Can People Who Abuse Their Partners Change?

(upbeat music) Welcome to Seating Safety, a podcast on cultivating conditions for health, healing, and violence prevention from futures without violence. I'm your host, Kate Bandertag. Can people who have hurt their partners change? In this episode of Seating Safety, we will be exploring ways that healthcare and social service providers can play a key role in helping people who have been abusive to confront their actions and change harmful patterns. We'll hear about practical strategies, new resources, and ways to promote accountability with my colleague at Futures Without Violence, Juan Carlos Arian. Well, thank you so much, Juan Carlos, for coming on this podcast and talking a little bit about the work you're doing at the intersections of health, well-being, and supporting everyone in the family to be accountable to violence and heal from violence. I think we're really excited to dive in, but first I'd love to just have you introduce yourself and share a little bit about the work you do. Sounds good. Thank you, Kate. It's a real pleasure to be in this podcast with you. So my name is Juan Carlos Arian. I'm a program director at Futures Without Violence with children and youth team, and we work in various projects with a health team. So I bring a few decades of experience on working with people who cost harm with a perspective of defining accountability, not a sponishment, but certainly as consequences and limits, but also as support for change. So that's part of the work. I've developed a lot of materials through the years done a lot of training and technical assistance. And here we are, ready for the next thing. - Well, I think my first question, and I think our audience will be interested to just get your reflection on this is kind of one around level setting around, can people who have hurt their partners actually change? - Yeah, that's an excellent question. And one that I get all the time, partly because there's been research about programs that work with people who cost harm, that normally are usually called batters or battering intervention programs or BIPs. And their research is mixed. There's a lot that we could say about that. There's been a lot of problems mythologically with some of the studies that grabbed the most attention. But aside from that, what I like to come back with is I actually believe that almost everyone can change. The big issue is whether they want to change because nobody can change unless they want to put the hard work into it. And another question that I find interesting is like, well, what are the conditions by which people change in their lives, right? And some people have studied this, right? Like there's all kinds of different models of how people go through, you know, reflection to denial, to pass the nile and so on. So this applies, this is pretty universal in that way. But obviously with using violence, it has a particular flavor if you will because there's of course a lot of shame associated with using violence and is not only breaking the denial, but it's also breaking the shame. That's also truth, of course, for survivors. - Thank you so much. I think that kind of creates a basis for us to move forward in our conversation. And I think is really important when we're thinking about, you know, all the different ways that healthcare providers and domestic and sexual violence advocates show up to support survivors. And what we know is so often survivors are asking us as help providers, whether healthcare or domestic and sexual violence advocates, I just want my partner to change. I just can someone step in and please help my partner. I just want the behavior to change. I just want them to stop hurting me and that's what I want. And so I think this begs the question of, okay, well, what can healthcare providers and others who are supporting survivors really be doing to address that ask that survivors are making of us? And we know that survivors can not and should not be the ones who are really supporting their partner or people who have been abusive to change. So who should or could be playing that role? - That's a great question. And there's a lot in there that I agree with that you put there. So maybe we'll start with the last thing that you said, which I told I agree that it shouldn't be survivors or any person that is really the recipient of the violence, it could be children too, it could be all the members of the family. Those are not the people that should be responsible for supporting the person to change. Now, basically everybody else in my opinion can play a role on this. But now I want to go to the beginning or your beginning statement because so important, because I think often health providers, DV advocates and other folks are hesitant to work with people who cost for various reasons. But one of them is like, well, that's not my job. I'm here to support survivors. Those people can be locked up and let's throw away the key, whatever you want to think about it. But it's so important to go back to that, that what you said is that the truth is that the majority of survivors, especially survivors of a caller, the research is very clear on this, are telling us exactly that. And they might not want to stay with the person, but they still want them to change. They still want them to be a good father to their children if it can be done safely. And even if those elements are not there, I always say that survivors are the most generous people that I've ever met because I've heard so many times, people really caring about their, even their ex-partners and one that to happen, that change to happen is not universal. And we have to recognize that some survivors say, I want nothing to do with the person or I want him to go to jail, which, you know, doesn't often happen anyway, but we need to really listen to what survivors want. So the first thing to recognize is that working positively with people who cause harm is a survivor centered approach. And in fact, see them as full people and not as monsters or caricatures or stereotypes is survivor centered. Because survivors don't see them that way. Most survivors don't see them as monsters, even if they have been suffering abuse for a long time. They see them as multi-dimensional people with both flaws and strengths and often they still love them. So I think it's so important that we, first of all, get into that mindset that by engaging people who cause harm, we are being survivor centered by enlarged because that's what many, many survivors want to do. Now in terms of the role, that's an interesting one. I have a colleague who used to be a probation officer, Jim Henderson, his name. And he talks about the wall of accountability. And basically the concept is that if everyone plays