Men’s Behaviour Change Programme (MBCP) Theoretical Frameworks: An Overview.
MBCPs –an introduction
MBCPs emerged in late 1970s and early 80s, mainly in developed countries. ‘Batterer Programmes’ in USA, ‘Domestic Violence Perpetrator Programmes’ in UK and ‘Men’s Behaviour Change Programmes’ in Australia. The original programmes arose to intervene directly with men who were violent to their partners and children in order to protect the current victims and potential other victims from further violence (Brown et Al., 2016)[1]. First MBCP (perpetrator intervention programme) in Australia started in 1983 in Adelaide (Lazarus and McCarthy, 1990)[2]. The MBCPs in other parts of Australia emerged in the following years. MBCPs are increasingly becoming connected with the legal system (Centre for Innovative Justice, 2015)[3] and part of a broader spectrum of interventions with those of who use violence in relationships to promote compliance and address criminogenic risks and needs (NSW, 2017)[4].
MBCPs are built on the assumption that victim safety is best achieved when the perpetrator is held accountable for his violence. MBCPs hold the perpetrators accountable for their violence. However, the MBCPs can also pose serious danger for the family members, including the current victims, of the perpetrators. There has been increased calls from DFV services in Australia for standardisation of MBCPs (Mackay et al., 2015)[5], and for adequate provisions such as advocacy, safety planning, support, education group and safe housing to warrant safety and security of the victims.
As MBCPs developed over the years so did the intervention models/frameworks. Theoretical frameworks play a critical role in shaping modalities and strategies of men’s behaviour change interventions. Different conceptual frameworks place different emphasis on the interventions. MBCPs vary considerably in frameworks, duration, format and collaborations.
A range of providers (from custodial or community correctional settings to non-statutory setting by non-government organisations) run and deliver the programmes. Participations of men in these programmes can be voluntary or mandated by the court order. Intensity, duration, scope, intersectional approach, mandated vs non-mandated vary considerably.
MBCPs are predominantly group based programs (NSW, 2017)[6]. However, men who are found ‘not group ready’, face language or other barriers, or who have untreated comorbid issues are also seen on an individual basis in the MBCPs. Groups can be closed (no new men enter until the group completes is full cycle) or open (sometimes called ‘rolling groups’) where men enter and leave the program at set points.
The Duluth Model, Cognitive Behavioural Therapy (CBT) and Narrative approach are most commonly used models/frameworks for MBCPs in Australia and other countries. The early MBCPs followed Duluth model. Many programs in Australia frequently utilise a combination of these approaches. Over time, CBT and Narrative therapy have gained popularity both in Australia and overseas. The frameworks evolved as the results of empirical debates around why some men use violence in intimate relationships and how the perpetrators can be prevented from reoffending.
All these frameworks are distinct in theoretical underpinning, modalities, change effects and safety of the victims taken into consideration. However, all frameworks share common elements and aim a common goal –enhance safety and wellbeing of women and children. No framework ‘fits for all size.’ Every framework operates with some criticisms. Most of the MBCPs are drawn on multiple theoretical or conceptual underpinnings (Urbis, 2015)[7].
MBCP Theoretical/Conceptual Frameworks –
Duluth Model
Originally developed in Duluth, Minnesota in the early 1980’s by a group of feminist activists, the Duluth model has been widely adopted in MBCPs in the USA and other parts of the world, including Australia.
The theoretical underpinnings of Duluth model are that men’s DFV occurs in hierarchical power relations, which are gendered and patriarchal in nature and that the gendered and hierarchal power relations are perpetuated, maintained and reinforced by social norms, culture and social and political institutions (Paymer and Pence, 1993)[8]. In the gendered and hierarchal power relations, men hold position in the higher-end while women hold position in the lower-end putting women at risk of men’s control and coercive behaviours and attitudes. The Duluth model views that men’s violence in intimate relationships is a deliberate choice that they perpetrate to maintain authority over other family members. Thus men must take full responsibility of their violence (Mackay et al, 2015; Moss, 2016[9]). Some men, who hold patriarchal power relations over their female partners, may not be abusive and violent if the female partners are unchallenging to their power, control and patriarchal positions in the relationships.
DFV is seen as a social problem rather than mental health issue in Duluth Model. Feminist approach of power and control is applied in the interventions to interrupt men’s violence. Interventions occur through assessment including incorporating an intersectional approach of risk assessment and moving into group based programs. Structured and formal curriculum is used for the group work. Adult learning principles and methods such as vignettes, role-play, body-movement, group practice and discussions are used in the group work. Beliefs and attitudes around violent and abusive behaviours are the primary learning and educational focuses on the model. The model does not see anger as the cause of male DFV and thus does not give primary focus on anger management in the learning process as a solution of the problem (Gondolf, 2017)[10]. Drawing direct causal links between men’s DFV and their own disadvantages, trauma experiences, lateral violence, war/refugee experiences, racism, discrimination and drug addiction or mental health condition is limited in the model (Moss, 2016[11]).
