The ISTC "Baloney Watch" Archives
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On Fads in Psychotherapy

Once again: Does Batterers' Treatment Work

We've been over this territory several times in the past--just plug in "violence" or "batterer" on our search page and a number of studies will come up.  However, coming across an excellent study makes revisiting the subject difficult.  Researchers Babock, Green, and Robie performed a meta-analysis of 22 studies that included some measure of recidivism.  Bottom line:  overall, the treatment worked.  In particular, those who received treatment had lower rates of recidivism than did the control groups, although the effect sizes were small.  Importantly, the type of treatment did not matter.  Neither were there any differences between police reports versus partners reports of recidivism.   Given the equivalence of findings and since retention is a major issue, the authors conclude with the recommendation that "treatment should be tailored to the type of offender rather than adhering to a specific model."

Babcock, J.C. et al. (2004).  Does Batterers' Treatment Work?  Clinical Psychology Review, 23, 1023-1053

Treatment of Domestic Violence: Does it Work?
The short answer?  No.  At least, it doesn't decrease recidivism.  The only reliable predictor of future problems?  The number of previous domestic violence convictions.  The problem?  In addition to the violence left unaddressed, treatment has become mandatory for those convicted of the offense in spite of a lack of evidence that it accomplishes anything.  Hmm.  It isn't the first, nor will it likely be the last, that public policy is driven by something other than research.  Think anger management here.  It's such a popular treatment option nowadays that Hollywood made a movie about it not long ago.  And yet, there is virtually no data supporting its efficacy.

Gordon, J.A. & Moriarity, L.J. The effects of domestic violence batterer treatment on domestic violence recidivism.  Criminal Justice and Behavior, 30, 118-134.

Is Couples Therapy for Partner Abuse an Oxymoron?
Well, if you listen to various experts and follow the winds of fashion in the therapy industry, the only acceptable answer is yes! However, the work of group of researchers challenges this latest sacred cow. In their latest study, couples were randomly assigned to either conjoint or the fashionable gender-specific group therapy and found that both approaches resulted in decreases of physical and psychological aggression. Moreover, commonly expressed fears regarding conjoint treatment were not supported--that is, wives were not more fearful of participating with their husbands, were not more fearful during the sessions, did not blame themselves for the violence, and were not placed at increased risk because of the intervention.

Translating this research into clinical practice: Ideological and theoretical commitments should take a distant back seat to practices that will engage people in changing their behavior.

O'Leary, K.D. et al. (1999). Treatment of wife abuse: A comparison of gender-specific and conjoint approaches. Behavior Therapy, 30, 47-505.

Strange that this is such a surprise. Eve Lipchik and Tony Kulbicke pointed this out some time ago in their chapter in Handbook of Solution-Focused Brief Therapy (Jossey-Bass, 1996).

What are the Effects of Low Self-Esteem? Nothing!
You hear it at workshops, read it in professional books, and see it on Oprah-esque television talk shows: low self-esteem is the root of much--if not most-evil--in the country. Almost everything is blamed on it--most recently, the apparent rash of shootings by adolescents in the public schools. This lead an entire State (California) to spend millions of dollars trying to improve the self-esteem of young people through activities and programs in the public schools. All this in spite of absolutely no evidence that self-esteem is an important causal variable in the production of any behavior--especially aggression. If anything, the research suggests that Americans do not suffer from low but rather an inflated sense of self-esteem--they think they are capable of things that that simply are not. In the State of California, for example, self-esteem builders were successful in their efforts to get kids to "think better of themselves." So much so, in fact, that students bragged about being great at subjects (e.g., math) that they were actually quite poor at. Japanese students, by comparison, had relatively low self-esteem but could add. Interested parties should read the work of Baumeister (1999) who has spent his career studying self-esteem.

Baumeister, R.F. (1999). Low self-esteem does not cause aggression. APA Monitor, 30(1), 7.

