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Transforming Destructive into Constructive


             DV THERAPIST
                GUIDE




  A COLLABORATIVE/NARRATIVE MODEL IN
          OFFENDER TREATMENT

                                BY ROD MINAKER
Copyright 2010 by Bergen and Associates Counselling. ALL RIGHTS RESERVED. Any use of materials,
  including reproduction, modification, distribution or republication, without the prior written consent of
                        Bergen and Associates Counselling is strictly prohibited.


                      FIRST EDITION 09/27/2010
1




    1
2




Contracting with Client Introduction
Close contracting needs to occur within this phase of therapy. It would be worthwhile to have the
following items completed prior to therapy
    • Release of Information to speak with the Crown or Lawyer to ascertain the
       allegations/charges made against the client
    • Phone/live session with the partner in the domestic incident
    • Conflict Tactics Scale completed by client and partner (about client)

From the information given above, it would be advisable to produce a behavioral specific statement
about the incident(s), e.g.:
David hit his wife Joanne three times last Sunday night after drinking “more than 2 six packs”
leaving bruises on both his face and back. David has called Joanne a “fat whore” 5 times in the
past year. David has insisted on sex with Joanne when she didn’t want to. Joanne has had bruising
on her wrists and arms as a result of two of their final conflicts. David controls all of the household
income giving Joanne an allowance of $25.00 per week.
Try to avoid:
    • David abused Joanne while drunk
    • David is an alcoholic who abuses his wife
    • David is an alcoholic who hit his wife

Jenkins Invitation to Responsibility
Repositioning Shame
Have you ever begun to look at it this closely before?
   • With your eyes wide open?
   • Beginning to see it like it really is?
   • Not like you wish it was?
What are you realizing?
What are you seeing?
What difference is it making?
How does it affect you?
How are you managing to stay with it?

Identity and Preferred Direction
What difference does it make when you call it abuse?
Is this the right direction for you to be taking?
Does it fit with the kind of person you want to be?
How will it help you?
Will it make you stronger or weaker?

Past Attempts to Reconcile
You have made apologies many times but have you ever looked this closely before?
What are you realizing about these apologies?
What would an apology mean without this level of realization?

                                                                                                          2
3




Jenkins Inquiry Continued
Empathy for Partner
Who has carried the hurt and humiliation about this incident in the past?
Who needs to carry it?
Whose job is it?
What would it mean if you left it for (Sue) to carry?
Can you afford to do this?

Personal Responsibility
How are you beginning to take this on your shoulders?
Will it make you stronger or weaker?
How will it help you?
   • Ensure you never abuse again?
   • Treat Sue with genuine respect?
   • Make restitution to Sue?
   • Become the person you want to be?

Appeals to an Ethical Self
How does this step fit with being ‘the guy’ you really are?
How much can you respect the step you are taking?
How will this step help you quit abusive behavior?
How will this step help you make amends? To your family? Yourself? To your community?
How will this step help you show your true colors?

HOMEWORK/IN-SESSION COLLABORATION
Creating Alignment for Therapy
In 25 words or less, where would the client say your work together is headed?
In 25 words or less, what would you say your work with this client is headed?




                                                                                        3
4



                                     (see Externalizing Section)




Individual Factors
Substance Abuse Assessment (CAGE-AID)
CUTOFF/ANNOYANCE/GUILT/EYE OPENER on a scale of 1-5 (5 being the most severe)
    1. Have you ever felt you ought to cut down on your drinking or drug use?
    2. Have people annoyed you by criticizing your drinking or drug use?
    3. Have you felt bad or guilty about your drinking or drug use?
    4. Have you ever had a drink or used drugs first thing in the morning to steady your nerves or to
        get rid of a hangover (eye-opener)?
Scoring: Item responses on the CAGE are scored 0 for "no" and 1 for "yes" answers, with a higher
score an indication of alcohol problems. A total score of 2 or greater is considered clinically
significant.

