BACKGROUND..................................................................................i
1.0 DECLARATION OF PRINCIPLES...................................................1
2.0 PURPOSE FOR THE STANDARDS................................................5
3.0 DEFINITION OF DOMESTIC VIOLENCE.....................................8
4.0 STANDARDS OF CARE...................................................................11
4.1 General Ethical Issues...........................................................................11
4.4 Confidentiality Issues............................................................................12
4.5 Program Issues.....................................................................................13
5.0 EDUCATION AND TRAINING REQUIREMENTS........................4
6.0 TREATMENT APPROACHES..........................................................15
7.0 TREATMENT STANDARDS.............................................................16
8.0 DISCHARGE CRITERIA.....................................................................9
APPENDIX
I. DEFINITION SECTION.....................................................................20
II. SAFETY AND PROTECTION PLAN...............................................22
III. CONTROL PLAN................................................................................24
IV. CLIENT CONTRACT..........................................................................26
V. INTAKE EVALUATION....................................................................27
VI. TREATMENT EVALUATION AND MONITORING COMMITTEE...37
VII. TACTICS OF POWER AND CONTROL WHEEL......................... 43
VIII. NON-VIOLENCE AND EQUALITY WHEEL..........................44
IX. EXCEPTIONS TO THE PRIVILEGE OF CONFIDENTIAL
COMMUNICATION............................................................................45
X. CERTIFICATION GUIDE...................................................................47
Finally, the Task Force, in its planning for the effective implementation
of these STANDARDS, will form a TREATMENT EVALUATION AND MONITORING
COMMITTEE to act on behalf of the three agencies to assure that the
STANDARDS are in effect and followed within Treatment Programs. Reports
by the TREATMENT EVALUATION AND MONITORING COMMITTEE on programs
for perpetrators will be returned to the Probation Department and the District
Attorney's and the City Attorney's Domestic Violence Prosecution Units.
Those programs meeting the STANDARDS will become the approved and
chosen treatment programs to whom the three agencies will refer court mandated
perpetrators.
1.0 DECLARATION OF PRINCIPLES
The treatment of offenders in the State of California employs a variety
of theories, modalities, and techniques. Domestic violence perpetrators
are a separate category of violent offenders requiring a specialized approach.
The goals is cessation of violence.
To this end, the Task Force and these STANDARDS subscribe to the
following principles:
1.1 Violence can never be condoned under any circumstances. All behavior
whether intentional or unintentional, has consequences and is the sole responsibility
of the actor. Perpetrators of domestic violence must learn that engaging
in violent behavior has consequences, such as being arrested or being placed
on a deferred sentence, suspended sentence or probation. The most prevalent
causes of domestic violence include the following:
a) The reality of a patriarchal cultural value system that imbues perpetrators
with a belief of entitlement based on the status of their gender. For many
male perpetrators, the entitlement principle is most graphically stated
as: "The bottom line is, I have the right to use brute force to get
what I want in this relationship, and I will use it".
b) The perpetrator's immediate community of peers is also a causal factor
in supporting the use of violent and abusive acts against a partner, primarily
against women. Either by their peers' acts of omission, such as keeping
the code of silence, or by acts of commission, such as agreeing violence
was right, perpetrators may find implicit or explicit support for their
violence.
c) The family from which the individual perpetrator originated is a causal
factor. A history of father's abuse of mother in the family of origin places
an individual man at greater risk to use violence and abuse against his
partner.
d) The individual perpetrator's inner psychological make-up and symbolic
world is a fourth causal factor, albeit of less significance than the preceding
three for most perpetrators. Nonetheless, an understanding of this inner
world is related to understanding that individual's use of violent and abusive
acts against a partner.
e) Finally, the fifth causal factor of environmental stressors includes
specific situations and events that can increase the risk of the individual
becoming a perpetrator when combinations of the first four factors are
present. These include stressors of unemployment, poverty, underemployment,
job threatening situations, use of abuse of alcohol and/or other drugs,
and other environmental stressors that significantly increase threats to
the individual's ability to effectively cope with daily life task in a relationship
with a partner.
The multiple causes of domestic violence remain underpinned by the entitlement
belief that use of brute force is an acceptable, permissible action to maintain
power and to take control in a conflict situation. Change of such violent
and abusive actions requires accountability for these actions to authorities,
and responsibility for one's own behavior. One step in accountability and
responsibility is the payment for the treatment program. Payment of one's
own treatment is an indicator of responsibility and is a requirement of
the STANDARDS.
1.2 The plight, rights, and individual differences of the victims should
be respected.
Victims of domestic violence undergo tremendous turmoil and fear as a result
of the violence inflicted. Their feelings and their potential for suffering
further harm should always be of utmost consideration. Coordination between
the perpetrator's and victim's therapists is highly recommended within the
laws of confidentiality.
1.3 The individual differences and rights of the perpetrator should be respected.
Each individual has different needs which should be provided for in the
treatment plans.
1.4 Treatment providers should design and implement appropriate treatment
programs.
The creation of appropriate programs requires a basic understanding of domestic
violence dynamics, methods of intervention, and proper and safe alternatives
to violence. Providers should be equipped to perform their stated services
and not misrepresent their capabilities. Any treatment provider who blames
the victim or in any way places the victim in a position of danger is in
violation of the principles of these STANDARDS. As research on domestic
violence perpetrators progresses, philosophical and programmatic changes
may be necessary to implement more effective programs.
1.5 Treatment providers should cooperate and communicate with other interrelated
agencies such as law enforcement, the courts, probation, victim advocates,
battered women's shelters, district and city attorneys' offices.
Treatment of the offender is one element of a comprehensive community based
intervention, which includes the criminal justice system's actions. Treatment
can occur once domestic violence is reported. Continued interagency communication
and cooperation is essential to assess the lethality of the violent offender,
the potential for harm to the victim, and the effectiveness of the programs.
Effectiveness is to be measured by reduced recidivism (i.e. lower rates
of recurring acts of violence and abuse). The task force encourages the
development of local coalitions to enhance interagency communication and
to strengthen program development.
1.6 Treatment providers can contribute to heightened public awareness of
the seriousness of domestic violence.
Traditionally, domestic violence was regarded as a private family matter
not requiring intervention. Only within the last ten years has the criminal
justice system recognized the gravity of this behavior and finally elevated
it to criminal status. Public awareness may require an active role on the
treatment provider's part to disseminate this information.
1.7 Treatment providers should maintain individual standards that reflect
professionalism.
It is important to maintain a personal integrity that is consistent with
professional standards. For example, in matters of personal conduct regarding
this issue, providers should and will uphold non-violent actions in their
own lives in their relationships with their partners.
1.8 County standards should undergo continuous review and revision consistent
with treatment programs' experiences, new knowledge from outcome research
demonstrating what approaches are more effective, and new theoretical understanding
of the causes and the interventions.
The TREATMENT EVALUATION AND MONITORING COMMITTEE is committed to
meeting at least six times per year. Review and updating of the standards
will be conducted once every two years at a minimum.
1.9 The Task Force recognizes the fact that culturally diverse populations
have unique treatment needs.
All treatment agencies should strive to serve culturally diverse populations.
It is beneficial for staff composition to reflect the cultural diversity
of the community they serve.
2.0 PURPOSE FOR DOMESTIC VIOLENCE TREATMENT STANDARDS
The San Diego County Task Force's Treatment Standards for Domestic Violence
perpetrators was created to assure the following:
2.1 The purpose of treatment standards is to eliminate all forms of domestic
violence.
2.2 Treatment standards provide a means of reducing or eliminating violence,
reflect concerns of the people of the County of San Diego, are endorsed
by the Task Force, and, as adopted and used by the County's Probation Department,
District Attorney's and City Attorney's Domestic Violence Prosecution units,
will further the protection of the public.
2.3 Treatment standards provide recognition of current, appropriate intervention
methods that provide the public with expectations of service.
2.4 Treatment standards establish a minimum level of responsibilities and
services expected from treatment providers, which allow the TREATMENT
EVALUATION AND MONITORING COMMITTEE to evaluate programs and
provide a basis for future program development.
2.5 Treatment standards help ensure that defendants will receive appropriate
therapy that is compassionate, humane, consistent, and based on individual
needs.
