Title:
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Exploring the Impact of the Therapeutic Alliance and Structural Factors in Treatment Groups for Domestically Abusive Men
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This research explored domestic abuse perpetrator group dynamics with
especial attention to the vital role ofthe therapeutic alliance and the
constructions men have of their own narratives; it provides important lessons.
for future efficacy research with its attention to group process rather than a
focus on measurable outcomes. Three Programmes participated and differed
from each other on characteristics such as duration and approach; one was
mainly therapeutic with additional cognitive-behavioural aspects (Programme
A), one was mainly cognitive-behavioural with additional therapeutic aspects
(Programme B), and one was the Home Office accredited Integrated Domestic
Abuse Programme (IDAP) (cognitive-behavioural only) (Programme C). The
data set was comprised of interviews with men from each programme
(completers and non-completers, n=20), 50 hours of reviewed sessions from
each Programme, and a Staff Day. The method of analysis for the interview
data was based on the psychoanalytic defended subject, Free Association
Narrative Analysis.
RESULTS
Key findings from this research are: that there were therapeutic
alliances in the group between the facilitators and the participants and in one
instance between participants; that even a strong alliance needed sufficient time
to be of greater benefit to the participant; and that negative and neutral alliances
generally appeared unsupportive of treatment goals. Facilitation and structural
factors facilitating a robust alliance were: attention to feelings, leavings and loss; consistently high quality facilitation; boundaried compassion; gender
equality; group alliance; appropriate facilitator sharing; organisational clarity;
motivational interviewing; individual session work; longer length and content
flexibility. Factors found to undermine the alliance were: inconsistent
facilitation; disrespectful communication; inattention to feelings, loss and
leavings; pedagogy; shaming; content rigidity and lack of organisational clarity.
The term 'boundaried compassion' was developed to bridge the necessity to
label some behaviours as unacceptable whilst being compassionate to the
person.
Additional findings: the high quality facilitation in the context ofa brief
intervention (15 weeks for Programme B) was experienced as genuinely
traumatic for most of their respondents. Combining CBT and other therapeutical
approaches appears complimentary. When men were committed to the process
of change, they fell into two categories: putting a 'leash' on (controlling) their
anger, and 'breaking down the mask' of their defences (changing fundamental
attitudes and beliefs, including those regarding masculinity).
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