125

British Journal of Clinical Psychology (2019), 58, 125–139

© 2018 The British Psychological Society
www.wileyonlinelibrary.com

Improving empathy with motivational strategies in

batterer intervention programmes: Results of a
randomized controlled trial


Angel Romero-Mart
ınez1* , Marisol Lila2, Enrique Gracia2 and
Luis Moya-Albiol1
1
Department of Psychobiology, University of Valencia, Spain
2
Department of Social Psychology, University of Valencia, Spain

Objectives. Empathy (i.e., the ability to decode emotions, as well as cognitive and
emotional empathy) is involved in moral reasoning, prosocial behaviour, social and
emotional adequacy, mood and behaviour regulation. Hence, alterations in these
functions could reduce behaviour control and the adoption of specific types of violence
such as intimate partner violence (IPV). Although interventions for IPV perpetrators focus
on reducing IPV risk factors and increasing protective factors to prevent this kind of
violence, the study of the effectiveness of these programmes in promoting changes in
empathy (cognitive and emotional) has been neglected.
Design. Hence, the main aim of this study was to compare the effectiveness of two
different modalities of IPV intervention programmes (Standard Batterer Intervention
Programs [SBIP] vs. SBIP + Individualized Motivational Plan [IMP]) in promoting empathic
improvements after both interventions.
Method. Participants were randomly assigned to receive SBIP (n = 40) or SBIP + IMP
(n = 53). The effectiveness of the intervention in the total sample and the group effects
were evaluated with general linear model repeated-measures ANOVA.
Results. Results revealed that only the IPV perpetrators who received the SBIP + IMP
were more accurate in decoding emotional facial signals and presented better cognitive
empathy (perspective taking) after the intervention programme.
Conclusions. Our study reinforces the view that different modalities of IPV interven-
tion might lead to different cognitive outcomes after the intervention. Thus, these results
may help professionals to develop specific intervention programmes focused on
improving cognitive abilities in order to reduce IPV recidivism.

Practitioner points
 Interventions for batterers’ neglected empathic changes after these programmes.
 Not enough randomized controlled trials for these kinds of interventions.
 An improvement in the ability to decode emotions after the intervention programme.
 An improvement in cognitive empathy (perspective taking) after the intervention programme.
 Different modalities of IPV intervention might lead to different cognitive outcomes after the intervention.

*Correspondence should be addressed to Angel Romero-Mart
ınez, Department of Psychobiology, University of Valencia, Avenida
Blasco Iba~nez, 21, Valencia 46010, Spain (email: Angel.Romero@uv.es).

DOI:10.1111/bjc.12204
126

Angel Romero-Mart
ınez et al.

