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Family Violence Review:
Prevention and Treatment of Abusive Behaviour

TABLE OF CONTENTS

Prepared by:
Barbara Appleford
Appleford Associates

The points of view expressed in this research report are those of the authors and do not necessarily reflect the views of the Correctional Service of Canada. This report is also available in French. Ce rapport est également disponible en Français. It is available from the Communications Branch, Correctional Service of Canada, 340 Laurier Avenue West, Ottawa, Ontario, K1A 0P9.

MARCH 1989

1989, N°. R-03

Introduction
Definitions And Descriptions
Causes Of Family Violence
Characteristics Of Abusers
Treatment Of Family Violence Abusers
Applications To Corrections
Recommendations For Corrections
Conclusions
References

I. Introduction

"The only inference to be drawn from thousands of studies of child rearing is that it is beneficial to have been kindly and affectionately brought up. This conclusion should surprise nobody since it conforms to the universal experience."

Sir Aubrey Lewis quoted by Greenland (1978)

For many centuries family violence was considered a private affair subject to treatment as a crime only when resulting in severe injury or death. It is only recently that it has been recognized as a serious social problem requiring the intervention of criminal justice, social welfare and mental health agencies. Revelations of the prevalence of family violence and its effects on the well-being and development of its victims first came to light in regard to child abuse in the 1950’s, later in the 1970’s in regard to wife abuse and finally in the eighties concerning elder abuse.

There are many arguments about the relative importance of various factors in the development of violent behaviour. However, there is little doubt that among the most unfortunate effects of experiences of family stress, conflict and abusiveness in childhood, for a large group of abused individuals, is the reenactment of violent and abusive behaviour in adolescence and adulthood.

For example, studies of general populations have shown that stressful family life and/or emotional rejection during childhood are related to abusive disciplining as a parent and also to the abuse of elders by their adult children (Herrenkohl, Herrenkohl and Toedter, 1983). The less supportive the early home atmosphere, the greater the severity of disciplining as a parent. Being a victim of maternal or paternal abuse is also strongly linked with violent adult behaviour. If both are present the risk is increased.

The children who have been abused are very often the same children who become labelled as juvenile delinquents. Mann, Friedman and Friedman (1976) studied 536 court-identified and self-identified violent juvenile offenders. They found a predominance of disturbed family relations among the youths regardless of whether or not they were apprehended. Family-related measures were the strongest predictors of violent offending. For example, parental defiance (open aggression against parents in the home) was related to violent offending whereas positive family role behaviour (participation in constructive, helpful family activities) was related to non-offending.

Similarly, Loeber and Stouthammer-Loeber (1986) in a review of the delinquency literature concluded that socialization variables were "among the most powerful predictors of juvenile conduct problems and delinquency". Variables included parental supervision, parental rejection, parent-child involvement, parents’ marital relations, and parental criminality. McCord (1979) found that parental characteristics and child-rearing practices were the strongest predictors of later adult convictions for violent crimes.

Violence is produced by a host of biological, economic, demographic, cultural and psychological factors. The task of this review is to outline the factors which are relevant to the occurrence of family violence and to the treatment of abusers and to apply this information in the context of the correctional system. The emphasis in this review is upon physical wife abuse and thus to a lesser extent upon other abusers (e.g., child, elder and husband abusers), or other types of abuse (emotional/psychological and sexual abuse). The incest offender is not considered by this review because of the special dynamics and treatment needs of this group.

This review was conducted under contract for the Research Branch of the Correctional Services of Canada, Corporate Policy and Programs and as part of a family violence initiative being undertaken by the Ministry of the Solicitor General.

Il. Definitions And Descriptions

A. Definitions

As in many areas of social concern, the questions of definition are problematic. On the one hand, definitions vary according to the etiological assumption which is being favoured. On the other hand, the definitions vary because of the difficulty of determining which behaviours are to be tolerated and which behaviours are to be considered abuse. Child abuse provides a good example.

The difficulty of definition in the field of child abuse is due to the lack of well-defined punishment standards. As Bensel (1985) notes "How is it possible to define for a parent or caretaker what is ’reasonable use of physical force to restrain or control the behaviour of a child’ when a community condones the use of corporal punishment by school teachers or in other areas of communal living?" (p. 9). Does walking too quickly for a child to keep up or failing to provide medical care count as abuse?

As has been demonstrated, cultural factors play a large part in determining whether or not behaviours are abusive. The following neutral definitions are likely to be met with general agreement.

Physical Abuse

Physical abuse occurs when there is any non-accidental form of injury, physical assault or rough handling causing physical injuries or discomfort inflicted by a caretaker or by a spouse.

Psychological/Emotional Abuse

Psychological/emotional abuse occurs when there is threatening, chronic rejecting, ignoring, criticizing, confinement, isolation, humiliation, intimidation, derogation, infantalization, destruction of property or treatment diminishing identity, dignity or self-worth inflicted by a caretaker or a spouse.

Neglect

Neglect is an act of omission and involves the withholding of physical necessities such as food, shelter, personal and hygienic care, medical care, or the avoidance of caregiving responsibilities which causes the abused person to be in danger of suffering physical or psychological harm or hinders physical and intellectual growth.

Financial Abuse

Financial abuse occurs when there is withholding of finances and/or the necessities of living, trickery, fraud, theft, misappropriated or misused funds or management of property in a manner that benefits the abuser and is not in the best interest of the abused.

Wife Abuse

Wife abuse is physically or sexually assaultive or psychologically abusive behaviour by a man against a woman in an intimate, sexual, peer and usually cohabitating relationship (adapted from Ganley, 1982). For the purposes of this review, the terms abuse, assault and battering are used synonymously.

Child Abuse

Child Abuse is any action by a caretaker which results in physical, emotional or developmental harm to a child. Child abuse is distinguished by the intensity of the abuse and the fact that it is targeted and repeated (Purdy and Nickle, 1981).

Elder Abuse

Elder abuse is harm that is caused by an abuser to an adult who is vulnerable primarily or partly due to age. This abuse is not limited to physical harm but also includes neglect and psychological and financial abuse.

B. Incidence

1. Wife Abuse

In Canada in 1985, 40.1% of homicides were attributable to family quarrels; of these, 47% were spousal homicides. The Canadian Urban Victimization Survey (1982) carried out by the Ministry of the Solicitor General revealed that 14% of assaults against males and 37% of non-sexual assaults against females took place in the victims’ homes or in the homes of friends and acquaintances. The same Canadian survey estimated that the police are aware of only one-half of assaults by spouses or former spouses. According to U.S. data there is, in fact, greater likelihood of being assaulted, physically injured or killed by a family member than by any other person (Straus, Gelles and Steinmetz, 1980).

A survey conducted by Straus and colleagues (1980) revealed that nearly one half of all U.S. couples experience violence at some point in their marriages. In a majority of spousal assaults the aggressor is considered to be the man. Data from the 1982 Urban Victimization Survey (Solicitor General of Canada), indicate that women were the victims in 77% of family related assaults, 90% of assaults between spouses and 80% of assaults between ex-spouses.

A 1987 Toronto study surveyed 604 currently married or cohabitating women between the ages of 18 and 50. Over 14% reported having been physically abused by their husband during the survey year and 36.4% reported having been abused by their husband, boyfriend or date on some occasion (Smith, 1987). Straus and colleagues (1980) found a lower annual U.S. incidence rate (i.e., at least one incident during a year) of husband to wife violence of 12.1%.

2. Child Abuse

Seventy-three percent (73%) of parents of children between the ages of 3 and 17 reported at least one violent occurrence during the course of child rearing (Straus et al, 1980). The latter survey also showed that over 97% of American children experience physical punishment. For one in 7 of these children, the abuse is severe enough to be termed child abuse (Straus, 1983).

Other U. S. data suggests that at least 5.7 out of 1000 children are abused in a year. This represents 3.4/1000 who are physically abused and 2.2/1000 who are emotionally abused. (The rate of sexual abuse is more firmly established and much higher). Neglect rates are 5.3/1000 (Bensel, 1985).

3. Elder Abuse

The problem of elder abuse is only just beginning to be recognized; consequently, agreement on definition and incidence has not yet been reached. Estimates range from 3.2% of elders not living in institutions (U.S. data by Pillemer and Finkelhor, 1986) to 2.2% of elders being cared for at home (Manitoba data by Shell,1982) to 10% of elders living with family (U.S. data quoted by the Senior Citizen’s Secretariat in Nova Scotia).

The true magnitude of the problem of family violence is not known. It is estimated that police/social welfare authorities are aware of only one-half of assaults by spouses or former spouses (Solicitor General, 1982), 20% of abused children (Bensel, 1985) and 7% of cases of elder abuse (Pillemer and Finkelhor, 1986).

C. Description

1. Wife Abuse

Domestic violence cases which come to the attention of the police follow a typical pattern. The couples are predominantly unmarried, with low educational levels, with a high rate of unemployment (20 to 60%) and with the men having been involved in previous violent incidents reported to police (Sherman and Berk, 1984). A London Ontario survey of police records found that approximately one in five assailants had a police record for marital violence (Jaffe, Wolfe, Telford and Austin, 1986). The women tended to be better educated than the men. Thirty-six percent (36%) of the women had been victims of violence in previous relationships.

Interviews with 105 women who had been housed at a transition house in Regina (Regina Transition Women’s Society, 1984) describe a different set of characteristics. In this group, the couples were predominantly married, with only a 12% male unemployment rate (level of education and proportion with prior police involvement were similar).

The Regina interviews produced the following descriptions of the abuse. Seventy-seven percent (77%) of the women had been primarily physically abused and 13% were emotionally abused. More than half of the emotionally abused women had also been physically abused. Almost half of the women had been forced to engage in sexual intercourse and 36% of these had been physically hurt as a result.

The incidents of wife assault are typically recurrent. Of the Regina women who had been physically abused, 95% had been abused on more than one occasion. Twenty percent (20%) were abused once a week or more, 20% once a month or more and 14%, 6 or more times a year. Most of the abused women in the Regina study attempted to end or head off the abuse by avoiding certain topics, locking themselves away, fighting back or threatening to call the police. Whatever the escape attempts by the wife, however, incidents of battering usually escalate in frequency and severity (Dobash and Dobash, 1984).

Wife assault, in contrast to assault against husbands, often results in injury. In Edmonton (Solicitor General, 1982), 61% of women assaulted by their spouses or ex-spouses were injured and 27% sought medical treatment. In the Regina study, 46% of the women were injured badly enough to seek medical treatment.

The likelihood of spouse abuse increases with remarriage. Spouse abuse is more common in families in which one or both of the partners is divorced i.e., the same behavioral patterns are carried over from one marriage to another (Kalmuss and Seltzer, 1986).

Because the preponderance of research and clinical reports reviewed by this paper concern physical abuse (versus emotional abuse or neglect) the terms abuse, assault or battering should be assumed to refer to physical forms unless otherwise indicated.

2. Child Abuse

Many physically abused children are very young: 40% are under 6 years of age. Boys are abused more often up to adolescence, after which abuse of girls is more common (Gelardo, 1987).

On the most serious of cases, injuries include the effects of severe beatings, burns and bites: bruises welts, broken bones, scars and serious internal injuries. Emotional scars are the most long lasting effects of the abuse, whether or not there are lingering physical injuries.

It has always been thought that women were the more frequent abusers of children. Recent research, however, has suggested that fully one-half or more of child abusers are men (Gelardo and Sanford, 1987). There have also been indications that females are more likely to be the abusers of children under 2 years whereas males are the more likely abusers of older children aged 13 - 15 (Bensel, 1986). Bensel notes that following single mothers, the next most common groups of child abusers are fathers and stepfathers.

Child abuse is not usually one event. It is more often a pattern of behaviour which persists over an extended period of time (Cohn, 1983). The data reported earlier suggest that neglect has the highest rate of occurrence, followed by physical abuse and finally by emotional abuse.

3. Elder Abuse

Only 10% of elderly people live in institutions, the remainder living alone or with family members. Accordingly, 93% of elder abuse is perpetrated by family members. Surveys of social services personnel in reference to identified cases of elder abuse are not in agreement as to which family members are most often abusers (i.e., sons, daughters or spouses). The surveys tend to agree, however, that a majority of elder abusers are males and a majority of victims are females.

