The effectiveness of cognitive behaviour psychotherapy for male perpetrators of domestic violence who voluntarily seek help

Research suggests that domestic abuse is a hidden crime in society which leaves victims living in fear and isolation. Many healthcare and community prevention strategies have been implemented to support women and children yet there is a lack of evaluated research on the effectiveness of intervention programmes for perpetrators who voluntarily seek help. This study aims to develop and evaluate a schema focused model of aggression and therapeutic approach specifically for perpetrators of domestic abuse who voluntarily seek help. A comparison is drawn between Completers and Non-Completers of the therapy programme to determine developmental and maintenance interference factors to effectiveness. The Aggression Schema Model (ASM) proposes that bio-evolutionary functions, attachment needs, learning and repetition in conjunction with formative childhood and adulthood experiences influence the development of hostile cognitions and interacting cognitive subsystems. Implicational meanings further influence affect and behaviour regulation. Abuser Schema Therapy (AST) is designed to transform hostile implicational meanings which are relevant to aggressive behaviour. AST is based on a gender-neutral, non confrontational approach to therapeutic intervention and process. A realist methodological approach was adopted and a quasi-experimental design applied. Self report measures of aggression, reaction, assertiveness and dysfunctional attitude were administered pre and post therapy. Qualitative data was attained from case studies, semi-structured assessments and questionnaires. The ASM and AST are critically discussed. The quantitative findings indicated a significant reduction in physical aggression, hostility and anger, whereas verbal aggression did not significantly change over time. Further reactions to anger provoking situations and assertiveness were significantly reduced and dysfunctional attitudes indicated factors improving to psychological strengths and increase in self-esteem. The results were maintained after a 3-month follow-up Interference factors to completion of AST are identified and discussed and case studies are reported which illustrate bio-evolutionary functions, attachment relationships and formative experiences pertinent to the development of abusive schemas in childhood and adulthood. In conclusion, the results of this study add to knowledge and understanding of therapeutic practices for perpetrators who voluntarily seek help. AST and ASM provides a schema model and therapeutic approach which can inform community based and healthcare agencies to work towards reducing aggression in the home to ultimately help victims of domestic abuse.