a part in accountability except for the survivors, that is what will really change things. I like to think about it more as kind of a circle of accountability, it's a little softer for me and for my particular approach. And we are not saying that for instance, a healthcare provider or an advocate or a faith leader can do this by themselves, right? There are services, there are people that specialize in supporting people to change, whether it's with battle intervention programs, restore justice, transformative justice, supervised visitation of other hood programs. There's actually quite a few pathways of accountability. But I think the role that anyone can play, including health providers, is to open the conversation, make people aware that this is an issue, make people aware that there's help available. The other big piece of help that is new is help line, right? A call for change where we can talk more about about that later, but we were people who cause harm now can call a helpline and get help that way. So basically the idea of recognizing that any healthcare provider will have some patients who are people who use domestic violence that cause harm. So at least opening the door to educating them about the harm that they are doing, about the cycle of violence, even about what constitutes abuse because sometimes when working with people who cause harm, they don't necessarily think about non-physical abuse as being harmful, right, even though we obviously know that clearly. And then giving them referrals or opening the door for that kind of help, I think anyone can and probably should do that. - That gives us a lot to think about. And one thing I kind of wanted to pause before we move on and ask you is, I notice you're using the language, people who cause harm as opposed to perpetrator or abuser. Can you talk a little bit about why you're using that language? - Yes, thanks for that question. So historically in our, in the domestic violence movement, we have used words like better perpetrator or fender. And many people still use it, which is okay, you know, I'm not the language police, you can use whatever term you want to use. However, in the last few years, and because of the influence of restorative and transformative justice practitioners, more and more people are used what we call people first language. And for me, it's more than, you know, language is powerful, right, language is more than language. Language shapes our mindset when we do something. So I feel that for me at least, when I call someone a better, it's almost this thing like, okay, once they're always a better, that's the essence of who you are, right? Can go going back to what we were saying before, seeing someone as you need dimensional, that that's all they are. When we use people first language, like people who use violence, people who cause harm, even people who better, that I think separates the personhood from the actions. And for me, that's more than language. That's the approach really, because if you don't separate those things, then you're coming from a place that will create shame, right? Shame, like someone like Renab Brown has said that the difference between shame and guilt, that shame is feeling bad about who you are, right? And guilt is feeling bad about something you have done. - Oh, wow. - Very different. And there's solid research that shows that people don't change when they're in the space of shame. If you shame someone, they will not change. So I think trying to avoid that, I mean, it's difficult to avoid it completely, because we naturally go there, but at least trying to create the conditions that people, or at least not pushing them to shame, or worse, guilt, it's actually a healthy and useful feeling, because people should feel guilty about having done bad things. And that's part of the process of change. So for me, it's more than just words. It's really a framework of how I think about this issue. - That's really helpful. And I think I definitely agree with you that how we talk about it does influence how we think about it and how we respond. And so that's really helpful. I also think about how the word perpetrator or offender in addition to not being people first and creating space for change is also very couched within a criminal legal approach to violence. And we know so much intimate partner violence, happens in a way that is not against the law, right? Is not necessarily a crime, but it's still abuse. And so I think that terminology that you're using kind of could capture all the different ways that folks are being controlled and hurt by a partner. So I really appreciate that shift. - Totally agree. - So I just may add that one of the main interests when working with people who cost harms to do it outside coercive systems, because you cannot teach people not to be coercive by being coercive, right? You don't teach children not to hit other children by heating them, right? It just doesn't work that way. And unfortunately, at least in the US, most of the programs that work with people who cost harm are within the criminal legal system, the child welfare system, and so on. We're starting to see exceptions to that, but they are not a lot of those. So if we are going to engage people outside systems, i.e. when they are not mandated by courts and so on, language really matters, right? I mean, who wants to go to a batter's intervention program? - Right. - No one will show up. You can still not sugar code it. You know, I for 12 years work and directed a program where about half of the folks were non-mandated, and it was called Man Overcoming Violence. I mean, it was very clear what it was, but we never called it a batter's program. - Right. - Mm-hmm. People are a part of the solution when they're coming there, they're not being labeled as people who cannot change the benefits identity. - So something you were talking about a little bit ago brings me to the next question I have for you, which is thinking about how health and social service providers and domestic and sexual violence advocates even could be a part of this web of support and accountability for folks who have used violence and caused harm towards their partners. What are some specific strategies or tools that health and social service providers could use to engage people who maybe have hurt their partner or maybe are at risk of being abusive in their relationships? - Well, that's such a timely question, Kate, because as you know, we have been working in the last few months on a choose safety card, and for those of you who are not familiar with Ques, you can visit our website and learn more about it, but these are pocket-sized cards that open like a little accordion and have different panels with basic information about domestic violence. The health team