Results are inconclusive about the effectiveness of intervention programmes for intimate
partner violence (IPV) perpetrators (Arias, Arce, & Vilari~ no, 2013; Babcock, Green, &
Robie, 2004; Cunha & Goncßalves, 2014; Eckhardt et al., 2013; Feder & Wilson, 2005;
Pinto et al., 2010). In general terms, the main aim of these types of interventions is to
reduce IPV risk factors and increase protective factors, which in turn prevent violence
against their partners in current and future relationships (Bowen, 2011; Ferrer-Perez,
Ferreiro-Basurto, Navarro-Guzm
an, & Bosch-Fiol, 2016; Gondolf, 2004). However, these
conclusions vary greatly from one study to another, depending on the study design or the
source of information on recidivism (victim’s report or official report) (Arbach & Bobbio,
2018; Babcock et al., 2004; Cunha & Goncßalves, 2014; Lila, Gracia, & Catal
a-Mi~ nana,
2018; L
opez-Ossorio et al., 2018). Hence, it is difficult to precisely determine the degree
of success of IPV intervention programmes.
The research on the effects of Standard Batterer Intervention Programs (SBIP) has
focused to a large extent on the effectiveness of these programmes in reducing IPV
recidivism, which is considered the final outcome (Bowen, 2011). However, certain
studies have paid attention to proximal outcomes, that is, those variables that are
meaningful in the risk of IPV recidivism, such as alcohol consumption, self-esteem,
attitudes towards violence, impulsivity, anger (state and trait), psychological adjustment,
social support, and awareness of serious offences, among others (Arias et al., 2013;
Babcock et al., 2004; Eckhardt et al., 2013; Lila, Gracia, & Herrero, 2012; Lila, Gracia, &
Murgui, 2013; Mart
ın-Fern
andez, Gracia, & Lila, 2018). Because court-ordered interven-
tions for IPV perpetrators are mandatory sentences ordered by a judge, IPV perpetrators’
engagement in them tends to be low (Eckhardt, Holtzworth-Munroe, Norlander, Sibley, &
Cahill, 2008; Kistenmacher & Weiss, 2008). Therefore, SBIPs incorporating new
therapeutic strategies, such as motivational interviewing, retention techniques, ‘stages
of change’ and strength-based theories, could better meet idiosyncratic IPV perpetrators’
needs, increasing their adherence to treatment (Crane & Eckhardt, 2013; Kistenmacher &
Weiss, 2008; Lila et al., 2018; Murphy, Eckhardt, Clifford, Lamotte, & Meis, 2017; Musser,
Semiatin, Taft, & Murphy, 2008; Santirso, Mart
ın-Fern
andez, Lila, Gracia, & Terreros,
2018). Thus, interventions focused on individual needs may offer interesting opportu-
nities to produce cognitive changes in IPV perpetrators by increasing their intervention
engagement. Nevertheless, they neglect other neuropsychological/cognitive variables
that play an important role in behaviour regulation (e.g., emotion decoding and empathy).
It has been suggested that cognitive abilities such as the ability to decode emotions (a
basic source of information to infer another individual’s perspective based on their facial
expressions), cognitive empathy (the ability to understand how another person sees the
world and the ability to consciously put your mind into the mind of another person
(perspective taking)) and emotional empathy (although emotional contagion is a
component of this, emotional empathy is the ability to understand or feel what someone
else feels, and so ‘experience sharing’ is the key (affective arousal)) are involved in moral
reasoning, prosocial behaviour, social and emotional adequacy, mood and behaviour
regulation (Balconi & Canavesio, 2016; Burnett, Chandler, & Trantham-Davidson, 2016;
Ramsøy, Skov, Macoveanu, Siebner, & Fosgaard, 2015; Schipper & Petermann, 2013; Zaki,
2014). Thus, alterations in these functions could reduce behaviour control and favour the
adoption of antisocial behaviours such as IPV (Heinz, Beck, Meyer-Lindenberg, Sterzer, &
Heinz, 2011; Romero-Mart
ınez, Lila, Catal
a-Mi~ nana, Williams, & Moya-Albiol, 2013;
Romero-Mart
ınez, Lila, Sari~nana-Gonz
alez, Gonz
alez-Bono, & Moya-Albiol, 2013; Romero-
Mart
ınez & Moya-Albiol, 2013). According to the somatic marker hypothesis (Damasio,
Tranel, & Damasio, 1991), this poor emotion and/or behaviour regulation would lead
 Improving empathy in batterers 127