The model, first, helps men to identify and name violent behaviours, beliefs and attitudes. The model then explores the men’s use of denial or minimisation of their violence, to assist men to take responsibility for and be accountable for their violence. The ‘Power and Control Wheel’ is used as a lens to enable men to expose and recognise various types of violence they perpetrate and uncover the links between their violence and patriarchal power and control. The wheel serves to counter denial and helps men to take responsibility for their behaviours (Gondolf, 2017). Third, the model educate them to develop alternative skills to abuse and violence by changing their harmful attitudes and beliefs. The perpetrators are encouraged to change from adopting behaviours in the ‘Power and Control Wheel’ to using the behaviours on the on the ‘Equality Wheel’ which form the basis of more egalitarian relationships (Babcock et al., 2004[12]).
The Duluth model does not work in isolation of other services. It is embedded in a larger, integrated and collaborative system of local services, which include arrest, court orders, sanctions against non-compliance to court orders, risk assessment, support and shelter planning for victims, child protection and specialist referrals (Pence and Shepard, 1999)[13]. The MBCPs with Duluth model, operate with close link to the judicial system, in which the ongoing safety of victims –women and children –is given highest priority (Day et al., 2009[14]). The focus of the model is broader than just interventions with offenders. It is a system response to domestic and family violence. In this integrated and collaborative approach, the model uses the power of those agencies to fill power gaps that exist between the perpetrators and the victims of DFV. When all these agencies work collaboratively, the model works more effectively.
The Duluth model has been criticised for being too ‘confrontal’ in its approach and that its focus on structural factors (e.g., gendered power relations) fosters a one-size fits all approach and interventions that are less person-centred (Day et al., 2009). Vlais et al. (2017[15]) argues that a didactic and overly confrontative chalk-and-talk approach is not taken in Duluth model. Instead, the model keeps men’s violence in the view and is taken in the centre of the interventions.
The other criticisms of Duluth model are that the men are not allowed to draw direct causal links between their violence and their own disadvantaged and that the practitioners deliberately avoid thorough conversations with men of their psychological distress, experiences of childhood trauma, alcohol and other drug issues and the effects of poverty to hold men accountable for their violence (Moss, 2016).
Given than the MBCPs that follow Duluth model take interagency approaches and apply broader interventions with the perpetrators, the criteria for effectiveness and success of the programs will be somewhat different from programs that follow other models. For example, successful interventions within this model may mean linking the victims to support services that can facilitate a process for separation, provide shelters and so on.
Cognitive Behavioural Therapy (CBT)
The CBT model, developed by psychologists, is therapeutical in nature. The therapy takes place in group setting with use of structured and pre-developed modules. Where required, one-to-one therapy is also provided. Multiple adult learning methods such as role-play, group exercise, group feedback, practice and homework are used in the therapies. CBT interventions for domestic and family violence are generally short-term and concentrate on present difficulties (Department of Corrections, 2012[16]).
Within CBT, domestic and family violence is conceptualised as a consequence of problems with the person’s thoughts, assumptions, beliefs and behaviours and the interventions are made with the assumptions that violence is learned behaviour which can be replaced with taught non-violent behaviours (Department of Corrections, 2012; Mackay et al, 2016). The perpetrator continues using violence as he finds violence functional for him. Within CBT, it is viewed that the perpetrators of DFV can change their behaviours (Mackay et al, 2016). The behaviour changes take place identification of thoughts, thought processes and beliefs that contribute to the violence; then by applying alternative thoughts, beliefs and behaviours that are respective and non-abusive, aggressive violence, which involves acquiring communication skills and social skills, including anger management, which are alternative to violent behaviours.
The CBT model targets the thoughts, choices, attitudes and meaning systems that are associated with violent and controlling behaviour. CBT approach typically focus on modifying faulty cognitive processes and building behavioural skills to reduce anger, manage conflict and increase positive interaction. The interventions also address areas such as coping with intense emotions, relationship skills and individual psychological difficulties (Department of Corrections, 2012). Mental pathways to violence, justifications for violence are explored and challenged (direction and indirectly through group processes and activities). Men who use violence are encouraged to think about and change their understanding of violence, examine the circumstances surrounding their violence, and to disrupt the cognitive chain of their own cognitions and behaviours that leads to the occurrence of their violence.
Both the unlearning and learning processes are retrospective. The group work and inter-active adult learning methods of the therapies are key to the processes. The process takes place slowly. As men continue in group work in the successive weeks, the learning outcomes improve further and his original thoughts and beliefs in relation to the specific behaviour begin to weaken. Simultaneously, he begins to perceive new thoughts and beliefs that are contrasting to the old ones. Over time, the new beliefs and thoughts are being consolidated and he begins reorganising behaviours that are respectful, peaceful and acceptable.