at Futures has been working for 15 years in this card, mainly focusing on survivors, but I know you folks have been having conversations for probably a few years about, well, how can we extend these to also include people who cause harm? So in the last year, so we have collaborated the children's team and the health team at Futures to develop such cards. And it's interesting because there's been some wonderful opportunities to do this. I'll speak first about another project that we have been doing with a research organization called Child Trends. So we got a grant from OPRE and HHS to develop the safety cards, particularly for responsible fatherhood programs and healthy marriage programs. And these are programs you can imagine, fatherhood programs works with fathers, not necessarily fathers who cause violence, all fathers basically, you know, to become better fathers and being involved with their children and healthy marriage programs work sweet individuals and couples again to enhance their relationships in various ways. So we developed cards for these programs and it's exciting because we're working with Child Trends and their son evaluation of the use of this card. So we went through a pilot and this cards again for the first time, including information both that speak to survivors and people who cause harm. And one of the ways that we do that and hasn't been able to contain everything in a car where the real estate is very precious in some way. But it's making the connections of course, determining what is a healthy relationship. We start there, right? Or a caring relationship, then what is not and how when it crosses over to abuse, then recognizing that many people grow up in the in-house roles where they has been abused. And that sometimes people reproduce those behaviors, always emphasizing that even if you grew up in a house where that happened, that's never an excuse to be abused. If you still have the responsibility of not doing that. Then universally we talk about how using violence or being a survivor of violence actually affect your health and there's plenty of research that, right? And then we talk about some strategies that people can use, both people who cost harm and people who are survivors, and then resources that they can access. And one of the exciting things that I think this makes it much more easy in some way to create this car right now is what I mentioned before, the helplines for people who cost harm. The first one started here in Massachusetts in 2020. You're in the pandemic actually, it has been expanded now to California. They really worked nationally. It's called a call for change. You can look it up. But there's also other states and communities that are developing their own helplines. For instance, how so, Rudd Merlant is just starting one. There's one in Vermont and there's others working. So it's an idea whose time has come, if you will. So in the context of fatherhood programs and healthy marriage programs, we have some preliminary results from the cards. And some things echo very much previous research on the QS cards, which is that people, the practitioners love them and like them much better than screening. We heard almost universally that screening is such a difficult conversation and so awkward and it seems so formal, where it's like talking based on the cards is very natural. It opens the conversations. It opens all the possibilities. So that's all over the results of their research. And we are actually surprisingly seen that there's just by this relatively simple intervention, there is some movement in how participants, because we did some quantitative research to how participants think about domestic violence, especially there's some significant, I mean, statistically significant increases on people saying that they feel more comfortable talking about their relationships and their conflict on their relationships with others, with practitioners and so on. Even some attitudes that in particular the fatherhood program that can be the base for abuse like, you know, a man should always know where their partner is and those kinds of things, right? There is some movement just from the initial conversation. What will be interesting, yeah, I know, what will, we will need to do further research and hopefully we can do some of that is to see if people are accessing the resources as, as, because of, because of this intervention. But then in addition to those two cards, really a set of cards, we also collaborated with health team developing a card specifically for health providers. And it's called building carrying and save relationships. It's available both in English and Spanish. We're just piloting it right now. We are just unveiling it right now. So it's not available on our website in this moment. Hopefully it will be soon. But so far the practitioners that have seen it are very excited about using it. And we are hoping to work with some community health clinics in probably different states to really see how they are received by patients and how practitioners are using them and really refine them maybe a little bit more and then we'll be able to distribute them and to give some training around how to use them. So it's super, super exciting development. That is exciting to hear because I know when I'm training health care providers, often the question comes up, what are we, what do we do for, you know, the man or, you know, what are we doing for the person who is actually hurting my patient? How do I address that? And I think there's kind of not always been a great answer. I don't know that I've always had a good answer for that question. And I think being able to have a tangible resource that is inviting people into thinking about and reflecting on their own behavior and their relationships and also has a place where folks can go. There's a number to call where someone is, you know, going to talk with you and help you reflect on your behavior and kind of all the things that we do know, inspire and support people to change and be accountable. So that's really exciting to learn about. And I know folks will definitely be interested in using that car. Yes. And if I may add, I think the Q's approach is perfect for people who cost harm. We know from the research that of course with survivors is very effective because it's not about disclosure, right? It's universal education. Everybody gets it. Everybody gets more than one. They approach us altruistic. You know, maybe you know someone that you can pass this on, to and that works very well with survivors. And our hypothesis is that it will work, I don't know, maybe even better, but as well with people who cost harm for what we were saying before, the shame element. I think it's more difficult to get disclosures for people who