A Qualitative Study of the Perspectives of Domestic Violence Survivors on Behavior Change Programs With Perpetrators.

This study investigated the process of change in intimate partner violence (IPV) perpetrators through in-depth interviews with their (ex-)partners. Programs designed to help perpetrators change their behavior, have yet to be endorsed by rigorous evaluation. In this context, this study explored survivors' perspectives for direction on how these programs might be further developed. Interviews were conducted with 18 IPV survivors, who had recently had the experience of having a (ex-)partner complete a perpetrator program. The study employed iterative data collection and analysis, in keeping with the grounded theory approach to qualitative research. Researchers used secondary coding to enhance study rigor. Lines of enquiry which were relevant to perpetrator program development were identified in an expert review of interim findings, after nine interviews. Survivors described change on a spectrum, from highly significant change, through uncertainty about change, to harmful change. Some survivors described their subscription to new standards of family safety, following the support and time-out they had been afforded during their partners' treatment. Study findings give us pause to consider what we can realistically hope to achieve through traditionally formatted psycho-educative group-work programs with perpetrators. Survivors described the need for long-term sustained change in perpetrators and genuine feelings of safety for themselves and their children. We discuss the role the current perpetrator programs might play in achieving these aims and point toward the inadequacy of commonly used behavior-counting tools in program evaluations. Based on the current study findings, we suggest that perpetrator programs can become perpetrator centric, and stray from their original conceptualisation as just one part of an integrated response to IPV. We lend support to calls for the use of survivor safety, and well-being measures, in program evaluations.

Family group decision-making for children at risk of abuse or neglect: A systematic review.

Background: Capturing the scale of child maltreatment is difficult, but few would argue that it is anything less than a global problem which can affect victims' health and well-being throughout their life. Systems of detection, investigation and intervention for maltreated children are the subject of continued review and debate. Objectives: To assess the effectiveness of the formal use of family group decision-making (FGDM) in terms of child safety, permanence (of child's living situation), child and family well-being, and client satisfaction with the decision-making process. Search Methods: Both published and unpublished manuscripts were considered eligible for this review. Library staff from Scholarly Information (Brownless Biomedical Library) University of Melbourne, conducted 14 systematic bibliographic searches. Reviewers also checked the reference lists of all relevant articles obtained, and reference lists from previously published reviews. Researchers also hand-searched 10 relevant journals. Selection Criteria: Study samples of children and young people, aged 0-18 years, who have been the subject of a child maltreatment investigation, were eligible for this review. Studies had to have used random assignment to create treatment and control groups; or, parallel cohorts in which groups were assessed at the same point in time. Any form of FGDM, used in the course of a child maltreatment investigation or service, was considered an eligible intervention if it involved: a concerted effort to convene family, extended family, and community members; and professionals; and involved a planned meeting with the intention of working collaboratively to develop a plan for the safety well-being of children; with a focus on family-centred decision-making. Data Collection and Analysis: Two review authors independently extracted the necessary data from each study report, using the software application Covidence. Covidence highlighted discrepancies between data extracted by separate reviewers, further analysis was conducted until a consensus was reached on what data were to be included in the review. Two authors also independently conducted analyses of study bias. Main Results: Eighteen eligible study reports were found, providing findings from 15 studies, involving 18 study samples. Four were randomised controlled trials (RCTs; N = 941) the remainder employed quasi-experimental designs with parallel cohorts. Three of the quasi-experimental studies used prospective evaluations of nonrandomly assigned comparison groups (N = 4,368); the rest analysed pre-existing survey data, child protection case files or court data (N = 91,786). The total number of children studied was 97,095. The longest postintervention follow-up period was 3 years. Only four studies were conducted outside the United States; two in Canada and one in Sweden and one in the Netherlands. The review authors judged there to be a moderate or high risk of bias, in most of the bias categories considered. Only one study referenced a study protocol. Eleven of the fifteen studies were found to have a high likelihood of selection bias (73%). Baseline imbalance bias was deemed to be unlikely in just two studies, and highly likely in nine (60%). Confounding variables were judged to be highly likely in four studies (27%), and contamination bias was judged highly likely in five studies (33%). Researcher allegiance was rated as a high risk in three studies (20%) where the authors argued for the benefits of FGDM within the article, but without supporting references to an appropriate evidence base. Bias from differential diagnostic activity, and funding source bias, were less evident across the evidence reviewed. This review combines findings for eight FGDM outcome measures. Findings from RCTs were available for four outcomes, but none of these, combined in meta-analysis or otherwise, were statistically significant. Combining findings from the quasi-experimental studies provided one statistically significant finding, for the reunification of families, favouring FGDM. Ten effect sizes, from nine quasi-experimental studies, were synthesised to examine effects on the reunification of children with their family or the effect on maintaining in-home care; in short, the effect FGDM has on keeping families together. There was a high level of heterogeneity between the studies (I 2 = 92%). The overall effect, based on the combination of these studies was positive, small, but statistically significant: odds ratio (OR), 1.69 (confidence interval [CI], 1.03, 2.78). Holinshead's (2017) RCT also measured the maintenance on in-home care and reported a similar result: OR, 1.54 (CI, -0.19, 0.66) not statistically significant. The overall effect for continued maltreatment from meta-analysis of five quasi-experimental studies, favoured the FGDM group, but was not statistically significant: OR, 0.73 (CI, 0.48, 1.11). The overall combined effect for continued maltreatment, reported in RCTs, favoured the control group. But it was not statistically significant: OR, 1.29 (CI, 0.85, 1.98). Five effect sizes, from nonrandomised studies, were synthesised to examine the effect of FGDM on the number of kinship placements. The overall positive effect based on the combination of these studies was negligible: OR, 1.31 (CI, 0.94, 1.82). Meta-analysis was not possible with other outcomes. FGDM's role in expediting case processing and case closures was investigated in six studies, three of which reported findings favouring FGDM, and three which favoured the comparison group. Children's placement stability was reported in two studies: an RCT's findings favoured the control, while a quasi-experimental study's findings favoured FGDM. Three studies reported findings for service user satisfaction: one had only 30 participants, one reported a statistically significant positive effect for FGDM, the other found no difference between FGDM and a control. Engagement with support services was reported in two studies; neither reported statistically significant findings. Authors' Conclusions: The current evidence base, in this field, is insufficient to draw conclusions about the effectiveness of FGDM. These models of child protection decision-making may help bring about better outcomes for children at risk, or they may increase the risk of further maltreatment. Further research of rigour, designed to avoid the potential biases of previous evaluations, is needed.