2.6 Treatment standards mandate that only the highest level of professionalism
will be accepted and encourage individual and program responsibility in
reaching these STANDARDS.
2.7 Treatment standards will enhance the public's awareness of issues
involved in domestic violence, give victims and perpetrators increased access
to treatment, and reinforce the concept that violent behavior is unacceptable.
2.8 Treatment standards will provide stimulation for research. The assimilation
of research results will help improve treatment methods.
2.9 Treatment standards acknowledge that treatment programs, in combination
with criminal justice interventions, and other appropriate interventions
such as shelters, are an acceptable method of reducing violence and are
sanctioned by California Penal Code 243 (e), as quoted below:
243. Battery; punishment
(e) When a battery is committed against a non cohabiting former
spouse, fiancee, or a person with whom the defendant currently has, or
has previously had, a dating relationship, the battery is punishable by
a fine not exceeding two thousand dollars ($2,000), or by imprisonment in
the county jail for a period of not more than one year, or by both. If probation
is granted, or the execution or imposition of the sentence is suspended,
it shall be a condition thereof that the defendant participate in, for no
less than one year, and successfully complete, a batterer's treatment program,
or if none is available, in another appropriate counseling program designated
by the court; however, this provision shall not be construed as requiring
a city, a county, or a city and county to provide a new program or higher
level of service as contemplated by Section 6 of Article XIIIB of the California
Constitution.
The Legislature finds and declares that these specified crimes merit special
consideration when imposing a sentence so as to display society's condemnation
for such crimes of violence upon victims with whom a close relationship
has been formed.
California Penal Code Sections 273.5(e), (f), and (g), as quoted below,
also sanction treatment programs:
(e) In any case in which a person is convicted of violating this section
and probation is granted, the court shall require supervised counseling
as a condition of probation unless, considering all of the facts and the
circumstances, the court finds counseling inappropriate for the defendant.
(f) If probation is granted, or the execution or imposition of a sentence
is suspended, for any person convicted under subdivision (a) who previously
has been convicted under subdivision (a) for an offense that occurred within
seven years of the offense of the second conviction, it shall be a condition
thereof that he or she be imprisoned in the county jail for not less than
96 hours and that he or she participate in for no less than one year, and
successfully complete, a batterer's treatment program, as designated by
the court. However, the court, upon a showing of good cause, may find that
the mandatory minimum imprisonment, or the participation in a batterer's
treatment program, or both the mandatory minimum imprisonment and participation
in a batterer's treatment program, as required by this subdivision, shall
not be imposed and grant probation or the suspension of the execution or
imposition of a sentence.
(g) If probation is granted, or the execution or imposition of a sentence
is suspended, for any person convicted under subdivision (a) who previously
has been convicted of two or more violations of subdivision (a) for offenses
that occurred within seven years of the most recent conviction, it shall
be a condition, thereof that he or she be imprisoned in the county jail
for not less than 30 days and that he or she participate in for no less
than one year, and successfully complete, a batterer's treatment program
as designated by the court. However, the court, upon a showing of good cause,
may find that the mandatory minimum imprisonment, or the participation in
a batterer's treatment program, or both the mandatory minimum imprisonment
and participation in a batterer's treatment program, as required by this
subdivision, shall not be imposed and grant probation or the suspension
of the execution or imposition of a sentence.
2.10 Treatment standards encourage countywide communication and interaction
among treatment providers.
3.0 DEFINITION OF DOMESTIC VIOLENCE
For the purpose of this manual, the definition of domestic violence
as defined by California Penal Code Sections 242; 262, (a) and (b); and,
273.5, (a), (b), (c), and (d) is as follows:
3.1 Battery and Spouse Abuse defined:
242. Battery defined. A battery is any willful and unlawful use of force
or violence upon the person of another. (Enacted 1872).
262. Rape of spouse.
(a) Rape of a person who is the spouse of a perpetrator is an act or sexual
intercourse accomplished against the will of the spouse by means of force
or fear of immediate and unlawful bodily injury on the spouse or another,
or where the act is accomplished against the victim's will by threatening
to retaliate in the future against the victim or any other person, and there
is a reasonable possibility that the perpetrator will execute the threat.
As used in this subdivision "threatening to retaliate" means a
threat to kidnap or falsely imprison, or to inflict extreme pain, serious
bodily injury, or death.
(b) The provisions of Section 800 shall apply to this section; however,
there shall be no arrest or prosecution under this section unless the violation
of this section is reported to a peace officer having the power to arrest
for a violation of this section or to the district attorney of the county
in which the violation occurred, within 90 days after the day of the violation.
273.5 Corporal injury of spouse, cohabitant of opposite sex, or mother or
father of his or her child; counseling as condition of probation; conditions
for imposition of jail sentence.
(a) Any person who willfully inflicts upon his or her spouse, or any person
who willfully inflicts upon any person of the opposite sex with whom he
or she is cohabiting, or any person who willfully inflicts upon any person
who is the mother or father of his or her child, corporal injury resulting
in a traumatic condition, is guilty of a felony, and upon conviction thereof
shall be punished by imprisonment in the state prison for 2, 3, or 4 years,
or in the county jail for not more than one year, or by a fine of up to
six thousand dollars ($6,000) or by both.
(b) Holding oneself out to be the husband or wife of the person with
whom one is cohabiting is not necessary to constitute cohabitation as the
term is used in this section.
(c) As used in this section, "traumatic condition" means a condition
of the body, such as a wound or external or internal injury, whether of
a minor or serious nature, caused by a physical force.
(d) For the purpose of this section, a person shall be considered the father
or mother of another person's child of the alleged male parent is presumed
the natural father as set forth in Section 7004 of the Civil Code.
3.2 The following expanded definitions of domestic violence are included
as a broader reference and a guide for treatment providers.
1) Physical violence: aggressive behavior including but not limited
to hitting, pushing, choking, scratching, pinching, restraining, slapping,
pulling, hitting with weapons or objects, shooting, stabbing, and damaging
property or pets.
2) Sexual violence: use of physical force to make someone perform
any sexual act against one's will.
3) Psychological violence: using the power gained through physical
and sexual violence to control the actions and behavior of another person
through the following types of abusive actions:
a) threatening any and all forms of physical violence or sexual violence;
b) other threats to take away the person's livelihood, take the children,
commit suicide, harm the person emotionally;
c) acts of intimidation to put the person in fear such as looks, gestures,
loud voices, smashing something or destroying property;
d) isolating the person by controlling what they do, who they see and talk
to, and where they go;
e) emotionally abusing the person by putting them down, making them feel
bad about themselves, calling them names, making them think they are crazy,
and other mind games;
f) economically abusing the other by trying to keep them from getting
a job, making them ask for money, giving them an allowance, and taking their
money;
g) sexual abuse other than outright forced sexual acts and and rape including
verbal attacks on the sexual parts of the person's body and treating them
like a sex object;
rape including verbal attacks on the sexual parts of the person's body and
treating them like a sex object;
h) using the children to make the other feel guilty about the children by
attacking their parenting, using the children to give messages, using visitation
as a way to harass the other parent, and interrogating the children to accomplish
surveillance of the other's life and actions;
i) in this patriarchal culture the use of male privilege to claim entitlements
of a superior status, thus treating his partner like a servant, making all
the big decisions, and acting like the master of the castle; and
j) additional forms of abusive actions, although not enumerated here, in
the context of physical and sexual violence.
Defining domestic violence in greater detail as done in the preceding paragraphs
alerts the treatment providers to attend to all forms of such violent and
abusive behavior by perpetrators.
3.3 In addition to the above definitions, it should be noted that domestic
violence perpetrators typically exhibit one or more of the following characteristics:
1) Little or no concern for the consequences of their behavior;
2) Little or no empathy for their victims;
3) Increased power and control over the victim;
4) A pattern of recurrent violent and abusive behavior which may escalate
in frequency and severity in many cases, although may stabilize at a set
level of violent and abusive acts in other cases.
4.0 STANDARDS OF CARE FOR TREATMENT PROVIDERS
These STANDARDS are written as a guideline for intervention with
clients who commit acts of violence that involve adult-to-adult intimate
relationships. They do not include other acts of family violence such as
child abuse or elder abuse.