Pillemer and Finkelhor (1986) surveyed 2,020 seniors in the general Boston area and found that 58% of perpetrators were spouses and 24% were adult children. Among currently married elderly Straus et al (1980) and Pillemer and Finkelhor (1986) estimated incidence rates of physical spouse abuse differently: 5.2% and 2.5% respectively.

Surveys are also in disagreement with respect to the incidences of physical, emotional and financial abuse in the maltreatment of the elderly. Two Canadian studies found that financial abuse was the most prevalent (Shell, 1982; Stevenson, 1985). The most common types of physical abuse were beatings and bodily assault and the most common type of emotional abuse was verbal abuse.

Considering the currently available information concerning proportions abused during one year, it appears that wife abuse is the most common form of family violence when compared to elder and child abuse (omitting consideration of sexual child abuse). The fact that a high proportion of elder abuse is abuse by a spouse suggests some overlap between these two categories of abuse.

Both wife and child abuse may be considered to represent the abuse of power by an abuser who is dominant by virtue of physical strength or family role (Finkelhor, 1986). Elder abuse, where the perpetrator is a son, daughter or a spouse may also represent the abuse of power.

Ill. Causes Of Family Violence

A. Individual Psychological

The individual psychological approach locates the source of family violence in personality or psychological disturbances of the individual perpetrators. Indeed, child abusers often reveal a history of emotional deprivation and physical abuse in their own childhoods. It is posited that since these parents were deprived of the emotional nurturing and care required for healthy psychological development, they are unable, as parents, to provide nurturing, empathic care to their own children. These parents are thought to require from their children the nurturance they themselves missed.

Bernard and Bernard (1984) reported MMPI profiles of 46 self-referred wife abusers and listed the following characteristics: angry and irritable; erratic and unpredictable; distrustful; insecure; and alienated. They concluded that the wife abuser was a "severely alienated person with a character disorder". In general, research does not indicate that wife abusers are more likely to have character disorders than non-abusers (in clinical populations) but some similarities between character-disordered individuals and wife abusers have been noted. For example, Hotaling and Sugarman (1986) suggested that the groups are similar in terms of childhood background (e.g., witnessing or experiencing abuse), adult adjustment problems (e.g. inconsistent work behaviour), and difficulty in maintaining interpersonal relationships. Hamberger and Hastings (1986) provided a comprehensive description of the personality disorders of wife abusers but failure to introduce a non-abusing comparison group make the findings difficult to apply.

There are few reliable findings which differentiate abusers from non-abusers on the basis of psychological or psychiatric diagnostic categories. There are, however, a number of psychological characteristics which seem to distinguish wife abusers from non-wife abusers (e.g., high need for power and dominance, low assertiveness, and cognitive rigidity). These characteristics are considered to influence rather than cause the violence. There has been no evidence to suggest that psychological factors alone are sufficient to account for family violence.

B. Alcohol Abuse

The association between alcohol and other substance abuse and family violence has been well documented. Research indicates a 60% to 70% rate of alcohol abuse and a 13% to 20% rate of other drug abuse among wife batterers during assaults (Roberts, 1987). Shell (1982) estimates that 25% of elder abusers are alcoholics. It is generally agreed that alcohol facilitates or "triggers" rather than causes the assault and is often used to legitimize or excuse the violence (Powers and Kutash, 1982).

Whether many abusers act violently because they are drunk or drink in order to have permission to act violently, the extent of alcohol or other drug abuse in cases of family violence is an important factor in determining treatment needs and prognosis for non-offending. Many service providers exclude the uncontrolled alcohol or drug abusers from treatment (CSC Survey of Treatment Programs for Wife Abusers, 1988).

C. Interactional/Systems

Systems theory attributes family violence to difficulties in family relationships. Problems such as wife abuse are approached as interactions using the couple rather than the individuals as the unit of analysis. Accordingly, Neidig (1985) argues that "spouse abuse is by definition an interpersonal transaction. It is violence which occurs in the context of an ongoing relationship. The behaviour of each individual within a marriage is dependent upon the behaviour of the other and each behaviour can be thought of as both a cause and effect". Both parties participate in spouse abuse, although not necessarily equally. Consequently, the labels abuser and victim are considered to be irrelevant.

There has been a great deal of controversy raised when this model has been applied to spouse abuse. The arguments involved are presented in a later section. However, the model has been successfully applied to other family problems. The work by Gerald Patterson and colleagues in Oregon is one of the most well known of examples. Patterson’s work focuses on the communication between parents and children in which expectations, rewards and punishments are unclear and shows how parents and children can become trapped in a pattern of aversive interchanges. Further, the work illustrates that aggressive behaviour can be produced by maladaptive interaction systems. Through this and other research, it has been made clear that family interaction patterns are relevant targets for change when dealing with aggressive and other significant disruptive behaviors of children and that intensive work with families is a potent tool for the prevention of delinquency (Gendreau and Ross, 1987).

D. Sociological

One prominent sociological view maintains that family abuse is caused by the interactions of social class, social isolation, lack of environmental supports and situational stress factors. Proponents emphasize that abusive families are characterized by a high incidence of family and marital instability, high unemployment, low income, low educational attainment and isolation from social support systems. All of these factors are indicators of stress. External stresses are considered to contribute to internal stresses within individuals and families and the combined pressure results in violence. That the majority of families of low socioeconomic status have not been shown to be abusive and that family violence is found in all classes of society are a few of many contradictory findings which suggest that the sociological explanation, in isolation from other factors, is not sufficient to account for the phenomenon of family violence.

Other sociological theories emphasize the stressful nature of the family lives of family abusers. For example, the physical, emotional and financial stress caused by the sudden and wanted dependency of a parent are thought to be the keys to the understanding of elder abuse and neglect. According to this view, economic stresses, the lack of support services for the care of elderly parents and the approaching old age and poor health of the caregiver create "an emotional pressure cooker".

E. Societal Norms

For centuries, child and wife beating were considered to be necessary and desirable components of the patriarchal family system (Greenblat, 1983). Since the nineteenth century, these ideas have been vigorously challenged by activists in the women’s movement, child protection advocates and the like.

Rules of behaviour are never constant, varying according not only to historical trends, but also within the same time period, according to context. For example, murder is viewed differently when committed against an enemy soldier than against a neighbor. Crimes involving persons known to the offender are viewed as less serious than crimes against strangers. How is family violence interpreted today? Many researchers and practitioners, e.g., Dobash and Dobash (1984); Straus, (1980) claim that cultural norms largely condone family violence. The following excerpt from the Criminal Code of Canada supports this notion.

"Every school teacher, parent or person standing in the place of a parent is justified in using force by way of a correction toward a pupil or child, as the case may be, who is under his care, if the force does not exceed what is reasonable under the circumstances."

Criminal Code of Canada.
Section 43

This quote is analogous to the often cited "rule of thumb" which governed physical maltreatment of wives until recently in several U.S. states. The incidence of corporal punishment in the schools has increased over the last 29 years (Health and Welfare, 1985) and the overall physical punishment of children has not diminished appreciably (Schene, 1987).

Elder abuse investigators theorize that "ageism" i.e., prejudice against the elderly, contributes to their victimization. Negative stereotyping of the elderly as physically feeble, useless, mentally deficient and unproductive is the product of a culture which values youth and economic productivity (Senior Citizen’s Secretariat, undated). Another point of view suggests that the abuse of elders, spouses and children alike is integral to a family life and a society which is characterized by violence.

Straus and colleagues (1980) found that 77% of Americans viewed spanking and slapping a 12 year old child as normal. In respect to spouse abuse, this survey revealed that just under one in four wives and one in three husbands thought that slapping one’s partner was "normal" behaviour.

Greenblat (1983) interviewed a random sample of 30 men and 50 women. Forty-one percent (41%) of the men and 16% of the women gave at least one circumstance under which they would consider hitting appropriate for husbands (38% of men and 20% of women thought that hitting was appropriate for wives). The circumstances in all cases were predominantly precipitating characteristics of the victim and many were sexual in content.

Later in the investigation, the questions were posed differently. More than half of each sex strongly disagreed with the statement "there are some conditions under which it is acceptable for a husband to slap his wife". Approximately 16% of men and 10% of women agreed. More respondents (20% males and 16% females) agreed that it was acceptable for a wife to slap her husband. This was attributed by Greenblat to the belief that female aggressors are far less likely to do harm than male aggressors.

Tolerance and understanding were measured by reactions to hypothetical situations. While the violent behaviour was still largely unacceptable, implicit tolerance and legitimacy was implied in many of the reasons offered for the man’s behaviour by the same disapproving individuals. These excuses (e.g.,wife’s behaviour, stress on the job, drunkenness and being out of control) effectively absolved the man of responsibility.

According to Greenblat, even though there is substantial disapproval of hitting one’s spouse (the amount depending on the question and the method of information gathering) the fact that the disapproval is accompanied by implicit tolerance based on "out of control" and diminished responsibility theories makes violent behaviour more likely (Greenblat, 1983).

Adherence to cultural norms which sanction violence is thought to contribute to the development of family violence when in tandem with other influences such as sex role socialization and family dynamics.

F. Family Violence as a Subset of Violence in General

Until recently, violent crime and family violence have rarely been considered together. However there has been some information collected regarding the extent of involvement by wife abusers in violence outside the home. For example, Fagan, Stewart and Hansen (1983) interviewed 270 victims of spouse abuse (97% female). Over one-half of the batterers were said to have been violent with non-family members as well. Eighty percent (80%) of this group had been arrested for violent behaviour outside the family (4 times or more a year in one half of the cases). Hofeller (1982) reported that 36% of the assaultive husbands were violent outside the home. Browning (1984), in a survey of treatment programs for wife assaulters notes that 20% of the clients were violent outside the marital relationship. Hotaling and Sugarman (1986) in a review of abuser characteristics reported that the violent orientation of men who physically assaulted their wives often extended outside the family. That is, there was a greater likelihood of non-family violence among this group than among non-violent husbands. Violent husbands were more likely to engage in other forms of anti-social behaviour than men who were not violent toward their wives.

Fagan and Wexler (1987) propose that family violence and violence on the street be considered as different points on a continuum. There is some evidence to support this conclusion. Recall, for example, the relationships noted earlier between family variables and subsequent violent crime, e.g. McCord (1979). Fagan and Wexler reviewed the literature on the family backgrounds of men who were violent only toward their wives and men who were violent towards both their wives and outsiders. They concluded that exposure to violence as a child, whether as victim or observer, significantly increased the probability of being generally violent as well as of being violent only toward the wife.

Fagan et al (1983) found that the severity and frequency of violence in the home and the presence of abuse during pregnancy were positively related to general violence. The more severe the violence, the greater the likelihood of violence outside the home.

The evidence reported above has been countered by the uncovering of a number of important differences between generally violent and domestically violent men; for example, depression (Maiuro, Cahn and Vitaliano, 1986) and criminal background (Cadsky and Crawford, in press). These characteristics are discussed more fully in later sections as are other ways in which wife abusers can be differentiated. The importance of the general violence argument lies in the suggestion that there may be different types of abusers with different background characteristics.

G. Social Learning Theory

"Ultimately violence occurs because men find it satisfying and effective in achieving their personal ends. Violence at this level can be fought only if we remove the incentives for it and if we change the motives that produce it."
Toch , 1984

Social learning theory posits that all behaviour is learned through a combination of positive and negative reinforcement and modelling. The most basic mode of learning results from the rewarding or punishing outcomes that actions produce. This learning is influenced and mediated by cognitions. That is, people make generalizations and develop hypotheses by observing and imagining different outcomes, without having the actual experiences.

Most behaviour however, is learned through the modelling of others’ behaviour. The amount and type of the observational learning depends on a large number of factors including: the characteristics of the observer, the characteristics of the observed person or modelled activity (e.g., whether there are valued or pleasing characteristics); observed or experienced rewarding or punishing consequences of the behaviour; and the associational patterns (e.g., the opportunity to observe aggressive behaviour depends on the people with whom one regularly associates).

The important role of modelling in the development of family violence has been supported by the findings that many wife abusers were witnesses of wife abuse in their original families. This modelling, coupled with the rewarding enactment of aggression (i.e., regaining of control and dominance or the ending of an unpleasant state of arousal) would be considered to be sufficient conditions for the repetition of wife assault (Dutton, 1988).