Challenging the "rules" for treating abusive men
Recently, ISTC reported the results of research which showed overwhelmingly that treating men who are abusive works (click here)! Now, results from another study challenge another cherished therapeutic fad. In contrast to the current belief that abusive men should never be seen together with their partners in treatment, this study found that group therapy involving both spouses and focusing on the elimination of physical aggression is effective! Once again, reality triumphs over theory! In any event, over 75% of women return to the relationship with their abusive partner following treatment. Making ending abusive relationships the aim of treatment is, therefore, not only unlikely but potentially dangerous. Indeed, avoidance of thoughts or feelings related to the abuse was a predictor of drop out from treatment!

Schlee, K.A., Heyman, R.E., and O'Leary, K.D. (1998). Group treatment for spouse abuse. Journal of Family Violence, 13, 1-20.

What really matters in treatment of people who batter/abuse their partner?
Drop out and treatment failure are commonly reported problems in clinical work with couples with husband-to-wife violence. Previous studies have shown that the best predictor of outcome for any problem in any kind of treatment is the client's engagement in the process. And, one of the best indicators of engagement is the client's rating of the therapeutic relationship with the clinician. The question is, with whom? Husband, wife, the couple? In this study at least, the husband's alliance with the therapist (in either group or conjoint treatment) was a better predictor of decreased levels of both mild and severe physical aggression than the wives' alliance. The authors counsel, "promoting a therapeutic alliance with the husband is paramount."

Brown et al. (2000). Therapeutic alliance: predicting continuance and success in group treatment for spous abuse. Journal of Consulting and Clinical Psychology, 68, 340-5.

Is Violence in the "Eye of the Beholder"?
Most studies find that violence--anything from a slap to a regular pattern of battery--are reported in one-third of dating relationships. This study found, however, that there is surprising disagreement within couples over whether violence has occurred. In contrast to what might be expected, most of the denial of abuse occurred in men that had been on the receiving end of violence by their female partner! The authors note that they found, "perpetrators without victims and victims without perpetrators" (p. 14) and caution therapists not to assume--when a couple disagrees about whether verbal or physical aggression has occurred--that only one (usually the female) is telling the truth. Cooper, G. (1998). The Slippery Perception of Violence. Family Therapy Networker, 22(1), 14.

What works with juvenile offenders? Separating the chic from the effective
Everyone is worried about the explosion in juvenile crime. The question is, what do we do about it? A lot of stuff has been tried and, so far, it's hard to say what works with this population. This state of affairs may finally be coming to an end, however. A recent report completed for the National Institute of Justice, reviewed the research, separating fact from fiction with some surprising findings.

Adapted from :Sherman, L. (1999). Cited in Psychology Today, 32(1), 13.

*Olds, D. et al. (1998). Long term effects of nurse home visitation on children's criminal and antisocial behavior. Journal of the American Medical Association, 280, 1238-44.

The Black and White on John Gray
Unless you've been on Mars or Venus, you most certainly have heard of John Gray. His book, "Men are from Mars, Women are from Venus" has sold nearly ten million copies, he has appeared in all of the popular media outlets, has his own infomercial, and has even done a short stint on Broadway. The pop-psychology darling of the middle-class has all but sewn up the market on marriage and relationships. His books, tapes, and CD's often occupy a greater amount of shelf space than all the other books on intimate relationships combined in bookstores around the country. The question that begs asking is, "Why?" When compared with scientific data on intimate relationships, Gray's theories and advice fall seriously short. Worse yet, they seem to reinforce gender stereotypes that may ultimately lead couples to NOT address conflicts usefully.

Consider the following comparison between Gray, and noted relationship expert John Gottman whose book Why Marriages Succeed or Fail (Simon and Shuster, 1997) is a result of scientific study of marital relationships. The difference proves the old adage that, "what ails the truth is that it is mainly uncomfortable, and often dull. The human mind seeks something more amusing, and often caressing (H.L. Mencken).

Marano, H.E. (1997). Gottman and Gray: The two Johns. Psychology Today, 30(6), 28.