Personal Stress Profile

Relational Factors
History of Couple Conflict

Power and Control Behaviors
(see Power/Control Wheel)

Conflict Communication Style
Passive /Passive-Aggressive /Aggressive /Assertive

Cultural/Family History Factors
Reflexive Cultural Interview
Cultural Education
In (your country of origin)
    • How do people resolve conflicts?
    • What is considered an unacceptable behavior for women/men when in conflict?
    • What actions are used to point out what is unacceptable from the other person?
    • What are these actions meant to communicate? What do they communicate to the recipient?
    • How would you compare how you settle conflicts in comparison to people from your culture?

Growing the Exception
   • Have you ever gone against common practices in your culture?
   • What does this say about you as a person (in the context of what role they are in)?
   • If you were to resolve conflicts with your partner in a non-violent way, would this be more or
     less honorable in (your country of origin)?
   • How would you think of yourself if you could successfully resolve conflict in a non-violent
     way?
                                                                                                        4
5


                                    (see Externalizing Section)




Cultural/Family History Factors
Reflexive Cultural Interview
Appreciative Inquiry
   • Since coming to Canada what are some of the benefits you enjoy that you did not have in
       (your country of origin)?
   • What is it like for you and your family to have these benefits?
   • To whom do you talk about these benefits with?
   • If you knew that it was against Canadian Law to (description of controlling violent behavior)
       your spouse/partner or anyone, what sort of actions should be discarded and what actions
       should be kept in conflict situations

Reflexive Family History Interview
Anger Inquiry
   • As a child, could you tell when your mother/father was angry? What did it look like?
   • What impact did your parents’ anger have on you? Others?
   • What toll has your parents’ anger taken on your life?
   • What effects has their anger had on others close to you?
   • Has this learned anger created problems for you in relationships? If so, in what ways?

Growing the Exception
   • Which of your parents’ behaviors that you notice in yourself would you want to “live on”?
     Let go of?
   • How would you rather live your life?
   • What do these intentions say about who you are?
   • Can you think of a time when you were able to manage your anger?
   • What does it mean to you that you have been able to do this?
   • What abilities or know-how does it show?




                                                                                                     5
6


                                     (see Externalizing Section)




Power/ Control Wheel
All abusive actions come from a context of power and control over the other person. Below is an
exhaustive list of ways people utilize power and control in relationships. What is the way your anger
“tricks” you into expressing itself inappropriately?




                                                                                                        6
7


                                      (see Externalizing Section)




Externalizing Interviewing

Purpose of “Experience of the Problem” Questions
To separate the problem from the person through externalizing language and develop a rich
understanding of a person’s experience of their relationship with that problem.

Purpose of “Effects of the Problem” Questions
To develop a thorough understanding of the effects the problem has had on the person in different
aspects and different relationships in their life. While we may learn about mixed effects and possibly
beneficial effects, the primary focus is on negative effects of the problem.




Purpose of “Preferences about the Problem” Questions
To invite a person to consider how the problem’s effects fit or don’t fit with their preferred direction
in life. To offer them an opportunity to take a position in relation to the problem, make their
intentions and values known, and mobilize emotional energy behind that position.

Purpose of “Response to the Problem” Questions
To elicit and elaborate a story of the person’s efforts to develop a different relationship with the
problem (which may be to resist it, oppose it, overcome it, cope with it, contain or outgrow it, use it
constructively, etc.). To invite the person to give meaning to this story and examine future
possibilities as that story unfolds.