Social learning analyses are at the basis of other causal theories of domestic violence which are outlined on this paper (i.e., intergenerational transmission, societal norms, structural/political). Even though it has been argued that learning explanations are not sufficient to account for all behaviours, they are among the most persuasive of theories and have provided a rich source for theoretical formulations, treatment design and empirical investigation in many areas including the area of domestic violence.

H. Intergenerational Transmission

One of the most consistent and influential findings in the family violence literature is the occurrence of significant levels of physical and emotional abuse in the family backgrounds of abusive adults. Thus, a history of abuse as a child is considered to be an important factor in the development of later abusive behaviour.

For example, Herrenkohl, Herrenkohl and Toedter (1983) interviewed 251 male and female parents who had been charged with abuse or neglect of their children.

Compared to parents who were not abusive, the abusive parents were more likely to have been exposed to abusive discipline in childhood. Straus et al (1980) found that the surveyed men who had been exposed to violence in childhood were three times more likely to have assaulted their wives in a one year period.

Straus et al (1983) analyzed interview data of 2143 U.S. families according to different levels (severity) of violence to discover if the experience in childhood of "ordinary violence" versus abusive violence would mitigate against serious violence in adulthood. Ordinary violence was defined as minor acts of violence: slapping, shoving, pushing and throwing things. The experience of ordinary violence was related to the repetition of ordinary violence with the subjects’ own children and, in addition, increased the likelihood of severe violence toward both wives and children. It appeared that the discrimination between ordinary violence and serious violence was not as meaningful as the lesson that violence is a legitimate resort in times of frustration, stress, disappointment, hurt or fear.

Straus found that the more violent siblings were toward each other, the more violence they experienced at the hands of parents. This was true for ordinary physical punishment and child abuse.

Kaufman and Zigler (1987) challenged the widely held view that abused children become abusive parents by a review of the relevant literature. They found comparisons difficult to make because of variations in experimental design, sources of data (e.g., case records, self-report), subjects, and outcome measures. Estimates of rates of intergenerational transmission ranged from 18% to 70%. Kaufman and Zigler concluded that a conservative estimate of the rate of abuse among individuals with a history of abuse is between 25% and 35%. "This suggests that approximately one-third of all individuals who were physically abused, sexually abused or extremely neglected will subject their offspring to one of these forms of maltreatment, while the remaining two-thirds will provide adequate care for their children".

Critics of intergenerational theory (e.g., Kaufman and Zigler) point out that even though intergenerational transmission is an important concomitant of family violence, it is by no means a sufficient explanation. It must be remembered that most people who grow up in violent homes do not go on to abuse their children or their spouse: neither do abusive adults all derive from abusive families. Other factors must obviously be contributing to the development (or non-development) of intra-familial violence (Herrenkohl et al, 1983; Straus, 1983; Straus et al, 1980).

Kaufman and Zigler were able to shed light on a few of the possible mitigating factors. Parents who did not repeat the cycle of abuse were more likely:

to have been abused by only one parent and to report a supportive relationship with the other;
to have healthier babies;
to be more openly angry about and able to detail the abuse;
to report less stress; and
to be involved in an emotionally supportive heterosexual relationship.

I. Structural/Political(Wife Abuse)

"A man left his home and walked down the block to the bus stop. He got into an argument with a stranger and proceeded to hit him several times. When told of this encounter, we ask, why was he so violent? The man then returned home and got into an argument with his wife. He hit her several times. We ask, why did she stay?"

Fagan and Wexler , 1987

The above quote highlights the structural/political view of the essential difference between the ways that violence toward strangers and violence toward wives are viewed. The first violent event invites universal concern but the response to the other is ambivalent. Structural/political theory argues that psychological, interactional or situational analyses alone cannot explain violence against women because underlying all of these proposed mechanisms is the legitimization of patriarchal domination (i.e., the awarding of greater power and dominance to men).

Dobash and Dobash (1984) found that in general, the behavioral sequencing of spousal violence is typical of violent episodes in general. However, when the victim of the violent episode is a wife, the motivations of the partners are different. Dobash and Dobash claim that the research on violence generally ignores gender and therefore bases conclusions on the erroneous assumption "that all violent events involve two males squaring off in some sort of adolescent contest of honour". In their analyses of wife assaults they found that most wives were not combative in that they did not seek altercations with their husbands and in fact made a variety of efforts to de-escalate or end the conflict. Thus, the violence was more the result of an unequal power situation than a conflict between equals.

According to Dobash and Dobash, the majority of assaultive husbands have the intention of punishing, regulating or otherwise controlling their wives though physical, psychological or other means rather than being out of control and striking out blindly at the most convenient target. They view situational factors as important to the development of the action but not to the ultimate or underlying motivation. Arguments are buttressed by pointing out that many men who have psychological problems of low self esteem, fear of intimacy do not abuse their wives. The debate concerning the relative saliency of expressive (impulsive) and instrumental (calculated) aggression in wife abuse is a central one and has not yet been resolved (e.g., Berkowitz, 1983).

The structural/political point of view, which is the one adopted by pro-feminist theorists, researchers and therapists, has provided much of the impetus for the development of victims services such as transition homes and has also been influential in pointing out alternative approaches to the treatment of assaultive husbands (see chapter V for further discussion).

J. Ecological

A number of investigators (e.g. Dutton, 1988; Fagan and Wexler, 1987) have proposed ecological models of family violence which take into account the contributions of many of the causal theories outlined above. Given the support for each, contrasted with the observation that they are all flawed by the inability to fully explain phenomenon of family violence, the ecological approach has considerable merit.

Fagan and Wexler propose an integration of the theories relating to societal norms, sex-role socialization (not specifically discussed in this review) and intergenerational transmission in order to explain different targets of abuse. According to these authors, when childhood sex-role socialization legitimises the exercise of male dominance and there is the threat or use of violence against family members, violence against family in adulthood can be predicted. Community and behavioral norms which express the functional value of violence, combined with traditional (male dominant) sex role socialization increases the likelihood of violence toward both family and strangers. Less traditional sex-role socialization mitigates against violence toward family members.

Dutton (1988) suggests a "nested ecological" approach to explaining wife assault. The model assumes that there are important ecological factors at four levels of analysis.

The Macrosystem

This level contains broad sets of relevant beliefs and values, for example, the patriarchal ideology which supports male supremacy over women.

The Exosystem

This level contains societal factors such as family stress, unemployment and the presence or absence of social supports.

The Microsystem

This level contains the influential interactional patterns in the family or marital relationship such as power- and democracy- based patterns.

The Ontogenetic Level

This level contains the developmental history of the individual (e.g., victimization as a child) and psychological characteristics (e.g., need for power and dominance).

Dutton (1988) provides the following illustration:

"wife assault would be viewed as likely when a male with strong needs to dominate women (ontogenetic) and exaggerated anxiety about intimate relationships (ontogenetic), who has had violent role models (ontogenetic) and has poorly developed conflict - resolution skills (ontogenetic) is currently experiencing job stress or unemployment (exosystem), is isolated from support groups (exosystem), is experiencing relationship stress in terms of communication difficulties (microsystem), and power struggles (microsystem) and exists in a culture where maleness is defined by the ability to respond to conflict aggressively (macrosystem)."

p. 24; 26

IV. Characteristics Of Abusers

A. Wife Abusers

An extensive list of abuser characteristics may be gathered from clinical and survey sources (e.g., Currie, 1987; Star, 1983; Roy, 1982; and Browning, 1984) as well as research sources (e.g., Dutton, 1988; Maiuro et al, 1988; Bernard and Bernard, 1984; Shields and Hanneke, 1983; Henderson and Hewston, 1984; Howell and Pugliesi, 1988). Below is a summary.

Demographic: male; unemployed; under-educated; low occupational status; early thirties or younger.
Psychological: angry and hostile; depressed; isolated; lacks trust; impulsive; immature; difficulty expressing emotion; difficulty identifying own emotions; alternates between passivity and explosive aggression; character disordered; high need for control and dominance; dependent; moody; non-assertive; victimized as a child; fears abandonment; possessive and controlling; fears intimacy; cognitively rigid.
Attitudinal: externalizes blame ; minimizes the frequency and severity of assaults holds rigid definitions of masculinity/femininity and male/female roles; has minimizing, denying, deceiving attitudes; not interested in personal change.
Behavioral: abuses drugs and alcohol; abusive toward children; threatens suicide and homicide.

Empirical Validation of Wife Abuser Characteristics

How many of these characteristics can usefully be considered to be risk factors i.e., reliably associated with an increased probability of husband to wife violence? Hotaling and Sugarman (1986) provided a review of the characteristics of physically abusive men and abused women which have been uncovered by research. They note the following deficiencies in current family violence research: a) the use of clinical samples (i.e., pre- selected) b) the absence of comparison groups and c) the failure to properly define important variables. Using stringent criteria, Hotaling and Sugarman selected 52 studies from over 400 empirical reports up to 1984.

Only one of 42 characteristics of the female victims met the criteria for inclusion as a risk factor: the finding that abused wives are more likely than non-abused wives to have witnessed violence between parents. According to Hotaling and Sugarman, having been abused in childhood did not meet the criteria because victimization in childhood probably occurs with the same frequency among women in conflicted but non-violent relationships as among physically abused women. Therefore when the former are used as controls, differences do not appear.

The risk factors in husband to wife violence delineated by Hotaling and Sugarman may be summarized as follows. It appears that physically violent husbands are more likely to be generally violent and aggressive in the family (i.e., violent also with children); and to have been exposed (as witnesses) to family violence in childhood. Compared to non-violent men, they are less assertive and possess fewer educational and economic resources. Somewhat less strongly associated with wife abuse are: violent victimization as a child; unemployment; number of criminal arrests; low self esteem; and age (younger men are more likely to be violent than older men).

The following paragraphs summarize some of the more recent (since 1985) studies of wife abuser characteristics relating to control and dominance, assertiveness and the externalization of blame.

Dutton (1988) reported that domestically violent and maritally conflicted (but not violent) men were distinguished from a happily married group on measures of the need for power and dominance with the former evidencing greater need. Dutton postulated that men who are high in the need for power and dominance but not assaultive find other means of dominating their partners (e.g., verbal).

A study by Maiuro, Cahn and Vitaliano (1986) provided information about the nature of the assertiveness deficit in domestically violent versus non-violent men. The domestically violent men were higher in anger and hostility and lower in initiating/request behaviors. The more hostile the individual, the lower in assertiveness. Maiuro and colleagues suggest that violent husbands lack the more adaptive skills in resolving conflicts and thus resort to more concrete physical methods. Wife abusers may have no difficulty defending their rights but have not acquired the ability to express their needs and wants in positive, non-destructive ways.

Dutton (1988) found that wife assaulters did not differ from other groups in general assertiveness but did differ on measures of spouse-specific assertiveness i.e., significantly lower. This characteristic combined with a high need for power and dominance might increase the likelihood of wife abuse.

In the study by Dutton (1988) one third of the assaultive men attributed the assault to actions or provocations from the victim. It is because of the widespread observation that wife abusers do not take responsibility for the violence that acceptance of responsibility is one of the first issues in assessment and treatment. The most resistant client does not assume responsibility and ultimately is the least likely to benefit from treatment (CSC Survey of Group Treatment Programs, 1988). In the Dutton study, self-referred men were more likely than court-referred men to attribute the cause of the violence to themselves but also more likely to minimize the severity and frequency of the assaults.

Shields and Hanneke (1983) contrasted domestically violent, non-family violent and generally violent husbands in a study of attribution processes. They found that in all groups there was significantly greater blaming of outside agencies than blaming of self. It may be that the externalization of blame is typical of violence or of criminality generally and not confined to wife abusers.

B. Child Abusers

Demographic characteristics of child abusers are: younger than wife abusers (late teens and early twenties); female; single parent (40% to 50%); poor, with incomplete high school education; and fundamentalist in religious orientation. These characteristics are derived predominantly from clinical records and are thus biased toward single parent (most are female), under-educated and low income individuals because of the greater likelihood that this group will come to the notice of child protection and other social service (social welfare) organizations. The following clinical/psychological characteristics may more closely resemble the female abuser than the male abuser.

