Professional Documents
Culture Documents
DOI 10.1007/s10991-008-9029-6
Abstract This article offers a new perspective on the assessment, treatment and
management of adults who are violent to their partners. Using a worked case
example, it describes how a solution-focused approach is used to develop, and
evidence, safety for all family members.
Keywords Domestic violence Child protection Male and female violence
Risk assessment Safety building Solution-focused therapy
123
68
J. Milner
This includes the provision of sensor lights, secure doors with peepholes, fencing,
assistance with obtaining non molestation orders, alarms and dedicated telephone
lines. DVT liaises closely with the police, housing departments, health visitors,
social services and solicitors.
DVT also provides support for the partners of men on Integrated Domestic Abuse
Programmes (IDAP) provided by the Probation Service. These programmes are
based on an assumption that domestic violence is asymmetrical and the result of the
abuse of power on the part of men towards known women. Thus interventions are
aimed at re-educating men in groups where they are challenged about their attitudes
towards women, and their presumed denial and minimisation, and their partners are
supported.1 DVT finds that a substantial number of men fail to complete a
programme, but still ask for help in overcoming their violence. The reasons for noncompletion put forward by the menand their partnersare that they find the
programme unduly repetitive, inappropriate to their circumstances, and unnecessarily confrontational. For these men, and their partners, DVT makes a referral to
Resolutions (Yorkshire), a small consortium that offers solution focused therapy
(SFT) to people who are violent, and their partners. This alternative method is
described below, using a worked case example.
The Method
Solution focused therapy has no specific theory on the nature of domestic violence,
acknowledging that women can be violent to their partners2 and that men and
women can both be violent within their relationships,3 as well as the more usually
discussed male-on-female violence. SFT accepts that domestic violence is complex
and that there are many situational determinants, thus it is interested in the meanings
of violence to the people involved and their capacity for change, emphasising the
importance of determining what safety will look like for everyone involved. What
safety actually consists of, and how it will be evidenced, can be difficult to
determine so all the concerns are listed and then everyone involved is asked what
the violent person/s will be doing differently when the concerns no longer exist.
These indicators of safety are framed in clear behavioural terms so that there is no
confusion between inputs (prescribing a programme of therapy), outputs (attending
a programme), and outcomes (behavioural change). Outcomes are the new
behaviours expected (for example, s/he has developed constructive ways of dealing
with stresswhich can be detailed, evidenced and confirmed). People who have
been on the receiving end of violence find no difficulty in saying what safety will
look like to them (for example, s/he will be listening to me, talking to me in a quiet
voice, staying sober, etc.). Professionals often find it a little harder to describe what
1
See, for example, Pearson (1997); McKeowan et al. (2001); Fitzroy (2002, pp. 734); on the incidence
of female-on-male violence; Muptic et al. (2007, pp. 753774); on violence in same sex relationships see
Renzetti (1992) and Leventhal and Lundy (1999).
123
69
safety looks like, probably because they have been encouraged to focus on risks.
Where there are no indicators of safety, it is clear to the violent person as well as
professionals that there is dangerousness. The violent person then has a choice
between accepting restrictions and constraints or changing their behaviour.
SFT is based on the idea that all problems have exceptionstimes when the
problem could have happened but somehow did notso the starting point with
people who are violent is to identify the times they could have abused someone but
controlled themselves instead. Therapy focuses on the details of when and how
these exceptions occurred, utilising the strengths used by the person in these
instances to develop more safety for everyone in their family. The emphasis is on
solutions so the approach is future oriented, helping the violent person to find more
satisfactory ways of being in their relationships. It accepts that people are able to
move forwards without necessarily looking at the past in depth and offers them
invitations as to how they wish to be in the future.