Male IPV Perpetrator's Perspectives on Intervention and Change: A Systematic Synthesis of Qualitative Studies.

OBJECTIVE: To add to our understanding of change processes by analyzing perpetrators' perspectives on intervention. METHOD: Fourteen databases were searched and 27 articles reporting relevant qualitative findings were identified. Analytic coding was applied across the findings and discussion sections of all 27 study reports to form an interpretive account of the data set. Studies were also grouped according to their perceived theoretical standpoints, and a summary of themes in each grouping is presented. FINDINGS: Study participants were largely positive about their experiences in intervention; new learning such as conflict interruption techniques and new communication skills were commonly cited benefits. Perpetrators attend perpetrator intervention programs with a range of motivations, ranging from a determination to change who they are, to a determination to avoid a custodial sentence. The most common barriers to change, found in this analysis, were cognitive distortions, emotional dysregulation, gendered social constructions, and self-esteem issues. CONCLUSION: Further qualitative investigation, of rigor, with the intention-to-treat population of intimate partner violence perpetrators involved in perpetrator programs is needed. At this point, we would venture that qualitative research, with perpetrators, underlines the precept that formidable barriers to change exist in this population. The centrality of group work to perpetrator interventions should be reconsidered in light of the complexity of the change task and in light of the heterogeneity of this population.

Participants' Views About the Survivor Contact Element of IPV Perpetrator Programs: A Preliminary Study.

Advocacy services, for victims and survivors, are at the core of our response to Intimate Partner Violence (IPV). The survivor contact element of IPV perpetrator programs is recognized as a necessary safety measure for their operation. Within the context of equivocal evaluations of these programs, and the impetus to find opportunities to enhance their effectiveness, this study report explores the service user perspective on survivor contact work. In-depth semi-structured interviews were completed with 18 perpetrators and 18 survivors involved in three Irish-based programs, and findings were analyzed using grounded theory principles. Almost without exception, survivors were positive about their engagement with an outreach service. There was evidence to suggest that perpetrator program outreach services do reach survivors who may not ordinarily make contact with an advocacy service. In general terms, survivors felt validated as survivors, they felt supported, they learned about abusive behaviors and some saw the service as a monitor of what their partner was saying during group work. However, some survivors described their fear that any reports of ongoing abuse, which they offered, would attract reprisals from their partner or the attentions of child protection services. More determined application of criminal justice measures, and enhanced resourcing of the survivor contact element of these programs, should be considered.

Survivor Perspectives on IPV Perpetrator Interventions: A Systematic Narrative Review.

More effective work with perpetrators of intimate partner violence (IPV) can be built upon a better understanding of how and why they change their behavior. This article presents a systematic narrative review of female IPV survivor perspectives on the changes brought about by IPV perpetrator programs. Fourteen databases and web search engines were searched and 16 articles reporting relevant qualitative findings were identified. Survivors often reported some level of positive change through their partner's engagement with a program, but the sustainability of this change is unclear and there was also some negative feedback. From the survivors' perspective, key barriers to perpetrator change include alcohol dependency, mental health challenges, relationship dynamics, and their family of origin. Mechanisms by which perpetrators are held to account, namely, survivor validation and judicial measures, were seen as central to the change process. Survivors perceived changes in perpetrator behavior (the use of conflict interruption techniques and new communication skills) and changes in perpetrators' belief systems (adopting new perspectives). Changes in belief systems were associated with more complete desistence from violence and would appear more difficult to effect. The review highlights the complexity in this field, which is discussed by the authors with reference to practice, policy, and research.