them to select immediate reinforcements without taking into account the future
consequences, either negative or positive. Therefore, they would fail to use the
information available in the environment to foresee the consequences of their behaviour
(Sun, Yao, Wei, & Yu, 2015). Hence, it is necessary to analyse these variables because they
could increase the risk of reoffending by influencing the use of therapy, treatment dropout
or engagement.
Romero-Mart
ınez, Mart
ınez, Lila, Pedr
on-Rico and Moya-Albiol (2016) examined
whether IPV perpetrators experienced changes in emotion-decoding abilities and
empathy after completing a mandatory SBIP. After ending the intervention, participants
who attended the whole programme showed improvements in their emotion-decoding
abilities and higher scores on perspective taking. Nevertheless, participants did not
experience changes in fantasy, personal distress or empathic concern. Romero et al.
(2016) were unable to identify a specific part of the intervention that improved these
cognitive abilities. Although this intervention did not contain specific cognitive training
designed to improve cognitive abilities, participants received training in cognitive
restructuring, emotion management skills and problem-solving, among others (Lila et al.,
2018), which may explain these improvements. In this regard, some studies have
demonstrated that problem-solving training would improve these abilities in different
populations through slower and controlled processing, step by step (Kurowski et al.,
2014; Romero-Mart
ınez et al., 2017). Although it is difficult to attribute the cognitive
improvements to test bias because they present high test–retest reliability and stability
over a 1-year period (Fern
andez-Abascal, Cabello, Fern
andez-Berrocal, & Baron-Cohen,
2013; Ingram, Greve, Ingram, & Soukup, 1999), the lack of research conducted with an
appropriate control (i.e., a randomized controlled trial [RCT]) reduces the confidence in
the reliability of these results. Thus, it is necessary to use RCTs to find out which strategies
used in SBIPs produce specific empathic (emotion decoding, perspective taking, fantasy,
empathic concern and/or personal distress) improvements.
The primary objective of the present study was to evaluate the differences between
SBIP and SBIP + Individualized Motivational Plan (IMP) in IPV perpetrators’ cognitive
outcomes after ending both interventions. Based on the evidence showing that SBIP
produces cognitive-emotional changes in IPV perpetrators (Romero-Mart
ınez, Lila, &
Moya-Albiol, 2016), and SBIP + IMP demonstrates higher efficacy than SBIP in producing
changes in IPV perpetrators, with the former group showing lower self-reported physical
violence and greater reductions in the risk of recidivism assessed by therapists compared
to the SBIP group (Lila et al., 2018), our initial hypothesis was as follows: (1) SBIP and
SBIP + IMP would produce improvements in emotion-decoding abilities and empathy;
and (2) SBIP + IMP, compared to SBIP alone, would be more likely to increase
participants’ commitment to the dynamics and activities of the intervention, dedicating
more attention and effort to the activities proposed (Lila et al., 2018), and thus produce
greater improvement in cognitive-emotional abilities.

Method
Participants
The final sample was composed of 93 IPV perpetrators. Twenty IPV perpetrators were
excluded from the analysis because they did not complete the second neuropsychological
assessment, or they did not finish the intervention (see Figure 1). IPV perpetrators were
recruited from the participants in a psycho-educational and community-based treatment
128

Angel Romero-Mart
ınez et al.

Assessed for eligibility (n = 160)

Excluded (n = 2)
-Refused to participate

Randomized
Allocation

Allocated to SBIP (n = 79) Allocated to SBIP + IMP (n = 79)

Completed intervention (n = 57) Completed intervention (n = 63)
Follow-up

Lost to follow-up (n = 22) Lost to follow-up (n = 16)

-Non-compliance with programme rules = 14 -Non-compliance with programme rules = 9
-Derived to alcohol/drug treatment = 8 -Derived to alcohol/drug treatment = 7
Analysis

Analysed (n = 40) Analysed (n = 53)

Excluded from analysis = 17 Excluded from analysis = 10

Figure 1. Consort diagram of the study.

programme (mandatory for male abusers). Because they were sentenced to <2 years in
prison and had no previous criminal record, participants had been given a suspended
sentence on the condition that they would attend an intervention programme (Lila et al.,
2018). The inclusion criteria for controls included: males over 18 years of age with no
physical or mental problems, no severe substance abuse problems and no severe cognitive
impairment.
All subjects gave their informed consent for inclusion before they participated in the
study. The study was conducted in accordance with the Declaration of Helsinki, and the
protocol was approved by the Ethics Committee.

Study design
Participants were randomly assigned to receive the Standard Batterer Intervention
Programs (SBIP) or SBIP plus Individualized Motivational Plan (SBIP + IMP) (see
Figure 1). For further details, see Lila et al. (2018). Forty participants received SBIP
alone, and 53 were allocated to the SBIP plus IMP condition. The main reason for not
receiving the complete allocated intervention programme, in both cases, was non-
compliance with the programme’s attendance rules. Table 1 provides the description and
characteristics of both conditions.

