Arthur L. Cantos

Correlates of therapy referral in foster children

In order to identify the correlates of the behavioral maladjustment of children in foster care, a group of children in foster care who had been referred for therapy was compared to a group of children who had never been in therapy during their foster care placement on several relevant variables. Referred and nonreferred children differed on several important behavioral indicators: number of externalizing and internalizing behavior problems, behavioral competence, and mental age. Results of this comparison suggest that the age of the child when first placed in care, the number of different placements the child experiences during care, and the type of foster care placement (kinship vs. nonkinship) may all be related to the need for clinical services in this population. Theoretical and practical implications of these relationships are explored.

One Size Does Not Fit All in Treatment of Intimate Partner Violence

A critical examination is needed of the often mandated one-size-fits-all Duluth intervention for male perpetrators of intimate partner violence (IPV). The underlying philosophy of Duluth-based interventions is evaluated as well as the treatment outcome literature for this intervention. There is very little evidence to justify the current legal system practice of mandating all perpetrators to psychological interventions addressing power and control issues. A literature review of scientific findings with IPV perpetrators and the issues that need to be taken into consideration in developing alternative evidence-based interventions are presented. The evidence seems to favor heterogeneity and not homogeneity with respect to both type of perpetrator and type of violence. Assessment and treatment suggestions are made to address this evidence-based heterogeneity and a call is made to those responsible to stop perpetuating the practice of mandating all perpetrators to attend a single intervention for which there is very limited evidence of effectiveness. About two-thirds of male perpetrators of IPV cease being physically aggressive against their partners if they are assigned to a probation officer, but there is minimal evidence that the addition of a Duluth-based intervention makes perpetration less likely.

Domestic Violence Perpetrator Programs: A Proposal for Evidence-Based Standards in the United States

In the United States, the judicial system response to violence between intimate partners, or intimate partner violence (IPV), typically mandates that adjudicated perpetrators complete a batterer intervention program (BIP). The social science data has found that these programs, on the whole, are only minimally effective in reducing rates of IPV. The authors examined the social science literature on the characteristics and efficacy of BIPs. More than 400 studies were considered, including a sweeping, recently conducted survey of BIP directors across the United States and Canada. Results of this review indicate that the limitations of BIPs are due, in large part, to the limitations of current state standards regulating these programs and, furthermore, that these standards are not grounded in the body of empirical research evidence or best practices. The authors, all of whom have considerable expertise in the area of domestic violence perpetrator treatment, conducted an exhaustive investigation of the following key intervention areas: overall effectiveness of BIPs; length of treatment/length of group sessions; number of group participants and number of facilitators; group format and curriculum; assessment protocol and instruments; victim contact; modality of treatment; differential treatment; working with female perpetrators; working with perpetrators in racial and ethnic minority groups; working with lesbian, gay, bisexual, and transgender (LGBT) perpetrators; perpetrator treatment and practitioner–client relationships; and required practitioner education and training. Recommendations for evidence-based national BIP standards were made based on findings from this review.

Subtypes of batterers in treatment: empirical support for a distinction between type I, type II and type III.

This study explores the existence of different types of batterers in a sample of 266 men who had been court referred for intimate partner violence. The data collected in the assessment that have been used to perform a hierarchical and a two-step cluster analysis fall into three areas: aggression towards the partner, general aggression and presence of psychopathology and personality traits, more specifically, alcohol use, borderline and antisocial personality traits, psychopathy traits, state anger and trait anger, anger expression and control, anger, hostility, and, finally, impulsivity. The results show a typology consisting of 3 types of batterers on the basis of violence level and psychopathology: low (65%), moderate (27.8%) and high (7.1%). This study provides empirical support for the development of batterer typologies. These typologies will help achieve early detection of different types of batterers, allowing us to tailor interventions on the basis of the needs of each of the types.

Perpetrator Type Moderates the Relationship Between Severity of Intimate Partner Violence and Recidivism

The present study investigated the predictive utility of violence severity ratings on recidivism based on behavior-based subtypes (family only [FO] violent and generally violent [GV]) of intimate partner violence (IPV) perpetrators. Participants consisted of 328 men between the ages of 17 to 72 sentenced to probation in Lake County, Illinois between 2006 and 2008. The relationship between ratings of violence severity for the arresting event, based on victims’ and perpetrators’ accounts to responding police officers, and domestic violence recidivism for a 3-year postprobation completion/termination period was examined. Utilizing victims’ accounts, the Kaplan–Meier log rank test revealed a significant main effect for violence severity. In addition, perpetrator type moderated the relationship between violence severity and postprobation recidivism, such that a positive association was found for GV men but not for FO violent men. Results corroborate the predictive utility of assessing violence severity at the arresting event, particularly within GV men of IPV.