Child abusers are described as: impulsive; hostile; low in self-esteem; with diminished and negative family interactions; experiencing greater life stress (Hamilton, Stiles Melowsky and Beal, 1987); isolated; depressed; victims of abuse and/or neglect as children; lacking basic communication skills (difficulty expressing needs or feelings); dependent (Star, 1983); and frequent users of projection and externalization as defence mechanisms. The association between the less severe psychological disturbances and child abuse has been a frequent finding (Gelardo and Sanford, 1987). However, it is also argued that child abusers present the range of psychological disturbances found in most clinical populations (Pressman, 1984).

There are a number of child-rearing characteristics generally seen as particular to child abusers:

High and inappropriate expectations of children;
Lack of relevant child development information;
Lack of regard for the child’s need and rights;
Rigid authoritarian disciplinary values;
Greater use of physical punishment than non-abusing parents; and
Reliance on the child to satisfy unmet dependency needs.

These factors have not been subjected to the same empirical scrutiny as have the wife abuser characteristics described above.

C. Links Between Child, Wife and Elder Abuse

The information concerning the connections between wife, child and elder abuse derives from interviews with victims and abusers. As has been noted, the largest proportion of elder abuse is spouse abuse. In addition, Schlesinger (1984) notes that there is a 50% chance that abused children will themselves abuse their dependent parents.

Links between wife abuse and child abuse are equally strong. According to Bensel, if a husband hits a wife there is a 50% to 80% chance he will also hit the children (1986). More conservative estimates place the rate for wife abusers at 30%, 28% and 16% for "punishing the children too harshly" (Fagan, 1983), "engaged in child abuse" (Hofeller, 1982) and "chronic child abusers" (Hofeller, 1982), respectively. According to Straus and colleagues (1980), approximately 43% of fathers who frequently and seriously abuse their wives also abuse a child three or more times during a year.

For seriously assaulted mothers the child abuse rate is 50%. Wives who are being abused the most severely mete out the severest abuse to their children. Even those who are subjected to comparatively "milder" forms of wife assault (e.g., pushes and slaps) are twice as likely to severely assault their children compared to women who have not been physically abused by their husbands (Straus et al, 1980).

D. Types of Abusers

One of the reasons why so many of the commonly accepted abuser characteristics have not been validated by research may be the existence of several different types of abusers each with a different etiology and ultimately different treatment needs.

Questions in this regard are only beginning to be investigated, thus many of the results and suggestions offered in this section are tentative and/or speculative. Two categories of abusers suggested by the literature are presented below. Overlap among types is to be understood; none of the categories is exclusive.

1. Domestically Violent Versus Generally Violent Wife Abusers

This typology divides abusers (particularly wife abusers) according to the targets of the violence. We propose that the domestically violent abuser (violent only against the wife) describes the man who suffers from a range of intra-psychic personality or emotional problems e.g., fear of intimacy, fear of abandonment, chronic low self-esteem, and depression. This individual would be psychologically poorly equipped to cope with any interpersonal challenge and the marital relationship, being the most stressful of these, would produce additional pressure. In contrast, the generally violent man (violent against the wife and others outside the home) has adopted violence as a life-style; this individual regards violence as a desirable and acceptable means of handling conflict.

Maiuro et al, (1988) compared men who were assaultive outside the family, men who were assaultive only with their wives and men who were assaultive both within and outside the family. All groups evidenced higher levels of anger and hostility than controls, but the domestically violent men (violent only toward wife) scored significantly higher than controls in respect to measures of depression. This finding offers an explanation for the observation that not all wife assaulters are powerful and/or hostile individuals. In fact, many have been characterized as weak and ineffectual (Maiuro et al, 1988).

Dutton (1988) differentiated wife assaulters from groups of generally violent, non-violent maritally conflicted and happily married men with respect to anger in response to scenes of marital conflict. The wife abuse group differed significantly from all the others in response to scenes of abandonment by females. This group tended to perceive more abandonment and experience consequent anger in response to the abandonment scenes and was more likely to indicate that they would react with physical aggression. The results of the Maiuro et al and Dutton studies lend support to the suggestion of psychological vulnerability in the domestically violent group.

Cadsky and Crawford (in press) compared a group of men who had assaulted only their wives to a group who had assaulted their wives and other people (to a lesser extent). The mixed assaulter group: a) reported leaving home at a younger age; b) were more likely to have behaved in an antisocial manner as children; c) were more likely to have been convicted of a crime, to have been first convicted at a younger age and to have more convictions for crimes against persons and for crimes involving violence; d) had a higher rate of violence toward previous partners and more overall and more severe violence in the current relationship; e) were more hostile; and f) were more likely to be diagnosed (DSM-111) as antisocial personality disorder. The authors considered the mixed assaulter group to be unlikely to benefit from traditional treatment approaches (e.g., cognitive/behavioral group treatment).

Toch (1984) provides numerous examples of the generally violent type. He describes these men as self-oriented, seeing themselves and their needs as being the only factors of social relevance. "Other people are viewed as objects rather than as persons whose needs must be taken into account". Cadsky and Crawford (in press) describe this group as "having shallow emotions, .. being self-centered with callous attitudes toward others and not learning from experience". These individuals would also, in other schemes, be described as psychopathic personalities. Ross and Fabiano (1985) outline the psychological/cognitive skills deficits which are attributable to the psychopathic personality: egocentricity; lack of empathy; inability to identify in interpersonal situations; and poor judgement.

The development of the type of aggression described here (termed by Berkowitz as "self-oriented") is thought to be through the social learning mechanisms of social reinforcement, modelling and observation of aggressive behaviour. By these means, the violent behaviour becomes an important part of the man’s positive personal and social identity. The violence is often stimulated by perceived humiliation such as a child’s defiance or a wife’s flirtatious behaviour. The goal of the aggression may be to restore self-esteem through regaining the child’s or the wife’s "respect" (Berkowitz, 1983).

2. Expressive Versus Instrumental Violence: Wife and Child Abusers

In this typology we contrast violent abusers according to presumed drive. Expressive or pressure removing abusers have a tendency to "explode" in situations with which they are unable to deal. This type of violence is thought to be influenced by deficits in communication and control skills and a limited repertoire of interpersonal strategies. Toch (1984) terms this offender as the "panic in the corner type" whose violence constitutes a last minute effort to obliterate situations to which he is not equipped to respond otherwise. The violence may be seen as a reaction to situational stress and has a desperate "lashing out" tone. According to Berkowitz (1983), the expressively violent person responds to aversive stimuli with violence if the inhibitions against aggression are weak and if there is a suitable target.

The relative absence of skills deficits contrasts the instrumentally violent abuser from the expressively violent abuser. Instrumental aggression is presumed to be consciously directed at the particular victim and directed at achieving a particular result (versus merely escape from pressure). This may describe the type of abuser often cited in the profeminist literature (e.g., Dobash and Dobash, 1984) for whom the aim of the abuse is to coerce and control the woman. In the case of child abuse, Kadushin and Martin (1981) interviewed men and women who were reported to have abused their children. 44% said that they had initiated the abuse in order to teach the child a lesson or to reassert control that was being threatened.

Berkowitz points out, however, that purely expressive aggression is a rare phenomenon. Although the aggression can often be at least partly an involuntary response to the situation, "the father who bruises his child badly when spanking him and the husband who hurts his wife seriously in the heat of an argument probably meant to produce this outcome". In the case of wife abuse the choice of target may certainly be influenced by factors related to gender and power differentials.

The distinction between expressive and instrumental violence in this case refers to the relative influence of skills deficits and not to the question of whether choice of victim is a factor.

The findings cited in the above formulations clearly demonstrate that wife abuse and child abuse are not unitary phenomena: that there are different types of abusers and presumably different background factors. They may help to explain the lack of strongly established wife abuser characteristics in the research literature and why treatment outcomes have been so variable (See chapter V for further discussion).

V. Treatment Of Family Violence Abusers

Models employed in family violence treatment are analogous with the theoretical approaches to causation already outlined earlier in this paper. These are: individual/psychological; interactional or systems; structural/political; and social learning. An additional and major framework is provided by the cognitive behavioral (psycho-educational) approach. This method is an amalgamation of techniques based generally on learning theories and on the work of such authors as Novaco (1975), Meichenbaum (1977), Goldstein (1973) and Ross and Fabiano (1985). These methods assume a lack of appropriate self-control/self-monitoring skill and attempt to teach more adaptive behaviours.

A. Group Counselling of Wife Abusers

1. Description of Approach

Group counselling is the format of choice especially in the initial stages of treatment because of the opportunity afforded for the client to form ties with peers, receive offers of help and support from other men, and have available peer role models. Group processes tend to decrease the isolation of the abuser and his/her dependence on the victim (Pressman, 1984; Bernard and Bernard, 1984).

The majority of group programs base the treatment on the premise that the violence is learned behaviour and follow a cognitive/behavioral educative format utilizing modelling, role-playing, self-examination, discussion, confrontation, challenge and direct teaching as vehicles. The kinds of self-monitoring techniques generally employed are termed "anger management" and may be summarized as follows.

Recognition of anger signs ("early warnings").
"Time-out" as an emergency response i.e., leaving the situation to allow calming.
Self-talk (self-instruction): recognition and control of the negative self-talk which facilitates feelings becoming labelled as anger and being expressed as aggression.
Monitoring of conflict situations, e.g., through "anger logs" which promotes awareness of the physical, emotional and cognitive antecedents to the violence.
Relaxation: techniques which reduce tension and anxiety and teach responses which are incompatible with anger.
Most programs have as minimum goals the complete cessation of the physical violence; acceptance of responsibility (overcoming denial and minimization), the man being solely responsible for the battering; and learning of non-abusive alternative behaviour. Many programs include techniques to achieve the following additional goals.
Greater assertiveness and communication skills: non- destructive and non-manipulative means of expression.
Increased empathy and understanding of the destructive effects of violence on the victim and the marital relationship.
More flexible attitudes toward women i.e., restructuring of rigid sex-role expectations.
Broader, more flexible male identity.

Differences among programs relate to: the types of violence which are addressed (e.g., most programs emphasize physical abuse); the particular skills stressed; the importance of gender issues; whether and when issues of power and control are addressed; and the emphasis on the woman's safety.

Power and Control

Adams (1988) in a profeminist critique of treatment models, notes that most groups for batterers as described above, are broadly aimed at helping abusers to better manage their anger, cope with stress and improve communications skills. That is, they view wife abuse as a skills deficit or stress management problem rather than as a sexist control problem. Because of this the power and control dimensions are minimized or ignored. Profeminist programs, while recognizing the need for the learning of alternate behaviors and techniques for initially stopping the violence, place more emphasis on the challenging and ultimately the giving up of all attempts to control the wife through any abusive means (physical, verbal, sexual or psychological). Rather than a skills deficit, abusive behaviour by men should be seen as the selective use of well established (viable) control skills.

Feminists employ similar arguments against the use of anger control/anger management techniques. The latter methods assume that anger is something which gets "out of control", or "lost" and that the problem results from impulsivity or a lack of resources. The broad implication is that the abuser is partially helpless and therefore not fully responsible. This ignores the fact that the batterer according to the model, consciously uses violence to reinforce control over his partner. Thus treatment effectiveness is compromised.

The importance of dealing with abuse other than physical is noted by other clinical experience. For example, Star (1983) in her description of the Domestic Abuse Project in Minneapolis, quotes a therapist as follows: "it is possible to terminate the physical violence fairly quickly in therapy. Emotional, psychological or verbal abuse persists for a longer time, but even when that decreases you still find a lot of controlling and manipulative behaviour that continues for a long time". Similarly, MacLeod (1987) in a survey of transition houses, notes that physical aggression was often replaced by the greater use of psychological, verbal or economic violence. In an evaluation of group treatment for wife abusers, Hamberger and Hastings (1988) found that psychological abuse continued after the physical abuse had ended.

Safety of the Wife

Profeminist programs stress initially a non-negotiable abstinence from violence as the initial focus with the safety of the wife the prime concern. While most groups have as a goal the cessation of the violence, it is not clear that it is always such an immediate imperative.