                                                                                                           7
8


                                    (see Externalizing Section)




Externalizing Interviewing
Experience of the Problem
   • In what situations is XX most likely to come into your life?
   • How do you notice it when XX shows up?
   • What’s it like having XX in your life?
Effects of the Problem
   • When XX comes into your life, what effects does it have on you?
   • What has XX gotten you to do that goes against your better judgment?
   • What toll has XX taken on your life? (inquire about various aspects of life)
   • What effects has XX had on others close to you?
   • Has XX created problems for you in relationships? If so, in what ways?
   • What does XX try to convince you about yourself?
   • If XX were making decisions for you, where would it take you in your life?
   • If XX were to get stronger in your life over the next 6 months, what do you think your life
       would look like then?
Preferences about the Effects of the Problem
   • As you think about the various effects XX has had on your life and relationships, would you
       say these are positive or negative developments?
   • Are those effects something you’d like more of or less of in your life?
   • Why is that? In what ways do these effects fit or not fit with your hopes for your life?
   • Where would you rather take your life?
   • What do those intentions say about who you are and what you stand for in your life?
Response to the Effects of the Problem
   • You say that you don’t like the effects of XX and that you would like to find a way to keep it
       in its place. Towards that end, would it be okay if I ask you a little about some of your
       success in doing that?
   • Can you think of a time when you were able to keep XX in its place a bit or keep on in the
       face of its attempts to hold you back?
   • What did you do differently? How did you do that? Who helped you to do that? When or
       where are you more able to do that? (Go for details.)
   • What steps did you take to develop a different relationship to XX? What did you do first?
       Then what?
   • Was this a new development for you or have there been times in the past when you were able
       to do that?
   • What does it mean to you that you’ve been able to do this?
   • What does it tell you about yourself?
   • What capacities or abilities or know-how does it show?
   • How did you develop those capacities? Who helped you in developing them?
   • How would you describe somebody who was able to do that? Does that description fit for
       you?
                                                                                                      8
9




Individual
Help client identify which strengths in the Equality Wheel would resonate with the client and his/her
partner. Scaffold questions: identifying observable behavior, the intentions of such behavior, the
purpose of these intentions, the values inherent in such a purpose(s), and hopes/dreams/outcomes
that will result.




                                                                                                        9
10




     10
11




Relational




Step 1:
   • Identify people or beings (alive or dead, real or imagined) in the person’s past or present who
        would could serve as allies; recognizing, appreciating and standing in support of the person’s
        preferred response to problems or pursuit of preferred directions in life.
   • Get details of that relationship and its importance to both the person and ally.

Step 2:
   • Elicit specific times in which the ally witnessed examples of life outside the problematic
        story or within the alternative story.
   • Elicit a detailed story of those events (e.g. who, what, where, when, and how) and their
        meaning through the ally’s perspective.

Step 3:
   • Weave together contributions the ally has made to the person’s life and possible contributions
        the person has made to the ally’s life.
   • Explore the effects of these reciprocal contributions and their respective implications for the
        person’s identity.

Step 4:
   • Link the conversation to the present situation and to future possibilities.
   • Inquire whether the person would be interested in bringing the ally’s presence more into their
        current life as a community of support for preferred directions in life.



                                                                                                     11
12




     12
13




Fals-Stewart, William and Clinton-Sherrod, Monique. (2009). Treating Intimate Partner Violence
       Among Substance-Abusing Dyads: The Effect of Couples Therapy. Professional Psychology:
       Research and Practice. Vol. 40(3): 257–263.

Harris, Gregory E. (2006). Conjoint therapy and domestic violence: Treating the individuals and the
        relationship. Counselling Psychology Quarterly. 19(4): 373–379.

Jenkins, Alan. (1990). Invitations to Responsibility: The Therapeutic Engagement of Men Who are
       Violent and Abusive. Adelaide: Dulwich Centre Publications.

Madsen, W.C. (2009). Collaborative helping: A practice framework for family-centered
      services. Family Process, 48: 103-116.

Musser, Peter H. and Murphy, Christopher M. (2009). Motivational Interviewing With Perpetrators
      of Intimate Partner Abuse. Journal of Clinical Psychology: In Session. Vol. 65(11): 1218-
      1231.