Procedure
Intimate partner violence perpetrators were initially informed that refusing to participate
in the study would not affect their legal situation. Furthermore, potential participants
were informed that not participating in the study would have no legal repercussions.
Table 1. Characteristics of the SBIP and the IMP
SBIP
Duration 35 weekly group sessions
(2 hrs per session)
Type of Cognitive-behavioural intervention
intervention
Evaluation phase A single interview to obtain
information about the main risk
factors of the participant
Number of modules 1. First contact:
and/or strategies Norms for the group to function and
to build climate trust
2. IPV: Basic Principles:
To introduce basic concepts about IPV
and address responsibility attribution
3. Change strategies: individual variables:
To train in cognitive restructuring and
emotion management techniques
4. Change strategies: interpersonal violence:
To develop positive communication skills
in intimate relationships, empathy, and
awareness of IPV consequences on victims
SBIP + IMP
35 weekly group sessions (2 hrs per session)
SBIP + set of motivational strategies to increase
treatment compliance and motivation for change
(e.g. motivational interviewing, stages of change
approach, solution-focused brief therapy and
therapeutic alliance)
Three motivational interviews to target
participants’ personal goals of change
1. First contact: 1. Goal sharing
Norms for the group to function and to (at a group session)
build climate trust Goal reinforcement
and retention techniques
2. IPV: Basic Principles: 2. Goal sharing
To introduce basic concepts about IPV (at a group session)
and address responsibility attribution Goal reinforcement and
retention techniques
3. Change strategies: individual variables: 3. Intermediate individual
To train in cognitive restructuring and supervision of goals
emotion management techniques Sharing goal advancement
(at a group session)
Goal reinforcement
and retention techniques
4. Change strategies: interpersonal violence: 4. Goal reinforcement
To develop positive communication skills and retention techniques
in intimate relationships, empathy
and awareness
Improving empathy in batterers
of IPV consequences on victims
129
Continued
 130


Angel

Table 1. (Continued)

SBIP SBIP + IMP

Romero-Mart
ınez et al.

5. Change strategies: socio-cultural variables: 5. Change strategies: socio-cultural variables: 5. Goal reinforcement and
To discuss gender roles, sexist attitudes, To discuss gender roles, sexist attitudes, retention techniques
gender equality gender equality
6. End of intervention: 6. End of intervention: 6. Final individual supervision of goals
To prevent relapse and consolidate To prevent relapse and consolidate Sharing goal achievements
learning objectives learning objectives (at a group session)
Goal reinforcement and
retention techniques

Note. IMP = individualized motivational plan; IPV = intimate partner violence; SBIP = Standard Batterer Intervention Programs.
 Improving empathy in batterers 131

Each subject participated in three sessions in the psychobiology laboratories. In the

first sessions, participants were interviewed in order to exclude any individuals with
physical or mental illnesses. The second session took place the following day between
10 a.m. and 2 p.m., in order to minimize possible effects of fatigue later in the day. After
arriving at the laboratory, participants were taken to a room where they signed an
informed consent form to participate in the study, and data were collected on
demographic and anthropometric variables (age and body mass index). Then, a
neuropsychological test and a self-report were administered: Reading the Mind in the
Eyes (Eyes Test) and the Interpersonal Reactivity Index (IRI). After the intervention
programme (9 months later), the second session was repeated (1 week before the end of
the intervention phase) to assess the same neuropsychological and psychological
variables.

Therapists
In order to conduct the different treatment conditions, eight therapists with one or more
years of experience with batterer interventions received approximately 25 hrs of training
in their respective treatment condition protocols. They were blinded and equally
distributed in each condition (i.e., two pairs of therapists of both genders in four groups).
These therapists were supervised independently once every 2 weeks regarding their
group progress (i.e., group management, participants’ responses to treatment, establish-
ment of future sessions and/or treatment adherence). Moreover, intervention manuals
were written for each condition in order to guarantee the content of the protocol and
adherence to it (Lila et al., 2018).