Motivation for Treatment

Many practitioners (e.g.,Star, 1983) note that batterers are rarely motivated for treatment. Most enter treatment because they are being coerced by the justice system or by their wives. Most do not see the violence as a problem. "It takes several weeks in the program along with the support of other men before they see it that way" (Star, 1983). Fully one-third to one-half of men referred to batterers programs fail to follow through with treatment and, in one study, over five times as many men inquired about the program than enrolled in it (Gondolf, 1987).

Grusznski and Carrillo (1988) compared program completers to dropouts and found that completers reported fewer indirect threats of violence, had a higher level of education, were more likely to be employed full-time, witnessed (versus experienced) abuse more often in their family of origin and had more children. These findings and other similar findings (e.g., CSC Survey of Group Treatment Programs for Wife Abusers, 1988) suggest, not surprisingly, that the better functioning client; the client with more personal and social supports, is more likely to be successful in treatment (See "Evidence for Effectiveness" for further discussion of this point).

Despite the fact that few differences between court - mandated and self-referred men have been found, the external motivator assumed to be provided by the criminal justice system is in fact recommended by many programs (e.g., Dutton, 1988; Wachtel and Levens, 1984) because it gives the clear message that spousal violence is illegal and unacceptable. The actual deterrent effect of criminal justice system intervention is discussed in a later section.

Services for Women

While there is no evidence to date concerning the advantages or disadvantages (for male treatment) of parallel services for spouses, there is general consensus in the literature that such services are desirable for moral as well as practical reasons.

MacLeod (1987), following interviews with transition home workers, recommended closer cooperation and coordination between services for women and children and programs for the men. She reported that service providers feel that the man is more likely to be helped if the wife is also given support, helped to understand the changes which are occurring and helped to deal with her own response to the changes.

Contra-indicated Techniques

Ventilation Techniques

Ventilation techniques encourage the physical release of pent up angry energy via punching bags and the like. In fact, the evidence suggests that such techniques actually reduce rather than increase inhibitions against the physical expression of aggressiveness (Browning, 1984).

Fair Fight Techniques

These interpersonal conflict techniques make the line between abusive and non-abusive (acceptable) behaviour too ambiguous (Browning, 1984).

Marital Counselling

Most group practitioners argue that marital counselling in highly violent relationships is to be discouraged as it implies that the wife is partially responsible for the violence. There cannot be open communication between husband and wife if the wife still fears retaliation and if the husband still thinks that physical control is necessary to maintain his equilibrium.

According to most practitioners, marital therapy may be undertaken subsequent to group treatment as long as the violence has ended, the wife is no longer afraid and both wish to work on the relationship. Individual therapy may also be utilized where appropriate.

Client-centred Individual Therapy

Such therapy, because it is non-directive, is discouraged because it would be slow in stopping the violence and would present difficulty in changing well entrenched habits of denial of responsibility (Browning, 1984). Instead therapy must be directive and highly structured (Dutton, 1988).

2. Evidence for Effectiveness

Surveys and Estimates

Evaluations of the effectiveness of group treatment programs are rare. Preliminary findings of the CSC Survey (1988) indicate that only 25% include any sort of evaluation or monitoring procedures in their program structure. Similar observations have been made by other investigators (e.g., Browning, 1984; Pirog-Good and Stets, 1985). In Browning’s survey, estimates of non-recidivism rates through interviews with perpetrators and victims at various points during and following treatment ranged from 75% to 100% over the course of the group program, and 55% to 60% after 4 months. The CSC survey found reported rates of non-violence at 3 months to 1 year post treatment of 40% to 97% (average 70%). Estimates of the maintenance of or return to emotional/verbal abuse ranged from 33% to 80%.

Responses to the CSC survey indicated that a large number of group programs have as exclusion criteria a combination of the following factors: alcohol/drug abuse; general violence; psychopathic personality; and psychiatric problems.

The CSC survey also asked respondents to describe the client for whom their program was most successful and the client for whom their program was least successful. Composite profiles are outlined below. (Note that information is highly impressionistic).

Successful Client.

The successful client is young (25 to 35 years), employed, with high school education and of average or above average intelligence. He is recently separated from his wife and has a strong desire to reunite. Motivated and committed to change, he is able to accept responsibility for the violence. He is under direct threat of criminal justice sanction and/or the permanent breakup of the marriage. If drug or alcohol abuse is a problem, it is under control. He is minimally violent outside the marital relationship.

Unsuccessful Client.

The unsuccessful client is under 25 years of age or over 40 years of age, of limited intelligence and unemployed. His relationship with his wife/partner is unstable and short-term and he has no hope of reconciliation. This individual is unmotivated and does not accept responsibility for the violence in the relationship. He is a chronic abuser of alcohol and/or other substances, has psychopathic personality characteristics and is a manipulator. He has a history of general violence and is presently violent outside the family: the "hair trigger type" or a "barroom brawler".

To the extent that the criteria and the description of the unsuccessful client above describe the CSC client, and the corrections literature indicates that they do, choosing or obtaining community services may present difficulties. Even though most programs have a low rejection rate and a large majority of programs indicated willingness to consider federal offenders, it was clear from the information gathered in the course of this project (including discussions with survey respondents) that individuals under conditional release would be considered poor candidates for this type of group treatment and would indeed be likely to be rejected.

Deterrent Effect of Arrest

With arrest and surveillance (e.g., probation) but no treatment, what would be the expected rate of recidivism? Sherman and Berk (1984), in a comparison of recidivism rates at various points subsequent to criminal justice intervention, found the lowest recidivism rates of 13% to 18% for the arrest intervention (compared to mediation and advice) in respect to "new assault, property destruction or threatened assault" (cases of aggravated assault were excluded).

Discussions of the deterrent effects of arrest are important because of the high proportions of court-mandated clients in Canadian treatment programs for men who batter. A majority (85%) of Canadian programs receive at least 10% and as high as 100% (average 31.8%) of clients through criminal justice sources (CSC Survey, 1988).

Jaffe, Wolfe, Telford and Austin (1986), through examinations of London Ontario police files and interviews with wives, recorded the occurrences of various types of violence in the period between 12 months prior to police charges and the 12 months following. The results are illustrated below.

Table 1 - Post-Arrest Offending According To Form Of Violence
Form of Violence	Percent Reoffending (12 months) (a)	Percent Reduction (a)
threatened to hit or throw something at the other one	49.1	28.9
threw, smashed, hit or kicked something	47.5	30.5
threw something at the other	14.8	40.0
pushed, shoved or grabbed	54.1	26.7
slapped	29.5	41.7
kicked, bit or hit with a fist	22.9	34.3
hit or tried to hit with an object	18.0	27.2
beat up	24.6	38.4
(a) Taken and extrapolated from Jaff, Wolfe, Telford and Austin (1986).

The above figures suggest that criminal justice system intervention has a substantial "treatment" effect. In a study by Dutton (1987) none of the treated court mandated group (N=50) was reported to have used violence between intake and treatment (a range of two weeks to three months). In addition to indicating a deterrent effect of arrest, this finding adds support to the claim that assaultive males are able to alter their use of violence. In this context treatment might be seen as reinforcing this effect so that it can be maintained after the threat of criminal sanction is no longer experienced (Dutton, 1987).

Empirical Reports

The few empirical evaluations (i.e., investigations which include comparison groups and objective outcome measures) to date do not typically differentiate types of abusers and measure a limited number of outcomes. Outcome measures usually include the Conflict Tactics Scale (CTS, Straus, 1979). The findings are discussed below.

An evaluation by Dutton (1988) of anger management/assertiveness treatment (Assaultive Husband’s Project, Vancouver) found a significant reduction in severe violence during one year following treatment. Thirty-one (31) out of 37 wives (84%) reported no acts of severe violence. Verbal aggression was also reported to have dropped overall (although 8 wives reported increases). Wives’ and husbands’ reports were similar. The recidivism rate, according to police data, was 4% at both 6 months and 2-1/2 years for the treated group compared to 16% at 6 months and 40% at 2-1/2 years for an untreated group.

Hamberger and Hastings (1988) evaluated a cognitive/behavioral spouse abuse program in Wisconsin. Psychological, personality, and self-report violence data were compared for 32 program completers and 36 dropouts. Recidivism rates were determined by a combination of self-or spouse-report (CTS) and police data. Any report of recurrent violence minimal or severe during the year following treatment was considered to be an occurrence. Seventy-one point nine percent (71.9%) of completers were non-repeaters compared to 52.8% of dropouts.

Edelson and Grusznski (1988) reported similar results with six month follow up data (wives’ reports) on group treatment of three groups of batterers, at the Domestic Abuse Project in Minneapolis.

The results are displayed below.

Table 2 - Follow-Up Of Group Treatment Compared With Drop-Outs
Groups	Completers	Dropouts
1	67% non-violent	54% non-violent
2	67% non-violent(includes 43% threats without violence)
3	59% non-violent(includes 36% threatswithout violence)	56% non-violent(includes 34% threatswithout violence)

Edelson and Grusznski (1988) found large discrepancies between mens’ and womens’ reports in relation to threats of violence (reported more often by the women). As a result, the outcome measures were based on the wives’ reports alone.

The less dramatic results of Edelson and Grusznski, compared to Dutton (1988) and other clinical data, may reflect, as Dutton suggests, differences in dependent variables. For example, Dutton measured severe violence only while Edelson included other forms of direct and indirect violence (including pushing, restraining and threatening). It is also important to note the different picture which emerged when threats without violence were separated from non-violence (i.e., the absence of physical violence). One wonders whether or not the situation for the wives and families had actually changed much for the better.

Hamberger and Hastings (1988) compared self-reported violence ratings pre-and post treatment and found significant treatment gains which were maintained at one year follow up. The gains, however, related mainly to physical abuse: psychological abuse for the most part, continued. Significant reductions were seen in depression and anger, but there were no changes in personality profiles. The authors concluded that time-limited violence abatement training reduces situational behaviors without changing global personality features and that, consequently, manipulative interpersonal behaviour may be expected to continue after the physical abuse has stopped.

B. Marital Therapy for Violent Couples

1. Description of Approach

Systems Approach

There is little literature pertaining to the use of marital therapy with couples in which the man is violent (Neidig, 1985). Neidig claims that because of the relative silence of marital counsellors regarding treatment for abuse, the prevailing modalities suffer from a lack of consideration of relationship variables, basing information on one-sided accounts and working with only one-half of the relationship. Conclusions based upon only the reports of women are not reliable because the women would naturally tend to punctuate events in a biased way placing some behaviors in "bold relief" while obscuring others.

Systems therapists Weitzman and Dreen (1982) make similar points. They assert that "separation and rescue" are necessary in the first instance to ensure the safety of the battered spouse but that these measures alone fail to have an impact on the cycle of violence. This is because the bilateral nature of the violence is ignored. According to Weitzman and Dreen, the eruption of violence is due to struggles over power issues. Violent couples are characterized by rigid complementary roles whereby one partner exerts unilateral control and the other colludes. It is when this control is challenged or subverted by the underdog that violence ensues. The violence is directed at restoring the complementary role division.

The task of therapy is to establish the point at which the complementary status shifts and to intervene by:

defining the thematic conflict,
exposing the system’s characteristics by having the couple "enact" their system, and
giving behavioral directives, formulating behavioral contracts and suggesting alternative behaviours.

They recommend that the choice of marital therapy as a treatment depends upon the demonstration of sufficient self-control to stop any violence. They advise that if the situation is very volatile and the woman is fearful of violence, emergency measures are more appropriate.

Non-traditional Marital Therapy

Harris (1986) describes a method of marital therapy which combines individual and conjoint therapy sessions and provides a model which seems to answer to some degree the objections to marital therapy which were outlined earlier. For example, the primary goals are stated as 1) stopping the violence and 2) having each party accept appropriate responsibility for behaviour around the violence. The batterer must be convinced that his violence is under his control and not caused by his partner. The wife must be helped to stop feeling responsible and to understand that as long as she tolerates the abuse, it is likely to continue.

Star (1983) describes the marital therapy component of the Domestic Abuse Project. This treatment takes place, where appropriate, after the man has been involved in group therapy and the woman in supportive group or individual counselling. The goals of therapy include the teaching of effective communication skills; the processing of current feelings, especially those related to anger, hurt, or fear, the discussion of sexual issues, the sharing of the effects of violence and the learning of ways to relate interdependently rather than over-dependently. This example illustrates how marital therapy could be integrated into a comprehensive family violence treatment effort.

