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--> 5 Legal Interventions The current array of legal interventions to address family violence includes service interventions, procedural and jurisprudential reforms, and efforts to build capacity and expertise in legal and social institutions to invoke legal sanctions—whether threatened or actual. Legal interventions, which include both the criminal and the civil justice systems, have several goals: identifying cases to bring abusers and their victims under the control and protection of legal and social institutions; addressing procedural and evidentiary problems in criminal prosecution; expanding the array of civil interventions to protect victims of abuse; reducing further violence by offenders; and increasing the range of social and legal controls affecting individuals, families, and communities. Unlike patient-centered or client-centered health and social service interventions, the criminal justice system must also represent society's interests. Its desired outcomes are independent, and at times they may differ from, and even appear to conflict with, those of the people who have been abused. Legal interventions must take into account the issues of due process and concern for the rights of victims as well as those accused of wrongdoing, seeking a balance among interventions to enhance victim protection, facilitate the prosecution of offenders, and preserve the state's interest in fair procedures. Legal interventions for the treatment and prevention of family violence often focus on procedural changes in law enforcement—such as arrest policies and practices, civil orders of protection, and court standards for the admissibility of evidence—rather than the provision of direct services to clients. The evaluation of such procedural reforms is made difficult by the variations in state and county jurisdictions that influence local law enforcement policies and practices. In
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--> evaluating these interventions, many researchers define success as a reduction in recidivism—a program-specific goal that the criminal justice system seldom accomplishes for any other type of offense. This emphasis on a single, hard-to-achieve measure may diminish attention to changes in other important domains, such as individual and public health; child, adult, and family functioning; public safety; equity and fairness; social support and the use of community services; and costs (Worden, 1995). Family violence treatment and prevention interventions in law enforcement settings have received far less attention in the evaluation research literature than social service interventions (see Table 1-2); less than one-quarter of the studies (21 of 114 studies) selected by the committee for review in this report involve legal interventions. The large majority of these 21 studies focused on domestic violence (18 studies); within this subset, 7 studies examined the impact of spousal arrest policies. This is one of few areas in the family violence research literature in which replication studies have appeared (discussed in section 5B-3). These replication studies have created a database that shows real promise for secondary analyses not only for domestic violence but also for child maltreatment. For example, one recent study that focused on children who witness domestic assaults conducted a secondary analysis of the spousal assault research database to examine the characteristics and prevalence of children in the homes where police officers intervened in response to domestic violence cases (Fantuzzo et al., 1997). In general, however, evaluations of the effectiveness of legal interventions suffer from problems similar to those in the areas of social service and health care: small study samples, ethical and legal problems in implementing experimental designs and in reporting discovered abuse, the constraints of confidentiality statutes, inadvertent effects caused by the research project, and the complexity of independent variables in multiple and overlapping interventions. Neither research on the immediate effects of legal reforms nor assessments of the recurrence or cessation of abuse have been routinized for these interventions. Accordingly, policies and procedures reflect ideology and stakeholder interests more than empirical knowledge. With some exceptions (such as the research on arrest policies and domestic violence), the available evaluations are more descriptive than analytic. Experimental or longitudinal studies on the effectiveness of current interventions are rare. The current empirical literature is limited by the kinds of methodological shortcomings discussed in Chapter 3. Despite the absence of research on their effectiveness, legal interventions are thought by many to play an important role with regard to family violence. For example, as noted later in this chapter, treatment interventions are sometimes provided to offenders solely as a result of arrest and court intervention, and their impact may be influenced by the quality and intensity of court oversight. This chapter reviews legal interventions and the available evaluations of them, first for child maltreatment, then for domestic violence, and finally for elder abuse.
