Section III Draft: Note: grammar and spelling errors were not edited in this version. This is a good example of what asection III paper might look like. --rlw
Spouse Abuse: Treatments
Naomi Yamazawa
University of OregonTreatment of marital violence can be separated into two approaches, gender-specific and non-gender-specific treatments. In gender-specific treatments, men and women are treated separately. Anger-containment programs (Gondolf & Russel, 1986) and cognitive behavioral therapies (Hamberger & Hastings, 1988) are considered male specific treatments. For abused women, battered women’s shelters (Marsh & Walker, 1997) are currently available. Non-gender specific treatments involve three different types of approaches: unilateral, bilateral, and dyadic (Jennings & Jennings, 1991). In this paper, I will review both gender specific and non-gender specific treatments.
Gender Specific treatments
Treatments programs for men started in 1985 in response to the women’s and accompanying men’s liberation movements. Currently, there are two types of treatments: anger-containment programs and cognitive behavioral interventions. Anger-containment programs focus on refraining from violent behavior. Male spouse abusers confront the reality of what they are doing and how aggressive behaviors affect their life and the lives of others. They learn alternative behaviors, such as relaxation training and emotional awareness training (Malgolin & Burman, 1991). However, anger-containment programs have limitation. The study of Gondolf and Russel (1986) indicates that anger-containment programs are effective for physical but not for psychological violence.
In response to the criticism of anger-containment programs, cognitive behavioral interventions have been developed. The interventions include not only attitude change but also reeducation and cognitive-behavior alternation. In the reeducation process, exploration of sex roles, anti-sexist education, and a redefinition of manhood are emphasized. The process of cognitive-behavior change involves communication training, empathy building, and cooperative decision-making. The treatments are often offered in a group setting to avoid batterers’ isolation from society. Through group settings, male spouse abusers can recognize that their problems are not unique (Malgolin & Burman, 1991).
Hamberger and Hastings’s study (1988) conducted a 15-week cognitive-behavioral skills training program for male spouse abusers and measured the rate of violent behavior after 1 year following treatment. Tow-and-a-half-hour weekly sessions of group therapy were divided into two parts. The first part of the sessions was discussion of homework, and the second part of the sessions focused on learning and rehearsal of new skills. These include cognitive restructuring, self-imposed time-outs, communication and assertiveness, and active-coping relaxation. Subjects were divided into two groups, program completers who finished most of the sessions and dropouts who refused sessions part of the way through. The results showed dramatic decreases in the occurrence of violent behaviors after treatment and follow-up in program completers. However, the study showed that there was evidence of continued psychological abuse among program completers, and there was no change in basic personality.
Hamberger and Hasing’s study (1988) can be criticized. Although the study showed significant elimination of physical violence, psychological violence continued, and there was no change in batterers’ basic personalities. Another problem is that abusive husbands rarely admit the need for therapy or marital counseling. In fact, in Hamberger and Hasting’s study (1988), almost half of the participants dropped out. So fat, both anger-containment and cognitive behavioral interventions don’t seem to have significant effectiveness.
The female specific approach is battered women’s shelters. Shelters began in the 1970s in response to the safety needs of physically-abused women for nonjudgmental support. They also provide direct social support, such as child care, employment or financial assistance, housing assistance, and treatment for psychological problems, such as helplessness, depression, and poor self-esteem.
(Margolin & Burman, 1991 ; O’leary & Vivian, 1990).
McNamara, Ertl, Marsh, and Walker (1997) conducted an evaluation of a domestic violence shelter for battered women. Eighty-one physically abused women with a mean age of 31.8 years received three sessions of residential or outpatient counseling and case management services at the shelter. After three sessions, changes in both physical and psychological abuse, life satisfaction, and coping ability were assessed. The results showed that both physical and psychological abuse were more significant (p<.001), compared to psychological abuse (p<.01). Life satisfaction increased, and coping ability improved.
McNamara et al.’s study (1997) showed significant results overall; however, there was evidence that 40 subjects of the original 81 (50.6 %) dropped out between the pre-intake and Session 3. Therefore, the results were lacking in generality. In other words, “high functioning, less severe diagnose, and lower abuse as well as receiving by an experienced counselor were all related to greater global improvement” (McNamara et al., 1997). Furthermore, McNamara et al’s study indicated short-term outcome. Therefore the study can be criticized for its limitations on understanding how shelter services affect long-term outcomes. Follow-up measures were not conducted either. Therefore, a relapse of physical and psychological abuse can be possible.