cost harm in some ways, because of that shame and because of fear of legal consequences and many other things. So to do it from a perspective of universal education and having a resource now to refer to people, that's that's priceless. So I'm so excited. I think this is opening the doors to a different kind of approach and working with people who cost harm, which we didn't have before in this country. That makes a lot of sense, because I think, you know, what we know from research is that there's a lot of reasons, survivors of intimate partner and sexual violence are very reluctant to disclose to a healthcare provider when they're being asked those screening questions. Like, are you safe at home or has your partner hurt you in the last year and, you know, what we hear from survivors is there's a lot of fear answering that, you know, where is this information going and who is going to find out about it and, you know, are my kids going to get taken away if they find out I'm a victim of DV. And so I could see how that fear and shame of answering a screening question on, you know, using violence or experience of violence is even more so for folks who who have hurt their partner. I really think it would be very hard for someone to answer that question honestly and directly if being asked by a health or social service provider. So I definitely see how a more universal education approach where you're really just sharing information, making sure folks know, you know, what support exists in their community and highlighting the resources where they could get support for themselves or how to support a friend who might be using violence. I think that seems like a way of having the conversation that's more open and less, as you're talking about, less about, you know, meeting the barrier of folks shame, then maybe a screening approach would be. And so can you talk a little bit about, you know, I'm excited to hear that this card is coming out and, you know, that it's in the development process. Could you talk a little bit about any next steps that you might be taking with others to learn more about how it's being used in healthcare settings? Yes, absolutely. So as you know, better than me, the development of these cards take a lot of work. You know, they are simple, but there's so much work behind it. And so just in the development of the card, we already have gathered a lot of information from future staff, from allies, and doing focus groups with patients, with providers, and so on. But that's not the end of it, right? We have a pretty good product. So what we want to do, as I mentioned before, is really try it now with patients and providers. So see how it works because there's always room for refinement. And even though some people are already wanting to have the cards and use the cards, we want to make sure that we have the product that is really helpful for everyone. So the next steps will be to pilot the cards in two or two or three different sites. And we are right now in the middle of identified those sites, training folks, having them use the card, and then getting some feedback in case we need to change some things. And at that point, I think we pretty much will have a final product that will be available for everyone. Excellent. Very exciting. This has been a great conversation today. Is there anything else you think our audience would benefit from hearing about anything else you want to share around these intersections? Yes. I just want to say that I understand the hesitation to engage people who push harm. When I do trainings, I often ask what are people's concerns? Right? I also ask about their hopes. And one of the concerns that often happen that often comes up is that people will get hurt themselves right physically. And of course, that's a possibility. But I always say that chances are if someone gets hurt is the partner if something happens. So there are risks of unengaging people who cause harm. And we have to be super, super, super careful about how to do this. Of course, the absolutely basic practices that we never talk about this is just when both parties are in front of us, right? We don't put people on the spot either if you're talking about perpetration or victimization or whatever, you know, it always has to be a private conversation. And the other concern that I think makes sense is people feeling like, well, what if someone disclosed that they use harm? Right. And again, we will have training for this. But going back to this idea of the universal responses or the circle of accountability. For me, there's like four key elements that I have in mind that I think anybody can practice. The first one is telling the person, you know, I care about you. And you know, health care providers are in that profession because they care about their patients, right? So hopefully you can stay in a place where even though this person has on maybe some terrible things, you still care about their well-being, right? So that's number one. Number two is because I care about you, I don't want you to hurt your family or yourself, right? So if you couch it from the reality, which is like, you know, we don't want you to be doing this, you know? And then there's help, you know, there's help for you. And then people can change. That's the other, like we started the podcast with what? With that. And that's such an important message because I also for advocates, right? Because if we are telling partners that people absolutely cannot change, we are really doing at the service, you know, it's true that some choose not to change. But some do choose to change. And in my decades of work, I've seen many change. Again, it's all about the conditions that we create for that person to change. So again, I understand the hesitation, I understand the fear, but I think we practice and with reflection and changing our mindset about how to approach this, we can really change the way that we work with people who cost more. Excellent. Thank you so much, Juan Carlos. I thank you. I've left me with a lot to think about and I'm excited to hear more as this safety card gets developed and is being used by healthcare providers in the field. And maybe we can have you back on the podcast any year or so to hear more about what you've learned and share with folks any updates or questions or ideas that are generated through the process moving forward. But I think that wraps up our conversation today and so grateful to you Juan Carlos and we hope to have you on again soon. Thank you so much. I would love to come back and I have enjoyed it. Thank you very much. Thank you very much. You've been listening to Seating Safety. For resources and information from the National Health Resource Center on Domestic Violence, visit ipvhealth.org. Thanks for listening.