Female Offenders who Commit Domestic Violence: Aggression Characteristics and Potential Treatment Pathways Dr Annette McKeown Highly Specialist Forensic Psychologist Tees Esk & Wear Valleys NHS Foundation Trust

Aims & Objectives Inform understanding of female prisoners who commit domestic violence. Present research findings on a prison-based study exploring domestic violence in female prisoners. Consider practical implications of findings to guide treatment provision. Particularly consider treatment provision in custodial settings with female offenders.

Domestic Violence Background I In 1971, the first women’s shelter for domestic violence was opened. In 1971, following the opening of the UK’s first women’s shelter (Chiswick Women’s Aid) for domestic violence victims, its founder (Erin Pizzey) made a paradoxical observation: Almost immediately people working in the refuge with the women and children became aware that of the first hundred women coming into the refuge, sixty two were as violent as the partners they had left (Pizzey, 1998)

Domestic Violence Background II Erin Pizzey and Jeff Shapiro (1982) “Prone to Violence” Generational Abuse Frequently Mutual between partners Erin Pizzey found herself the victim of threats including bomb threat due to the presentation of her findings. Violence also culminated in the shooting of her family dog and she moved from England due to her concerns about her family’s safety. Erin Pizzey emphasised the impact of early abusive experiences. In reality, abuse rarely begins or ends with one person, or with one generation. What is left of Chiswick Women’s Aid is now Refuge….is of interest given that Erin Pizzey highlighted the mutual nature of domestic violence. Impact of childhood regardless of gender

Domestic Violence Background III US National Family Violence Survey (1975) echoed the earlier findings (Straus et al., 1981). There were unexpected findings indicating men and women were equally likely to perpetrate domestic violence. Findings that levels of domestic violence perpetrated by females comparable or could exceed levels of males (e.g. Archer, 2000, 2002; Bookwala, 2002; Dutton,2006). There were even some indications that women perpetrated more severe forms of violence than men (Cercone et al., 2005; Russell and Hulson, 1992).

Domestic Violence Background IV Findings that women tend to be more seriously injured than men in domestic violence relationships (e.g. Dutton-Greene & Straus, 2005; Walby & Allen, 2004 ). British Crime Surveys (BCSs) found figures indicating 35-50 per cent of victims were in fact male victims (Home Office, 1999, 2004a, 2006, 2007, 2008, 2009a, 2011). Research populations often students or general population. Little existing research exploring domestic violence in forensic and secure hospital populations.

Gender & Violence I In general violence, men have been found to be eight times more likely to commit overall violence in comparison to women (e.g. Felson, 2006). Considering existing aggression research can perhaps help provide a clearer understanding gender disparity regarding violence begins to unravel in relationships. It may also highlight where some of the gender differences in the characteristics of aggression in relationships may exist.

Females higher relational aggression (Crick et al., 2009) Gender & Violence II Females tend to adopt more indirect strategies of aggression (Bjorkqvist et al., 1994) Females higher relational aggression (Crick et al., 2009) Females aggression tends to be more reactive than instrumental (Verona & Carbonell, 2000) In murder offences, women more likely to murder intimate partner (Bloom et al., 2003) Some research demonstrated higher levels of relational aggression in females. Furthermore, with regard to an index offence of murder, females are more likely to murder an intimate partner and less likely to murder a stranger in comparison to male counterparts (Bloom et al., 2003; Greenfeld and Snell, 1999).

Domestic Violence in Custody I Lack of literature on prevalence of domestic violence amongst female prison samples. There is a lack of general literature exploring the prevalence and nature of same-sex relationships in custody. In UK, there are few existing statistics on the prevalence of aggression in same-sex relationships in custody.

Domestic Violence in Custody II In community, bi-sexual (49%) and gay women (29%) found to experience more domestic violence than heterosexual women (24%; Bureau of Justice Statistics, 2010). Same-sex female relationships in custody, risk management issues, predatory behaviour, violence, self-harm, jealousy and co-dependence relevant considerations (Bennett, 2000). Importance of considering violence in same-sex relationships particularly in custody where a number of women will present with a history of violence. The 2010 research is in relation to USA samples. Very little literature on same-sex relationships in custody.