2. Evidence for Effectiveness

Harris (1986) selected at random 40 cases of violent couples seen over a 5 year period (no comparison group). Thirty (30) were available for follow-up interviews. Characteristics of the couples and of the therapy were related to a 73% treatment success rate (not defined) as reported by the couples. Characteristics associated with success were increased age of batterer, higher income, later onset of violence and more sessions attended.

C. Individual Therapy for Child Abusers

1. Description of Approach

The psychological explanation, that abuse is caused by psychological or personality disturbances in the abuser, has given rise to a tradition of intensive, usually one-to-one therapeutic interventions. This treatment is aimed at a range of outcomes from more psycho-dynamically oriented (e.g., uncovering repressed conflicts and modifying defense mechanisms) to more cognitively oriented (e.g., correcting distorted perceptions, improving impulse control and improving parent-child relationships). The quality of the psycho-therapeutic relationship is of prime importance since the first task of rehabilitation is to re-parent the abuser, through a high degree of nurturance, support and acceptance. This is necessary in view of the abusers’ low self-esteem, feelings of inadequacy and unmet dependency needs (Pressman, 1984). Individual counselling may also concentrate on the here and now child rearing concerns, educating the abusive parent in regard to normal child development and behaviour, and fostering more realistic expectations. This work is highly demanding in terms of intensity and time. Often the work is shared among the primary therapists, lay therapists (often volunteer) who work with the parent in the home and are available on an ad hoc basis and self-help/support groups which further aid in establishing caring connections (Pressman, 1984).

2 Evidence for Effectiveness

Valid empirical demonstrations of the effectiveness of individual therapy with child abusers are lacking.

D. Parenting Skills Training for Child Abusers

1. Description of Approach

More recently, behavioral methods have been applied to the remediation of abusive parenting. Specific parenting and stress management skills are taught in individual, group and family settings.The techniques employed are cognitively based and similar in origin and design to the techniques currently utilized in the treatment of wife abuse. Cognitive skills taught include anger control, self-instruction, relaxation, thought-stop, monitoring of arousal, and impulse control (Gaudin and Kurtz, 1985). Many programs also include didactic methods (films, lectures etc.) which provide information on normal child development. Specific child management skills taught include contingent positive reinforcement, time out and consistency of response.

Otto and Smith (1980) recommend a therapeutic group approach to treatment arguing that one-to-one therapy alone does not provide ongoing support and education that abusing parents need in order to maintain non-abuse. They note that self-help groups are not always available and are variable in quality. Family treatment requires the involvement of the whole family and the abusing parent very often cannot enlist such support. The advantages of the group model include the provision of a wide support system.

According to Otto and Smith, the success of treatment depends on the initial motivation to change and the ability to stop the abusive behaviour as an first step in treatment.

2. Evidence for Effectiveness

Evaluations of traditional child welfare crisis intervention and case management programs in 1979 revealed that fully 30% of the parents served severely re-abused their children during the treatment period. Forty-two (42%) were reported to be unlikely to re-abuse their children subsequent to treatment (Cohn, 1983). These studies concluded that parents who received lay counselling and joined self-help programs as supplements to the professional case management were more likely to improve.

Gaudin and Kurtz (1985) in a review specifically of parenting training programs for abusers found greater evidence for effectiveness and concluded that the strongest evidence for treatment effectiveness was for the skills-based cognitive training methods. For example, Dawson, de Armas, McGrath and Kelly (1986) conducted an experiment comparing performance levels at different points during treatment of three neglecting parents. The cognitive/behavioral training, consisting of modelling, shaping, practice and feedback successfully improved the problem-solving skills of the parents.

Gaudin and Kurtz concluded that the parent training programs were most effective when given in combination with other supportive services e.g., crisis intervention and support groups.

E. Treatment of Elder Abuse

Because recognition of the problem of elder abuse has been so recent there is a lack of definable treatment modalities for dealing with either the abuser or the victim. Where there is expertise and experience, the funding is as yet lacking. The following list of treatments was formulated from suggestions in the literature and through personal communications with practitioners (e.g., Annette McCullogh, Kerby Centre, Calgary) Most are largely unavailable in Canada.

Counselling for abuser and abused elder.
Support/discussion groups for abusers or potential abusers.
Relief caregiving services.
Day care programs for abused elders.
Transition home placement for elderly female victims of spouse abuse.
Batterers programs for male spouse abusers

F. Conclusions on Effective Treatment

1. Wife Abusers

There is some modest evidence of success of group treatment after six months to one year with non-recidivism rates in a range of from 24% to 71.9% for all physical violence and of 84% for severe physical violence. This represents improvements (percentage reductions) in the range of 50.7% (severe violence) and 13% to 19.1% (all violence) compared to no-treatment and/or arrest only recidivism rates. The results are promising if not conclusive and are supportive of continued efforts to implement well-designed group treatment for men with substantial evaluation procedures in place. The results are also suggestive of a host of avenues for future research including the matching of client characteristics to treatment outcome and the measurement of variables more relevant to goals of treatment.

For example, if the goal is to stop all the violence and, in addition, to change the use of abusive methods of dealing with conflicts and of controlling other people, then measurement should include the latter range of behaviors. Since there has already been the suggestion that physical violence can be replaced by other less public and less visible forms of physical intimidation and psychological control, measures of verbal, psychological, emotional abuse should also be of interest. If the goal is to encourage empathy for victims and responsibility for marital satisfaction, then dependent variables relating to these factors should be introduced.

Information on the differential effects of treatment for different groups should also be relevant e.g., generally violent versus domestically violent. Results of the CSC survey indicate that generally violent men are more difficult to treat and would not be considered prime candidates for treatment. We have already pointed out that there may be characteristic differences between these two groups.

2. Child Abusers

As with wife abuse, firm conclusions based on clear demonstrations of effectiveness of child abuser treatments are not yet possible. Evaluations of group programs suggest the greatest success for the cognitive skill development approach.

It is important to note the similarities in treatment requirements for both child and wife abusers despite the differences in characteristics. Both groups show decreases in abusive behaviors when the treatment is directive, authoritarian, didactic, provides for support network (through group format or supportive individual services), and cognitive/skill development-based.

It must also be pointed out, however, that other less usual non-group and/or non-cognitive/educational treatments might also prove to be effective if tested. These conclusions are based on currently available information.

Vl. Applications To Corrections

A. Characteristics of Offenders

There has been no research relating to the characteristics of male federal inmates who have been family abusers nor is there any information on the actual extent of the involvement of inmates in family violence. In the absence of this information, it may be instructive, at a minimum, to describe the corrections context in terms of general offender characteristics and programs.

Andrews (1988) summarized the findings in regard to features which distinguish offenders from non-offenders.

"... On average, offenders relative to non-offenders are a) temperamentally impulsive, restless and b) violate a variety of conventional rules and procedures and do so from a young age, c) below average in verbal intelligence, d) lacking in cognitive coping and self-management skills, e) weakly tied to conventional settings, such as school and work, f) likely to associate with other offenders, and g) explicitly pro-criminal in their attitudes, beliefs and thinking styles."

Zamble and Porporino (1988) reported that the average educational level of a representative sample of male federal inmates was 9.5 years of schooling. Forty-five percent (45%) had not completed grade 10. Of the 34% who had been unemployed (four times the national rate), one-half had never worked at a single job for more than one year.

1. Cognitive Deficits

Zamble and Porporino (1988) described the typical inmate as "unable to cope with life’s ordinary challenges", lacking generally in problem solving/coping skills. Ross and Fabiano (1985), in a review of offender characteristics, also emphasized the findings related to cognitive skill development. They outlined the following characteristics which distinguish offenders from non-offenders:

action-oriented, non-reflective and impulsive
concrete, rigid, simplistic and illogical thinking
egocentric
lacking in empathy

Ross and Fabiano concluded that the most serious deficits are in the areas of social skills and interpersonal problem solving. These deficits relate directly to the ability to deal with interpersonal conflicts in an adaptive and pro-social manner and place the individual at risk for developing an antisocial lifestyle.

Few offenders exhibit all of these problems and some offenders exhibit none of them. According to Ross and Fabiano (1985), those most likely to be deficient in cognitive skills are adolescent offenders, chronic offenders, alcohol-abusing offenders, violent offenders and sex offenders.

2. Family Backgrounds

A longitudinal study by McCord (1979) followed 201 men who were tested and described as part of a delinquency prevention program between 1939 and 1945. Original records were matched with court records in 1979. Convictions for serious property crimes and serious personal crimes (e.g., assault, attempted rape, rape, attempted murder, murder and kidnapping ) were the outcome measures. Six variables related to home atmosphere in childhood were strongly related to criminal behaviour in adulthood: paternal deviance, maternal self-confidence, parental aggressiveness, parental conflict, supervision, and mother’s affection. Men who lacked maternal affection, who lacked supervision and who had fathers who were deviant were more likely to have committed property crimes. Men who lacked supervision, whose mothers lacked confidence and who had been exposed to parental aggression and conflict were more likely to have been convicted for personal crimes.

More recently, Zamble and Porporino (1988) reported that between the ages of 6 and 11 years, 19% of the inmates interviewed lived in single parent homes, 18% with relatives other than parents and 19% in foster homes or institutions. The latter figure is substantially higher than the figures for the general population. In at least 25% of the cases, there were clear indications of family problems.

Disturbed family relations have been shown to be implicated in criminal behaviour. However, there is little information to date on the family backgrounds of violent adult inmates. Lang, Holden, Langevin, Pugh and Wu (1987), in a study of inmates found that assaulters, as compared to murderers, armed robbers and non-violent controls, had the highest percentages of recidivism and close family members involved with the law and substance abuse. However, there were no differences among the groups with respect to social skills or family or peer relations nor with regard to a host of other variables including personality/psychological factors.

Gendreau and Ross (1987) in a review of treatment for violent offenders remark that the "truly violent offender is elusive" and, if they exist, they are small in number. The proportion of repeat violent offending is estimated to be only 4% of the population of offenders (Gendreau and Ross, 1987).

B. Related Correctional Programs

1 Cognitive Training

Ross, Fabiano and Ewes, (1988) describe a probation-officer operated group cognitive training program in the Oshawa/Pickering (Ontario) area aimed at reducing the recidivism of 22 high risk offenders. The program utilized the following techniques: structured learning therapy; lateral thinking; critical thinking; values education; assertiveness training; negotiation skills training; interpersonal cognitive problem solving; social perspective-training and role-playing; and modelling. The program focused on "modifying the impulsive, egocentric, illogical and rigid thinking of offenders and teaching them to stop and think before acting, to consider the consequences of their behaviour, to conceptualize alternative ways of responding to interpersonal problems and to consider the impact of their behaviour on other people, particularly their victims".

Measures of recidivism within a nine month period were substantially lower for the cognitive training group compared to matched life skills and regular probation groups (i.e., 18.1% versus 47.5% and 69.5% respectively).

2 Aggression Replacement

Among the most widely employed aggression treatment programs are the group programs developed by Goldstein in his work with violent adolescents (e.g., Goldstein, 1973; Goldstein and Glick, 1987). Goldstein and Glick divide the training into three distinct parts: structured learning; anger control; and moral education.

The structured learning component is based upon a cognitively-oriented social learning deficit model and is aimed at introducing personal, interpersonal and social cognitive skills with the overall goal of strengthening pro-social behaviors. It involves the following elements: a) modelling (demonstration of skills); b) role playing (rehearsal of skills); c) performance (praise and feedback); and d) transfer training (practice of skills in various situations).

The anger control component is based on stress inoculation research by Novaco (1975) and has the goal of inhibiting antisocial behaviour through the management and control of anger and aggression. These techniques are broadly similar to those described above in relation to group treatment for wife abusers and include: a) triggers (identification of internal and external events which act as stimuli for anger e.g., self-statements); b) cues (recognition/identification of physical sensations which signify anger arousal); c) reminders (generating arousal-reducing self-statements); d) reducers (techniques such as backward counting, deep breathing, peaceful imagery and reflection on long term consequences); and e) self-evaluation.