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--> Child Maltreatment Interventions In the 1960s, following the passage of legislation that established eligibility for federal funds for child protective services programs, nearly every state adopted mandatory reporting laws, child abuse registries, expanded and newly empowered child protection agencies, and training for personnel in social, legal, and medical agencies. The emergence of child sexual abuse as a social crisis in the 1980s resulted in skyrocketing prosecutions and new evidentiary and procedural rules for such cases (Melton et al., 1995; Weisberg and Wald, 1984). Detailed procedures were put into place to detect, investigate, adjudicate, and resolve cases of child maltreatment—through supervision of families, removal of children from the home, and termination of parental rights. There was initially strong resistance by child welfare advocates and service providers to the criminal justice system's growing role in these cases, largely based on the assumption that it either could not or would not consider the best interests of the child in making decisions. This resistance abated somewhat as the criminal justice system began to adapt to the special needs of children, establishing special courts to focus on family matters, and child welfare and mental health agencies acknowledged the deterrent role of legal restraints and sanctions on offenders. Eight legal interventions for child maltreatment are reviewed in the following sections: (1) mandatory reporting requirements, (2) child placement by the courts, (3) court-mandated treatment of child abuse offenders, (4) treatment for sexual abuse offenders, (5) criminal prosecution, (6) improving child witnessing, (7) evidentiary reforms, and (8) procedural reforms. The sections are keyed to the appendix tables that appear at the end of the chapter. 5A-1: Mandatory Reporting Requirements Prior to the medical recognition of the battered child syndrome in 1962 (Kempe et al., 1962), family violence reporting laws did not exist in federal or state statutes. Following a national advocacy effort focused on the protection of children who were physically abused, all 50 states had adopted laws by 1967 requiring health and other professionals to report suspected child abuse and neglect. Since the creation of child protective services systems and the enactment of mandatory reporting laws, increasing numbers of cases have been reported to child protection agencies without a comparable increase in the resources to support adequate investigation and response to these reports. Whether these objectives have actually been achieved is uncertain, although the number of cases reported to child protection agencies has increased significantly. The overall change since 1976 has been a growth of 331 percent, from an estimated 10 children reported per 1,000 in 1987 to 43 children reported per 1,000 in 1994 (National Center on Child Abuse and Neglect, 1996a,b). The rapid
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--> escalation in reported cases has had a significant impact on the investigation and substantiation rates and disposition practices of social service agencies. The 1988 National Incidence Study indicated that only 40 to 50 percent of all reported cases of child maltreatment were substantiated (Sedlak, 1991). By 1994, the rate of substantiated or ''indicated" reports had dropped to about 37 percent (National Center on Child Abuse and Neglect, 1996b). This imbalance has encouraged discretionary decisions in which service providers, especially in health settings, seek to provide their clients access to their own treatment programs in lieu of public services (Zellman, 1990, 1992; Brosig and Kalichman, 1992). These findings have prompted a search for revisions in the reporting requirements, to establish certain conditions under which well-trained reporters could exercise more flexibility in filing reports, provide a treatment or intervention plan in lieu of a child protective services investigation, yet maintain informal oversight of cases by child welfare officials (Finkelhor and Zellman, 1991). The mandatory reporting laws were adopted in the belief that they would reveal cases of child maltreatment that were previously undetected and would provide a means for children and families to receive appropriate services prior to the occurrence of serious injuries, thus enhancing child safety and well-being. In reviewing the research literature on this intervention, the committee found no evaluations of mandatory reporting of child maltreatment that meet its criteria for inclusion (use of a comparison or control group in conduct of the study). Research on this topic is generally descriptive—no quasi-experimental studies have been conducted that could provide guidance to policy officials and service providers. Designing a study on mandatory reporting with a control group is difficult for several reasons: the universal and mandatory nature of current reporting systems inhibits the formation of an appropriate comparison or control group, uncertainties exist about the appropriate outcomes to measure, and separating the outcomes of mandatory reporting from the outcomes of subsequent services is an immensely complex task. For example, should mandatory reporting be evaluated on the number of cases that are substantiated, on the number of cases that receive some other intervention because of the reporting, on improved state datasets, or on child health and well-being indicators, including child mortality and injury rates? Mandatory reporting requirements were adopted without evidence of their effectiveness; no reliable study has yet demonstrated their positive or negative effects on the health and well-being of children at risk of maltreatment, their parents and caregivers, and service providers. Several studies have identified significant variations in reporting practices among service providers (especially health professionals) and the presence of a large number of service providers who use discretionary judgement in deciding whether to report suspected cases, especially under circumstances in which a child or family is receiving treatment or intervention services. Nonexperimental research studies have indicated that the