Current Study

Research Papers McKeown, A. (2014). Female Offenders who Commit Domestic Violence Aggression Characteristics and Potential treatment Pathways. Journal of Forensic Practice,16(2), 127 – 138. McKeown, A. (2014). Attachment, personality and female Perpetrators of Intimate Partner Violence. Journal of Forensic Psychiatry & Psychology, 25(5), 556 – 573. McKeown, A. (2014). Intimate Relationships between Female Prisoners: Fact or Fiction. Forensic Update, 31 – 37. The STOP intervention is recommended to run over a 12-month period and includes assertiveness training, understanding anger and increasing understanding of empathy. undertaken by a charity in Leeds. The Domestic Violence and Abuse Intervention Programme undertaken by the TRYangle (2011) project in London is a group work intervention open to both male and female perpetrators

Current Study I Measures: Demographic Questionnaire Revised Conflict Tactics Scales (CTS2; Straus et al., 1996). An adapted version of the CTS2 to derive information about the prevalence and nature of domestic violence in previous relationships (Personal Communication Dr Nicola Graham-Kevan) Population: 92 Female Prisoners (55% violent offences vs. 45% non-violent) 67% of those that responded noted that they were currently in relationship (n = 60) The STOP intervention is recommended to run over a 12-month period and includes assertiveness training, understanding anger and increasing understanding of empathy. undertaken by a charity in Leeds.

Current Study II Demographic Findings: 65% of those in relationship were in a relationship with male (n = 39) 35% of those in a relationship, were in a relationship with a female (n = 21) Of those in a relationship with a female, 76% were indicted vs. to be another female prisoner (n= 16). In terms of previous relationships, 38% of respondents previous had relationships with female prisoners. Thirty of the 39 women were in relationship with male in community and nine with male in prison.

Previous Relationships Current Study III   Current Relationship Perpetrated Victimized Psychological Aggression 93% 92% Physical Assault 57% 52% Previous Relationships 90% 65% 73% Table 1: Prevalence and Frequency of Aggression and Victimisation in Most Recent Relationship in Past Year and Previous Relationships

Previous Relationships Current Study IV   Perpetrated Victimized Current Relationship No Violence 43% 48% Minor Violence Only 26% 14% Severe Violence 31% 38% Previous Relationships 35% 27% 10% 1% 55% 72% The STOP intervention is recommended to run over a 12-month period and includes assertiveness training, understanding anger and increasing understanding of empathy. undertaken by a charity in Leeds. The Domestic Violence and Abuse Intervention Programme undertaken by the TRYangle (2011) project in London is a group work intervention open to both male and female perpetrators Table 2: Prevalence of Minor and Severe Physical Assaults in Current and Previous Relationships

Previous Relationships Psychological Aggression Current Study V   Current Relationship Previous Relationships Physical Assaults Respondent Only 28% 4% Partner Only 16% 10% Mutual 56% 86% Psychological Aggression 8% 3% 88% 93% The STOP intervention is recommended to run over a 12-month period and includes assertiveness training, understanding anger and increasing understanding of empathy. undertaken by a charity in Leeds. The Domestic Violence and Abuse Intervention Programme undertaken by the TRYangle (2011) project in London is a group work intervention open to both male and female perpetrators Table 3: Mutuality of Physical Assaults and Psychological Aggression in Current and Previous Relationships

Current Study VI The STOP intervention is recommended to run over a 12-month period and includes assertiveness training, understanding anger and increasing understanding of empathy. undertaken by a charity in Leeds. The Domestic Violence and Abuse Intervention Programme undertaken by the TRYangle (2011) project in London is a group work intervention open to both male and female perpetrators Figure 1: Prevalence of Physical Assaults by Assault Type in Current Relationship

Implications for practice I Female prisoners present with treatment needs both as victims and perpetrators of domestic violence. There is a need for treatment interventions to incorporate issues relating to being victimised and perpetrating domestic violence. Promoting awareness of same-sex relationships and the potential for aggression to be evident in these relationships is very important in practice. Incorporating these issues within treatment approaches is also vital. The STOP intervention is recommended to run over a 12-month period and includes assertiveness training, understanding anger and increasing understanding of empathy. The Domestic Violence and Abuse Intervention Programme undertaken by the TRYangle (2011) project in London is a group work intervention open to both male and female perpetrators