SFT has no position on treatment format. Domestic violence is relational in
complex ways; for example, although people want the violence to stop, they rarely
want the family to be split up.4 Thus the practitioner works with the whole family
either separately or together, whilst taking care to ensure the safety of all vulnerable
family members. Safety precautions range from the sanctuary arrangements detailed
above, to the provision of safe supervised contact where couples are separated, to
emotional safety where they attend sessions together. Partners often turn up
unannounced at sessions, sometimes with small children in tow, so the practitioner
ensures that vulnerable family members are enabled to speak freely and safely. As
the method is attempting to determine each violent persons unique solution to the
problem, the programme of work is completely individualised. There is no notion of
a predetermined number of sessions where set topics are covered. Setting topics
would be an expensive use of resources as many violent people already know how
they should be behaving even if they havent yet managed to find ways of doing it,
so the content is set in negotiation with each family member, and other professionals
where they are involved. Professionals often anticipate denial and resistance but
violent people have good reasons for this behaviourshame, fear of the
consequences, possible loss of a relationship, etc, so the practitioner waits for
disclosures to emerge as the violent person begins to trust the therapeutic process.5
Therapy ceases when all concernedthe violent person, the vulnerable family
members, and professionalshave clear evidence that more constructive ways of
behaving have been demonstrated and evidenced. A successful outcome could be
that the family is safely reunited; equally it could be that the couple have negotiated
a constructive parting and have developed ways of safe and cooperative parenting.
To illustrate how the method works, the practice principles of the approach are
now outlined in detail, using a typical case example.
See, for example, Lipchik and Kubicki (1996, pp. 6598); Milner and Jessop (2003, pp. 127141);
Milner (2004, pp. 79101); Milner and Myers (2007, pp. 1929) and Milner (2008).
123
70
J. Milner
As this is a case involving child protection concerns, certain details have been changed to ensure that
the family is not identified.
123
71
losing Joelle, makes it difficult for Danny to sit calmly through sessions with social
workers. Helen sees herself as contributing the Dannys violence with her
unreasonably jealous behaviour; to test his commitment to her she demanded that
he give up dealing as she feared that some of his customers paid with sexual
favours. Although he did this, she was still was possessed with jealous thoughts and
tested his commitment further by disappearing with another man for several days
and boasting about it on her return home. Of the knifing episode, she says I didnt
deserve it, but I did ask for it. I wound him up. She is also frustrated with contact
arrangements as she knows that Danny dislikes her being a working girl but she
cant give this up at the moment as it supplies the only income they have. She also
excuses Dannys threats in court to the social workers on the grounds that they both
feel totally powerless and that no-one is listening to them. They are both grief
stricken at the removal of their child and described movingly how they avoid going
past toy shops as this reduces them both to tears. Grief of losing a child is often
mentioned by service users, with fathers talking about walking around with an
empty pram and mothers talking about going into the childs bedroom in the middle
of the night to attend to them even though they know they are not there.
Acknowledging that they have lost their child through their own behaviour in no
way lessens the hollow feeling of loss they experience.
It is important as a solution focused practitioner not to decide between the
various accounts of the violencethey have truth to the various people who hold
these views. Listening carefully to peoples understanding of their situations helps
them move beyond superficial responses,7 and avoids a sullen stand off that is often
instigated by confrontational approaches.8
Finding Exceptions to the Violence
Exceptions are the first indicators of safety and control so it is important to discover
these early on, and expand them. Although Dannys life had been saturated with
violence, both as a victim whilst in care and as an aggressor in his cocaine dealing,
he was not always violent. The most obvious exception is his behaviour around his
children; he had never lost his temper with any of them. This was confirmed by
Helen, and later by accounts of the contact supervisor and the health visitor. This
exception was explored through questions asking him the details of where, when
and how they occurred. Danny explained that it was impossible for him to get
wound up by the children because he is always aware of how vulnerable they are.
He was also able to say how he controlled himself when they were being difficult,
identifying that he was quiet, calm and patient in these situations. This then was the
beginning of a solution to Dannys violence; he was asked how he could develop
and expand these behaviours to other situations. He was able to report at the third
session that he had become aware of Helens vulnerability after watching someone
being beaten on television (when I used to beat her, she whimpered and cried but it
didnt bother me. I carried on till my arm ached. Seeing that woman cowering and
7
123
72
J. Milner
settle down with Helen (he admitted that he had slept around a lot but that Helen
was now his partner for life);
have Joelle back and for them to be a normal family where people all cared for
each other and were happy;
have social services out of his life;
study for a trade so that he could provide for his family without Helen having to
earn money as a working girl; and,
continue to see his older children and for Helens children to visit regularly.
