. Many educational institutions continue to teach the Duluth Model even as there is an emerging literature and research base that suggests treatment should be geared to all perpetrators, whether they be male or female and for those who operate and live outside of a heterocentric paradigm.
The Wexler Model is more geared to variations in the perpetrator profile (that is to say there are different types of domestic violence perpetrations and they are inflicted by not only males, but by other populations and genders as well). Treatment of batterers, using the Duluth Model, often is counter-intuitive for therapists who are accustomed to assisting clients using a systems approach. The number of clients who are in need of male batterer treatment is significant nationally. Because of under reporting and non-diverse treatment models and providers who generally work in one treatment paradigm the exact number of under served and non-treated batterers (of both genders and varying orientations) would be nearly impossible to estimate. Conversely, the exact number of male victims would be nearly impossible to estimate.
More research on male batterer intervention programs is needed, however some research suggests that Duluth based programs have outcomes of success that exceed 50%; it's use is warranted, while acknowledging that the program is limited. Duluth promotes client responsibility, and negates blame for battering related to substance use, anger problems, or victim behaviors (even as these are correlates to male battering). Power, control, and equality are key to helping batterers understand why it is they batter, and what it is they need to do, to stop, particularly with heterosexual male batterers.
For an Informational Summary of a
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. District of Columbia Licensed Independent Clinical Social Worker . DC License #LC50081569 .
. Florida Licensed Clinical Social Worker, Clinical Hypnotherapist and CSW Qualified Supervisor . Florida License # SW9297 .
.Member Greater Washington Society for Clinical Social Work . Member National Association of Social Workers .
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