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--> filing of a report disrupts therapy in relatively few cases, and that a therapeutic relationship can survive and at times benefit if the therapist confronts and reports abusive behavior (Watson and Levine, 1989; Weisz, 1995). The objectives and potential benefits of mandatory reporting include (1) increasing detection before violence escalates (when families might be more receptive to social support services), (2) relieving victims and family members of the reporting burden (and thus enhancing their safety), (3) enhancing health care provider response to family violence by fostering greater coordination among service systems, (4) punishing perpetrators, and (5) improving documentation, data collection, and knowledge about the epidemiology of family violence, which can enhance the evaluation of interventions and encourage communities to increase resources for prevention and treatment programs (Hyman et al., 1995; Hampton and Newberger, 1985). Experience with reporting practices has raised a number of concerns about the adverse impact and unintended consequences of reporting requirements on children, their parents and caregivers, and service providers in both health care and social service settings: (1) discouraging clients who do not want involvement with the law enforcement system from seeking social services and health care; (2) risking retaliation by the abuser against victims who reveal abuse; (3) creating expectations of services and protection that cannot be met; (4) flooding the social services system with reports that involve minor cases of child maltreatment; (5) interfering with provider-client relationships and rapport, especially in areas that involve trust, safety, goal setting, deterrence, and treatment; (6) encouraging inadequate responses by providers, especially from those who do not understand their reporting responsibilities or who may abdicate responsibility for ongoing care once a report has been made; (7) fostering poor case detection and data collection practices, including noncompliance, biased compliance, and false positive reporting, as well as confusion about what must be reported; and (8) encouraging greater surveillance bias, including class or ethnic bias in reporting, because of the disproportionate reporting of low-income and minority communities who rely on public services (whose care providers are more likely to file reports) rather than private care (whose care providers are likely to use greater discretion in determining whether a report should be filed) (Besharov, 1994; Hyman et al., 1995; Hampton and Newberger, 1985). Some critics have indicated that legal reporting requirements have weakened the protection of children by diverting administrative resources away from services for children and families in serious trouble in favor of investigation of minor cases (Besharov, 1994). The tendency to perceive family violence as
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--> criminal behavior has also raised concerns about the bias or stigma associated with reporting practices. There is concern that reporting requirements have stimulated false positive cases with damaging effects on some parents, children, and families, although the size of this impact is not known. Finally, many research investigators and sponsors believe that the reporting requirements represent an impediment to the conduct of population-based studies of child maltreatment (National Research Council, 1993a). The effectiveness of mandatory reporting therefore needs to be examined within the broad dimensions of family violence and the impact of reporting practices on child and family access to services as well as on data collection. More important, the impact of mandatory reporting laws should be judged by the ways in which they interact with other services to help protect children and adults from abuse and neglect and to mitigate their consequences. When criminal acts can be substantiated, mandatory reporting practices can result in the prosecution of cases that would not otherwise be detected. Mandatory reporting requirements can also diminish the use of discretionary judgment and exact an unknown price on the ability of service professionals to control the timing, nature, and scope of disclosures of child maltreatment to legal authorities. These impacts may or may not be harmful to children at risk and their families, depending on the circumstances and severity of the maltreatment that is disclosed. At this time, significant doubts exist about the ability of social service agencies to respond adequately to initial reports of suspected cases. These doubts suggest that greater caution is required before expanding the use of mandatory reporting requirements in protecting adult victims of maltreatment, especially in the areas of domestic violence and elder abuse. 5A-2: Child Placement by the Courts Juvenile courts (sometimes called family courts) can issue an order of protection, order services and treatment for the family, temporarily remove the child from the home, or, as a last resort, terminate parental rights and provide permanent placement for a child whose care is overseen by the child welfare system. This section deals with the role of the courts in making such decisions; the evaluations of placement outcomes (such as foster care and group homes) are covered in Chapter 4. The actions of juvenile courts are generally limited to cases of parental abuse and neglect (Bulkley et al., 1996). If the abuse or neglect is substantiated, the judge has a number of options, including requiring the parents to participate in treatment or cooperate with caseworkers as a condition of keeping the child at home; issuing a protective supervision order that allows parents to retain custody under certain conditions or under the supervision of the child protective services agency; removing the child from the home temporarily; giving custody of the child to the agency or other persons; and terminating parental rights to end the
