Necessary risks?

As many women choose to remain in relationships with violent men, intervention with perpetrators is a vital component in providing a service to reduce domestic violence. The Living Without Violence programme for perpetrators is a 36-week rolling programme with up to eight men at any given time. The first group work session was in September 2004 and in March 2005 a second group was started due to the high demand for the service.

To date there have been 60 referrals to the programme. About one-third were self-referrals, nearly half came from social services, and the remainder came from a variety of referrers including health and mental health professionals, therapists, probation officers and solicitors. 

More than half of the men referred to the programme reported being in a relationship, either cohabiting or living at a separate address to their partner. Partners and ex-partners of men accepted on the programme are contacted and offered support. The perpetrator programme and the partner support services have clear lines of communication in order to increase safety.

We would like to facilitate a partners’ support group to run alongside the men’s programme to provide partners not only with emotional support but also more understanding of what the men learn in the group. This is to preclude any further power imbalance developing in the relationship due to the men’s increased knowledge. Resources prevent this and so partner support consists of telephone contact from a designated worker and referral to other agencies.

At the end of October, four men had completed the full 36-week programme and a further eight had completed more than half of it. The men have requested that a support group be set up for those who have completed the programme.

Of the four who had completed the programme, one is in a fragile relationship, one is in a stable although very controlling relationship, one separated  from his partner during the programme and the last is in a long-standing volatile relationship. Children are involved in three of the cases.

One of these men, and his partner, has asked about the possibility of couple work to build upon changes made during the programme. Others have also shown an interest in this.

Couple work in situations of domestic violence has long been an area of controversy, and there are many clear arguments as to why treatment programmes for male perpetrators and separate support groups for female victims of violence are the appropriate intervention. It has been argued that couple counselling in the context of violent family relationships is inappropriate even when requested by both parties and when both want to maintain the relationship. The mere offering of couple work can imply that there is a mutual problem to be worked on and can hinder the perpetrator taking responsibility for the violence. 

The work itself can endanger the woman who may face threats and violence outside the therapy in response to what she has disclosed within it. The work may reinforce gender stereotypes, unequal power dynamics and further silence the woman. And the woman may feel responsible for ensuring the man gets help and may not feel able to voice a change of opinion about attending the therapy or remaining in the relationship.

Despite these reservations about couple work there are also theorists who advocate its necessity in some situations. Some maintain that interventions with the couple are only appropriate once the violence has stopped.(1) Others emphasise that the man should take responsibility for the abuse and express a strong desire to stop being abusive prior to the onset of couple work.(2) Meanwhile Goldner maintains that it is essential to address the relational bond in interventions with couples in violent relationships in order to both initiate change and ensure the woman’s safety.(3)

In facilitating the Living Without Violence programme we have heard many stories of couples attempting to remain together and make changes in their relationship. These couples will continue to do so, with or without support, and the violence in the relationship may or may not continue. We have come to the conclusion that if a couple are determined to remain together then couple work can assist in the reconstruction of the relationship, and in putting into practice skills learned on the group programme.

The offer of couple work is respectful of the woman’s decision to remain in the relationship, and acknowledges that the relationship has qualities other than the domestic violence. 

We have also found that a major motivating factor for many men to make changes in their position of power and control is the prospect of increased intimacy in their relationship. Working with the relationship gives the opportunity to build upon aspects of the man’s life which are positive, which will in turn reduce problematic and destructive aspects of functioning. To ignore the couple’s relationship is to ignore the reality of these people’s lives and it could be argued that the potential for future violence will only be reduced if there is couple work. The proviso, of course, is that the couple work itself should not increase risk. And at all times the man should be held accountable for his violence.

How to achieve this in practice has required careful thought. A multi-agency forum consisting of professionals from the Domestic Violence Project, the Living Without Violence programme, Relate, Safe as Houses Project, the women’s refuge, social services and the Clermont Solution Focused Therapy team was convened to address this. A protocol for couple counselling has now been drafted that deals with risk and safety. It explores the timing for couple work and who is suitable for couple work. While embracing the notion that all violence will have ended prior to couple work, it is recognised that lapses do occur within any process of change, and that the important factor to consider is level of risk. 

It is acknowledged that ideally the woman will have used support services prior to couple work so that she is not in a position of disadvantage to her partner who has been attending the group, but ultimately this is the woman’s decision. The couple work is to be preceded by individual sessions with the man and woman to assess the risk of further violence, the responsibility taken by the man for his violence, the commitment to the relationship and commitment to a non-violent future, and to ensure a safety plan is in place.

The couple work should be undertaken by a male and a female therapist, at least one of whom should have a full understanding of the dynamics of domestic violence. The main aim of couple work is not to keep the couple together but to work towards healthier functioning.

The next stage will be to put the protocol into practice and offer couple work to some of the men and their partners. It is likely that this will be initially taken forward, in Brighton, by the Clermont Solution Focused Therapy Team. Members of this team are not only skilled and experienced therapists, they also have a great deal of knowledge regarding risk assessment and domestic violence. 

Andy Cook is senior practitioner consultant at the Clermont Child Protection Unit, a specialist service within Brighton and Hove Council. She is also a member of the Living Without Violence treatment programme. Before that she was a social worker on a children and families duty and assessment team at East Sussex Council. She occasionally tutors on qualifying and post-qualifying courses for child care social  workers at Sussex University.

Training and learning
The author has provided questions about this article to guide discussion in teams. These can be viewed at www.communitycare.co.uk/prtl and individuals’ learning from the discussion can be registered on a free, password-protected training log held on the site. This is a service from Community Care for all GSCC-registered professionals.

Abstract
This article draws on the experience of working with perpetrators of domestic violence in a multi-agency programme started in Brighton in 2003. Its primary aim is to increase the safety of women and children. The article examines the pros and cons of couple work and is limited to discussing work with men in heterosexual relationships and in which the man is the perpetrator of the violence.

References
(1) M McMahon, E Pence, “Replying to Dan O’Leary”, Journal of Interpersonal Violence vol 11 (3), pp.452-455, 1996
(2) E Lipchik, A D Kubicki, “Solution-focused domestic violence: bridges toward a new reality in couples therapy”, in S D Miller and B L Duncan (eds) Handbook of Solution-Focused Brief Therapy, Jossey Bass, 1996
(3) V Goldner, “Morality and multiplicity: perspectives on the treatment of violence in intimate life”, Journal of Marital and Family Therapy vol 25(3), pp.325-336, 1999

Further information
The programme was initiated by the eb4U domestic violence project. eb4U is responsible for  the New Deal for Communities regeneration scheme in East Brighton.

Contact the author
Andy.Cook@brighton-hove.gov.uk