                                                                                                  13
Transforming Destructive into Constructive

     BERGEN & ASSOCIATES
        COUNSELLING




                                   Bergen & Associates is a counselling
                                   center that provides individual, couple,
                                       and family therapy in addition to
                                    TDC. Experienced therapists with a
                                   variety of expertise work with clients to
  Carolyn O Bergen                   help them reach their goals in their          Rod Minaker
Carolyn’s experience             relationships with themselves and others.     Rod has been leading
includes working with                   www.bergenandassociates.ca             anger management
men and women as                                                               groups for men and
individuals, couples and                                                       women since 2007.
families in a counselling                                                      Rod’s passion is to
setting. She has 20                                                            empower men and
years of experience                                                            women to manage their
working as a therapist,                                                        anger utilizing evidence-
over 8 years in her                                                            based research to date
present setting.

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Domestic Violence Therapist Guide

  • 1. Transforming Destructive into Constructive DV THERAPIST GUIDE A COLLABORATIVE/NARRATIVE MODEL IN OFFENDER TREATMENT BY ROD MINAKER Copyright 2010 by Bergen and Associates Counselling. ALL RIGHTS RESERVED. Any use of materials, including reproduction, modification, distribution or republication, without the prior written consent of Bergen and Associates Counselling is strictly prohibited. FIRST EDITION 09/27/2010
  • 2. 1 1
  • 3. 2 Contracting with Client Introduction Close contracting needs to occur within this phase of therapy. It would be worthwhile to have the following items completed prior to therapy • Release of Information to speak with the Crown or Lawyer to ascertain the allegations/charges made against the client • Phone/live session with the partner in the domestic incident • Conflict Tactics Scale completed by client and partner (about client) From the information given above, it would be advisable to produce a behavioral specific statement about the incident(s), e.g.: David hit his wife Joanne three times last Sunday night after drinking “more than 2 six packs” leaving bruises on both his face and back. David has called Joanne a “fat whore” 5 times in the past year. David has insisted on sex with Joanne when she didn’t want to. Joanne has had bruising on her wrists and arms as a result of two of their final conflicts. David controls all of the household income giving Joanne an allowance of $25.00 per week. Try to avoid: • David abused Joanne while drunk • David is an alcoholic who abuses his wife • David is an alcoholic who hit his wife Jenkins Invitation to Responsibility Repositioning Shame Have you ever begun to look at it this closely before? • With your eyes wide open? • Beginning to see it like it really is? • Not like you wish it was? What are you realizing? What are you seeing? What difference is it making? How does it affect you? How are you managing to stay with it? Identity and Preferred Direction What difference does it make when you call it abuse? Is this the right direction for you to be taking? Does it fit with the kind of person you want to be? How will it help you? Will it make you stronger or weaker? Past Attempts to Reconcile You have made apologies many times but have you ever looked this closely before? What are you realizing about these apologies? What would an apology mean without this level of realization? 2
  • 4. 3 Jenkins Inquiry Continued Empathy for Partner Who has carried the hurt and humiliation about this incident in the past? Who needs to carry it? Whose job is it? What would it mean if you left it for (Sue) to carry? Can you afford to do this? Personal Responsibility How are you beginning to take this on your shoulders? Will it make you stronger or weaker? How will it help you? • Ensure you never abuse again? • Treat Sue with genuine respect? • Make restitution to Sue? • Become the person you want to be? Appeals to an Ethical Self How does this step fit with being ‘the guy’ you really are? How much can you respect the step you are taking? How will this step help you quit abusive behavior? How will this step help you make amends? To your family? Yourself? To your community? How will this step help you show your true colors? HOMEWORK/IN-SESSION COLLABORATION Creating Alignment for Therapy In 25 words or less, where would the client say your work together is headed? In 25 words or less, what would you say your work with this client is headed? 3