General Ethical Standards for Treatment Providers
4.1 Treatment providers and agencies working with perpetrators of domestic
violence must meet standards outlined by professional groups with which
they are affiliated, e.g., the American Psychological Association, National
Association of Social Workers, California Association of Marriage and Family
Therapists, American Association of Marriage and Family Therapists, American
Association of Pastoral Counselors, the American Medical Association and
the American Psychiatric Association.
4.2 Treatment providers must maintain the following standards:
4.2.1 Be violence-free in their own lives.
4.2.2 Be free of criminal convictions involving moral turpitude.
4.2.3 Not communicate or act in ways that perpetuate attitudes of sexism
and victim-blaming.
4.2.4 Not abuse drugs or alcohol.
4.2.5 Immediately report a client's threats to do harm or kill another person
as guided by the Tarasoff and related rulings. (See appendix for guidance
on Tarasoff and related rulings).
a) These STANDARDS add another duty for Treatment Providers, in addition
to the expected actions under Tarasoff. This duty, per the Treatment Provider's
agreement to operate by the STANDARDS, is to report the threats to
the following authorities as well:
1) The Probation Officer; or
2) The Prosecuting Attorney; or
3) The Judge.
b) Releases of Information authorizing reporting to these authorities must
have been obtained from the client as a condition of enrollment in the Treatment
Program.
4.2.6 Immediately report child abuse or neglect by a client, pursuant
to
California Penal Code Article 2.5, Child Abuse and Neglect Reporting Act,
Section 11166.
4.2.7 Maintain open communication with the agencies involved by discussing
disagreements, problems, and issues related to treatment, intervention,
and management of cases.
4.3 Violations of these stated ethical standards will be reported to the
TREATMENT
EVALUATION AND MONITORING COMMITTEE whose members will then take appropriate
action.
Confidentiality Issues
4.4 A treatment provider shall not disclose, without the consent of the
client, any confidential communications made by the client to the treatment
provider during the course of treatment; nor shall a treatment program employee
or associate, whether clerical or professional, disclose any confidential
information acquired through that individual's work capacity; nor shall
any person who has participated in any therapy conducted under the supervision
of a treatment provider, including, but not limited to, group treatment
sessions, disclose any knowledge gained during the course of such therapy
without the consent of the person to whom the knowledge relates. Treatment
providers have the duty to warn potential victims of imminent danger if
the treatment provider believes that the victim may be at risk from a client
because of threats made or behavior exhibited.
These prohibitions shall not apply when a client makes indications that
they may be dangerous to the lives of others, or when:
1) a client or the heirs, executor, or administrators of an estate of a
client file suit or a complaint against a treatment provider arising out
of, or connected with, the care or treatment of such client by the treatment
provider;
2) a treatment provider was in consultation with a physical or mental health
professional against whom a suit or complaint was filed based on the case
out of which the suit or complaint arises;
3) a review of services of a treatment provider is conducted by a board
appointed by the governing licensing agency or its investigative agents;
and
4) an exception to privileged confidential communications is in effect as
defined in sections 1017, 1018, 1020, 1024, 1025, 1026, and 1027 of the
Evidence Code. (See appendix IX).
Program Issues
4.5 Treatment programs shall not exist in isolation. They shall maintain
cooperative working relationships with battered women's shelters, other
providers and criminal justice programs.
4.6 If a victim of a domestic violence perpetrator is also attending counseling,
treatment providers shall consider any relevant information regarding that
victim's progress provided by the victim's therapist as it relates to the
domestic violence perpetrator.
4.7 Treatment providers must provide a response plan for clients in crisis
within the client contract.
4.8 Treatment providers must provide admission to therapy within two weeks
of contact by a client. If this condition cannot be met, the treatment provider
will be required to refer the client to the original referral source and
notify the referral source.
4.9 Treatment providers must report any lack of response by a client to
the referral agent one week following the initial referral. The treatment
provider must also make a verbal report to the referral agent following
each absence or missed appointment. A written report is required following
two absences.
4.10 All treatment providers shall accept indigent clients. Fees shall be
on a sliding scale. All clients shall pay some fee. Referrals of indigent
clients shall be made to all certified treatment programs.
Note: The distribution of referrals of such clients to be determined by
the TREATMENT EVALUATION AND MONITORING COMMITTEE.
4.11 Treatment providers must provide information about referral services
for emergency calls and walk-ins.
4.12 Treatment providers shall document in writing all violations of the
client contract. If termination is effected, this documentation shall be
provided to the proper referring agent.
5.0 EDUCATION AND TRAINING REQUIREMENTS
All treatment providers of domestic violence clients must meet the following
criteria:
5.1 Master's or Doctorate degree in a human services clinical field, currently
licensed as a psychotherapist, or
5.2 For unlicensed persons, agencies may exempt standard 5.1 by providing
intense supervision, defined as the ability to have timely and direct access
to a supervisor on a daily basis. Supervisors must meet qualification 5.1
above and have at least one year of supervisory experience in domestic violence.
In addition, unlicensed persons must attend 24 hours of in-service training
and develop intervention skills, including education and counseling techniques.
These 24 hours are separate from those required in Section 5.3 below.
5.3 Prior to providing treatment, treatment providers must demonstrate that
they have participated in a minimum of 24 hours of formal domestic violence
training in programs accepted by the TREATMENT EVALUATION AND MONITORING
COMMITTEE.
5.4 All treatment providers must participate in 24 hours of approved
continuing education yearly. The content of the training must be relevant
to the problem of domestic violence such as: current practices and research
on the issue; gender analysis of the problem; sex role socialization as
related to domestic violence; and, cross cultural issues as related to the
problem. The verification and approval of the continuing education and training
will be carried out by the TREATMENT EVALUATION AND MONITORING COMMITTEE.
6.0 TREATMENT APPROACHES
6.1 Group Treatment.
GroupTreatment is the intervention of choice for domestic violence perpetrators.
Treatment providers, through their respective agencies, may decide whether
groups will be open (accepting new members on an ongoing basis) or closed
in structure. The groups may range from a minimum of 4 to a maximum of 12
clients in any particular treatment group. The individuals who are inappropriate
for group treatment, such as a person who is actively psychotic in behavior,
may be provided individual treatment for their domestic violence behavior,
accompanied by medical and psychiatric care for their psychosis.
6.2 Substance Abuse.
When the initial intake evaluation indicates drug and/or alcohol abuse,
this should be addressed at the onset of treatment.
Monitored antabuse and/or urine screens shall be used as adjunctive treatment
when indicated. Referrals to other agencies for specialized treatment may
be initiated in those circumstances. Violence cannot be successfully treated
without treating the substance abuse problems. Treatment for substance abuse
may not be substituted for a client's treatment for domestic violence behavior.
6.3 Inappropriate Treatment.
Any treatment approach or practice that blames or intimidates the victim
or places the victim in a position of danger is not appropriate.
Treatment techniques that have been shown to increase the risk and danger
to the victim, such as ventilation, punching pillows, hitting with batakas,
and other endangering approaches are not appropriate.
6.4 Couple Therapy vs. A Couple's Session.
It is not appropriate to begin domestic violence treatment utilizing couple
or family therapy. These modalities may be used after the criteria identified
in Section 7.2 are met. A couple's session (as opposed to ongoing couple
therapy) may be used to elicit information, arrange a separation, arrange
visitation for children, or to teach anger management skills such as time-out.
This modality should be used only after making plans to ensure the safety
of the victim.
7.0 TREATMENT STANDARDS
7.1 Intake Evaluation.
At intake, each client will be evaluated individually; the evaluation will
include the following:
7.1.1 A profile of the client's violent behavior which should include independent
descriptions from criminal justice agencies, victims, and other treatment
providers. Clients will be required to submit a copy of the arrest report,
the court order, and the probation report; in addition, the psychological
evaluation, if one has been completed.
7.1.2 A mental status examination and clinical impressions, if deemed appropriate.
7.1.3 An assessment of the client's potential for harm to self or others.
7.1.4 Medical health history, if deemed appropriate.
7.1.5 A description of substance abuse and its impact on the abuser and
family system.