Implications for Practice II Further research is required exploring the prevalence of intimate partner violence in female prison samples. Incorporating findings of mutuality of domestic violence within treatment directions would be highly beneficial for female prisoners. Increasing prison staff awareness is vitally important to promote awareness of offence-paralleling behaviour and consider risk management strategies. The STOP intervention is recommended to run over a 12-month period and includes assertiveness training, understanding anger and increasing understanding of empathy. The Domestic Violence and Abuse Intervention Programme undertaken by the TRYangle (2011) project in London is a group work intervention open to both male and female perpetrators

Interventions I S.T.O.P (Start Treating Others Positively, 2013) was a rolling group work intervention undertaken by a charity in Leeds. The Domestic Violence and Abuse Intervention Programme undertaken by the TRYangle (2011). The Preventing Violence and Abuse in Relationships Programme undertaken by the Families Without Fear Project (Families Without Fear, 2013) in London for female perpetrators of domestic violence. Domestic Violence Intervention Programme (DVIP) The STOP intervention is recommended to run over a 12-month period and includes assertiveness training, understanding anger and increasing understanding of empathy. In 2014, lost funding from National Lottery. The Domestic Violence and Abuse Intervention Programme undertaken by the TRYangle (2011) project in London is a group work intervention open to both male and female perpetrators Domestic Violence Intervention Programme (DVIP) for male perpetrators. here are few evaluations of Respect accredited programmes but one particularly well-known one in the UK is Project Mirabel (Kelly & Westmarland, 2015).  The authors sought to challenge previous evaluations by creating a new, methodologically rigorous version but there were significant issues including no pre-post inferential statistical analysis and a comparison of effect using all starters and the completers – so 99 vs. 52 men.

Interventions II There are no known interventions specifically for female domestic violence perpetrators run within the probation service or in custodial settings. In custodial settings, there are more general programmes suitable for violent offenders including: Life Minus Violence – Enhanced (Ireland et al., 2009) is running as a component of the Primrose Service for female female personality disordered offenders at HMP & YOI Low Newton CARE programme (National Offender Management Service, 2010) which is running in HMP Foston Hall. The STOP intervention is recommended to run over a 12-month period and includes assertiveness training, understanding anger and increasing understanding of empathy. The Domestic Violence and Abuse Intervention Programme undertaken by the TRYangle (2011) project in London is a group work intervention open to both male and female perpetrators

Interventions III Newer interventions suitable for both male and female perpetrator warrant further evaluation: Inner Strength (Women) – 26 sessions UP2U – 6 – 40 sessions Interventions based on gender-responsive and trauma-informed literature of value. Inner Strength Women (ISW) provides a unique strengths-based approach for female perpetrators of domestic abuse. ISW's purpose is to eliminate domestic violence and develop a safe family environment". Inner Strength Women Strong robust & empirically supported theoretical basis Process orientated & designed to be responsive to women offenders' learning styles Dialectical Behavioural Therapy techniques to help emotional management Cognitive Behavioural Therapy techniques for problem solving, conflict resolution & risk management Comprehensive facilitator training is available Call: 01772 842121 Forensic Psychological Solutions Presents Inner Strength Women The 26-session programme for women who perpetrate partner violence Inner Strength Women helps participants to :- Establish personally relevant goals Enhance resilience Manage stress Tolerate distress Understand how their learning history has shaped their interpersonal style Understand the function aggression serves for them & how to meet these needs without aggression Develop skills in conflict management Understand the consequences & impact of partner violence on partners and children Module 1 Engagement and Assessment  o   Module 2 Thinking, Feeling and Behaviour  o   Module 3 Relationships  o   Module 4 Skills for Change  o   Module 5 Targeted Sessions – Stalking Behaviours  o   Module 6 Targeted Sessions – Unhealthy Sexual Behaviours  o   Module 7 Targeted Sessions - Skills for Change 2 – Complex Emotions  o   Module 8 Targeted Sessions – Abuse and Substance Misuse  o   Module 9 Moving On 

Thank You Any questions? Annette.Mckeown01@hmps.gsi.gov.uk Annette.mckeown@nhs.net