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--> legal relationship between parent and child. Alternative dispositions to the termination of parental rights have been developed as well; for example, some courts award guardianship to third parties in lieu of termination, who provide care and parental support but who do not legally supplant the relationship of the natural parents. The courts can also establish timetables and deadlines to require public agencies to determine a service plan for the child. Although statutory bases for termination of parental rights differ by state, in all cases the burden of proof is the standard of clear and convincing evidence, a higher standard than in other civil proceedings. The burden of proof is on the petitioner—usually the government agency charged with child protection, but it can be others, such as family members, guardians ad litem, prospective adoptive parents, and others specified by state statute. There is a presumption in favor of maintaining the parent-child relationship and preservation of family ties (Santosky v. Kramer, 455 US 745, 71 L Ed 2d 599, 102 S Ct 1388, 1982). Testimony must include evidence that termination of parental rights would be in the best interest of the child. The parents are entitled to due process, notice, and an opportunity to be heard and represented by counsel. The justifications for termination of parental rights in child sexual abuse cases have included refusal to participate in or make progress in treatment, and failure to acknowledge responsibility or to take steps toward rehabilitation (Bross, 1995). The gravity of parental rights hearings has given rise to other procedural and service interventions designed to protect the child's interests in resolving the conflict between the risks of continued involvement with abusive parents and permanent separation from them. For example, the position of court-appointed special advocates (CASAs) has developed to represent the child's interests in custody negotiations; they are typically attorneys or trained lay volunteers who either function independently or work in conjunction with attorneys and caseworkers. Comparing a CASA lay volunteer model with a model using staff attorneys in a juvenile unit of the court, one descriptive study found that the use of CASAs resulted in more services obtained for children and reduced the time that the child spent in the home of the family of origin (Poertner and Press, 1990). They concluded that lay volunteer CASAs could represent children in juvenile court as well as trained court attorneys. The effectiveness of the juvenile court system in child maltreatment cases has not been formally evaluated. The courts have the ability to protect children by exercising the power to remove them from the home or to mandate treatment and services. Juvenile courts also have the ability to provide oversight and in-home monitoring and can act both to help the child and family and to punish the offender (Bulkley et al., 1996). The disadvantages of the juvenile court system include the removal of the child rather than the offender from the home; the lack of due process protections for those accused of abuse comparable to criminal court procedures; the risk of unnecessary intervention with families; long, indefinite,
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--> or multiple out-of-home placements; and unnecessary removal of some children without adequate preventive or treatment services (Bulkley, 1988). Evaluations of the effectiveness of the juvenile court system should consider what relevant outcomes constitute the most important indicators of its success or limitations. Examples include: the extent to which children's placement status remains uncertain or unstable during periods of court oversight; patterns of service utilization associated with cases in the juvenile court system compared with those that are administered by the social services agencies alone; and long-term measures of child health and well-being and family support associated with cases that are handled by juvenile courts. Such studies could compare the long-term outcomes of siblings or neighborhood children who were reported for maltreatment but were not referred for court attention to those of children whose cases received significant involvement by the juvenile court. Such studies could help clarify which characteristics of maltreatment cases are likely to stimulate court referrals and examine the disparities that exist in caseloads handled by judicial, social services, and health agencies. 5A-3: Court-Mandated Treatment for Child Abuse Offenders The courts can mandate parents to treatment as a condition for keeping or regaining custody of their children. In Chapter 4, we discussed types of treatment and treatment outcome studies of parenting practices and family support services (4A-1). Here we deal with the impact on treatment of its being mandated through the courts rather than being voluntary. Practitioners are divided on the wisdom of mandating treatment. Those who favor it believe that the threat of legal sanctions will encourage participation in treatment by parents who would otherwise refuse services. Those who question the wisdom of mandatory treatment emphasize the importance of client motivation for involvement in treatment and fear that court mandates may increase resistance to treatment. There has been very little empirical research to help settle this debate. Table 5A-3 lists two evaluations in this area that meet the committee's criteria for inclusion. One study compared parents ordered to a treatment program with those who voluntarily entered treatment (Wolfe et al., 1980). They found that court-ordered parents were more likely to complete the treatment program. However, the other study found no such differences in treatment completion between voluntary and court-mandated parents (Irueste-Montes and Montes, 1988). Both groups attended and completed treatment at similar rates and showed similar improvements in their interactions with their children. The researchers conclude that mandating treatment does not increase resistance to participation. Although they did not ask all court-mandated participants whether they would have voluntarily entered treatment, informal comments by some of these parents suggested that they would have dropped out of the 3-year program