7.1.6 Social / psychological / cultural history.
7.1.7 A treatment plan which addresses domestic violence, child abuse, sexual
abuse, alcohol and/or controlled substance abuse, and the presence or absence
of psychosis.
7.1.8 A client contract which specifies the responsibilities of the treatment
provider and the perpetrator. Client contracts must clearly specify that
following Intake Evaluation and during the client's time in the treatment
program, threats to harm or kill the victim (per the Tarasoff ruling), and/or
acts of child abuse or neglect, will be reported to the appropriate legal
agencies, and that potential victims will be warned.
7.2 The minimum length of treatment is one (1) year with a minimum of thirty
(30) sessions, following a schedule of one (1) session weekly for the first
twenty four (24) weeks, and one (1) session monthly for the last six (6)
months. The group sessions will be a minimum of one and one half (1 1/2)
hours per session. For the limited number of clients inappropriate for groups
who are treated within individual treatment, the same criteria of one year
minimum length of treatment, a minimum of thirty sessions once weekly the
first 24 weeks, and once monthly the final six months will apply. The individual
sessions will be a minimum of fifty (50) minutes, the traditional treatment
hour length.
7.3 Intervention Standards.
The following elements must be included in the treatment of domestic violence
perpetrators:
7.3.1 All treatment providers should have the knowledge and capability to
develop and provide a safety plan for a victim as appropriate.
7.3.2 A treatment plan should be implemented as determined through the intake
evaluation process.
7.4 Content of Treatment Program.
7.4.1 Agreement for non-violent behavior toward a partner, in place of violent
or abusive behavior.
7.4.2 (Note: there is no section 7.4.2).
7.4.3 Patterns of and cycle of violent or abusive behavior.
7.4.4 Family of origin's intergenerational patterns that model and transmit
violence as a taught and learned behavior.
7.4.5 Time Outs - client removes self from potentially violent encounters.
7.4.6 Myths and beliefs regarding provocation.
7.4.7 Control Plan - Client's individual and specific plan to control and
prevent the client from acting violently.
7.4.8 Tactics of power and control that include isolation, emotional abuse,
economic abuse, sexual abuse, using children, using male privilege, intimidation,
and threats.
7.4.9 Anger management and aggressive behavior control.
7.4.10 Stress management.
7.4.11 Sex role socialization and training and its impact on beliefs, attitudes
and behaviors toward the client's use of violent and abusive acts.
7.4.12 Conflict resolution.
7.4.13 Communication skills training.
7.4.14 Owning, reexperiencing, and taking responsibility for one's acts
of violence.
7.4.15 Personal and cultural attitudes towards the opposite sex, to include
attitudes of women hating or men hating.
7.4.16 Cultural and societal basis for violence to include values, beliefs,
and behaviors as institutionalized in a patriarchal society.
7.4.17 Definitions of alcoholism and other forms of substance abuse, their
impact on the abuser, and on the family system.
7.4.18 Parenting issues and skills as related to the impact of domestic
violence on children.
7.4.19 Skills for gaining intimacy in relationships.
7.4.20 Guilt and shame issues of the client related to their violent and
abusive actions.
7.4.21 Power sharing and decision making issues in a relationship.
7.4.22 Non-violence and equality model for relationships that includes non-
threatening behavior, respect, trust and support, honesty and accountability,
shared responsibility, economic partnership, negotiation and fairness, and
responsible parenting.
8.0 DISCHARGE CRITERIA
8.1 Therapist's judgments and information from the victim and/or relevant
agencies will be used to determine whether a client will be given either
an administrative discharge or certificate of completion. A certificate
of completion will be given under the following conditions:
Successful completion of the program with fulfillment of the client contract.
8.2 An administrative discharge is given under the following conditions:
An inability to continue in the program (e.g., a move out of state or a
referral to another treatment program).
8.3 Termination from the program will occur under the following conditions
and will include a written summary of the perpetrator's behavior in treatment.
Violation of the conditions of the client contract.
8.4 Re-admission following a termination, is permitted based on the reevaluation
by the court authorities, either the probation officer or prosecutor, and
the treatment provider.
8.5 At the time discharge or termination is being considered, if the client
continues
to exhibit behavioral signs of violence, the treatment provider must do
the following in a timely manner.
8.5.1 Contact the victim.
8.5.2 Contact court officials, specifically the probation officer and/or
prosecutor, and, provide a statement of the client's progress and standing
in the treatment program, with a recommendation regarding termination of
or continuation in treatment.
8.5.3 Ask the client to continue in therapy with increased involvement or
refer the client to another treatment program.
APPENDIX
I. DEFINITION SECTION
Domestic violence: Acts committed by a perpetrator against a victim
that include: physical violence; sexual violence; and, psychological abuse
that is perpetrated within the context of prior acts of physical and sexual
violence.
Note: For these STANDARDS, domestic violence is to be understood
as such acts by one adult against another adult, who are either: presently
married to one another (whether living together or separately); formerly
married to one another; cohabiting; formerly co-habiting; dating one another,
or formerly dating one another. Therefore, for these STANDARDS domestic
violence is clearly to be understood as distinguished from child abuse or
neglect, insofar as in child abuse and neglect the perpetrator is an adult
and the victim a child.
Domestic Violence Training: Is specific training that complies with the
outline for methods and philosophy as described in the STANDARDS.
The training will be acceptable if it is developed in conjunction with the
local domestic violence community.
Indigent Client: A perpetrator applying for program services who does
not have a current ability to pay the full program fee.
Note: The agency will determine the perpetrator's ability to pay by obtaining
a financial statement and applying indigence guidelines. These guidelines
may be obtained from various State agencies; however, one guideline should
be chosen and applied consistently.
Treatment Provider: A specific individual therapist or supervisor
within a treatment program who provides direct care to either the perpetrator
or the victim. All treatment providers and their supervisors must meet the
minimum qualifications outlined in the STANDARDS and must work in
a Fully Certified or Conditionally Certified program.
Treatment Program: An individual or organization that provides counseling,
advertises or sets itself forth as having the capacity to treat domestic
violence perpetrators.
Certified Treatment Program: An individual or organization that
advertises or sets itself forth as having the capacity to treat domestic
violence perpetrators that has received Full or Conditional Certification
by the TREATMENT EVALUATION AND MONITORING COMMITTEE.
Perpetrator: A person who commits acts of domestic violence against
a person who becomes the victim of such acts.
Victim: A person who is killed, destroyed, injured, or otherwise
harmed by or suffering from acts of domestic violence (which includes acts
of physical violence, sexual violence, and psychological abuse done within
the context of the physical or sexual violence) committed against the person
by the perpetrator.
II. SAFETY AND PROTECTION PLAN
Safety and Protection Plan: The actions taken by the Treatment Provider
to plan with and give to a person who is a victim of domestic violence the
information, procedures, steps and alternative actions for that person to
maximize their safety and protection from further acts of domestic violence.
A Safety and Protection Plan is for the victim, to be carried out by the
victim, and therefore developed in close consideration with their unique
circumstances. The judgments of the victim are to be respected in regards
to their implementing any or all steps of a Safety and Protection Plan.
One exception would be the situation in which a victim's capacity to act
for their own safety and protection is severely impaired, such that they
may not be responsible for or accountable for their own well being or actions.
For example: when a person is so severely injured they cannot act; when
a medical or mental condition exists to the extent actions for the person's
own safety and care must be taken by the Treatment Provider as in a suicide
risk situation requiring hospitalization; or, when intoxication from alcohol
or influences of other substances precludes the individual acting for her
own safety and protection.
The principle of empowerment of the victim is to guide the drawing up and
implementing of each Safety and Protection Plan.
Therefore, to reiterate, the Treatment Provider is to be guided by and respect
the judgment of the victim, although the victim may not follow the recommendations
of the Treatment Provider.
A Safety and Protection Plan will include but not be limited to the following
elements:
1. Police emergency phone number.
2. Emergency phone numbers for Battered Women's Hot lines and Crises lines.
3. Information and Referral to legal guidance resources, medical resources,
advocacy resources, counseling resources, and other resources as unique
to the individual victim.
