The Role of Food and Food Behaviors in Intimate Partner Violence

There is a paucity of research that systematically examines how food behaviors play a role in intimate partner violence (IPV). Therefore, this qualitative study aims to answer the broad question, what role do food behaviors play in intimate relationships? Food behavior narratives emerging from participants of court-mandated domestic violence (DV) offender treatment programs were analyzed using grounded theory methods. Five themes emerged. Two described inflammatory/harmful roles: (1) food as a trigger for anger and violence and (2) food as a mechanism of “othering.” One theme described the role of food behaviors in promoting unequal and equal relationships: (3) food as an embodiment of gender roles. Two themes described reconciliatory/beneficial roles: (4) food as a mechanism of recognition and (5) and food as a representation of group rapport. Food behaviors can escalate into conflicts but can also be used as a tool to resolve conflicts. Limitations and the need for future research are further discussed.

Forensic application of static and dynamic risk factors: Is it the right time?

It is common, accepted clinical practice to conduct risk assessments of individuals who commit sexual offenses using the combination of sexual violence risk actuarial measures and dynamic risk factors. This assessment approach has utility when identifying treatment targets, assessing progress in sexual offender treatment, and forming risk management plans. Little research has examined this method in forensic contexts such as deciding whether individuals who suffer from mental disorders are likely to engage in sexually dangerous behavior as defined by sexually violent predator or persons (“SVP”) involuntary civil confinement laws in the USA. In particular, it is uncertain whether the combination of sexual violence risk actuarial measures and dynamic risk factors (DRF) produces sufficiently reliable, relevant, and probative evidence for the trier of fact to properly evaluate the SVP legally defined likelihood of sexual dangerousness. This article explores the efficacy of combining actuarial measures of sexual violence risk and dynamic risk factors as applied in SVP risk assessments based on some commonly observed forensic practices among evaluators. Based on the analysis, recommendations for forensic practice and future research are offered.

A Pilot Study of the Swedish Sexual Offender Treatment Program

Purpose: The aim was to test whether dynamic criminogenic risk factors change after participation in a new cognitive-behavioral treatment program adhering to the Risk-Need-Responsivity (RNR) model, within a group of adult men convicted of a sexual offense in Sweden. Methods: Three psychometric tests from approximately 26 participants were completed. Therapists rated 46 participants using the Therapist Rating Scale-2 (TRS-2). Results: Participants reported a significant decrease in hypersexuality, small to medium effect size, a non-significant, increased, internal locus of control, but no change regarding attachment styles, posttreatment. Therapists rated significant decrease in all treatment needs posttreatment, medium to large effect size. Conclusions: The significant reduction of several criminogenic risk factors posttreatment indicates the treatment program may reduce problems related to increased risk of recidivism, especially hypersexuality. Moreover, treatment did not appear to have negative effects, motivating further implementation. However, to evaluate the effectiveness, more research is necessary.

Investigating the Relationship Between the Therapeutic Alliance and Treatment Outcome in Violent Offender Treatment

<p>The role of the therapeutic alliance (TA) has largely been ignored in the field of high-risk violent offender treatment. The focus on effective manualised treatment that reduces recidivism has led to improvements in treatment programme delivery, but at the cost of examining the therapy process. Considering previous research has consistently linked levels of alliance with treatment outcome in clinical and community treatment settings, it is imperative to investigate the role of the TA within high-risk violent offender treatment, because of the particularly challenging group that they represent. The aim of this thesis was to examine the relationship between the TA and treatment outcome, and the various factors that influence this relationship, within a violence prevention setting. To achieve this aim, a longitudinal study was conducted at the Rimutaka Violence Prevention Unit (RVPU) in Wellington, New Zealand, with a cohort of 70 men in treatment and their therapists, examining the TA, treatment outcome and associated variables over four time points throughout the eight month treatment programme. The results of this research are reported as four related studies. Study One explored the structure and patterns of the Working Alliance Inventory (WAI). Study One Part A was a Confirmatory Factor Analysis of the WAI, which tested the competing models of the factor structure of the WAI and explored whether rater perspective (client, therapist, observer) had an effect on the structure. It was found that a two-factor structure was the best fit for the WAI, and that all rater perspectives shared this structure. Study One Part B explored the pattern of the WAI over the four time periods of this study in order 8 to understand how the WAI changes over time, and whether this pattern differed by rater perspective. The results confirmed that changes in all rater perspectives showed a linearly increasing pattern of alliance over time. Study Two explored the client factors that affect the initial formation of the TA and examined whether these factors were specific to an "offender" or "general" client profile informed by previous research. Two client factors specific to an offender profile - motivation to change and criminal attitudes - were found to be significantly associated with the initial formation of the TA. Study Three examined the relationship between the TA and treatment outcome, and explored whether there were any factors that co-varied with or moderated this relationship. A small but significant association between alliance and outcome was found; however no significant co-varying or moderating factors were discovered. Lastly, Study Four drew together the data from Study Two and Study Three and tested whether these results fit the Revised Theory of the Therapeutic Alliance (RTTA) model (Ross, Polaschek, & Ward, 2008), or other models previously reported in the literature. Several significant models were found that partly supported the RTTA. The best of these models incorporated client motivation to change, TA and treatment outcome as measured by change in risk of violent reoffending. Overall, the results of this study support the importance of the TA and client motivation to change in violent offender treatment. The implications for these results and the clinical applications are discussed, limitations are outlined, and directions for future research are suggested.</p>

Investigating the Relationship Between the Therapeutic Alliance and Treatment Outcome in Violent Offender Treatment