123
73
Milner (2008).
123
74
J. Milner
Danny found it much harder to identify any strengths and resources; when asked
what were the good things about himself, he replied there arent any. This is a not
uncommon response from people who are violent. The consequences of their
violence are disproportionate to any immediate benefits in terms of tension release,
especially in the condemnation of the violence by both themselves and others. Being
told repeatedly that you are a bad person means that the person either stops listening
or becomes depressed; either state narrows the persons life and reduces their
chances of finding a solution. One way round this is to ask the violent person what
significant people in their lives would consider to be good about them but Danny
shrugged off Helens positive comments. Neither could he accept that Joelle might
consider him to have good qualities (of course Im good with her, Im her dad. Its
what dads do). So Danny was asked about the hardest thing he had ever done: this
was confirming a residential staff members abuse when interviewed as part of a
large child protection inquiry. From this, the qualities needed to take such a
courageous step were developed and both parents were able to acknowledge that
they had the necessary qualities to survive this difficult period in their lives:
courage, determination, a sense of justice, patience, and consideration for others.
These were all qualities they began to use to overcome frustrations that had led to
resentment and violence. They were also able to talk about happier futures where
their aspirations to be a normal family could be extended to being a successful,
happy family.
Scaling Safety and Progress
In working with domestic violence the first thing to do is assess the level of safety of
the person who has been hurt. Both Helen and Danny were asked a simple scaled
question: if 1 is Helen is not at all safe with Danny and 10 is she is completely
safe, where do you, Helen, put yourself (where do you, Danny, put Helen) on this
scale? Usually a couples ratings are slightly different, the scale allowing the
unsafe person to indicate this without fearing consequences by giving only a slightly
lower rating than the violent person. It doesnt matter what the numbers are as any
difference allows constructive discussion about what the person will be doing
differently when the rating is half or one point higher. Unusually, Danny and Helen
agreed, both rating her safety at 9, Danny on the grounds that there was no way he
would ever risk losing his baby again, if and when he got her back. Helen agreed
with this and said also that she had felt completely safe with Danny since the knifing
incident as he hadnt been getting wound up when she expressed jealous thoughts.
However, Danny did not see this new way of behaving as constructive; he felt it
stemmed more his current depressed state which meant he couldnt be bothered.
This was not, then, a solution that had the potential to be either satisfactory or
enduring.
As Helens jealousy was a significant factor in their relationship, she was asked a
scaled question about it: if 1 is you know for certain that your jealous thoughts are
based on solid fact and 10 is you are absolutely convinced that they are false, where
do you place yourself on this scale?. Danny placed her at 1 and Helen placed
123
75
herself at 3. Danny said that he could rate her higher on the scale when she didnt
carry on every time I make a comment about a good looking woman on
television. Helens ideas about moving up the scale were all to do with Danny
changing his behaviour, most of which were unreasonable in that he could never go
anywhere by himself without accusations of unfaithfulness.
Sexual jealousy is extremely difficult for people to control and does not respond to
reassurances on the part of the partnerthese usually result in demands for further
reassurances and restrictions. Helen continued to find it very difficult to control her
jealous thoughts but Danny found a way of tolerating them, he ignored them. He
demonstrated that he could do this under considerable provocation; after returning
from visiting his daughter from a previous relationship (during which he left his
mobile phone at home so that she couldnt ring him obsessively), she subjected him to
an inquisition that lasted all evening, most of the night and into the morning. She was
not only verbally abusive during this time but she also hit him. Other than telling her
politely to drop the subject, he made no reassurances about his behaviour and ignored
her behaviour as best he could. He reminded her the following morning when her tirade
ceased that it wouldnt be good for Joelle to hear her talking like this and that she knew
he had committed to her when I agreed for us to have a baby. Helen was partly
ashamed of her behaviour and partly pleased that Danny had been tested. Her jealous
thoughts remained but she became more able to stop them getting out of control.