Measures
The Eyes Test measures emotion-decoding abilities by identifying the emotion that best
represents the expression in the eyes in 36 photographs that show the eye region of the
face of different men and women. Participants must choose one adjective out of a set of
four. The total score, which ranges from 0 to 36 points, is obtained by adding up the
number of correct answers (Baron-Cohen, Wheelwright, Hill, Raste, & Plumb, 2001), with
a higher score interpreted as indicating stronger emotion-decoding abilities.
We employed the Spanish adaptation (Escriv
a, Navarro, & Garc
ıa, 2004) of the IRI
(Davis, 1983), which assesses cognitive empathy, in the form of perspective taking
(understanding another’s feelings and/or emotions) and fantasy (the ability to imagine a
fantastic world and understand motivations of fictional characters); and we assessed
emotional empathy with the empathic concern (sympathizing with others feelings) and
personal distress (experiencing distress by observing/imagining another’s suffering)
subscales. Items were rated from 1 (does not describe me well) to 5 (describes me well).
Cronbach’s alphas ranged from .76 to .81.

Data analysis
The Shapiro–Wilk test was performed to determine whether the evaluated variables fitted
a normal distribution, and it was observed that the variables followed the assumption of
normality (p < .05); therefore, we carried out parametric tests for statistical analysis of the
results. First, t-tests and chi-square tests were employed to study differences between
groups on socio-demographic and empathic variables.
132

Angel Romero-Mart
ınez et al.

The effectiveness of the intervention in the total sample was evaluated with general
linear model repeated-measures ANOVA, with ‘time’ (before and after intervention) as a
within-subject factor. To examine group effects, repeated-measures ANOVA was
conducted with ‘time’ as within-subject factor and ‘type of intervention’ (SBIP vs.
SBIP + IMP) as between-subject factors. For significant results, partial eta-squared (g2p )
was reported as a measure of the effect size (Richardson, 2011). Moreover, effect sizes for
the between-treatment conditions or time (before-after intervention) differences were
calculated using Cohen’s d (Cohen, 1988).
Pearson or Kendall rank correlation coefficients were calculated to assess relationships
between patient characteristics (age, nationality, marital status, educational level and
employment status) and treatment outcome, measured as the difference between the
score after treatment and the baseline score (i.e., change score). Afterwards, we ran a
partial correlation analysis with ‘type of intervention’ as covariate.
Statistical analyses were performed using IBM SPSS (Version 21.0; IBM Corp., Armonk,
NY, USA), and p ≤ .05 was considered significant. Average values are expressed as
mean  SD.

Results
Descriptive characteristics of the IPV perpetrators are summarized in Table 2. Groups did
not differ in age, nationality, marital status, economic status or educational level.
Moreover, there were no differences between groups in their criminal records (number of
months of prison sentence).

Before the intervention programme

Regarding empathy, groups did not differ on the eyes test score (t91 = 0.43, p > .05,
d = 0.09), IRI perspective taking (t91 = 1.10, p > .05, d = 0.23), fantasy (t91 = 1.19,
p > .05, d = 0.25), empathic concern (t91 = 1.73, p > .05, d = 0.36) or personal
distress (t91 = 0.18, p > .05, d = 0.04).

Effectiveness of the intervention programme in eliciting empathic changes

There was significant effect of ‘time’ in the total sample on the eyes test scores, F(1,
87) = 4.46, p = .04 g2p = .05, d = 0.47. After analysing each group separately, within-
group comparisons only revealed significant effects for ‘time’ on the eyes test in IPV
perpetrators who received the SBIP + IMP, F(1, 52) = 6.74, p = .012, g2p = .12, d = 0.51.
This group of IPV perpetrators presented higher eyes test scores after the intervention
programme (18.26  3.84 and 19.47  4.56, respectively).
Regarding IRI scores, a significant effect of ‘time’ was found in the total sample on the
perspective taking score, F(1, 92) = 8.10, p = .005, g2p = .08, d = 0.60. Within-group
comparisons only revealed significant effects of ‘time’ on perspective taking in IPV
perpetrators who received the SBIP + IMP, F(1, 52) = 4.16, p = .047, g2p = .08, d = 0.40.
This group of IPV perpetrators presented higher perspective taking after the intervention
programme (23.15  4.32 and 24.25  3.93, respectively). Nevertheless, there were no
significant ‘group’ or ‘time 9 group’ effects on IRI perspective taking. Also, there were
non-significant effects (time, group or time 9 group) on the rest of the IRI subscales
(fantasy, empathic concern and personal distress).
 Improving empathy in batterers 133