The Impact of Perpetrator Characteristics on the Completion of a Partner Abuse Intervention Program

This study examined how type of perpetrator (family only [FO] vs. generally violent [GV]), readiness to change, and stake in conformity function separately and together in predicting completion of a partner abuse intervention program (PAIP). Data were collected from 192 male perpetrators of intimate partner violence (IPV) who were court mandated to attend a PAIP. Participants were categorized as FO violent or GV based on a combination of their self-report and official records of violence. Stake in conformity has been defined as the degree to which an individual is invested in the values and institutions of a society. A composite stake in conformity score was computed for each participant based on his education level, and marital and employment status. Each participant was also assigned a stage of change score based on his responses on a validated measure of stage of change for domestic violence perpetrators. Analyses indicated that stage of change was not related to program completion or attendance. Type of perpetrator and stake in conformity composite score were significantly related to program completion. Perpetrators with higher stake in conformity scores and individuals categorized as FO attended more PAIP sessions and were more likely to complete the program. When both predictors were examined together, only stake in conformity composite score uniquely predicted program attendance and completion. These findings provide additional evidence that subtype of IPV perpetrator has implications for treatment responsiveness and provide preliminary evidence for the value of improved measurement of investment in societal institutions.

Proactive Versus Reactive Perpetrators: Aggression and Intimate Partner Violence

The relationship between proactive and reactive aggression could have significant implications for the conceptualization of intimate partner violence. In this study, victim statements found in police reports involving 299 unique adult male perpetrators were coded for proactive or reactive aggression content and analyzed in relation to existing measures of treatment outcomes. Family-only violent perpetrators were hypothesized to be rated as having used reactive aggression, and generally violent perpetrators were expected to have used proactive aggression. It was further predicted that proactive aggression would be more strongly associated with higher recidivism rates and lower intervention completion rates. Perpetrators were coded as 73.8% reactive and 26.2% proactive contrary to the assumptions of some sociocultural models of intimate partner violence, for example, the Duluth model. Chi square analysis was used to assess the relationship between type of aggression and typology. Reactive perpetrators who completed their intervention had significantly lower recidivism rates than reactive perpetrators who did not. Intervention completion was unrelated to recidivism rates for proactive perpetrators. In fact, no statistically significant difference was found between type of aggression and recidivism when controlling for intervention completion. Binary logistic regression was used to assess the relationship between type of aggression used, intervention completion, and recidivism with no significant associations found. These findings further clarify the relevance of reactive aggression in intimate partner violence perpetrators due to its relative frequency and potential intervention effects.

Stability of the Severity of Intimate Partner Violence

Prior research with a sample of male probationers indicates severity levels of one arresting intimate partner violence (IPV) offense are predictive of future frequency of such offenses and treatment completion. This study is an extended analysis looking at severity ratings across two IPV offenses to measure violence stability. The stability of IPV severity levels was analyzed in a sample of offenders in Lake County, Illinois. Offender subtypes of generally violent (GV) men and family only (FO) violent men were incorporated into stability analyses using generalized linear mixed modeling (GLMM) to determine whether certain types of offenders vary in violence levels over time. The purpose was to determine the predictive utility of using a single offense to determine the domestic violence trajectory for male probationers. Reoffense records of 80 men were collected from a larger sample of 352 males, ages 17 to 72 placed on probation in Lake County, Illinois, between 2006 and 2008. Severity of offenses was coded dichotomously based on a behaviorally derived measure. Results demonstrate 64% of reoffenders remained stable in IPV severity. Overall, severity levels decreased across time. This is the first study to use a probationary sample of men to analyze violence stability trends over time. This study confirms the utility of measuring a single offense to predict future violence trajectories for IPV offenders.

Enhanced Versus Basic Referral for Intimate Partner Violence in an Urban Emergency Department Setting

BACKGROUND Victims of intimate partner violence (IPV) frequently do not disclose abuse to medical providers. Therefore, research has examined the most effective screening and referral methods to help identify victims of abuse and connect them to needed resources. OBJECTIVES To determine the efficacy of referrals intended to connect IPV victims with behavioral health resources, while taking into consideration demographic and mental health variables. METHODS We examined a convenience sample of medically stable individuals in an emergency department setting. Participants were given the Mini-International Neuropsychiatric Interview and Partner Violence Screen measures to assess mental health and IPV victimization. Individuals that screened positive were randomized to a basic or enhanced referral and given a follow-up interview to determine referral success. Referrals were considered successful if an individual scheduled an appointment with provided behavioral health resources within the follow-up interval. RESULTS Two-hundred and one individuals were enrolled. Forty-one (20.4%) participants screened positive for IPV victimization. Male and female participants in the enhanced referral group were more likely to have a successful referral than those in the basic referral group, with a large effect size such that 72.7% of participants in the enhanced referral and 15.7% of participants in the basic referral group contacted referral resources. Both referral type and marital status significantly predicted referral success. CONCLUSION Comorbidity with mental health concerns measured as high within those that screened positive for IPV victimization. The enhanced referral showed to be an effective way to encourage participants to contact behavioral health resources.