4. A list of shelters, safe houses, and safe places where a victim can stay.
5. Temporary Restraining Order (TRO) information, including where, how,
and when a TRO can be obtained, cost of the TRO, and benefits and limitations
of the TRO.
6. Identifying clues and cues that are signals to the victim of increasing
danger of another incident of violence or abuse by the perpetrator against
the victim. These clues and cues are best organized in a continuum from
earliest warning signs of the most subtle variety to the extreme of overt
threats of violence by the perpetrator including threats to kill the victim.
The earlier the victim identifies warning signs, the greater
likelihood the victim can act for her own safety and protection before
another assault.
7. Tangible plans for the victim's use in an emergency to get away from
the perpetrator to include:
a) Keeping cash, checks, credit cards that would allow the victim to pay
for immediate emergency needs whether it be a hotel or motel room, food,
airplane, or bus ticket.
b) Packing and keeping an escape bag of personal articles, clothing, important
papers.
c) Keeping a second set of car keys.
d) Setting up warning codes and call for help codes with other family members,
neighbors, professionals, etc...
8. Changing locks on residence when TRO in effect.
9. Alerting employer and others to gain their assistance in providing safety
and protection for the victim; for example, alerting an employer to a TRO
restraining the perpetrator from the victim's place of employment.
10. Advocacy actions that the victim may find helpful for their safety and
protection, such as the Treatment Provider talking with an employer on behalf
of a victim.
11. Reviewing all of the above steps for their application to assuring safety
and protection for children in the family. Specifically, alerting day care
centers to the existence of a TRO restraining the perpetrator from coming
to the center or taking a child from the center.
12. Reviewing the Safety and Protection plan with the victim and when appropriate
practicing specific actions through rehearsals and role plays. Continuing
to review the plan in future contacts with the victim.
III. CONTROL PLAN
Control Plan: A Control Plan is the perpetrator's counterpart to the
Safety and Protection Plan for the victim. It is to be developed by the
perpetrator with the assistance of the Treatment Provider. The plan can
be effective only insofar as the perpetrator uses it to control violent
and abusive actions. The Treatment Provider should work with the unique
needs and circumstances of each perpetrator in assisting with the construction
of the Control Plan.
Below are some of the key elements of a control plan:
1. Identification of Stress Cues, and rating them on a scale of 1 to 10.
a. Physical changes telling of increasing stress.
b. Fantasies and mental rehearsals of violent or abusive acts.
c. Red Flag Words used by perpetrator.
d. Emotional changes.
e. Negative self talk.
f. Red flag words used by partner.
2. Time out steps to control violent and abusive acts.
a. Decide on the specific rating at which they will stop escalation of conflict,
for example at a level of 5 on a scale of 1 to 10.
b. Know what to do when taking time out, for example, leave the room or
house and go for a walk.
c. Know where to go, for example, to the park.
d. Choose an initial length for the time out, for example, twenty minutes.
e. Give a neutral time out sign to their partner.
3. Steps to use during Time Out.
a. Identify primary feelings.
b. Interrupt negative self talk.
c. Begin positive self talk.
d. Call a friend, a group member, a crisis line to assist in de-escalating
oneself during the time out.
4. Write out the Control Plan and rehearse the steps required. Include a
written statement of commitment to remain non-violent.
5. Do positive activities to manage stress for prevention of stress overload.
For example, a physical exercise program of 3 times weekly for at least
20 minutes each time.
6. Use the Control Plan regularly.
IV. CLIENT CONTRACT
Client Contract: The treatment agreement between the certified treatment
agency and the perpetrator. It must include the following:
1. An agreement to be free of all forms of violence as defined in Section
3.0 during the time in treatment.
2. Accepting responsibility for previous violent behavior.
3. An agreement specifying the number of sessions of the treatment program
and the program's allowed number of missed sessions.
4. An agreement not to use sexist or racist language in the group.
5. An agreement to meet financial responsibilities for treatment.
6. An agreement to be alcohol and drug free during treatment if this is
indicated during the evaluation process.
7. Signed releases of information by the perpetrator allowing the treatment
provider to share information with the victim, the court, and other agencies
as determined relevant for assessment and treatment of the perpetrator.
8. An agreement to fully cooperate in therapy by talking openly and processing
personal feelings.
9. A confidentiality agreement delineating the exceptions to client-therapist
confidentiality. These exceptions would include, but are not limited to,
reasonable suspicion of or admissions of child abuse or neglect, threats
to do bodily harm to or to kill another person (per Tarasoff), or suicide
threats judged so serious as to require involuntary apprehension, examination
and possibly commitment.
10. An agreement to respect the confidentiality of the other members of
the group.
11. An agreement not to violate TRO's or other orders of the Court, such
as conditions or Probation.
12. An agreement to use a crisis response plan.
13. An agreement to meet court-ordered family obligations.
Violations of any of the terms of the Client contract may lead to termination
from the treatment program and notification to the referring agency. Specific
violations will lead to termination and notifications as defined in the
STANDARDS Section 7.1.8 and Section 8.3.
The contract must be signed by the client and witnessed by the treatment
provider.
INTAKE EVALUATION
Intake Evaluation: The following is a guide for the steps and content
of an Intake Evaluation.
1. Face Sheet: Completed by client.
a. Basic identifying information.
b. Demographic information.
2. Inventories: Completed by client.
a. FSC High Risk Ten Question Inventory.
b. Violent and Abusive Behavior Inventories.
1) Modified Conflict Tactics Scale.
2) FSC Violent and Abusive Behavior Checklist.
3) Sonkin Inventory.
4) (D.A.P.) Domestic Abuse Project Violent and Abusive Behavior Inventory.
c. Anger and Beliefs Inventories.
1) NOVACO Anger Scale.
2) Inventory of Beliefs About Domestic Violence.
d. Power Balance and Relationship Inventories.
1) Richard Stuart's Decision Making Scale.
2) Dyadic Adjustment Scale.
e. Alcohol and Substance Abuse Inventories.
1) (MAST) - Michigan Alcoholism Screening Test.
2) (MAC) - MacAndrew MMPI Scale.
3) Alcohol Use Profile.
4) (SUDDS) - Substance Use Disorders Diagnostic Schedule.
5) (DRI) - Driver Risk Inventory.
6) (MACH) - Minnesota Assessment of Chemical Health.
7) (ASI) - Addiction Severity Index.
8) (ATP) - Alcohol Troubled Person Scale.
9) Alcohol Use Questionnaire.
10) Alcohol Troubled Person Scale.
f. Personality and Psychopathology Inventories.
1) Million Clinical Multi Axial Inventory.
2) (MMPI) - Minnesota Multiphasic Personality Inventory.
g. Depression and Suicide Risk Inventories.
1) Beck Depression Inventory.
2) Beck Hopelessness Inventory.
h. Stress and Isolation Inventories.
1) Preventive Measures Brief Stress Inventories.
2) Personal Problems Checklist for Adults.
3) Social Readjustment Rating Scale.
3. Intake Interview Outline - A guide for the assessment interview to be
completed by the Treatment Provider during the Intake Interview.
a. Patterns and history of physical violence, sexual violence and other
abusive acts against a partner to include:
1) Most recent incident of physical violence.
2) Incident that brought them to program.
3) First incident of use of physical force.
4) Most severe, serious incident.
5) Incidents that caused injury to partner.
6) Frequency of incidents.
7) Incidents in which objects were used as weapons
or weapons were used.
8) Incidents of sexual coercion, forced sex and/or rape of a partner.
9) Use of the following tactics of power and control against a partner;
as assessed from the "Tactics of Power and Control Wheel".
a) Isolation
b) Emotional abuse
c) Intimidation
d) Using male privilege
e) Sexual abuse
f) Threats
g) Using children
h) Economic abuse.
10) Incidents of surveillance of a partner such as following them and
spying on them.
11) Threats to kill the partner.
b. Pattern and history of relationships with intimate partner to include
1) Present relationship status: dating, living together, married, separated,
divorced, etc., and degree of anger and frustration or anxiety regarding
relationship.
2) Number of relationships and/or multiple separations in one or several
relationships.
3) Identification of those relationships in which client was violent and
abusive.
4) Sexual relations pattern, specifically degree of coerciveness or use
of force in sexual relations.