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--> or refused treatment altogether had the legal sanctions not been in place. Court oversight of treatment referrals thus seem to facilitate completion rates for offenders who would be unlikely to voluntarily participate in treatment programs. Whether completion results in improved parent-child interactions or positive child outcomes remains generally unknown in the research literature. 5A-4: Treatment for Sexual Abuse Offenders Treatment programs for sex offenders seem to be increasing in number, and adults who sexually abuse children are often offered treatment as part of or in lieu of other sanctions by the court. Such programs seek to normalize sexual preferences and enhance social functioning, working from the assumptions that deviant sexual acts result from an attraction to inappropriate partners or behaviors and that social deficits restrict access to appropriate partners and cause stress in the offender, both of which increase the likelihood of offensive behavior (Marshall and Barbaree, 1988). Although some efforts have been made to classify offenders in terms of their relationship to the target child, research studies cannot yet distinguish clearly between sexual offenses that involve familial relationships and those that do not. For example, one study classified two treatment groups as "incest offenders"—men who exclusively molested either their own daughters or granddaughters or who molested female children for whom they were serving as surrogate fathers, such as stepdaughters, adopted daughters, and daughters of a common-law wife—and "molesters of nonfamilial children"—men who molested children who were not their own and for whom they were not serving as the surrogate father (Marshall and Barbaree, 1988). Such distinctions are ambiguous in the research literature, however; sex offender programs often do not classify treatment groups according to the nature of the relationships between the victim and the offender. A 1994 survey found 710 sex offender programs in the United States, a 139 percent increase in programs since 1986 (Freeman-Longo and Knopp, 1992). The vast majority (573) of the programs were outpatient or community-based; 90 were prison-based; and the remaining 47 were other residential-based programs. Three general approaches are used in treating sex offenders: cognitive-behavioral, psychotherapeutic, and organic (also called biological or physical). Today, the cognitive-behavioral approach predominates (Freeman-Longo and Knopp, 1992) and consists of a number of cognitive and skills training methods, behavior control techniques, and, more recently, relapse prevention strategies borrowed from the field of addiction treatment (Marshall et al., 1991). The psychotherapeutic approach includes individual, group, and family counseling. The organic approach includes surgical castration, hormonal and other pharmacological treatments, and psychosurgery. There is no consensus in the research as to whether treating sex offenders reduces recidivism (U.S. General Accounting Office, 1996). It is generally believed
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--> that the recidivism rate for incest offenders is low compared with that of other child molesters (Furby et al., 1989). It has also been suggested that incest is related to family dynamics and opportunism rather than to inappropriate sexual preferences, suggesting that behavior modification treatment programs may be less effective with incest offenders (Quinsey et al., 1993). One study suggests that post-treatment recidivism rates vary widely with different offender characteristics, including type of offense; the growing body of literature on the treatment of sex offenders may therefore not be applicable to incest offenders (Furby et al., 1989). Table 5A-4 lists two evaluations in this area that meet the committee's criteria for inclusion. One study matched a treated and untreated group of child molesters, all of whom admitted their crimes and requested treatment (Marshall and Barbaree, 1988). Treatment consisted of cognitive-behavioral outpatient services. The treatment group had far lower recidivism rates than the control group on both official and unofficial measures. The other study compared the effectiveness of a multimodal inpatient treatment for incest offenders and heterosexual pedophiles. The treatment programs included group psychotherapy, social skills training, anger management, psychodrama, film discussion of victims, and stress inoculation (Lang et al., 1988). Both groups showed improvement, and incest offenders showed greater improvement than pedophiles on trait anxiety, fear of negative evaluation, social skills deficits, indirect hostility, and irritability. By the end of a 3-year follow-up, 7 percent of the incest offenders and 18 percent of the pedophiles had reoffended. The small sample size and lack of an untreated control group make it impossible to attribute changes to the treatment. In fact, the recidivism rates reported in this study are similar to those of the untreated control group rates in the Marshall and Barbaree (1988) study. Several reviews of less rigorous studies have shown some promising results from multicomponent, cognitive-behavioral treatment approaches, particularly with child molesters (Becker and Hunter, 1992; Marshall