The program uses modelling (demonstrations of the proper use of the anger control techniques) and guided practice (role-playing and feedback). "Hassle logs" are kept by the trainee and describe how she/he deals with everyday conflict situations. The material is used as practice during role-playing.

Although the techniques have been associated principally with adolescent groups, recent applications to adult inmate populations has indicated promising results (Kennedy, in progress). Kennedy treated 37 adult inmates utilizing Goldstein and Glick’s structured learning and anger control methods. All treatment groups improved substantially, when compared to delay treatment and scores on pre-program tests, according to self-report, scores on an anger inventory and responses to role-play scenarios. The longer the time in the treatment program, the greater the improvement. Changing the order of the treatments, for example, beginning with anger control (behavioral) or structured learning (cognitive) had no effect on the outcomes.

Other applications of the anger control and structured learning components of the Goldstein and Glick program as with other behaviorally based programs have been shown to be successful in producing higher levels of pro-social behaviors within institutions. Goldstein and Glick also report promising results when the programs are mounted in community settings. However, generalization of the behaviours to settings outside of the programs has not been demonstrated. Goldstein and Glick have introduced a number of innovations to try to produce these effects but to date evidence regarding long-term effects has not been forthcoming (Gendreau and Ross, 1987).

The moral education training component is based upon the application of the stage theory of moral development introduced by Lawrence Kohlberg. It involves classroom discussions of moral dilemmas set at various moral developmental stages. The dilemmas are intended to introduce cognitive conflict, provide role-taking opportunities and to result in transition to the next higher stage of development. Group members are asked to confront a moral dilemma, state a tentative position and examine and reflect on the position.

Moral Education training has been demonstrated to be effective in changing values but not corresponding behaviours. In addition, there is no evidence for long-term stability or generalization (Ross and Fabiano 1985).

3 Changing Attitudes

"The only change that endures is that which involves change of the inner man. The unchanged criminal lacks the thinking processes to function responsibly."

Yochelson and Samenow (1977)

The "thinking processes" above refer to the following offender attributes: refusal to accept responsibility or to be accountable; egocentricity (failure to see things from another’s point of view); lack of attachments to others; deceptiveness; untrustworthiness; suspiciousness; pervasive pursuit of power and control; and the requirement of immediate rewards. Yochelson and Samenow (1977) propose an intensive daily group program aimed at the hard-core habitual criminal. This program requires a major commitment of the offender’s and the therapist’s time and involves note-taking, self-report, self-examination and self-monitoring. The goal is to achieve "total responsibility". Other approaches to changing attitudes are outlined below.

Differential Association Theory

The differential association approach to changing pro-criminal attitudes is based on the social learning premise that criminal learning takes place through the modelling of criminal patterns (in isolation from anti-criminal patterns) and through reinforcement for exhibiting criminal behaviors. A prominent feature of this approach is the recognition and utilization of interpersonal relationship factors, such as characteristics of the model, in the learning process.

In a series of experiments, Andrews (1980) and colleagues varied conditions in Community Groups programs with probationers. These programs utilized equal numbers of citizen volunteers and offenders in discussion groups in which the topics of discussion were: "the function of rules, the validity and limits of common rationalizations for law violations, and a social learning perspective on self-control". The groups with the high-empathy (interpersonally skilled) and high socialization (conventional orientation) probation officer leaders, in comparison to recreation groups and waiting list controls showed a) the lowest recidivism rates b) the greatest increases on measures of respect for the law, courts and the police, and c) the greatest reductions in tolerance for law violation and identification with offenders. Success was also affected by the strength of the pro-social attitudes of the volunteers.

Further examination of the relationships between recidivism and the attitude changes produced (reported in Andrews, 1980), indicated that the following additional changes were predictive of non-reoffending: a) increased socialization; b) decreased psychopathology; and c) decreased wish to exert control over others.

In an investigation which included the provision of self-management training ("self-observation, self-instruction and self-consecration"), Wormith (1984) varied the quality of the attitude training and found that the group receiving the highest quality attitude training and the self-management training showed pro-social behavioral changes but the group which received the lower quality attitude program with self-management exhibited behavioral changes in the antisocial direction.

The high quality attitude training and self-management group was the only group to have no serious recidivism (sentence of more than one year) upon follow-up. It was also found that changes in attitude and personality played an important role in the offender’s success upon release.

The study concluded that both attitudinal and behavioral components should be provided in order to obtain the desired benefits. It is interesting to note, however, that Kennedy (in progress) found that the pro-criminal attitudes of the inmates changed substantially in the pro-social direction during the treatment even though there was no attempt to directly affect attitudes.

This group of studies, in addition to demonstrating the possibility of changing attitudes, also underlines the complexity of relationships between different types of programs and the importance of attention to the qualifications and qualities of the change agents.

Cognitive Programs

In a critique of Goldstein and Apter’s (1987) moral education training, Ross and Fabiano (1985) questioned the connection between moral reasoning and moral values. That is, it seems possible that a person may develop reasoning skills but continue to hold to an antisocial, or self-serving value system. Ross and Fabiano suggested instead that emphasis be placed upon the development of empathy (i.e., understanding of how others think and feel and seeing the world from another’s point of view) with the expectation that anti-social behaviour would consequently be inhibited. The ultimate goal of such training is the development of affective empathy which involves concern for others and the sharing of other people’s feelings. The moral dilemma discussion format is recommended by these authors because it provides opportunities for the development of this interpersonal reasoning and empathy.

As do Andrews (1980) and Yochelson and Samenow (1987), Ross and Fabiano stress the importance of the trainer as a model. Trainers must consciously act as models of pro-social values and positively reinforce pro-social attitudes and sentiments expressed by the client.

C. Effective Correctional Treatment

Efforts in defence of rehabilitation have provided several comprehensive descriptions of effective treatment in corrections. (i.e., Ross and Gendreau, 1980; Gendreau and Ross, 1987; Ross and McKay, 1980; Ross and Fabiano, 1985). Below are summarized the central conclusions of these reviews.

1. Individual Differences

Programs must be tailored to fit the individual offender’s abilities and learning styles. Gendreau and Ross give the example of teaching moral reasoning to youths who do not have the necessary cognitive skills required (e.g., abstract thinking style or adequate understanding of interpersonal dynamics). As Andrews and others have pointed out, trainer or therapist characteristics must also be carefully controlled.

2. Cognitive Skill Development

The more successful corrections programs are those which include techniques to modify the offender’s thinking. These techniques include the training of impulse control, self-analysis, critical thinking, and interpersonal cognitive problem solving.

3. Length of Treatment

Generally, the longer and more intensive the treatment the greater are the gains.

Vll. Recommendations For Corrections

A. Support for Families: Treatment and Prevention of Abuse

"The role the prisoner’s family can fill is one of the most potent and practical tools we have available in the prisoner/criminal rehabilitation effort."

Homer (1979) p.47

In many areas of the study of family violence, there are assuredly more questions than there are answers. However, the findings with regard to the dysfunctional family backgrounds of many of the perpetrators of family violence, whether apprehended or not, are clear and have been underscored throughout this paper. To continue the arguments in regard to the importance of family variables in abusive and criminal behaviour, we follow here with a discussion of the effects of family relationships on recidivism.

In programs utilizing parent behaviours to alter parent-child interactions, short-term reductions of antisocial behaviours have been demonstrated. Although the long term effects have not yet been established, researchers and practitioners are in agreement regarding the promise of early interventions in families in the prevention of future criminal behaviour (e.g., Gendreau and Ross, 1987; Loeber and Stouthammer-Loeber, 1986).

Programs focusing on the family relationships of adult offenders have also been shown to have effects on recidivism. The New York State Correctional Services Family Reunion Program, which involves extended family visits in on-site mobile homes, has been studied extensively in this regard. In the most recent analysis (Macdonald and Bala, 1986), a follow up study of 204 inmates who had participated in the family reunion program in 1982 and had been released as of December, 1984, showed a 19.6% return to prison rate. This rate was notably less than the projected rate of 26.5% based upon the system’s overall return rate.

Holt and Miller (1972, reported in Homer, 1979) found that 70% of inmates who had 3 or more visits from family members were arrest-free during the first year on parole compared with 50% of no-contact inmates. Twelve percent (12%) of the latter group returned to prison compared with only 2% of the former group.

Homer (1979), in a review of the literature, argued that whether or not a prisoner returns to family is an important factor in whether or not he/she recidivates. According to Homer, the inmates who live with wives, husbands or parents when on parole show the fewest problems when compared to inmates who live alone, with siblings or with others. The greater the family and/or social ties, the fewer the parole failures. Homer argues that "the strong positive relationship between strength of family-social bonds and parole success has held up for more than 50 years across very diverse offender populations and in different locales".

The above studies demonstrate that strong family ties can facilitate an offenders reintegration into the community and decrease the probability of criminal recidivism.

Therefore, this review recommends that the fostering of future harmonious family relations through family support be the basis for new family violence initiatives within the Federal correctional system. There is evidence to believe that family support would mitigate against criminal recidivism for present day offenders as well as against the criminal behaviour of future generations.

The package of programs suggested below should be encompassed under the rubric of family support with the goals of helping the inmate to develop and improve family-relevant skills such as effective parenting, anger control and communication skills. Wherever possible the inmate’s family should be assisted through counselling and appropriate referrals (e.g., self-help group for battered women, day care assistance).

In keeping with the conclusions of Zamble and Porporino (1988), it is recommended that family support programs should be introduced, provided and encouraged throughout the whole period of the inmate’s incarceration and most importantly at the outset, when receptivity to change is at its highest level.

B. Proposed Programs

1. Targets

While we have presented some discussion of the violent offender throughout this paper, it is by no means suggested that the violent offender is the only inmate to be targeted by family violence programs. In the populations studied by this review, not all men violent outside the home could be expected to be violent with their families just as not all men violent with their families would necessarily be violent outside the home.

Canadian correctional statistics for June, 1988, indicate that the marital status of federal inmates is distributed as follows: single, 49.8%; common law and married, 38.5%; separated and divorced, 9.8%; and widowed, 1.3%.

From these statistics may be identified at the outset a group with a history of marital conflict. In addition, for a sizeable proportion of inmates (38.5%), the value of strengthening family ties and preventing future family violence might indeed be appropriate. In this regard, Zamble and Porporino (1988) reported that among the most frequent problems listed by the male inmates were conflicts (fights/arguments) with wives and girlfriends. In general, the inmates were described as having casual, shallow and tenuous relationships with family and difficulties in maintaining relationships with women.

In the Zamble and Porporino study, 52% of male inmates claimed to have fathered children. Twenty percent (20%) were living with their own children prior to incarceration. In regard to female inmates, MacLeod (1986), amalgamated Canadian, British and Australian figures, and estimated that 50% to 70% of the Canadian female inmate population have borne children and 30% to 40% were actually caring for their children at the time of their incarceration. Planned Parenthood of New York Inc. (1987) reported that in the Bayview Correctional Facility in New York City, 80% of the women inmates were mothers and the majority would be returning to children for whom they must be primary caretakers.

2. Program Modules

A module approach is suggested because of the need to individualize treatment (Ross and Gendreau, 1980). Following the suggestions made in regard to effective treatment throughout this report it is also recommended that programs be directive and structured and at the same time utilize positive peer reinforcement and support. Inmates should be involved as much as possible in the organizational aspects of the programs. Programs should be learning-based, utilizing techniques such as modelling and role-playing as essential components. Treatment should be aimed at improving cognitive skills and inculcating pro-social behaviours.

Strict parameters should be established for involvement in the programs. For example, the inmate could be required to attend all but two of the meetings in order to have been considered a member. It would be a matter of record that the inmate graduated from or successfully completed the various modules.

Where appropriate and possible, links with community-based programs should be established early. Every effort should be made to ensure transfer of training and generalization to a range of situations and potential conflict content.

Where there are psychological problems which are more psycho-dynamic in nature such as depression, individual therapy should be made available.

It is recognized that programs similar to those suggested below are already in place in a number of Federal institutions e.g., anger management and family visiting. The programs described here, however, are specifically targeted to family violence.

a. Family Life Education

A general family life education program is suggested as the base from which more directed involvement can be fostered.