CBT model is less focused on socio-political issues and men’s power and control over women –the key conceptual underpinning of Duluth model. Rather CBT model concentrates on cognitive restructuring or learning skills to respond more effectively and non-violently (Ferraro, nd[17]). Gondolf (2012)[18] suggests that CBT is a ‘gender-based’ approach, which pays attention to the patriarchal social conditioning that shapes and mediates the ways men who engage in intimate partner violence think, perceive and understand their violence. Perpetrators’ attitudes and values regarding women, gender and use of violence toward women are usually addressed in modern cognitive-behaviour groups (Babcock et al., 2004). Gondolf further suggests that without paying attention to the patriarchal conditioning of men’s violence, a therapy itself is incapable to shift underlying patterns of men’s coercive control over their female partners.
Structurally, CBT is often composed of six phases. These phases include (i) assessment; (ii) reconceptualization; (iii) skills acquisition; (iv) skills consolidation and application; (v) generalization and maintenance; and (vi) follow-up treatment. While the specific phases may differ from program to program, all CBT-based programs encourage participants to first develop their ability to recognize distorted or unrealistic thinking when it happens, and then to change that thinking or belief to eliminate problematic behaviours.
However, the unlearning of violence is complex. Men learn violence-supporting attitudes and norms from multiple sources across multiple contexts, and the resulting behaviours can be highly reinforced through the benefits men obtain by exercising patriarchy. The model does not make it explicit that adequately address more personal and embedded aspects relating to men’s use of violence and its connections to wider structural inequalities (Mackay et al, 2016). There is also criticism (Babcock et al., 2004) that some CBT groups are not strictly cognitive or behavioural. They tend to address emotional components of violence such as empathy and jealous.
Narrative Therapy
Narrative therapy is a strength-based educational model, which is applied in both individual and group settings. The model operates within the theoretical underpinnings that men are the accomplices and recruits of patriarchy rather than inventors of patriarchy and that men do not consciously create inequality and hierarchy in their family relationships. Men’s norms and beliefs are shaped, mediated and influenced by dominant ideas on intra-family gender relationships that are conveyed and reinforced through popular culture, media, social and political institutions and legislations (White, 1989)[19]. Narrative therapists (Jenkins, 2009)[20] argue that men can change and that their reluctance to engage is not proof of a preference for unequal and patriarchal relationships. A man may be simultaneously invested in a sense of entitlement, control, and justification while desiring safer and more respectful relationships with their family members.
In narrative therapies, men are seen as partners in solving their problematic behaviours rather than as perpetrators whose erroneous thoughts, attitudes, and actions need to be corrected. Men are regarded as allies in helping to stand against coercive control, subjectification and unfair treatment (Berkowitz, 2004)[21].
Narrative therapy is collaborative practice between therapists and the men who use violence and men find the collaboration as an alternative to their passive participations in MBCPs (Jenkins, 2009). In this model, the therapists work with men on the assumption that the men are experts in their own lives. The therapists allow men to use their own life experiences, ethics and knowledge to confront their current violent behaviours. The therapists avoid traditional notions of practitioner expertness while engaging the men towards behavioural change (White, 2011[22]).
With use of the Narrative Therapy approach a therapist, first, helps a man understands how dominant male cultures or masculinities recruit, manipulate and influence him to act in ways that diminish his hopes for safe, respectful or loving relationships. Most of the men are unconscious or subconscious about the diminishing effects of the dominant masculinities. Second, the therapist helps him to unpack his relationship ethics and values that are respectful and inconsistent with his current violent behaviours. The unpacking is done through listening stories of his life events and/or identifying strategies that he previously has found helpful in maintaining non-abusing relationships. Dolman (2012)[23] argues that all men have relationship ethics that promote fairness and safety. Third, the therapist uses positive and respectful relationship ethics and values of the perpetrator as a tool to counter his current behaviours. The narrative therapists require an understanding that multiple desires coexist for men who abuse, and it is the responsibility of the programs to strengthen their ethics that stand against violence and that honour safety and generosity (Daniel, 2016).
For example, if a man shares a story of his own victimisation of violence by his own father, this could be picked up as an opportunity to explore his ethics about violence. In describing his ethics, he might begin to discuss the intentions he has for his own children and how he desires safety and respect for them. Likewise, if a man shares the stories of his past active or passive resistance or protest against violence or hierarchal control –for example, attempt to protect his mother in childhood from violent father– might be useful to explore his ethics of safety and protection and fairness/equality (Vlais, et al., 2017). The therapist can recruit those values and ethics to rethink his current behaviours and practices.
It is crucial that the
exploration and unpacking of the values and ethics need to be done in ways that
do not justify or rationalise his violence to his life events. It is also
crucial that the program practitioners do not automatically assume that the
dissonance created between his ethics/values and his current violent behaviours
will lead to changes. He can resolve the dissonance in many ways (Vlais, et
al., 2017). Adopting Narrative Therapy into a MBCP requires taking a real
interest in each man’s life in ways that are not collusive with his violence-supportive
narratives. Time is required to unpack man’s ethics and values inconsistent
with the use of violence, trajectories of development of the values and where
they have been put into practice, and how the use of non-violence can really
matter to his life and his family (Vlais, et al., 2017).
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[22] White, M. (2011). Narrative Practice: Continuing the Conversations. New York: Norton.
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