John Hamel & Associates
Alternative Behavior Choices Domestic Violence Perpetrator Program
San Francisco Bay Area
John Hamel, Ph.D., LCSW, Director
(415) 472-3275 * (925) 930-0900 * www.johnhamel.net firstname.lastname@example.org
John Hamel & Associates offers a range of mental health counseling services in the Greater San Francisco Bay Area, among them a domestic violence perpetrator program for voluntary and court-mandated clients. The program was launched in Pleasant Hill (Contra Costa County) in 1992, and initially consisted of one individual assessment sessions and 16 group sessions. The number of required group sessions was later expanded to 32, and then, in the mid-1990’s, to the current 52-week format for mandated offenders. Currently, we offer separate male and female court-approved perpetrator groups in several Bay Area counties. We serve clients from a variety of socioeconomic and ethnic backgrounds, and set our fees on a sliding scale to accommodate low-income individuals. Our facilitators have been trained in accordance to California PC 1203.098. Most (but not all) are licensed mental health professionals. They meet regularly for staff training and continuing education, and network with other perpetrator programs in the Bay Area and around the world through the Association of Domestic Violence Intervention Programs (www.battererintervention.org).
Ours is a manualized program with a discussion and educational component, including workbook exercises, role-plays and occasional audio and video presentations. The program is based on requirements set forth by California PC 1203.097 in combination with evidence-based practice, which the American Psychological Association defines as “the integration of the best available research with clinical expertise in the context of patient characteristics, culture, and preferences.” Our perpetrator program has evolved over the years, in accordance with the director’s 23 years of clinical experience as well as emerging social science research. The most accurate, up-to-date domestic violence research can be found at www.domesticviolenceresearch. org, courtesy of the scholarly journal, Partner Abuse. Key findings include the following:
- Domestic violence is not a unitary phenomenon. Offenders vary in the severity and type of abuse they perpetrate, family and criminal background, motivation for violence, readiness to change, mental health or substance abuse issues, and extent to which their partners are also violent.
- The risk factors most correlated with perpetration are: poor impulse control, having an aggressive personality and need to dominate, insecure attachment to romantic partners, harboring pro-violent attitudes (but not necessarily gendered beliefs), having experienced or witnesses abuse in one’s family of origin, high levels of stress (e.g., from unemployment, low income), substance abuse and being in a violent or high-conflict relationship.
- RAC (random assignment to condition) and quasi-experimental studies conducted with low-moderate level offenders do not find the group format to be more effective than couples or individual counseling.
- A recent meta-analysis found the CBT (Cognitive-Behavioral Therapy) model to be somewhat more effective overall than Duluth. The CBT model best addresses the primary risk factors associated with domestic abuse perpetration, and has been proven effective in reducing violence among generally-violent criminal offenders.
However, surveys have found that programs often combine elements from different intervention models (e.g., Duluth, CBT and/or Psychodynamic), making general comparisons difficult. The most cutting-edge outcome research has sought to identify specific factors that correlate with reduced recidivism, regardless of the program’s stated philosophy. RAC and quasi-experimental research findings indicate that perpetrators are less likely to re-offend upon program completion if offenders are closely monitored by probation and if group facilitators:
- Treat clients with respect and avoid harsh confrontations, even as they hold them fully accountable for their behavior
- Establish and maintain a strong working alliance, using Motivational Interviewing (MI), a form of interactive dialogue that appeals to clients’ better natures so they can figure out for themselves why violence is wrong, whom it affects, and what they can do to change
- Establish and maintain cohesion among group members
- Assign homework
- Provide case management services as needed
We view domestic violence not only as a means by which some individuals seek to dominate others, but also as a misguided attempt to get their needs met. We inform clients in no uncertain terms that domestic violence is a crime, but also that the use of violence indicates weakness. In keeping with M.I. approaches, we empower them meet their legitimate needs – e.g., for love and self-esteem – by teaching them practical ways to manage their emotions, change irrational and pro-violent beliefs, identify abuse patterns, and improve how they communicate and resolve interpersonal conflict. In doing so, our facilitators engage in “connection, not collusion,” assigning responsibility rather than blame, with an emphasis on client strengths. When clients are treated with respect, they are more likely to trust, overcome their fear of change, become open to learning and to “own” their behavior, resulting in lasting change.
Groups at all locations follow the same format and curriculum. Although men cause significantly greater physical and emotional damage to their victims and are far more likely to engage in sexual abuse and physical stalking, research indicates that male and female perpetrators are similarly motivated, engage in comparable rates of emotional abuse and control, and begin group at similar stages of readiness-to-change. Female perpetrators, however, express emotions differently than their male counterparts, are more likely to struggle with mental illness and encounter different stressors (e.g., childcare); so while the curriculum is the same for everyone, group discussions and processes differ across gender.
As much as possible, we strive to individualize our program, beginning with a thorough assessment and administration of validated questionnaires to help clients identify areas of strength and weakness and establish personal goals, and by having clients record their progress in their workbook log pages, through which they also gain insight into their particular abuse dynamics. Clients who are not able or willing to benefit from group may be provided with additional resources, referred to concurrent mental health or substance abuse treatment, or sent back to the courts for further evaluation and/or referral to another perpetrator program.
At group completion participants take part in a final one-on-one exit interview, during with they are given a final exam to test their knowledge of the course curriculum. They are also asked to complete the same assessment instruments administered at intake and to discuss the results with their group facilitator. Occasionally, a client may be asked to continue with additional sessions, but most of our clients successfully graduate. Although no RAC data is available, an outcome study of Marin perpetrator programs did find John Hamel & Associates to be the most effective in preventing recidivism.