Table 2. Mean  SD of anthropometric and demographic variables of participants

SBIP (n = 40) SBIP + IMP (n = 53)

Age (years) 41.80  10.69 39.75  10.19

Nationality
Spanish 75% 70%
Latin Americans 8% 12%
Africans 3% 4%
Eastern Europe Countries 14% 14%
Marital status
Married/Cohabiting 30% 25%
Divorced/Widowed/Single 70% 75%
Educational level
Basics 70% 49%
Advanced 18.5% 43%
College 11.5% 8%
Employment status
Employed 60% 53%
Unemployed 40% 47%
Criminal records
Months of prison sentence 8.69  6.17 9.81  7.09
before implementation of
intervention programme

Note. IMP = individualized motivational plan; SBIP = Standard Batterer Intervention Programs.

Relationships between variables

Regarding the relationships between participants’ characteristics and the empathic
variables (change scores for each variable), there were no significant associations
between variables. These values remained non-significant after including ‘type of
intervention’ as covariate.

Discussion
The present study has demonstrated that only the IPV perpetrators who received the
SBIP + IMP became more accurate in decoding emotional facial signals and improved
their perspective taking after the intervention programme.
The first main objective of the current study was to assess differences in emotion-
decoding abilities and empathy in two groups of IPV perpetrators who received different
types of interventions (SBIP vs. SBIP + IMP). It should be noted that, in general, findings
did not support the hypothesis that both types of interventions would produce
improvements in emotion-decoding abilities and empathy. Only SBIP + IMP leads to an
improvement in IPV perpetrators’ eyes test score and perspective taking. However, there
were no improvements in IRI fantasy, empathic concern or personal distress (or
sympathy). Indeed, these results support the second hypothesis of an advantage of
SBIP + IMP over SBIP in producing cognitive improvements. The SBIP + IMP appears to
be more effective than the SBIP condition in addressing the emotion-decoding abilities of
IPV perpetrators, thus supporting the second hypothesis.
134

Angel Romero-Mart
ınez et al.

A previous study found that adults’ facial emotion-decoding skills are not completely
innate and can be significantly improved through learning (Huelle, Sack, Broer,
Komlewa, & Anders, 2014). Our data reinforced this hypothesis. Indeed, the motiva-
tional techniques may improve the ability to attend to relevant emotional cues/facial
expressions through a slow, step-by-step assessment, compared to IPV perpetrators who
only received the SBIP. However, future research should assess whether IPV perpetra-
tors in the motivational condition spend more time exploring the face on this test than
those in the SBIP condition after the treatment, which may indicate a detailed
exploration of the face. The eyes test requires an advanced brain system (i.e., visual and
emotional processing, decoding, recognition), which not only involves new ways of
thinking, but also the recognition of complex emotional states (Thye, Murdaugh, &
Kana, 2018). However, specific underlying mechanisms through which inattention
deficits/distractibility influence emotion-decoding abilities in IPV perpetrators (Romero-
Mart
ınez et al., 2016) were not specifically tested in the present study. There may be a
direct association between these variables, or this association might be mediated by
other factors. Even so, it is necessary to conduct further research that combines these
interventions with specific cognitive training, in order to find out whether these
interventions are sufficient or need reinforcement to strengthen these cognitive
improvements. One possible and promising intervention involves developing exercises
with brain training programmes, specifically working memory training (Maleki &
Ahmadi, 2016) and empathy training.
It is necessary to highlight, however, that emotion-decoding abilities, perspective
taking and emotional empathy (personal distress and empathic concern) involve different
cognitive processes and, furthermore, are sustained by different brain systems (Martinez,
2017; Nyhus & Barcel
o, 2009; Sato et al., 2016; Stemme, Deco, & Busch, 2007).
Therefore, each of them requires different paths and techniques for improvement. Thus, it
makes sense that only a few of these empathic abilities (emotion decoding and
perspective taking) improved after the intervention. Regarding the fantasy subscale, the
absence of differences could be explained by the fact that this subscale actually measures
imagination and emotional self-control, rather than cognitive empathy (Baldner &
McGinley, 2014; Lawrence, Shaw, Baker, Baron-Cohen, & David, 2004). With regard to
emotional empathy, although the SBIP and SBIP + IMP included experiential training
(e.g., role-playing. . .), didactic training (lecture based), skills training and/or a combina-
tion of these methods (usually employed to improve emotional empathy) (Teding van
Berkhout & Malouff, 2016), there could be several reasons for the lack of differences on
the emotional empathy scales: (1) the use of a single self-report to assess emotional
empathy instead of other self-reports focused on this kind of empathy (e.g., Balanced
emotional empathy scale, Questionnaire measure of emotional empathy. . .); (2) the lack
of alternative ways to assess emotional empathy, such as the pictorial empathy test, The
Toronto Empathy Questionnaire (which may be appropriate in the context of our study);
and/or (3) the questionable four-factor solution of the IRI questionnaire (Batchelder,
Brosnan, & Ashwin, 2017).
As mentioned above, the SBIP contains problem-solving training (among others), so
that therapists working with IPV perpetrators can improve their ability to correctly
analyse feedback received in order to choose an appropriate alternative from their set of
strategies for dealing with an ever-changing situation (i.e., problems in cohabiting, couple
arguments) and to adopt the perspective of others (De Obeso Orendain & Wood, 2012).
Indeed, they must find other/alternative ways to view the problem or deal with it. In this
regard, IPV perpetrators have to change their strategy when the situation requires an
 Improving empathy in batterers 135

