Forest Bank Interim Report

BACKGROUND TO INNER STRENGTH
HMP Forest Bank commissioned TRAC Psychological to deliver a domestic violence treatment programme. They chose this course rather than using existing Duluth-based programmes because these are largely ineffective in treating domestic violence perpetration: “there is little support for the Duluth Model regarding the effectiveness of these types of programmes in reducing violence … Meta-analytic reviews of outcomes for these approaches have consistently found them to be of limited effectiveness, with effect sizes near zero” (Jewel & Wormith, 2010. See also RCT analysis Davis et al., 2000; Feder & Dugan 2002; Labriola et al., 2005).

INNER STRENGTH
Is a 26-session group-based therapeutic intervention for perpetrators of domestic violence. It adopts a positive psychological, strength-based approach to reducing the empirically identified risk factors for domestic violence. These are emotional dysregulation, poor coping, low resilience, ineffective conflict resolution skills. Inner Strength integrates the Risk, Need and Responsivity (RNR) principals with a strength- based collaborative model of intervention. Inner Strength targets deficits related to domestic violence offending behaviour i.e. “criminogenic needs”.

Medium risk offenders are likely to have criminogenic needs around their psychological functioning. Personality disorder (PD) is common in domestic violence offenders. Overall offender populations have rates of personality disorder that are estimated to be up to 78% in remand populations (Singleton, 1998) and 70% in prison populations (MoJ, 2011). Rates differ by offence type, for example Schroeder: 26% of non-violent, 50% of violent, 33% of sexual and 68% of sexual-violent offenders had one or more PDs. Inner Strength recognises that many offenders have complex needs that Cognitive Behavioural Therapeutic (CBT) techniques alone cannot address, because CBT-focused interventions work at the cognitive level but cognition is severely impacted by intense emotion. Therefore, Inner Strength also uses Dialectical Behaviour Therapy techniques to build emotional regulation skills in conjunction with Cognitive Behavioural Therapeutic techniques.

ATTRITION
By December 2013 four cohorts of Inner Strength had been completed with attrition in the first three cohorts being zero and one participant lost on the last (fourth) cohort. This translates to 96% completion, which fairs very favourably with rates for other domestic violence programmes. Generally the literature suggests that between 50% and 75% of offenders who enrol in domestic violence treatment programmes fail to complete them. Those who drop out are higher risk than those who complete.

MEASURES
There were five questionnaires administered pre-programme and three post programme. The questionnaires were:
1. Partner Violence assessed by the Conflict Tactics Scale
2. Controlling Behaviours assessed by the Controlling Behaviours Scale-Revised
3. Emotional Awareness and regulation assessed by the Emotional Self-Efficacy Scale
4. Coping styles assessed by the Coping Styles Questionnaire
5. Resilience assessed by the Resilience Scale

THE COHORT
High levels of bidirectional (male to female and female to male) physical aggression, with no significant difference between reports about their own or their partners’ use of physical aggression, d = 0.29 (men higher)
High levels of bidirectional verbal aggression, with no significant difference between reports about their own or their partners’ use of verbal aggression rates of verbal aggression than their partners = 0.29 (men higher)
High levels of bidirectional controlling behaviours, no significant difference between reports about their own or their partners’ use of controlling behaviour, d = -0.21 (women higher)
High levels of bidirectional using children to control, with men saying their partner used significantly more of these behaviours than they did, d = -0.59 (women higher)

PSYCHOLOGICAL CHANGE
One essential principle for therapeutic change is that a study’s results must be not only significant but meaningful (Schuele & Justice, 2006). For this reason, current thinking is that effect sizes should be included in evaluations.

A commonly used measure of effect size is Cohen’s d. This allows the magnitude of the effect to be quantified and hence compared to other studies. In regards to the strength of effects, Cohen (1988) defined effect sizes as small, d = 0.2, medium, d = 0.5, and large, d = 0.8. Interventions for domestic violence usually find no or small (d=.20) effects of programme completion.

The effect sizes for the psychosocial change score are reported below in Table 1:
Table 1: Inner Strength participant change scores pre- to post-treatment

The data presented above demonstrates positive psychosocial change. All effect sizes are in the predicted direction. For emotional regulation there were very large, significant increases in all four measured aspects (Managing own emotions, Identifying own emotions, Dealing with other people’s emotions and Perceiving other people’s emotions from facial and body cues).

Coping with stress showed large, significant increases in helpful coping styles (Problem-focused and Detached coping) and reductions in unhelpful coping (Avoidant and Emotional coping). There was also a moderate increase in resilience (although this did not meet statistical significance with this small sample size).

REOFFENDING DATA COMPILED BY HMP FOREST BANK
This research has been conducted with a cohort of 31 individuals who have completed the course (between September 2012 to February 2014). At the date of this analysis (March, 2014) 58 % of those who took part in the programme have been released from custody.

METHODOLOGY
The method for research has been system checked using Police computers including PNC, OPUS and Icis. There has also been research for involvement in domestic violence calls to the police to provide a fuller picture.

RESULTS
No conviction evidence could be found for any of the cohort in relation to domestic violence reoffending since release.
There was one recorded arrest for violence which was to be tried at court. The offence was recorded by Lancashire Constabulary and therefore it is not possible to confirm whether this was domestic violence related. Further checks into involvement of the cohort in domestic violence incidents within Greater Manchester found only one individual, who was involved in two incidents. The incidents were recorded as being of a minor nature with Police deeming it unnecessary to speak to the individual on either occasion.

CONCLUSION
This preliminary data suggests that Inner Strength has been successful in engaging domestic violence offenders (as evidenced by the low attrition rates). The psychometrics suggests extremely encouraging therapeutic effects in reducing criminogenic needs. The reoffending data to date also suggests that Inner Strength graduates have thus far not been reconvicted of any domestic violence offences.

Overall, the information in this interim report suggests that adopting a strength-based approach based on empirically supported theory and best clinical practice may offer an effective means of reducing domestic violence