5) Jealousy and possessiveness toward partner, including degree of obsessive
thoughts about the partner and fear of losing partner.
6) Most significant heartbreak and loss of love experiences and how lived
through, how recovered, or other responses such as withdrawal from loving
or seeking revenge.
c. Family of origin - present status and history of specific problems to
include:
1) Three generation genogram identifying key and significant relationships,
bonding, and conflicts.
2) Domestic violence by one parent against the other parent or parent figure.
3) Abused, neglected or abandoned as a child by one or both parents or parent
figures.
4) Sexually abused as a child by one or both parents, parent figures or
other family members.
5) Alcoholism, alcohol abuse, drug addiction, or drug abuse.
6) Mental illness.
7) Suicides in family of origin.
8) Murder of member or members of family of origin.
9) Homicides by member or members of family of origin.
10) Divorce.
11) Death of a parent or parents or parent figures.
12) Violence by siblings against brothers or sisters or others outside the
family.
13) Forms of discipline by parents or parent figures.
d. Same sex peer group membership and belonging - present status and
history to include:
1) Present group(s) to which now belong or with whom associated.
2) Amount of time spent with group(s).
3) Nature of group's activities.
4) Attitudes of group members toward opposite sex.
5) Attitudes and beliefs of group members regarding violent and abusive
treatment of opposite sex.
6) Use of alcohol or drugs by group members.
7) Acts of violence or abuse by group members as known to client.
8) Clients beliefs about actions group members would take if they knew about
client's violence against partner.
9) Actions taken by group members if they do know.
10) Lack of same sex peer group and/or pattern of isolation including few
friends or friendships.
e. Opposite sex friendship(s) - present status and history to include:
1) Number of, if any friends of opposite sex.
2) Length of friendship(s).
3) Nature of friendship(s).
4) Experiences of and beliefs about partner's responses to client's opposite
sex friendship(s).
f. Other violence - history of violent behavior against others than an intimate
partner to include:
1) As a child or a teenager of violence committed such as fighting in school,
fist fights, or fighting in sports.
2) Participating in or witnessing gang violence or violence in the neighborhood.
3) As an adult acts of violence such as street fights, fights in bars,
or fights with peers while in the military.
4) Training for fighting such as boxing, karate, judo, etc.
5) Arrest(s) and criminal record for violent acts.
6) Prior TRO's against client.
7) Violent acts committed against siblings or other family members.
g. Alcohol and substance use, abuse, or addiction history to include:
1) Brief natural history of alcohol and drug use, including most recent
use, first use, episodes of abuse, patterns of use, and impact on any significant
area of life.
2) Arrest, DUI's related to alcohol or drug use.
3) Counseling or treatment for alcoholism or drug addiction.
h. Medical and mental illness history to include:
1) Suicide ideation, attempts, or crises.
2) Hospitalization for mental illness.
3) Acute or chronic depression.
4) Personality disorders diagnosed or diagnosable.
5) Head injuries that could precipitate violent actions.
6) Medications now taking or have taken.
7) Previous counseling, psychotherapy or psychiatric assistance.
i. Conflict patterns to include frequency, severity and style of conflict
in other relationships with:
1) Family member.
2) Friends.
3) Neighbors.
4) Employer.
5) Co-worker.
6) Authority figures such as police.
j. Environmental and situational stressors to include:
1) Present financial standing (income, and indebtness).
2) Stability of present employment, if employed.
3) Brief or chronic unemployment.
4) Sources of additional financial support.
5) Employment conflict threatening job.
6) Illness of family member.
7) Separation from spouse by job requirements or military deployment.
8) Other environmental or situational stressors.
k. Child care and disciplining of children to include:
1) Child care performed primarily by client or partner (approximate number
hours of child care performed daily and weekly).
2) Methods and patterns of physical discipline of children such as:
a) Spanking with hand.
b) Spanking with object such as belt.
c) Slapping child on face.
d) Hitting child with fist.
e) Other forms of physical discipline.
3) Methods and patterns of other forms of discipline of children such as:
a) Grounding.
b) Room confinement.
c) Sit in corner.
d) Giving chores.
e) Removing privileges.
f) Consequences directly related to offending behavior.
g) Others stated by client.
l. Lethality risk assessment to include:
1) Present threats to kill the partner.
2) Past three to kill this partner or other partners.
3) Use of weapons such as knives, guns, heavy blunt instruments such as
a baseball bat, or other potentially lethal weapons against a partner.
4) Possession of lethal weapons.
5) Degree of obsession, possessiveness, jealousy regarding the partner.
6) Suicide crises in which killing the partner would be the first act.
7) Violations of a TRO with demonstration of little concern for consequences
of arrest and jail time.
4. Independent records and description of the client's acts of violence
and abuse that may be reviewed and used in the intake interview, assessment,
and treatment planning.
a) Police report from time of arrest.
b) Investigators report, if available.
c) Prosecutor's investigation and statements taken from the perpetrator
or victim.
d) Victim's statement.
e) Court transcript.
f) Statements on the TRO.
g) Medical reports from examinations of the victim, that may include photographs.
h) Witnesses' statements.
i) Probation officer's report.
j) Other________________________________.
5. Release of information signed by client authorizing exchange of information
between the treatment provider and the following individuals or agencies.
a) The victim.
b) The court.
c) The probation officer.
d) Previous therapists and present therapist.
e) The shelter.
f) The prosecutor.
g) Child Protective Services.
h) Medical personnel such as a doctor.
i) Family of the perpetrator.
j) The Conciliation Court Counselor.
k) Others, as needed.
NOTE: The release of information should be limited to those individuals
and agencies relevant to each perpetrator. Further, the safety and protection
of the victim remains an underlying rationale for the release.
6. Client Contract to be reviewed in detail with the client by the treatment
provider and signed by the client. (See the guide for a client contract
in the previous section of the STANDARDS). The treatment provider
also signs as the witness.
7. Other forms and matters that should be reviewed with the client at the
intake evaluation are:
a) Fees and payment procedures.
b) Schedule of group sessions.
c) Group rules.
d) Goals of the Treatment Program.
e) Books and materials to be used in the program.
8. Treatment Provider's Impressions: The information gained from the various
reports, statements, inventories, and intake interview will be the basis
for the judgments made about the perpetrator regarding the following:
a) Perpetrator's acceptance of or denial of responsibility for violent acts
committed.
b) Perpetrator's level of commitment to attend, participate, and change
through the treatment program. This commitment may vary from none to a moderate
level of commitment at the time of intake.
c) Perpetrator's ability to use the type of treatment the program offers,
and, if judged unable or inappropriate the action directed by the STANDARDS
should be taken. For example:
1) If actively alcoholic or drug addicted chemical dependency treatment
is to precede treatment for domestic violence.a
2) If mentally ill, such as psychotic, appropriate psychiatric and medical
care is to be provided first.
3) If unable to tolerate involvement in a group, as with some persons with
schizoid personalities, individual treatment may be required.
9. Treatment Plan: The final disposition action by the Treatment Provider
regarding the individual client is the culmination of the Intake Evaluation.
This disposition is drawn up in the Treatment Plan and should include the
following:
a) The decision regarding the client entering the treatment program:
1) Admission into the program now.
2) Deferred admission, with a referral out to address one of
the several problems identified earlier, before beginning treatment.
3) Referral to another treatment program though the original referring source,
because of considerations that would make the other program more appropriate;
reasons may be geographical location, fees, or inability to begin the client's
treatment in the time required by the court.
4) Rejection of the client for the treatment program for reasons that
could include:
a) Lethality risk considered too great.
b) Client's denial and minimization too great and acceptance of responsibility
too little, such as in complete denial of having committed any act of violence,
claiming the police, the prosecutor, and the court are completely wrong,
and the client insists they do not belong in the treatment program.
b. The Treatment Plan will also specify the stages or phases of the treatment
program and inform the client of optional other services as available per
the guidelines of the program.
1) Individual treatment sessions at a particular time of crisis or upon
successful completion of the first twenty four weeks of group treatment.
2) Couple treatment sessions after completion of the first twenty four weeks
of group treatment as guided by the STANDARDS.