  • 5. 4 (see Externalizing Section) Individual Factors Substance Abuse Assessment (CAGE-AID) CUTOFF/ANNOYANCE/GUILT/EYE OPENER on a scale of 1-5 (5 being the most severe) 1. Have you ever felt you ought to cut down on your drinking or drug use? 2. Have people annoyed you by criticizing your drinking or drug use? 3. Have you felt bad or guilty about your drinking or drug use? 4. Have you ever had a drink or used drugs first thing in the morning to steady your nerves or to get rid of a hangover (eye-opener)? Scoring: Item responses on the CAGE are scored 0 for "no" and 1 for "yes" answers, with a higher score an indication of alcohol problems. A total score of 2 or greater is considered clinically significant. Personal Stress Profile Relational Factors History of Couple Conflict Power and Control Behaviors (see Power/Control Wheel) Conflict Communication Style Passive /Passive-Aggressive /Aggressive /Assertive Cultural/Family History Factors Reflexive Cultural Interview Cultural Education In (your country of origin) • How do people resolve conflicts? • What is considered an unacceptable behavior for women/men when in conflict? • What actions are used to point out what is unacceptable from the other person? • What are these actions meant to communicate? What do they communicate to the recipient? • How would you compare how you settle conflicts in comparison to people from your culture? Growing the Exception • Have you ever gone against common practices in your culture? • What does this say about you as a person (in the context of what role they are in)? • If you were to resolve conflicts with your partner in a non-violent way, would this be more or less honorable in (your country of origin)? • How would you think of yourself if you could successfully resolve conflict in a non-violent way? 4
  • 6. 5 (see Externalizing Section) Cultural/Family History Factors Reflexive Cultural Interview Appreciative Inquiry • Since coming to Canada what are some of the benefits you enjoy that you did not have in (your country of origin)? • What is it like for you and your family to have these benefits? • To whom do you talk about these benefits with? • If you knew that it was against Canadian Law to (description of controlling violent behavior) your spouse/partner or anyone, what sort of actions should be discarded and what actions should be kept in conflict situations Reflexive Family History Interview Anger Inquiry • As a child, could you tell when your mother/father was angry? What did it look like? • What impact did your parents’ anger have on you? Others? • What toll has your parents’ anger taken on your life? • What effects has their anger had on others close to you? • Has this learned anger created problems for you in relationships? If so, in what ways? Growing the Exception • Which of your parents’ behaviors that you notice in yourself would you want to “live on”? Let go of? • How would you rather live your life? • What do these intentions say about who you are? • Can you think of a time when you were able to manage your anger? • What does it mean to you that you have been able to do this? • What abilities or know-how does it show? 5
  • 7. 6 (see Externalizing Section) Power/ Control Wheel All abusive actions come from a context of power and control over the other person. Below is an exhaustive list of ways people utilize power and control in relationships. What is the way your anger “tricks” you into expressing itself inappropriately? 6
  • 8. 7 (see Externalizing Section) Externalizing Interviewing Purpose of “Experience of the Problem” Questions To separate the problem from the person through externalizing language and develop a rich understanding of a person’s experience of their relationship with that problem. Purpose of “Effects of the Problem” Questions To develop a thorough understanding of the effects the problem has had on the person in different aspects and different relationships in their life. While we may learn about mixed effects and possibly beneficial effects, the primary focus is on negative effects of the problem. Purpose of “Preferences about the Problem” Questions To invite a person to consider how the problem’s effects fit or don’t fit with their preferred direction in life. To offer them an opportunity to take a position in relation to the problem, make their intentions and values known, and mobilize emotional energy behind that position. Purpose of “Response to the Problem” Questions To elicit and elaborate a story of the person’s efforts to develop a different relationship with the problem (which may be to resist it, oppose it, overcome it, cope with it, contain or outgrow it, use it constructively, etc.). To invite the person to give meaning to this story and examine future possibilities as that story unfolds. 7