Danny said he loved her enough to put up with them.
They were also asked where on the safety of Helen scale they thought social
workers would rate them. These ratings were much lower than their own and they
talked resentfully about being disbelieved by social workers when they said that
they had no fears of the violence recurring. They were then asked what they would
be doing differently when the social workers could agree that Helen, and Joelle,
were safe. Although they felt it unfair that they had to make all the effort, they knew
that they had to get on better with their social workers, and agreed strategies for this
which used the competencies identified earlier. Instead of waiting for social workers
to contact them they volunteered information, kept appointments on time, were
polite, and remained patient throughout some very intrusive questioning. Sadly the
social workers did not see any improvement. As Scourfield found in his research
into child protection social worker attitudes,11 once a hypothesis is developed, it
tends to remain and the rigid template he found operating in domestic violence
casesmen seen as threat to women and children with women expected to choose
their children over their partners or be considered as failing to protectwas evident
here. Also there was the genuine fear they had of Danny. Danny found the solution
to this problem too; he consulted his solicitor and an independent social worker was
appointed. Danny and Helen had no difficulty in working with this person.
Assessing Willingness, Confidence and Capacity
Government guidance is explicit about the need for social workers to work in
partnership with parents and ensure their effective participation so it could be
11
123
76
J. Milner
expected that social workers understand that parents initial responses will be hostile
and make attempts to set the scene so that motivation can be improved and
constructive relationships established. This often doesnt happen for a number of
reasons: the social worker has prime responsibility for the child not the parents;
common working hypotheses in domestic violence anticipate denial and resistance,
and encourage a confrontational approach; laborious procedures inhibit creative
work; and, in this case example, the social workers were fearful of Danny. When
this happens, the solution focused approach is to determine how best the parents can
improve relationships with social workers and whether they need to increase their
willingness, confidence or capacity to change their behaviour.
This is done by a series of scaled questions. Willingness is assessed by asking if
1 is you cant be bothered and 10 is you will do anything it takes to get your child
back, where are you on this scale?. Similarly, capacity is assessed by asking if 1
is you havent a clue about what to do differently and 10 means you know exactly
what to do to change, where are you on this scale?, and confidence is about their
confidence in their ability to change. Not surprisingly in view of their resentment at
how they were being treated by social workers, Danny and Helen scored lowest on
the willingness scale, although their capacity ratings were low until they were
reminded of their competencies. Increasing their willingness was introduced by
asking them what they would be doing differently when they were one point higher
on the scale and linking this to the safety of Helen scale mentioned above. Letting
resentments go was an important part of their growing ability to engage with the
family assessment process.
Joelle was returned to her parents care and there has no been no further violence,
but the whole process would have been a pleasanter experience for all concerned
had everyone been clear from the outset about exactly what was expected of these
parents, and how it would be evidenced, that would convince the professionals that
it was safe to close the case. Where parents are unable, or unwilling, to provide this
evidence, then it is clear to both them and others that they cannot reasonably expect
to be allowed to care for their child. A sample preliminary safe care plan which
would outline the essential safety indicators, and thus structure the work, for a
couple such as Danny and Helen is appended.