3) A problem solving meeting of the victim and perpetrator on an as
needed basis, for example, to make child visitation arrangements.
c. The Treatment Plan will address the full range of the client's assessed
needs as related to the clients' violent and abusive behavior. The issues
of child abuse, child neglect, child sexual abuse, committed by the client;
as well as, the client's own history of having been abused as a child, will
be addressed in the Treatment Plan. Only those conditions or problems that
are identified and agreed upon by the STANDARDS will be treated before addressing
the violence, specifically alcoholism, drug abuse, or severe psychopathology
such as psychosis.
d. Notification of the disposition and the Treatment Plan will be provided
the referral source, whether the Probation Officer, Prosecuting District
Attorney, Prosecuting City Attorney. This notification should be by telephone
and in writing.
e. A written statement of the Treatment Plan will be maintained in the Treatment
Program's records with other documents contained in the individual client's
case.
10. Summary of the nine elements outlined in the above Intake Evaluation
Guide.
a. Face Sheet.
b. Inventories.
c. Intake Interview Outline.
d. Independent Records and Descriptions of the perpetrator's violent acts.
e. Release of Information.
f. Client Contract.
g. Other Forms and Matters.
h. Treatment Providers Impressions.
i. Treatment Plan.
VI. TREATMENT EVALUATION AND MONITORING COMMITTEE
Treatment Evaluation and Monitoring Committee. The Committee formed
by the San Diego County Task Force on Domestic violence, and carried on
by its successor, the San Diego County Coordinating Council on Domestic
Violence.
Task and Responsibilities: The tasks and responsibilities of the COMMITTEE
will include:
1. Designing the necessary application forms to be completed by the Treatment
Program when applying for certification.
2. Evaluation of Treatment Programs for perpetrators for compliance with
the STANDARDS. Evaluations are to be conducted in the following manner:
a. A minimum of three Committee members will conduct the Evaluation. These
three members will be from different representative groups on the COMMITTEE.
Conflict of interests will preclude any Committee member evaluating
their own program.
b. Evaluations by the three member team will be reviewed by the COMMITTEE
for the COMMITTEE's concurrence with the findings.
c. Evaluations of all existing Programs presently receiving referrals from
the three referral sources within the first six months of the founding of
the COMMITTEE.
d. Evaluation of new Programs as they are formed and request to gain
referrals from the three referral sources.
1) Within one month of the Program's request for referrals.
2) Within one month of the Program's request for Evaluation prior to requesting
referrals.
e. Evaluation of Programs using the Certification Guide provided within
the STANDARDS.
f. Findings of the Evaluation will be provided the Treatment Program within
two weeks of the evaluation and will either be:
1) Full Certification.
2) Conditional Certification.
3) Pending Certification.
3. Definitions of Certification Categories:
a. "Full Certification" means that the applicant has met all
STANDARDS and is now certified to provide court ordered domestic
violence treatment.
b. "Conditional Certification" means that the TREATMENT EVALUATION
AND MONITORING COMMITTEE has certified the applicant for a limited time
period negotiated by the COMMITTEE and the program. The applicant
must meet the criteria for certification and final determination will be
made by the COMMITTEE.
c. "Pending Certification" means that the TREATMENT EVALUATION
AND MONITORING COMMITTEE has determined that the application is not
in compliance and cannot deliver services to court ordered perpetrators
until the applicant is compliant.
d. Programs that have been given Conditional or Pending certification will
be provided an itemized, detailed listing of actions necessary to be Certified.
A time limit will be set to meet those requirements not to exceed sixty
days.
e. Treatment Programs may also be evaluated by the COMMITTEE as either
having Failed Certification or their certification is rescinded; as defined
below:
1) "Failed Certification": Those programs determined to be of
a Conditional or Pending Certification status, who do not fulfill the required
conditions to comply with the STANDARDS within the time permitted,
will be classified as "Failed Certification".
2) "Rescinded Certification": Programs with Full Certification
could lose their certification based on violations of the STANDARDS;
the violation must be of a gross or grievous nature.
f. Examples of gross or grievous violations are given below, but not limited
to these examples.
1) Negligence such as in a failure to act to provide reasonable care
for a victim who was seriously and specifically threatened with bodily harm
and/or death by a client, per the Tarasoff and related Rulings. (See Appendix
IX for guidance regarding the Tarasoff and related Rulings).
2) Violating client's confidentiality such as publicizing the client's identity
to the media in a promotion of the program without the client's consent.
3) Engaging in sexual relations with a client.
4) Failure to report child abuse or neglect.
5) Taking bribes from a client.
6) Falsification of records.
4. Monitoring of those Treatment Programs receiving referrals of court mandated
perpetrators.
5. Reporting to the following referral sources of court mandated perpetrators:
a. Probation Department.
b. District Attorney's Domestic Violence Prosecution Unit.
c. City Attorney's Domestic Violence Prosecution Unit.
6. Reports will include:
a. Programs in compliance with the STANDARDS.
b. Certification status of Treatment Programs as:
1) Full Certification.
2) Conditional Certification.
3) Pending Certification.
c. Listing of Programs not in compliance with the STANDARDS.
d. Actions required of Programs to become Certified, when they are either
Conditionally Certified or Pending Certification and the time limit within
which those required actions must be completed.
e. Listing of Programs who have failed to meet the required actions within
the time limit and notice of:
1) Failed Certification.
2) Rescinded Certification.
7. Removal from the listing of approved programs, those that have failed
to be certified or certification was rescinded; and, guidance to the three
identified referral sources to cease referrals to such programs.
8. Keeping of records and documents of compliance reviews of programs,to
be available to the public.
9. Meetings at intervals adequate to conduct the business of the Committee,
no less than six times annually.
10. Review and update of the STANDARDS at a minimum of every
two years based on the following:
a. Research findings demonstrating more effective treatment approaches than
those selected by the existing STANDARDS.
b. Information from the practice and experience of treatment providers
that identify needs for specific revisions, modifications, or additions
to the STANDARDS.
c. Information from the clients that identify needs for specific revisions,
modification, or additions to more effectively address their treatment needs.
d. Information from victims and other sources that indicate needs for revisions,
modifications, or additions for more effectively meeting victims' needs
for safety and protection.
11. Re-evaluations of Treatment Programs for continuing certification will
be required every two years. Earlier reevaluation of a Treatment Program
will be triggered by a complaint of a gross or grievous violation of the
STANDARDS as outlined above in section 3., f.
12. Monitoring and assuring indigent clients are referred to all Treatment
Programs in an equitable manner.
13. Maintaining continuing education records, thus, verifying the treatment
providers are meeting continuing education requirements as set by the STANDARDS.
14. Reviewing and approving these classes and training programs and
certifying them as meeting the requirements for continuing education.
Membership
The Committee will be comprised of nine members:
1. Two members from the staff of Shelters for Battered Women.
2. Two members from the staff of the Treatment Programs for perpetrators.
3. One member from the Probation Department's Domestic Violence Unit.
4. One member from the District Attorney's Domestic Violence Prosecution
Unit.
5. One member from the City Attorney's Domestic Violence Prosecutor
Unit.
6. One member to be a man who has successfully completed his Treatment,
maintained a violence free life following Treatment, and demonstrated leadership
by service to other perpetrators or battered women.
7. One member to be a woman who is a survivor of a battering relationship
and is active on behalf of battered women.
Selection of Members:
Members will be nominated through the Founding Committee of the San Diego
County Task Force. Nominees will be presented to the General Membership
of the Task Force. The Task Force General Membership will vote to complete
the final selection of the Committee from the nominees presented in each
of the seven representative groupings. The following are guidelines for
nomination and selection of members:
1. Nominees will be known amongst their peers and have demonstrated competent,
ethical actions in their area of work.
2. Gender balance will be essential to the COMMITTEE.
3. People of color will be represented on the COMMITTEE.
4. County wide representation will be important.
The Executive Committee of the San Diego County Coordinating Council on
Domestic
Violence will assume the role of the founding members for accepting nominees
to the COMMITTEE and presenting them to the Council's General membership
for a vote.
Terms of Membership:
Members will serve two year terms on the COMMITTEE, with the following
exception: this exception to the two year term is provided to allow the
forming of the COMMITTEE in such a manner as to provide continuity
and overlap of members on the COMMITTEE.