appropriate social response. We expected the motivational learning reinforcement of

SBIP + IMP to involve better perspective taking improvements in IPV perpetrators, and so
it makes sense that this intensive weekly training would explain the increase in the
perspective taking score.
To the best of our knowledge, this is the first study to examine the effectiveness of two
interventions for IPV perpetrators by assessing changes in specific higher-order cognitive
domains (assessed by a neuropsychological test and a self-report) after both programmes.
Two strengths of our study are that we report these findings in a relatively large sample of
IPV perpetrators (approximately 100 participants) in a randomized study. Moreover, we
reinforced our findings with a neuropsychological test that presents considerable test–
retest reliability. Nonetheless, in future research, a larger and more structured assessment
of different cognitive domains should be carried out through a neuropsychological
battery, in addition to considering a follow-up assessment 3 or 6 months after the
intervention. It would also be advisable to include a group of IPV perpetrators receiving
cognitive training or IPV perpetrators without SBIP, in order to help to confirm that the
observed changes are directly caused by the intervention and not by uncontrolled
variables. Hence, future studies will benefit from comparing SBIP versus SBIP + motiva-
tional plan versus SBIP + cognitive training versus SBIP + motivational plan + cognitive
training. Moreover, the current study may not be able to account for the specific
components of the intervention that produced the change in the specific variables
analysed in our study. There are certain individuals who present risky characteristics that
interfere with treatment adherence (i.e., mental disorders, heavy drug use. . .), and so it
would be interesting to combine the previously mentioned treatments with an individual
treatment approach integrating motivational interviewing strategies with cognitive-
behavioural therapy (Murphy et al., 2017). Finally, future studies should consider the
impact of IPV perpetrators’ alexithymic symptoms (which are closely related to empathy
deficits), as well as their impact on the risk of IPV recidivism.
In conclusion, our study shows that the two interventions studied improved several
types of empathic abilities in IPV perpetrators, and these improvements were larger in IPV
perpetrators who received the SBIP + motivational plan. Moreover, our study supports
the view that different modalities of IPV interventions might lead to different cognitive
outcomes after the intervention. Thus, these results may help professionals to develop
specific intervention programmes focused on improving cognitive abilities in order to
reduce IPV recidivism.

Acknowledgements
The implementation of this study has partly been made possible by funding from the Beca
Leonardo a Investigadores y Creadores Culturales 2018 de la Fundaci
on BBVA. Project
supported by a 2018 Leonardo Grant for Researchers and Cultural Creators, BBVA Foundation.
The Foundation accepts no responsibility for the opinions, statements and contents included
in the project and/or the results thereof, which are entirely the responsibility of the authors.

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Received 14 June 2018; revised version received 6 September 2018