Work stream II: Perpetrators’ Trial Gene Feder, Helen Cramer, Karen Morgan, Jayne Bailey, Neil Blacklock, Marianne Hester, William Turner & Chris Newman al

Questions Do perpetrator groups (working with male perpetrators) reduce domestic violence & abuse? And do female ex/partners & the men themselves think perpetrator groups reduce abuse?

Background Need not only to support victim/survivors but also address perpetrators’ behaviour – largely heterosexual men Best models for addressing perpetration are groups Group models used widely in UK and elsewhere – but need stronger evidence that groups really work ie a trial Past research group trials on mandated populations eg prison populations measures not adequately capturing change

Stages of development Identifying a ‘best bet’ perpetrator group by looking at the literature and getting opinions from experts Making decisions on the measurements we can use that will capture meaningful outcomes? Setting up a small pilot trial (to be run by Splitz Wiltshire) in Bristol / N. Somerset / S.Glos If the pilot trial works, we will run a full trial in at least two geographical locations  

Methods addressing research question: Randomised controlled trial Treatment - 26 week group programme Control - usual care Randomised controlled trial – some men get group intervention, some men get phone call once a month (control)

Study inclusion 48 men (24 to intervention and 24 to control arm) AND as far as possible their women partner/ex partners 12 month follow-up. Data collected at regular intervals throughout trial. Male heterosexual groups only (opportunities for wider inclusion) Community-based - recruitment from multiple sources + WS1 advocate. Partners/ex-partners offered support irrespective of whether male is allocated to intervention or control arm. Most important outcome: are partners / ex partners of men safer and do they feel safer?  

(Some) key concerns   Can we get a small pilot trial to run successfully that makes us think a full trial might work? Can we recruit enough men & retain them? Can we recruit and retain female ex/partners? Is our intervention acceptable to all involved? Are there any safeguarding issues? If a pilot trial works can we run a full trial to answer our key research question: Are perpetrator groups effective at reducing domestic violence?

Outcomes using to answer question: Do perpetrator groups reduce domestic violence & abuse? Relevant outcome measures – currently under consideration Abuse measures Mental health measures Health Substance abuse Socio-demographic measures Cost data   Abuse measures e.g. Composite Abuse Scale, COHSAR scale for men, Child abuse measure + police reports Mental health measures e.g. CORE-OM, PHQ-9 (depression), GAD-7 (anxiety), Post-Traumatic Stress measure + self report on problems & treatment Health e.g. Short Form-12 & EQ-5D (general health & quality of life) Substance abuse e.g. AUDIT (alcohol), DUDIT (drugs) Socio-demographic measures e.g. age, number of children at home, ethnicity, income, occupation Cost data

Referral routes for male perpetrators Male advocate from IRIS+ DVA advocacy hub – ie workstream I Children's services Social services Other health practitioners? Health visitors? Probation & prisons – (men on short term sentences)* Mental health services Addiction services Self referral Police *However we do not want to recruit men who have been ordered to attend a DVPP.

Other referral routes? We are looking for all referral pathways in the B/NS/SG area – does anyone come across men concerned about their behaviour in relationships? Where do you refer them at the moment? Would your service be a potential referral pathway for reprovide?

Contact Karen Morgan Research Fellow, reprovide Email: Karen.morgan@bristol.ac.uk Tel: 0117 3314588 http://www.bristol.ac.uk/primaryhealthcare/researchthemes/reprovide/