et al., 1991; Martens, 1992). Reviews of studies of psychotherapeutic approaches concluded that counseling was insufficient by itself to change the behavior of sex offenders (U.S. General Accounting Office, 1996). Organic treatments have shown some evidence of effectiveness, but no consensus exists about which drug is most effective or about the duration of positive effects (U.S. General Accounting Office, 1996). Marshall et al. (1991) suggest that organic treatments should not be viewed as a means for reducing reoffending in and of themselves, but they may be appropriate as a means of reducing an offender's sex drive until cognitive-behavioral treatments can begin to build self-control. Although cognitive-behavioral approaches and other forms of treatment appear to show some positive outcomes of treatment for sex offenders, more rigorous characterizations of the types of offenders involved in treatment are needed before the effectiveness of treatment programs in reducing repeat sexual offenses
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--> can be determined for incest offenders and others who are involved in ongoing familial relationships with their victims. For incest reoffending, attention is required to the circumstances in which offenders are referred to or request treatment, and the ways in which treatment is used as a deterrent in determining whether an offender can maintain custody or remain in contact with the child or family. 5A-5: Criminal Prosecution of Child Abuse Offenders The impact of criminal prosecution of child abuse on the protection of children has not been rigorously evaluated. The question of whether to criminally prosecute child maltreatment offenders is shaped by competing views of the role of the legal system in influencing behavior and responding to individuals, families, and community needs. Those who are opposed to criminal action believe that it hurts the family, that the criminal justice system is insensitive to families' and children's needs, and that district attorneys and police officers focus more on prosecution than on referrals for treatment and services. Those who favor criminal prosecution believe that it is an effective way to enforce the laws, deter future abuse, discourage unacceptable behavior, and coerce individuals into treatment. This perspective reflects a belief that, as a matter of policy, one should not selectively forgo prosecution of criminal behavior for the sole reason that the victim is related to the offender. There are no evaluations in this area that meet the committee's criteria for inclusion. The research cited in this section is either descriptive or lacks control groups. In most states, reports of maltreatment are made to a designated child protection agency (see discussion in section 5A-1 above). After investigating, the agency may report serious cases to law enforcement officials (some states require child protective services to report all cases of abuse and neglect to the district attorney). Once a case is referred to law enforcement, prosecutors have broad discretion in whether or not to file charges and whether to drop or accept the case. Research focusing on the decision making of prosecutors has examined variables that play a role in the acceptance and rejection of cases; decisions to prosecute vary widely, with many factors determining whether a prosecutor decides to proceed (Whitcomb, 1992). In a federally sponsored 3-year study in four cities, prosecutors were influenced by mandatory reporting requirements, statutes regarding procedural and evidentiary practices, and the availability of alternatives to prosecution, such as counseling (Office of Juvenile Justice and Delinquency Prevention, 1994). Another study found three primary characteristics related to prosecutors' decisions to file charges: age and maturity of the victim, the relationship between the victim and the perpetrator, and the evidence of abuse (Borland and Brady, 1985). Younger children may be less competent to testify and lack credibility, so
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Complete table on previous page.
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--> Intervention Citation Initial/Final Sample Size; Duration of Intervention Follow-up Data Collection Results Mediation or arrest. Sherman and Berk, 1984a N = 314/161 Police reports of subsequent violence, interviews with victims Arrested suspects manifested significantly less subsequent violence than those who were ordered to leave. The victim report data show that the arrested subjects manifested significantly less subsequent violence than those who were advised. Victims interviewed 6 months postintervention One of three police responses: short arrest, full arrest, and mediation. Sherman et al., 1992b N = 1,200/563 "Hotline" reports called in to local battered women's shelter by police encountering a case of domestic battery, arrests for repeat violence, offense reports of repeat violence, two interviews conducted with victim Results show no evidence of an overall long-term deterrent effect of arrest. The initial deterrent effects observed for up to 30 days disappear. By 1 year later, short arrest alone, and short and full arrest combined, produce an escalation effect. Arrest has different effects on different types of offenders. Victims interviewed 6 months postintervention One of three police responses: arrest, citation, or no action. Steinman 1988, 1990 N(X) = 49/48 N(O) = 168/156 Conflict Tactics Scales, victim interviews, police and court records of repeat violence Compared with no action, arresting and citing offenders produced more abuse in baseline cases and less when tied to other sanctions. Court sanctions coordinated with arrest policies did not lower abuse directly, but they transformed arrest and, to a smaller effect, citations into deterrents. 12- to 24-month follow-up SOURCE: Committee on the Assessment of Family Violence and Interventions, National Research Council and Institute of Medicine, 1998.