Although these practice principles are described discretely and sequentially
above, in therapy they are woven together, with the focus shifting depending upon
which element is most relevant at each session. For example, searching for
exceptions is more likely to occur in earlier sessions, although scaled questions are
useful throughout. Goal setting is begun in early sessions but is revisited regularly as
parents goals widen, and sometimes to accommodate social workers changing the
goal posts when early demands are met. This latter is frustrating for parents and,
although a good test of anger control, it is best if the solution focused therapist can
establish what social workers will consider to be a good outcome of their workin
detailat an early stage. This is not an easy process as social workers, and courts,
are expected to frame their concerns in terms of risk rather than safety. The
situational and relational aspects of domestic violence make risk assessment a very
inexact science. A study of 840 men who attended a domestic violence programme
123
77
in the US found that the differences between re-offenders and non-reoffenders are
not substantial enough to predict or identify high-risk offenders.12
Outcomes
A solution focused approach to working with people who are violent may seem to
be counterintuitive: how can the problem be sidelined without grave consequences,
surely past behaviour is the best indicator of future behaviour, how can a solution
not necessarily be linked directly to the problem? Strange though the method may
seem, it actually works. Three year follow up of over 100 adults following a solution
focused programme shows a success rate of approximately 7375 percent, with a
drop out rate of approximately 2527 percent.13 Other research into the use of SFT
with a variety of violent offenders has found it similarly effective.14
Conclusion
This article suggests that a solution focused approach to working with violence
increases effectiveness because it bypasses tensions and difficulties inherent in more
traditional approaches. Particularly it avoids confrontation, recognising that this is
negatively related to behavioural change.15 Instead it promotes genuine partnership,
responsibility taking and clarity about safety.
Appendix
A sample preliminary safe care plan for Joelle and Helen
Concerns
Safety
12
Gondolf and White (2001, pp. 361380). For a fuller account of the problems in risk assessment, see
Milner and Myers (2007).
13
Milner (2008).
14
Turnell and Edwards (1999); Milner (2004); Milner (2008); Milner and Myers (2007); Lee et al.
(2003, 2007); Myers (2005, pp. 97112); Turnell and Essex (2006).
15
Gondolf (1998, pp. 6465, 8789); Marshall (2003, pp. 2530); Gadd (2004, pp. 173197).
123
78
J. Milner
Appendix continued
Concerns
Safety
5. Danny and Helen are grieving for their daughter 5. Danny and Helen will be handling the, hopefully,
and this is adding to their stress levels.
temporary loss and supporting each other.
6. Danny does not like Helen being a working girl. 6. Helen will be in other work or training.
This adds to his stress
Goals
Social services goals are for Danny and Helen to demonstrate that the safety
indicators listed above are present.
Danny and Helens goals are for Joelle to be returned to their care, social services
out of their lives, and live a normal life.
Current Indicators of Safety
1.
2.
3.
4.
5.
Helen says she feels safe now and this is evidenced in how she can talk freely
about events in front of Danny and tell him what she wants.
Danny has never lost his temper with any of his children. Children do not stress
him out. This has been confirmed by Helen, health visitors, and contact
supervisors.
He has given up dealing in cocaine. This has been confirmed by him moving to
a new address, avoiding old customers and getting rid of his old mobile phone
number. Police checks reveal no evidence of current dealing.
He accepts that his actions led to Joelle being removed from his care and this
has been a wake up call for him.
Contact supervisors report that both parents are capable of meeting Joelles
needs. They are not afraid of Danny, who is always punctual, polite and
considerate.
Action Plan
1.
2.
Danny will be offered therapy to help him learn how to control his temper and
handle stress. A good outcome of the therapy will be that Danny is peaceable
and calm, and can talk to people politely, even when stressed.
Helen will be offered therapy to help her learn to control her jealous thoughts.
A good outcome of the therapy for Helen will be that she feels more secure
about herself and can control her jealous thoughts.
123
3.
4.
5.
6.
79
Contact arrangements will be varied so that the parents can obtain work or
training. They will be offered guidance and assistance in obtaining suitable work.
Social services will support the parents in their grief at being parted from Joelle
by ensuring that they are given full information about Joelles life in the foster
home, consulted about any issues that may arise concerning Joelles well-being,
and involved in her care as much as is practically possible.
As far as possible, appointments for the parenting assessment will be arranged
around the parents existing commitments. Social workers will be sensitive to
both parents possible reactions to talking about earlier abusive experiences.
If social workers have any other concerns they will explain these to Danny and
Helen promptly.
Time Frame
Joelle is developing rapidly and a decision about her future cannot be delayed too
long. The expectation is that the parents will demonstrate safety within a time frame
of four months, progress to be reviewed monthly.