This program would involve a series of non-threatening "information evenings" each devoted to an aspect of family life. The events would utilize community speakers, films or dramatizations to be followed by open-ended guided discussion. Topics would include effective parenting, violence in families and communication. At the end of the evening the appropriate modules would be outlined.

The experience of the Arthur Kill Correctional Facility in Staten Island, New York, reported by Garnet and Lubell (1982) lends support to the notion of building upon general introductory events. In 1982, a community wife abuse group (Women’s Aid in Crisis, Inc.) conducted exploratory sessions on domestic violence. These were open meetings in which the inmates were not asked if they had a history of domestic violence but were simply invited. The authors noted that the men (50 to 70 inmates each session) came to the meeting initially out of curiosity and remained out of intense interest. Following the information and film section, about one-half of the group would leave. The ensuing discussion was "usually spontaneous and dynamic" and included expressions of loneliness and anger at the spouse and questions about child support and custody. Some inmates discussed their worries about returning to their partners and wanted advise on how to deal with anticipated high level emotional conflict. For a few inmates, exposure in a group was too threatening - these inmates were offered private meetings following the group discussion. The authors considered that the meeting resulted in a good level of interest in follow-up involvement in a wife abuse program. Unfortunately, there was no information on the longer term outcome or success of the program.

b. Anger Management

Anger management programs should comprise the range of cognitive techniques employed in the community since there is no evidence to indicate whether any component is more effective than another. Groups for wife abusers should be conducted separately from groups for child abusers in view of the differences in characteristics and the issue of gender. Anger management programs should not be utilized in isolation from other modules especially from those which are intended to further strengthen the understanding of the dynamics of the violence, to change underlying attitudes and to establish alternative behaviors based on changes in orientation i.e., violence in relationships, sex roles, and moral education. Detailed assessment of the functions of anger, aggression and control in the inmate’s violence (e.g. instrumental or expressive) would assist in determining the need for an anger management versus an attitude change focus.

Since wife batterer and parenting programs with anger abatement components are available in many communities, parole arrangements, where appropriate, should allow inmate attendance. One of the obvious advantages of such an arrangement is the provision of peer pro-social modelling.

c. Communication

This module would include the teaching of assertiveness and non-abusive communication in heterosexual relationships. It would employ practice in both initiating/request as well as response behaviours.

d. Violence in Relationships

This module would teach alternatives to violence as a means of control in spousal relationships. It would stress the importance of compromise and negotiation and other non-abusive strategies.

e. Sex Roles

This module would foster awareness of damaging and limiting sex-role expectations and myths surrounding male/female, husband/wife, mother/father and parent/child roles.

f. Parenting Training

Parenting training would comprise a mixture of didactic and discussion techniques aimed at providing information on normal child development, teaching non-abusive child rearing techniques and reinforcing protective and nurturing attitudes toward children.

Discussions of the inmates’ own victimizations as children could be utilized to foster empathy. In this regard, information on the effects of abuse on children and on the intergenerational transmission of violence might lead to an appreciation of the effects of the inmate’s behaviour on others and provide incentives for change. Discussions of relationships with parents could extend to issues surrounding the needs of the elderly.

Following the New York model (Planned Parenthood of New York, 1987), in prisons for men, parenting groups could be termed "fathering" groups instead to emphasize the fact that fathers are parents (and responsible) as well as mothers.

g. Values Discussion Groups

Values discussion groups based on different models outlined in this paper should be developed and instituted on a demonstration basis. In addition, efforts to change pro-criminal attitudes through the modelling of pro-social attitudes and behaviours by change agents and community volunteers should be important elements in the design of every module.

h. Problems of the Newly Released Offender

Inmates may be concerned about re-establishing relationships with wives, husbands, boyfriends or girlfriends. They may worry that they will be greeted by children who no longer recognize them as mother or father or are angry at them for going away. This module would provide a forum for discussion and preparation for these difficulties.

A similar program was offered in the New York correctional system (Planned Parenthood of New York, 1987). Male participants listed problems they considered important. "At the top of the list were remarriage and step-parenting, sexual adjustment and the need for partners to understand that ex-inmates may not be ready to be responsive, reestablishing connections with children who have moved away, getting support and understanding from partners and the community, and finding a job" (p. 16).

C. The Family Visit as Workshop

Essential to the success of the programs described above is the support of family contacts. The family visit or family contact, as conceived by this review, would be the "workshop" or "practicum" where skill and knowledge acquired would be tested and applied in a supportive environment. The inmate could be assigned specific "homework" to be carried out during a visit.

In order to refocus the family visit as a "family living" workshop, it should be managed in the same way as any rehabilitative program. Observation of the dynamics of the family visit, could help to identify strength and weaknesses of inmates and family members and help in program planning. The family visit can be employed to increase awareness of marital and family responsibilities and to practice parenting and communication skills.

It is often observed that male inmates are "at sea" during family visits and do not know what to say to wives or how to behave with children. Father’s report feeling frustrated at not being able to contribute to the upbringing of their children or to help their wives with family problems.

Contact with children is particularly important for mothers in prison. According to MacLeod, "the role of mother is often the only positive link female inmates have to a realistic and constructive future life". Separation from their children is one of the most serious problems faced by incarcerated women (Baunach, 1985). Special needs within this group are experienced by native offenders since their children are more likely to be lost to the child welfare system and be placed in non-native foster homes.

Family contacts are also important for the inmate’s family. The imprisonment of a parent, especially if he/she is the breadwinner, results in economic and emotional hardships and contribute to the breakup of the family (Homer, 1979). Fishmen (1988) notes that regular communication with their inmate husbands greatly improves the social and family lives of most wives.

The programs described above, with the family visit or contact as workshop would allow inmates to play a positive role in their families and to take part in decision-making and would better prepare both the family and the inmate for successful reintegration.

D. Identification and Assessment

1. Risk Factors for Wife Abuse

The prediction of family violence requires consideration of a number of situational and psychological factors. The following factors are associated in varying degrees with a risk of wife abuse. As will be seen, the factors are few in number and thus limited in usefulness in identifying past or present wife abusers.

Table 3 - Risk Factors For Wife Abuse
&nbps;	* Strong Association	* Less Strong Association	Not Strongly Established as Yet
Background Factors	Low occupational Status low income low educational level	History of unemployment history of criminal arrests 25 to 35 years of age
Behavioral Factors	Sexual aggression toward wife Violent towards children Abuse of alcohol or drugs	&nbps;	Threats of suicide or homicide
Psychological Factors	low assertiveness witnessed violence as a child	low self-esteem experienced violence as a child high need for power/dominance externalizes blame for abuse	rigid sex-role attitudes fear of abandonment fear of intimacy impulsive cognitively rigid
*the material in these two columns is taken from Hotaling and Sugarmen, 1986

2. Offender Assessment

Thorough assessment of history and needs would be essential in order for the case managers and/or treatment personnel to assist the inmate in choosing the appropriate modules. The assessment would include thinking processes, cognitive strengths and weaknesses, lifestyle, motivations, values, attachments and needs.

Table 4 displays the proposed programs matched with assessed needs and characteristics. This scheme is a first attempt at a guideline - is tentative at best - and should not preclude self-referral as an outcome of the family life education program.

Table 4 - Programs Matched With Needs
Program	Targets	Needs/Characteristics
Anger management/control	wife and child abusers	impulsive expressive violence
Communication	wife and chid abusers	low assertiveness
Violence in Relationships	wife abusers	high need for power/dominance instrumental violence lifestyle violent
Sex roles parenting	wife and child abusers wife and child abusers parents	rigid sex role socialization instrumental violence
Values Discussion	wife and child abusers	instrumental violence lifestyle violent lack of empathy egocentricity

E. Further Research in Corrections

1. Victims

It has been estimated by practitioners in the criminal justice field that between 70% and 80% of incarcerated women have been victims as children or as adults of one or more kinds of family abuse. While the abuse most often mentioned is incest, the actual prevalence of different types of abuse in this context is unknown. There is a need for further documentation and study of these questions so that appropriate treatment can be supported.

Any family support program dealing with family violence issues must consider both the victims and the abusers, not only because of the immediate need to provide therapeutic assistance to the inmate victim, but also in the context of prevention because victim and abuser are very often the same.

2. Natives

The Correctional Law Review (1988) notes that the families of native offenders are characterized by a higher degree of instability and problems than the families of non-native offenders. In addition, natives are more likely to be sentenced to correctional institutions for violent crimes. Unfortunately, natives participate less in rehabilitation programs in prisons. The participation rate, while still low, is higher for native specific programs. Many native offenders have specific cultural needs which are not experienced by non-natives. Further research into family violence/family support programs in prisons should examine the special needs of native offenders and should consider the unique requirements of this group in the design of programs.

3. Assessment

Thorough assessment of background characteristics, behaviour, cognitions, personality, values and attitudes as well as complete history and description of the offender’s experience with violence are fundamental prerequisites for family violence research in corrections. This information would provide the basis for delineation of abuser types which could be matched with program outcome.

There is a need for research which discovers and evaluates assessment instruments and methods in the family violence area and makes recommendations for assessment applications in corrections settings.

4. Program Evaluation

Evaluations of treatment programs should compare: different types of treatment (e.g., cognitive/behavioral group treatment compared to psycho-therapeutic group treatment); different lengths of treatment; different elements of treatment (e.g., changing beliefs and attitudes with or without behavioral training); and different outcomes (e.g., physical abuse, threats, and emotional abuse).

In view of the confusion and dissatisfaction regarding the current methods of assessing treatment outcome, it is important to explore and assess other outcome measures. There is also a need to develop and test more feasible methods of long-term follow-up.

Vlll. Conclusions

A serious attempt to combat family violence in the corrections context requires that the offender be viewed from the beginning as a social being with important family ties. Service planning must proceed from the time of admission with the goal of identifying, strengthening and preserving the inmate’s significant relationships. The inmate needs to be given the opportunity to understand the relationships in his/her life and to exercise the ability to make decisions about these relationships. Consideration of the effects and positive possibilities of significant family relationships can be a valuable part of an overall rehabilitation strategy.

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Family Violence Review: Prevention and Treatment of Abusive Behaviour

TABLE OF CONTENTS

I. Introduction

Il. Definitions And Descriptions

A. Definitions

Physical Abuse

Psychological/Emotional Abuse

Neglect

Financial Abuse

Wife Abuse

Child Abuse

Elder Abuse

B. Incidence

1. Wife Abuse

2. Child Abuse

3. Elder Abuse

C. Description

1. Wife Abuse

2. Child Abuse

3. Elder Abuse

Ill. Causes Of Family Violence

A. Individual Psychological

B. Alcohol Abuse

C. Interactional/Systems

D. Sociological

E. Societal Norms

F. Family Violence as a Subset of Violence in General

G. Social Learning Theory

H. Intergenerational Transmission

I. Structural/Political(Wife Abuse)

J. Ecological

The Macrosystem

The Exosystem

The Microsystem

The Ontogenetic Level

IV. Characteristics Of Abusers

A. Wife Abusers

Empirical Validation of Wife Abuser Characteristics

B. Child Abusers

C. Links Between Child, Wife and Elder Abuse

D. Types of Abusers

1. Domestically Violent Versus Generally Violent Wife Abusers

2. Expressive Versus Instrumental Violence: Wife and Child Abusers

V. Treatment Of Family Violence Abusers

A. Group Counselling of Wife Abusers

1. Description of Approach

Power and Control

Safety of the Wife

Motivation for Treatment

Services for Women

Ventilation Techniques

Fair Fight Techniques

Marital Counselling

Client-centred Individual Therapy

2. Evidence for Effectiveness

Surveys and Estimates

Deterrent Effect of Arrest

Empirical Reports

B. Marital Therapy for Violent Couples

1. Description of Approach

Systems Approach

Non-traditional Marital Therapy

2. Evidence for Effectiveness

C. Individual Therapy for Child Abusers

1. Description of Approach

2 Evidence for Effectiveness

D. Parenting Skills Training for Child Abusers

1. Description of Approach

2. Evidence for Effectiveness

E. Treatment of Elder Abuse

F. Conclusions on Effective Treatment

1. Wife Abusers

2. Child Abusers

Family Violence Review:
Prevention and Treatment of Abusive Behaviour