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--> TABLE 5B-4 Quasi-Experimental Evaluations of Court-Mandated Treatment for Domestic Violence Offenders Intervention Citation Initial/Final Sample Size Duration of Intervention Follow-up Data Collection Results Court-mandated batterer treatment. Chen et al., 1989 N(court-referred abuses) = 120 (12% attended no sessions, 63% attended more than three-fourths of the sessions) N(nonreferred abuses) = 101 Recidivism reports and a weighted offense scale to measure recharging on any offense, with violent offenses given more weight Results indicate that the relationship between attendance and recidivism is not linear. Clients who attended 75% of the treatment sessions or more showed decreased recidivism; others showed no impact. 8 2-hour sessions Court-mandated batterer treatment. Dutton, 1986 N(X) = 50 N(O) = 50 Police records, including court appearances and convictions; Conflict Tactics Scales completed by husbands and wives Program completers had a 4% recidivism rate 3 years posttreatment according to police records. Conflict Tactics Scales scores reported by both treated husbands and wives showed significant posttreatment decreases from pretreatment levels. Rates of verbal aggression also decreased posttreatment. 3 hours per week for 16 weeks Follow-up ranged between 6 months and 3 years postintervention Orientation groups, therapeutic treatment groups, and follow-up self-help group for batterers. Edleson and Grusznski, 1989 Study One N(program completers) = 32; 27 of their female partners were interviewed N(noncompleters) = 31; 30 of their female partners were interviewed Interview with female partners, modified Conflict Tactics Scales Approximately two-thirds of the men who completed treatment were found to be nonviolent 6-10 months postintervention. Slightly more than one-half of the men who received some treatment but did not complete the program were reported as nonviolent postintervention. Study Three: N(program completers) = 112; 84 of their female partners were interviewed N(noncompleters) = 47; 37 of their female partners were interviewed
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--> Intervention Citation Initial/Final Sample Size Duration of Intervention Follow-up Data Collection Results Edleson and Grusznski, 1989 (continued) Therapy groups met 2.5 hours twice a week for 8 weeks. Self-help follow-up groups met 2.5 hours per week for an indefinite period. Follow-up interviews about 1 year after intake. Three treatment modalities were explored: a self-help model, an education model, and a combined model of group work; each was offered in 12 and 32 sessions to batterers. Edleson and Syers, 1990 N(X) = 283/70 12 weeks of one 2.25-hour session per week; or 16 weeks of two 2.25-hour sessions per week Reports of repeat partner violence, incidence and severity, use of threats of violence as reported by partner or batterer if partner not available Two-thirds of the men who completed the intervention programs who could be located at follow-up were found to be nonviolent. Short-term, relatively structured group treatment tended to produce the most successful results. Men's involvement with the courts and lack of prior mental health treatment predicted lower levels of violence at the 18-month follow-up. 6- and 18-month follow-up Cognitive behavioral skills training program for male spouse abusers with three components: cognitive restructuring, communication/assertiveness, and active-coping relaxation. Hamberger and Hastings, 1988 N(X) = 71/32 N(noncompleters) = 36 Physical violence recidivism as reported by batterer or partner on Conflict Tactics Scales, and official police records of calls and arrests Results showed significant decreases in occurrence of violent behaviors after treatment and up to 1-year follow-up in subjects (32) completing the intervention. Compared with program dropouts (36), completers showed a lower rate of physical violence recidivism over the 1-year follow-up period. There was evidence of continued psychological abuse among completers in some cases. 3 weeks of psychometric evaluation and 12 weeks of 2.5 hours of weekly group therapy 1-year follow-up