<p>The role of the therapeutic alliance (TA) has largely been ignored in the field of high-risk violent offender treatment. The focus on effective manualised treatment that reduces recidivism has led to improvements in treatment programme delivery, but at the cost of examining the therapy process. Considering previous research has consistently linked levels of alliance with treatment outcome in clinical and community treatment settings, it is imperative to investigate the role of the TA within high-risk violent offender treatment, because of the particularly challenging group that they represent. The aim of this thesis was to examine the relationship between the TA and treatment outcome, and the various factors that influence this relationship, within a violence prevention setting. To achieve this aim, a longitudinal study was conducted at the Rimutaka Violence Prevention Unit (RVPU) in Wellington, New Zealand, with a cohort of 70 men in treatment and their therapists, examining the TA, treatment outcome and associated variables over four time points throughout the eight month treatment programme. The results of this research are reported as four related studies. Study One explored the structure and patterns of the Working Alliance Inventory (WAI). Study One Part A was a Confirmatory Factor Analysis of the WAI, which tested the competing models of the factor structure of the WAI and explored whether rater perspective (client, therapist, observer) had an effect on the structure. It was found that a two-factor structure was the best fit for the WAI, and that all rater perspectives shared this structure. Study One Part B explored the pattern of the WAI over the four time periods of this study in order 8 to understand how the WAI changes over time, and whether this pattern differed by rater perspective. The results confirmed that changes in all rater perspectives showed a linearly increasing pattern of alliance over time. Study Two explored the client factors that affect the initial formation of the TA and examined whether these factors were specific to an "offender" or "general" client profile informed by previous research. Two client factors specific to an offender profile - motivation to change and criminal attitudes - were found to be significantly associated with the initial formation of the TA. Study Three examined the relationship between the TA and treatment outcome, and explored whether there were any factors that co-varied with or moderated this relationship. A small but significant association between alliance and outcome was found; however no significant co-varying or moderating factors were discovered. Lastly, Study Four drew together the data from Study Two and Study Three and tested whether these results fit the Revised Theory of the Therapeutic Alliance (RTTA) model (Ross, Polaschek, & Ward, 2008), or other models previously reported in the literature. Several significant models were found that partly supported the RTTA. The best of these models incorporated client motivation to change, TA and treatment outcome as measured by change in risk of violent reoffending. Overall, the results of this study support the importance of the TA and client motivation to change in violent offender treatment. The implications for these results and the clinical applications are discussed, limitations are outlined, and directions for future research are suggested.</p>

Assessing States’ Intimate Partner Violence Offender Treatment Standards using a Principles of Effective Intervention Framework

Court-ordered treatment programs are a widely used response to intimate partner violence (IPV) and many states have developed standards to guide programs. The current study provides an update to Maiuro and Eberle’s. (2008) review of states’ standards and extends the literature by using the principles of effective intervention (PEIs; i.e., risk, need, responsivity, treatment, and fidelity) as an organizational framework to examine standards. Findings showed that 84% of states had standards in 2020, compared to 88% in 2007, and extensive changes both within and across states’ standards had occurred. Regarding the PEIs, in line with the risk principle most states mandated the use of risk assessments; inconsistent with the needs principle, few states used these assessments to classify clients into risk levels or inform individualized treatment. The majority of standards addressed the treatment principle by outlining a required structure and duration, but few attended to responsivity factors (e.g., identifying treatment modalities, attending to specific client factors). Regarding the fidelity principle, most standards outlined education or training requirements for staff and required periodic program reviews or audits, but few standards were evidenced-based and only about half required that programs collect data to measure effectiveness. Taken together, findings suggest that standards have continued to evolve and that the integration of PEIs into IPV treatment is only just beginning. Standards provide a rich opportunity for future researcher–practitioner partnerships in the field of IPV intervention.

Victim empathy-based content in aggression treatment: exploring impact within a secure forensic hospital

Purpose This study aims to explore the impact of inclusion of victim empathy-based content in offender treatment. Design/methodology/approach This study first presents a systematic review of 20 papers before proceeding to consider qualitative interviews with therapists (n = 7) and forensic patients (n = 5), who had completed a long-term violence therapy (Life Minus Violence – Enhanced, LMV-E©). The research explored perceptions of forensic patients and treatment facilitators when completing victim empathy work and explored any negative effects this may have. Findings Findings from the systematic review indicated five themes: interventions incorporating victim empathy can be effective; there are positive risk-understanding consequences from completing victim empathy work; offenders perceive victim empathy positively; the emotional impact of victim empathy work on offenders’ is poorly explored; and completing victim empathy in treatment groups receives mixed evaluations from offenders. The systematic review was used to inform the interview themes for the resulting qualitative study with facilitators and forensic patients. This study indicated six themes: victim empathy content facilitates change; victim empathy content can be difficult for patients; victim empathy content can lead to an emotional response; victim empathy content can be beneficial, with the process important; victim empathy content can help understand risk, and patients’ experience of treatment begins before attending sessions. Practical implications The potential impact of victim empathy content needs to be evaluated before sessions are completed, accounting for client expectations and treatment readiness. This should include ensuring that appropriate support is in place. Any support provided to patients should be regularly reviewed. Originality/value The study represents the first to apply detailed analysis to this topic area and with a complex group.

International overview of phallometric testing for sexual offending behaviour and sexual risk

Phallometry is an objective method of assessing male sexual arousal. The main applications in forensic psychiatry concern the evaluation of men charged with or convicted of sexual offences, the evaluation of those with suspected paraphilias not subject to the criminal justice system, risk assessment and measurement of response to sex offender treatment. In some jurisdictions, phallometry is incorporated into legal decisions about release from custody or discharge from secure hospitals. This paper provides a brief overview of the international development of phallometry, considers challenges to its broader adoption and discusses future directions for research and clinical practice.