1. The following first term members from the following representative
groups will serve a one year term on the COMMITTEE:
a. One staff person of the Shelters' group.
b. One staff person of the Treatment Providers Group.
c. The representative from the men who were perpetrators.
d. The representative from the District Attorney's Domestic Violence Prosecution
Unit.
2. Replacement members for those serving an initial one year membership
will be selected at the end of the first year.
3. Replacement members for those serving a two year membership will be selected
at the end of the second year of the COMMITTEE's founding.
4. Selections of Committee members will continue in this alternate year
sequence throughout the life of the COMMITTEE.
5. Replacement of a Committee member who resigns or leaves the COMMITTEE
will be done through the following steps:
a. Interim appointment until the next General Membership meeting. Nominees
to be presented to the Executive Committee of the Coordinating Council,
who will select the individual nominee for the interim appointment.
b. Presentation of nominees to the earliest General Membership meeting for
a vote to decide who will complete the term of the member who resigned or
left the COMMITTEE.
Disagreements Over Evaluation Findings:
The findings of the Evaluation of the Treatment Program by the COMMITTEE
may result in disagreement from the Treatment Program. The Treatment Program
shall be entitled to present its disagreement to the entire COMMITTEE
and appeal for the COMMITTEE to alter its findings.
VII. TACTICS OF POWER AND CONTROL WHEEL
VIII NON-VIOLENCE AND EQUALITY WHEEL
IX EXCEPTIONS TO THE PRIVILEGE OF CONFIDENTIAL COMMUNICATION
Exceptions: Per the Evidence Code and Tarasoff Rulings:
Section 1017 - No privilege exists as to a confidential communication
made to a psychotherapist who is appointed pursuant to court order to examine
the patient. This exception does not apply where the court has appointed
a psychotherapist at the request of defendant's lawyer in a criminal proceeding
for the purpose of determining whether defendant should enter a plea based
on insanity or base a defense on his or her mental or emotional condition.
Section 1018 - No privilege exists if the services of the psychotherapist
were sought or obtained to enable or aid anyone to commit or plan to commit
a crime or tort to escape detection or apprehension after the commission
of a crime or a tort.
Section 1020 - No privilege exists in a proceeding where either the psychotherapist
or the patient alleges a breach of duty, such as in a malpractice action,
arising out of the therapeutic relationship.
Section 1023 - No privilege exists in a proceeding initiated at the request
of a defendant in a criminal action to determine his or her sanity.
Section 1024 - No privilege exists when the psychotherapist believes that
patient's mental or emotional condition causes him or her to be a danger
to himself or herself or to others and the disclosure is necessary to prevent
that danger.
Section 1025 - No privilege exists in a proceeding brought by the patient
to establish his or her competence.
Section 1027 - No privilege exists where the patient is under 16 years of
age and the psychotherapist has reason to believe the child has been the
victim of a crime and the disclosure is in the best interest of the child.
TARASOFF V. BOARD OF REGENTS
When a psychotherapist determines that his or her patient presents a serious
danger of violence to another, the psychotherapist incurs an obligation
to use reasonable care and make a reasonable effort to protect the intended
victim. The psychotherapist is required to take one or more steps to prevent
the violence. It may be necessary for the psychotherapist to warn the intended
victim of the danger, warn individuals who in turn would warn the victim,
notify the police, or take other steps which are reasonable under the circumstances.
Disclosure should be discreet and accomplished in a fashion that preserves
the privacy of the patient to the fullest extent compatible with
the prevention of the threatened violence. In making the determination
that a patient presents such a danger, the psychotherapist need only exercise
the degree of skill, knowledge and care ordinarily possessed and exercised
by other psychotherapists under similar circumstances.
The court's reasoning in Tarasoff is that by entering into a psychotherapist-patient
relationship, the psychotherapist assumes some responsibility for the safety,
not only of the patient, but also of any third person whom the psychotherapist
knows to be threatened by the patient.
The notification by a psychotherapist of an intended victim or others does
not constitute a breach of confidentiality. Section 1024 of the Evidence
Code states that there is no privilege "if the psychotherapist has
reasonable cause to belive that the patient is in such mental or emotional
condition as to be dangerous to himself or to the person or property of
another and that disclosure of the communication is necessary to prevent
the threatened danger." Note Section 1024 permits the disclosure of
otherwise confidential communications under specified circumstances. Tarasoff,
speaks to a narrower set of circumstances under which there is a duty to
take actions for reasonable care to protect the victim from the threatened
harm, and as interpreted by some as a duty to warn, and includes a potential
liability for failure to act. The duty to disclose to prevent harm does
not arise where "risk of harm is self-inflicted or mere property damage."
Bellah vs. Greenson.
CRIMES AND TORTS (Evidence Code Section 1018)
When a patient tells a psychotherapist that he or she has committed a crime
or tort, the information is privileged. However, there is no privilege if
the services of the psychotherapist were sought to aid in the planning or
commission of the crime or tort or to escape detection or apprehension.
CHILD ABUSE (Penal Code Sections 11165 - 11172 - 11174)
(Evidence Code Sections 1026, 1027)
Recent legislation which went into effect January 1, 1981, repealed earlier
child abuse provisions contained in the Penal Code and added a series of
new sections.
Section 11166 of the Penal Code mandates reporting suspected incidents of
child abuse to a child protective agency immediately or as soon as practically
possible by telephone, with a written report to follow within thirty-six
hours.
X CERTIFICATION GUIDE
Certification Guide and Instruction
1. This Guideline is meant to be used as a means of certifying treatment
programs for the treatment of domestic violence perpetrators. The process
will involve a combination of reviewing written reports and plans, and oral
interviews, and may involve on-site visits.
2. Supportive documentation means written documentation from outside sources
specifically addressing the Standard involved. These sources might include
professional organizations, other professionals, and interested or related
organizations.
3. The written portion of the certification will be derived from the application
form which has been completed by the program under consideration for certification.
4. The oral portion of the certification will involve oral interviews by
the TREATMENT EVALUATION AND MONITORING COMMITTEE. The COMMITTEE
will require an oral interview with the Treatment Program Director and
specific treatment providers.
5. On-site requirements will be met by a visit to the treatment facility.
6. Compliant means that the TREATMENT EVALUATION AND MONITORING
COMMITTEE has determined the STANDARDS have been met by the
applicant.
7. Non-compliant means that the TREATMENT EVALUATION AND MONITORING
COMMITTEE has determined that the applicant does not meet a standard.
If this rating is received, Conditional or Pending Certification must be
given. It can be converted to full certification once all standards are
complied with.
8. Pending Certification means that the TREATMENT EVALUATION AND
MONITORING COMMITTEE has determined that the applicant is not in compliance
and cannot deliver services to court ordered perpetrators until the applicant
is compliant.
9. Conditional Certification means that the TREATMENT EVALUATION AND
MONITORING COMMITTEE has certified the applicant for a limited time
period negotiated by the COMMITTEE and the program. The applicant
must meet the criteria for certification and final determination will be
made by the
COMMITTEE.
10. Full Certification means that the applicant has met all standards
and is now certified to provide court ordered domestic violence treatment.
Those programs determined to be of a Conditional or Pending Certification
status, who do not fulfill the required conditions to comply with the STANDARDS
within the time permitted, will be classified as "Failed Certification".
11. Failed Certification means those programs determined to be of a Conditional
or Pending Certification status, who do not fulfill the required conditions
to comply with the STANDARDS within the time permitted.
12. Rescinded Certification means those programs with Full Certification
or Conditional Certification that lost their certification based on violations
of the STANDARDS, the violation having been of a gross or grievous
nature.
a) Examples of gross or grievous violations are included in but not limited
to the examples as sited in Appendix VI under "Tasks and responsibilities",
Section 3., f.
b) The vote by the nine members of the TREATMENT EVALUATION AND
MONITORING COMMITTEE to rescind a Program's Certification, must be by
a count that is the majority plus one vote. Thus, six of nine members must
agree to this action.
13. Re-evaluation of a Program for continuing certification will be conducted
every two years. Earlier re-evaluation could be brought about by a gross
or grievous violation of the STANDARDS.