Social Services will be confident enough to return Joelle to her (monitored)
parents care when the parents have demonstrated that all the indicators of safety
listed above are in place. They will be confident enough to close the case when these
changes have been sustained over a period of six months. Should safety not be
demonstrated, the plan will be for Joelle to be placed for adoption.
References
Cavanagh, K., and R. Lewis. 1996. Interviewing violent men: Challenge or compromise? In Working with
violent men. Feminism and social work, ed. K. Cavanagh, and V. Cree, 87112. London: Routledge.
Dobash, R.E., R.P. Dobash, K. Cavanagh, and R. Lewis. 2000. Changing violent men. London: Sage.
Fitzroy, L. 2002. Violent woman. Questions for feminist theory, practice and policy. Critical Social
Policy 21: 734.
Gadd, D. 2004. Evidence-led policy or policy led evidence? Cognitive behavioural programmes for men
who are known to be violent towards women. Criminal Justice 4: 173197.
Gondolf, E. 1998. Do batterer programs work? A 15 month follow-up of a multi-site evaluation. Domestic
Violence Report 3: 6465; 8789
Gondolf, E., and R.J. White. 2001. Batterer program participants who repeatedly re-assault: Psychopathic
tendencies and other disorders. Journal of Interpersonal Violence 16: 361380.
Lee, M.Y., J. Sebold, and A. Uken. 2003. Solution focused treatment of domestic violence offenders.
Accountability for change. Oxford: Oxford University Press.
Lee, M.Y., J. Sebold, and A. Uken. 2007. The role of self-determined goals in predicting recidivism in
domestic violence offenders. Research on Social Work Practice 17: 3041.
Leventhal, B., and S.E. Lundy. 1999. Same-sex violence. Strategies for change. London: Sage.
Lipchik, E., and A.D. Kubicki. 1996. Solution-focused domestic violence: Bridges towards a new reality
in couples therapy. In Handbook of solution focused brief therapy, ed. S.D. Miller, and B.L.
Duncan, 6598. San Francisco: Jossey Bass.
Lord, A., and P. Willmott. 2004. The process of overcoming denial in sexual offenders. Journal of Sexual
Aggression 10: 5161.
Marshall, W.L., G.A. Serran, Y.M. Fernandez, R. Mulloy, R.E. Mann, and D. Thornton. 2003. Therapist
characteristics in the treatment of sexual offenders: Tentative data on their relationship with indices
on behaviour change. Journal of Sexual Aggression 9: 2530.
123
80
J. Milner
McKeowan, K., T. Haase, and J. Pratschke. 2001. Distressed relationships does counselling help?.
Dublin: Marital and Relationship Counselling Services.
Milner, J. 2004. From disappearing to demonised: the effects on men and women of professional
interventions based on challenging men who are violent. Critical Social Policy 24(1): 79101.
Milner, J. 2008. Domestic violence: Solution focused practice with men and women who are violent.
Journal of Family Therapy 30: 2751.
Milner, J., and D. Jessop. 2003. Domestic violence: Narratives and solutions. Probation Journal 50(2):
127141.
Milner, J., and S. Myers. 2007. Working with violence. Policies and practices in risk assessment and
management. Basingstoke: Palgrave.
Muptic, L.R., J.A. Bouffard, and L.A. Bouffard. 2007. An exploratory study of women arrested for
intimate partner violence. Violent women or violent resistance? Journal of Interpersonal Violence
22: 753774.
Myers, S. 2005. A signs of safety approach to assessing children with sexually concerning or harmful
behaviour. Child Abuse Review 14: 97112.
Pearson, P. 1997. When she was bad: Violent women and the myth of innocence. Toronto, Canada:
Random House.
Renzetti, C.M. 1992. Violent betrayal. Partner abuse in lesbian relationships. London: Sage.
Scourfield, J. 2003. Gender and child protection. Basingstoke: Palgrave.
Turnell, A., and S. Edwards. 1999. Signs of safety. A solution oriented approach to child protection
casework. New York and London: W. W. Norton.
Turnell, A., and S. Essex. 2006. Working with denied child abuse. The resolutions approach.
Maidenhead: Open University Press.
123