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--> Intervention Citation Initial/Final Sample Size Duration of Intervention Follow-up Data Collection Results Court-mandated, cognitive-behavioral batterer treatment offered by three organizations: a nonprofit association, a church sponsored agency, and a feminist organization. Harrell, 1992 N(nonprofit) = 43 N(church) = 51 N(feminist) = 13 25% did not complete assigned treatment N(0) = 86 Data gathered from victim and offender interviews: reports of severe violence, physical aggression, threats of violence, psychological abuse Treatment did not appear to reduce the prevalence or incidence of abuse. There were no significant differences between treated offenders and those not ordered to treatment in the cessation of severe violence or threats of violence. In both groups, 80-85% abstained from severe violence during the treatment period. A significantly smaller proportion of offenders in treatment abstained from physical aggression: 57% for treated offenders versus 88% for nontreated offenders. Nonprofit: 12 weekly group sessions of 1 to 1.5 hours Church: individual intake session followed by eight group sessions of 1 to 1.5 hours Feminist: minimum of 12 weekly group sessions of 1.5 hours 4- to 6-month postintervention follow-up Court-managed batterer treatment in a psychoeducational, unstructured group. Palmer et al., 1992 N(X) = 30/17 N(O) = 28/15 Subject and partner reports and police reports of repeated violence against partners, Basic Personality Inventory Recidivism rates based on police reports were found to be lower for the treatment group than for the control group. They were also found to be lower for men initially exhibiting greater depression. Short, unstructured treatment intervention seemed to have long-term benefits. 10 weekly 1.5 hour sessions 1-year follow-up Group preparation for men about to enter batterer treatment group. Tolman and Bhosley, 1989 N(T×1) = 44/16 N(T×2) = 68/34 Rate of joining the treatment group after completing the orientation; rate of attendance at batterer treatment group after completing the orientation. The intensive workshop format resulted in significantly fewer dropouts from the ongoing group prior to completion of four sessions. The impact of the intensive workshop may diminish over time. T×1 = maximum of four group sessions, 1 hour each T×2 = intensive pre-groupworkshop, 12 hours over 2 days SOURCE: Committee on the Assessment of Family Violence and Interventions, National Research Council and Institute of Medicine, 1998.
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--> TABLE 5B-5 Quasi-Experimental Evaluations of Criminal Prosecution Intervention Citation Initial/Final Sample Size Duration of Intervention Follow-up Data Collection Results Prosecution options: diversion to counseling, probation with counseling, other sentencing, drop permitted. Ford and Regoli, 1993 N(diversion) = 112/84 N(probation) = 116/74 N(other) = 112/83 N(drop permitted) = 112 Repeat violence, severity and frequency of violence, time to reoffense, data collected from victim interviews, offender interviews, and police records Policy alternatives to traditional sentencing do not appear more effective in protecting victims 6 months following case settlement. When defendants are arrested under a warrant and their victims are permitted to drop charges and choose not to, those women are significantly more likely to experience less violence. Follow-up 6 months after settlement of case SOURCE: Committee on the Assessment of Family Violence Interventions, National Research Council and Institute of Medicine, 1998. TABLE 5B-7 Quasi-Experimental Evaluations of Systemic Approaches Intervention Citation Initial/Final Sample Size Duration of Intervention Follow-up Data Collection Results Home follow-up visits by social workers and police; public education. Davis and Taylor, 1995 N(X) = 436/414 Victims' self-reports of violence (modification of Straus' weighing system), police records, awareness and use of domestic violence services Results indicate no effects of home visits or public education on the number or severity of violent incidents as reported by victims. Data did indicate significant increases in reports of violence to the police as a function of both home visit and public education interventions. 72% of victims were interviewed at 6 months postintervention Implementation of coordinated police, judicial, and social service response. Gamache et al., 1988 Three communities Arrest data, rate of prosecution, number of convicted batterers mandated to counseling Community intervention projects had a significant impact on both police and judicial responses to woman battering. SOURCE: Committee on the Assessment of Family Violence Interventions, National Research Council and Institute of Medicine, 1998.
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