  • 9. 8 (see Externalizing Section) Externalizing Interviewing Experience of the Problem • In what situations is XX most likely to come into your life? • How do you notice it when XX shows up? • What’s it like having XX in your life? Effects of the Problem • When XX comes into your life, what effects does it have on you? • What has XX gotten you to do that goes against your better judgment? • What toll has XX taken on your life? (inquire about various aspects of life) • What effects has XX had on others close to you? • Has XX created problems for you in relationships? If so, in what ways? • What does XX try to convince you about yourself? • If XX were making decisions for you, where would it take you in your life? • If XX were to get stronger in your life over the next 6 months, what do you think your life would look like then? Preferences about the Effects of the Problem • As you think about the various effects XX has had on your life and relationships, would you say these are positive or negative developments? • Are those effects something you’d like more of or less of in your life? • Why is that? In what ways do these effects fit or not fit with your hopes for your life? • Where would you rather take your life? • What do those intentions say about who you are and what you stand for in your life? Response to the Effects of the Problem • You say that you don’t like the effects of XX and that you would like to find a way to keep it in its place. Towards that end, would it be okay if I ask you a little about some of your success in doing that? • Can you think of a time when you were able to keep XX in its place a bit or keep on in the face of its attempts to hold you back? • What did you do differently? How did you do that? Who helped you to do that? When or where are you more able to do that? (Go for details.) • What steps did you take to develop a different relationship to XX? What did you do first? Then what? • Was this a new development for you or have there been times in the past when you were able to do that? • What does it mean to you that you’ve been able to do this? • What does it tell you about yourself? • What capacities or abilities or know-how does it show? • How did you develop those capacities? Who helped you in developing them? • How would you describe somebody who was able to do that? Does that description fit for you? 8
  • 10. 9 Individual Help client identify which strengths in the Equality Wheel would resonate with the client and his/her partner. Scaffold questions: identifying observable behavior, the intentions of such behavior, the purpose of these intentions, the values inherent in such a purpose(s), and hopes/dreams/outcomes that will result. 9
  • 11. 10 10
  • 12. 11 Relational Step 1: • Identify people or beings (alive or dead, real or imagined) in the person’s past or present who would could serve as allies; recognizing, appreciating and standing in support of the person’s preferred response to problems or pursuit of preferred directions in life. • Get details of that relationship and its importance to both the person and ally. Step 2: • Elicit specific times in which the ally witnessed examples of life outside the problematic story or within the alternative story. • Elicit a detailed story of those events (e.g. who, what, where, when, and how) and their meaning through the ally’s perspective. Step 3: • Weave together contributions the ally has made to the person’s life and possible contributions the person has made to the ally’s life. • Explore the effects of these reciprocal contributions and their respective implications for the person’s identity. Step 4: • Link the conversation to the present situation and to future possibilities. • Inquire whether the person would be interested in bringing the ally’s presence more into their current life as a community of support for preferred directions in life. 11
  • 13. 12 12
  • 14. 13 Fals-Stewart, William and Clinton-Sherrod, Monique. (2009). Treating Intimate Partner Violence Among Substance-Abusing Dyads: The Effect of Couples Therapy. Professional Psychology: Research and Practice. Vol. 40(3): 257–263. Harris, Gregory E. (2006). Conjoint therapy and domestic violence: Treating the individuals and the relationship. Counselling Psychology Quarterly. 19(4): 373–379. Jenkins, Alan. (1990). Invitations to Responsibility: The Therapeutic Engagement of Men Who are Violent and Abusive. Adelaide: Dulwich Centre Publications. Madsen, W.C. (2009). Collaborative helping: A practice framework for family-centered services. Family Process, 48: 103-116. Musser, Peter H. and Murphy, Christopher M. (2009). Motivational Interviewing With Perpetrators of Intimate Partner Abuse. Journal of Clinical Psychology: In Session. Vol. 65(11): 1218- 1231. 13
  • 15. Transforming Destructive into Constructive BERGEN & ASSOCIATES COUNSELLING Bergen & Associates is a counselling center that provides individual, couple, and family therapy in addition to TDC. Experienced therapists with a variety of expertise work with clients to Carolyn O Bergen help them reach their goals in their Rod Minaker Carolyn’s experience relationships with themselves and others. Rod has been leading includes working with www.bergenandassociates.ca anger management men and women as groups for men and individuals, couples and women since 2007. families in a counselling Rod’s passion is to setting. She has 20 empower men and years of experience women to manage their working as a therapist, anger utilizing evidence- over 8 years in her based research to date present setting.