CONTENTS

About This Course

Table of Contents

1. Introduction to the Issues
2. Understanding Alcohol Abuse
3. Understanding Violence Against Women
4. Alcohol and Domestic Violence
5. Alcohol, Sexual Assault, and Rape
6. Prevention and Early Intervention
7. Screening and Assessment
8. Diagnosis and Treatment
9. Legal and Ethical Issues

Supplements
Fact Sheets
Videos
Resources

Silence Hurts
Alcohol Abuse and Violence Against Women

The Transtheoretical Model in Relation to Male Abusers

The following information has been adapted from: Lawson, D.M. (2003). Incidence, explanations, and treatment of partner violence. Journal of Counseling & Development, 81, 19-32.

Recently, process models of counseling have also been applied to men's abuser's groups. This transtheoretical model¹explains the process of change through five stages:

1. Precontemplation
2. Contemplation
3. Determination
4. Action
5. Maintenance

Issues of responsibility, highly important when working with abusive men, are introduced in the early stages of therapy, but receive more emphasis as the men move through the stages of change.

The first two stages (precontemplation and contemplation) are particularly relevant when working with abusive men. The primary goal during these early sessions is to increase consideration and motivation for change. Therapists can achieve this through a supportive and empathic environment where resistance to change and the consequences of the abuse are explored. In order to encourage willingness to change, therapists are not encouraged to be confrontational. The intent is to prepare the client for the preparation to change stage.

It is not uncommon for men to be at different stages with different issues. For example, a man may be in the precontemplation stage with their acceptance of responsibility for violence, yet be operating in the preparation for change stage as he plans how to communicate more clearly with his partner without angrily withdrawing. Therapists might apply active listening, open-ended questions, and reframing to allow the client to begin to accept basic acceptance of their violence.

As men move closer to the contemplation and preparation stages, therapists could employ more focused cognitive interventions. Men in groups could be shown how they think in polarities ("If I don't have control, I'm not a man"), how they selectively focus on their partner's negative behavior, the pros and cons of change, and the long-term effects of abusive behavior.

During the preparation to change stage, after the client has made a commitment to change, the counselor could use more focused behavioral-oriented interventions such as:

• Renewed commitment to nonviolence
• Setting realistic goals to end abuse
• Constructing strategies to reach these goals

As the client moves on to the action and maintenance stages, the therapist would teach specific skills using the cognitive-behavioral and feminist approaches. In addition, issues related to relapse prevention and maintenance of new thoughts and behaviors would be addressed. Psychodynamic/interpersonal interventions would be interspersed throughout the treatment, especially at points of resistance and change.

References

1. DiClemente, C.C. & Prochaska, J.O. (1982). Self-change and therapy change of smoking behavior: A comparison of processes of change in cessation and maintenance. Addictive Behaviors, 7, 133-142.