Practice Profile: Interventions for Persons Who Committed Intimate-Partner Violence: Cognitive Behavioral Therapy

The practice includes interventions that are designed to reduce partner violence by identifying and changing the thought processes leading to violent acts and teaching new skills to control and change their behavior. These interventions use cognitive behavioral therapy as applied in a domestic violence setting. The practice is rated Ineffective in recidivism outcomes for violent offenses and ineffective in reducing victimization.

Practice Goals/Practice Theory

Cognitive Behavioral Therapy (CBT) interventions for domestic violence were developed by psychologists to treat violent behavior. These interventions approach violence as a learned behavior; thus, according to the CBT model of psychology, nonviolence can also be learned by those who may potentially perpetrate a crime. CBT attempts to change the behavior by identifying the thought processes and beliefs that contribute to the violence. Physically abusive men are encouraged to think about and change their understanding of violence, examine the circumstances surrounding their violence, and disrupt the cognitive chain that leads to their commission of violent acts of domestic abuse. By demonstrating how they use violence as an anger outlet, obtain compliance from their victims, and empower themselves with a sense of control, therapists encourage change in their thoughts about violence while teaching them cognitive behavioral techniques such as communication skills, nonviolent assertiveness, social skills, and anger management. Usually, CBT models of treatment for domestic violence also address the emotions underlying the violent behaviors and the their attitudes toward women.

Target Population

The target population of CBT for domestic violence almost exclusively comprises male batterers. However, although not reviewed here, the principles of CBT interventions can be transposed to other treatment settings and offender types.

Practice Components

CBT is a form of psychotherapy that focuses on patterns of thinking and the beliefs, attitudes, and values that underlie that thinking. It is not a distinct therapeutic technique, but rather a general term for a classification of similar therapies. These specific approaches include rational-emotive behavior therapy, rational behavior therapy, rational living therapy, cognitive therapy, and dialectic behavior therapy. Participants in CBT programs learn specific skills that they can use to effectively solve daily problems and to achieve legitimate goals and objectives.

Structurally, CBT is often composed of six phases. These phases include 1) assessment, 2) reconceptualization, 3) skills acquisition, 4) skills consolidation and application, 5) generalization and maintenance, and 6) follow-up treatment. While the specific phases may differ from program to program, all CBT-based programs encourage participants to first develop their ability to recognize distorted or unrealistic thinking when it happens, and then to change that thinking to eliminate problematic behavior.

A typical CBT program is provided by trained professionals or paraprofessionals (Clark 2011). Licensed and certified therapists often deliver CBT programs in small-group settings and incorporate lessons and exercises involving role play, modeling, and demonstrations. Individual counseling sessions are also often part of CBT. Clients are given homework and actually conduct experiments on their own between sessions. Some of the specific therapeutic techniques used in CBT programs may include

• Self-instruction using imagery, affirmations, or motivational self-talk
• Coping techniques for negative thoughts
• Relaxation techniques
• Exposing the person to a fearful situation, gradually undoing the automatic negative response, and presenting a positive response
• Role play
• Graded task assignments

Additional Information

Another model of interventions targeted at people convicted of domestic violence is the Duluth Model. There are a number of differences between interventions for domestic violence that use CBT and interventions that use the Duluth Model. One main difference between the two types of interventions is in the theories underlying each. With CBT, violence is viewed as a learned behavior, which can be addressed by changing patterns of thinking and promoting and reinforcing nonviolent alternatives. The Duluth Model proposes that the principal cause of domestic violence is a social and cultural patriarchal ideology that historically has allowed men to control women through power and violence; the model does not assume that domestic violence is caused by mental or behavioral health problems, substance use, anger, stress, or dysfunctional relationships. The Duluth Model focuses on changing dominant and controlling behaviors, to foster more egalitarian relationships. In addition, CBT is a therapeutic approach, whereas the Duluth Model is viewed as psychoeducational programming (Babcock et al. 2004; Arias, Arce, and Vilariño. 2013) However, the distinctions between the two models are often unclear (Babcock et al. 2004).

These sources were used in the development of the practice profile:

These sources were used in the development of the practice profile:

Clark, Patrick M. 2011. “Cognitive Behavioral Therapy: An Evidence-Based Intervention for Offenders.” Corrections Today 73(1):62–64.

Arias, Esther, Ramón Arce, and Manuel Vilariño. 2013. “Batterer Intervention Programmes: A Meta-Analytic Review of Effectiveness.” Psychosocial Intervention 22:153–60. (This meta-analysis was reviewed but did not meet CrimeSolutions criteria for inclusion in the overall outcome rating.)

Following are CrimeSolutions-rated programs that are related to this practice:

Strength at Home Couples (SAH-C) Program to Prevent Military Partner Violence

EVOLVE: Court-Mandated Program for Serious Male Batterers

Explore, Question, Understand, Investigate and Practice, Plan, Succeed (EQUIPS) Domestic Abuse Program (New South Wales, Australia)

Why might a practice's outcome ratings differ from the ratings of specific programs encompassed by that practice?