Not many studies of women’s shelters were conducted. Therefore, it’s still difficult to evaluate women’s shelters. Furthermore, diversity in shelters makes researchers it difficult to study the provision of safety and care for women, and the education of women about the process of collective liberation. Researchers need to consider a diversity of criteria in assessing the effectiveness of women’s shelters (Russll, 1988).Non-gender specific treatments
Non-gender specific treatment involves the presence of both abuser and the abused. Currently, there are three approaches for couple treatment: unilateral, bilateral and dyadic. In the unilateral treatment, the male batterer has the ultimate responsibility for the violence, even if both husband and wife engages in physically violent behaviors. There is no interactive treatment of the individual. Each partner is treated independently of the other. Abused wives are provided with individual or group therapy emphasizing support, guidance, and empowerment, and they are helped to free themselves from their traditional passive-dependent role. Abusive husbands, depending on their aggressiveness, are either arrested, incarcerated, fined, or court-mandated to pursue counseling (Jennings & Jennings, 1991).
Bilateral treatment reflects more of a systems theory In this view, both the husband and wife are seen as victims. Therefore, both spouses are expected to change to improve their relationships. The treatment is conducted separately in parallel individual or group counseling. The goal of the therapy is to encourage abusive men to stop violent behavior and take responsibility for their violence. At the same time, the abused wives are expected to change their side of the problem (Jennings & Jennings, 1991).
Dyadic treatment is mutual and interactive conjoint treatment. In the treatment, each spouse must have responsibility for his/ her contribution to the problematic interaction and make an effort to improve their relationship (Jennings & Jennings, 1991).
I reviewed both gender specific and non-gender specific treatments. Today, non-specific treatment is more effective than gender specific treatment. According to Malgolin and Burman (1991), conjoint therapy provides the spouses with not only the same educational materials but also with a safe environment to express their feelings. On the other hand, it is pointed out that gender-specific treatments would be more likely to show relapses than conjoint therapy because structural changes for the whole family cannot occur. However, conjoint counseling gives “ ambiguous and contradictory messages to the abuser about how much responsibility he should take for ending his violence” (Malgolin & Burman, 1991). In the case of some abusive individuals who are too abusive, conjoint therapy may raise the risk of aggression in the treatment. Various arguments about treatments still continued. There is still no single effective and appropriate therapy for domestic violence.
Goldman, A. (1992). Comparison systemic and emotionally focused approaches to couples therapy. Journal of Consulting and Clinical Psychology. Vol. 60 (6), 962-969. References
Note: References were in APA style but not shown that way here.Gondolf, E. W., & Russell, D. (1986). The case against anger control treatment programs for batterers. Response to the Victimization of Women and Children. Vol. 9 (3), 2-5.
Hamberger, L. K. & Hastings, J. E. (1988). Skills training for treatment of spouse abusers: An outcome study. Journal of Family Violence. Vol. 3. (2), 121-130.
Jacobson, N. S. & Bussod, N. (1983). Marital and family therapy. In B. Woman (Ed.), Handbook of Clinical Psychology, (pp. 611-630). NY: McGraw Hill.
Jennings, J. P. & Jennings, J.L. (1991). Multiple approaches to the treatment of violent couples. The American Journal of Family Therapy. Vol. 19 (4). 351-362.
Malgolin, G. & Burman, B. (1993). Wife abuse versus marital violence: Different terminologies, explanations, and solutions. Clinical Psychology Review. Vol. 13. (1), 59-73.
McNamara, J. R., Ertl, M. A., March, S. & Walker, S. (1997). Short-term response to counseling and case management intervention in a domestic violence shelter. Psychological Reports. Vol. 81. 1243-1251.
O’Leary, K.D. & Vivian, D. (1990). Physical aggression in marriage. In F. D. Fincham and T. N. Bradburg (Eds.) The psychology of marriage: Basic issues and applications. (pp. 323-348). NY: Guilfold.
Russell, M. (1988). Wife assault theory, research, and treatment: A literature Review. Journal of Family Violence. Vol. 3. (3), 193-208.
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