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Posts tagged Interventions
Building Choice in Domestic Abuse Perpetrator Interventions: Reflections on What Clients, Victims and Practitioners Need 

By Nicole Renehan and David Gadd 

As the Probation Service moves towards a ‘new generation’ of programmes for domestic abuse perpetrators, it is important not to forget the lessons of the past. It is more than two decades since the inception of the Duluth Domestic Violence Pathfinder, the first probation-led programme for domestic abuse perpetrators in England and Wales. Despite the lack of an outcome evaluation, and a report critical about the early stages of its implementation (Bilby and Hatcher, 2004), the Integrated Domestic Abuse Programme, and an alternative Community Domestic Violence Programme, were rolled across all probation areas by 2005. The evidence in terms of what worked for domestic abuse offenders remained elusive nonetheless, with only one post-hoc evaluation more than ten years later suggesting marginally better outcomes for abusive men who at least start a programme (Bloomfield and Dixon, 2015). Both programmes were disbanded in favour of Building Better Relationships (BBR), currently the only accredited programme in probation for domestic abuse perpetrators, now about to be retired with a very limited evidence base against which to judge its effectiveness. As BBR is replaced with Building Choices, we must learn whatever lessons we can about how to intervene safely and effectively with perpetrators of domestic abuse. We do, however, know that the BBR era will not leave the intervention landscape unblemished. Two ethnographic studies, two inspections, and an evaluation feasibility study all raised substantive concerns regarding the quality of its implementation, unsustainable waiting lists, a less-than-impressed probation client group about the service received, and a stressed and overstretched workforce (Renehan and Gadd, 2024; Hughes, 2024; Teasdale et al., 2023; HM Inspectorate of Probation, 2023; 2018). The most critical lesson of Duluth – that effective work with men who abuse cannot be secured without adequately supporting their partners – has not always been heeded. It will need to be if Building Choices, a more generalised strengths-based programme, is to enhance the safety of adult survivors and their children at risk of repeat victimisation and to protect any new partners that men – who have been domestically abusive – form relationships with. Both the Home Office and the VCSE sector have agreed clear standards in terms of working with domestic abuse perpetrators (Home Office, 2023; Respect 2022). These include centralising victim safety; multi-agency working; timely, accessible and gender-informed interventions; and suitably skilled and supported intervention practitioners who can foster motivation for change. Fostering motivation, of course, relies upon the quality of the relationship between practitioner and client, something that can be hard to achieve for practitioners with high caseloads. The working alliance, therefore, should not be subordinated in any intervention, generalised or otherwise. There is scope for this within the Building Choices model, though it still requires considerable elaboration. Three elements provide the scaffolding of a preliminary, optional module ‘for those that need it’: • establishing a sense of safety • building working relationships • stimulating curiosity in change In this Academic Insights paper, we argue that these three elements should form the bedrock of – and be embedded throughout – any safe and effective intervention.  We explain some of the challenges that must be surmounted if the Probation Service is to achieve this.    

Academic Insights 2024/05 Manchester, UK:  HM Inspectorate of Probation, 2024. 14p.

Interventions for Intimate Partner Violence During the Perinatal Period: A Systematic Review

By Olivia Mercier, Sarah Yu Fu, Rachel Filler, Alexie Leclerc, Kari Sampsel, Karine Fournier, Mark Walker, Shi Wu Wen, Katherine Muldoon

Background: Intimate partner violence (IPV) is a prevalent global health problem. IPV that occurs before pregnancy often continues during the perinatal period, resulting in ongoing violence and many adverse maternal, obstetrical, and neonatal outcomes.

Objectives: This scoping review is designed to broadly capture all potential interventions for perinatal IPV and describe their core components and measured outcomes.

Search Methods: We conducted a search for empirical studies describing IPV interventions in the perinatal population in June 2022. The search was conducted in MEDLINE, EMBASE, PsycInfo, CINAHL, Cochrane Central Register of Controlled Trials, Web of Science, Applied Social Sciences Index & Abstracts, ClinicalTrials.gov and MedRxiv. Hand-searching of references from select articles was also performed.

Selection Criteria: Included studies described an intervention for those experiencing IPV during the perinatal period, including 12 months before pregnancy, while pregnant or in the 12 months post-partum. The search encompassed January 2000 to June 2022 and only peer-reviewed studies written in either English or French were included. Included interventions focused on the survivor exposed to IPV, rather than healthcare professionals administering the intervention. Interventions designed to reduce IPV revictimization or any adverse maternal, obstetrical, or neonatal health outcomes as well as social outcomes related to IPV victimization were included.

Data Collections and Analysis: We used standard methodological procedures expected by The Campbell Collaboration.

Main Results: In total, 10,079 titles and abstracts were screened and 226 proceeded to full text screening. A total of 67 studies included perinatal IPV interventions and were included in the final sample. These studies included a total of 27,327 participants. Included studies originated from 19 countries, and the majority were randomized controlled trials (n = 43). Most studies were of moderate or low quality. Interventions included home visitation, educational modules, counseling, and cash transfer programs and occurred primarily in community obstetrician and gynecologist clinics, hospitals, or in participants' homes. Most interventions focused on reducing the revictimization of IPV (n = 38), improving survivor knowledge or acceptance of violence, knowledge of community resources, and actions to reduce violence (n = 28), and improving maternal mental health outcomes (n = 26). Few studies evaluated the effect of perinatal IPV interventions on obstetrical, neonatal, or child health outcomes.

Authors' Conclusion(s): The majority of intervention studies for perinatal IPV focus on reducing revictimization and improving mental health outcomes, very few included obstetrical, neonatal, and other physical health outcomes. Future interventions should place a larger emphasis on targeting maternal and neonatal outcomes to have the largest possible impact on the lives and families of IPV survivors and their infants.

Campbell Systematic Reviews, Volume 20, Issue 3, September 2024