Intimate partner violence (IPV) represents a significant clinical problem among veterans and service members. Numerous studies indicate that veterans and service members with greater posttraumatic stress disorder symptoms are at particularly high risk for IPV use (Marshall, Panuzio, & Taft, 2005; Taft, Watkins, Stafford, Street, & Monson, 2011). With large numbers of returning U.S. military members, there is an increasing need for effective IPV intervention among this population.
Dr. Casey Taft and his colleagues have developed an IPV intervention program to be implemented among military veterans and service members. The Strength at Home Men’s Program (SAH-M) is a cognitive-behavioral group therapy that takes into account how trauma influences social information processing leading to IPV. Current theory and research indicate that traumatic experiences can drastically change the way that people view themselves, others, and the world, which then has important consequences for how they interact with others. Many traumas are the result of negligent or purposeful actions of those that were deemed to be trustworthy (e.g., family members). Furthermore, in combat, there is a need to constantly evaluate surroundings in search of potential threat. Consequently, someone exposed to a traumatic event may develop a deep mistrust of others and a predisposition to interpret their intentions as hostile or threatening. This tendency may serve to escalate conflict when interacting with one’s partner, increasing IPV risk.
The SAH–M program involves 12 sessions covering a variety of areas, including psychoeducation about trauma and IPV, teaching conflict management and communication skills, discussing the role of core themes (e.g., mistrust and power/control issues) underlying trauma and abusive behavior, and discussing how military training and experiences may contribute to negative relationship communication behaviors (Taft et al., 2013). An early small pilot study with this program found reductions in IPV behaviors at 6 months follow-up showing large effect sizes (Taft et al., 2013).
Recently, a randomized controlled clinical trial was conducted to examine the efficacy of SAH–M among a sample of 135 U.S. veterans and service members (Taft, Macdonald, Creech, Monson, & Murphy, in press). Participants were randomized to receive either SAH-M or Enhanced Treatment as Usual (ETAU), which involved clinical referrals for mental health and IPV services and ongoing IPV assessment during the study. Additionally of note, the study included IPV reports from 82.2% of the participants’ partners, which helps protect against potential IPV underreporting.
Taft and colleagues (in press) found that SAH–M participants evidenced greater reductions in physical and psychological IPV across time compared to those in the ETAU condition, particularly from pre- to post-treatment. When different forms of emotional abuse were disaggregated, the SAH-M program appeared particularly effective (relative to ETAU) at reducing behaviors that involve controlling one’s partner through isolation and monitoring.
This study provides empirical support for the SAH-M program and is the first randomized controlled clinical trial to demonstrate efficacy of an IPV intervention program among military veterans and service members. The effects of SAH-M found in this study are especially noteworthy in the context of the broader literature on IPV intervention programs, where rigorous research designs are uncommon and where modest, statistically non-significant findings are typical (Babcock, Green, & Robie, 2004).
The trauma-informed approach taken by SAH-M may be one reason for its success in reducing IPV. While it’s well-known that military veterans and service members are exposed to high rates of trauma (with all participants in this clinical trial reporting exposure to at least one traumatic event), it is notable that even civilian samples of men enrolled in IPV intervention programs report high rates of trauma exposure (e.g., Maguire et al., 2015). Thus, an important future step will be to examine how efficacious SAH-M may be among civilian men who use abusive behaviors.
Discussion Questions:
- How might traumatic experiences increase risk for the use of abusive relationship behaviors, beyond the ways mentioned in this blog piece?
- In what ways might civilian and military populations differ that are relevant to the implementation of the Strength at Home Men’s Program?
Blog Post Authors:
Adam D. LaMotte, University of Maryland, Baltimore County. Mr. LaMotte is currently a graduate student in the Human Services Psychology program at the University of Maryland, Baltimore County. Adam has worked with Dr. Taft on research concerning the influence of trauma and PTSD on the use of intimate partner violence among military veterans.
Casey T. Taft, National Center for PTSD, VA Boston Healthcare System, and Boston University School of Medicine. Dr. Taft’s program of research is on the etiology and prevention of intimate partner violence, with a particular focus on the influence of trauma. Currently, he is conducting additional research on the Strength at Home program, as well as overseeing its implementation at different Veterans Affairs sites across the U.S.
References
Babcock, J. C., Green, C. E., & Robie, C. (2004). Does batterers’ treatment work? A meta-analytic review of domestic violence treatment. Clinical Psychology Review, 23, 1023-1053. doi:10.1016/j.cpr.2002.07.001
Maguire, E., Macdonald, A., Krill, S., Holowka, D. W., Marx, B. P., Woodward, H., & … Taft, C. T. (2015). Examining trauma and posttraumatic stress disorder symptoms in court-mandated intimate partner violence perpetrators. Psychological Trauma: Theory, Research, Practice, And Policy, Advance Online Publication. doi:10.1037/a0039253
Marshall, A. D., Panuzio, J., & Taft, C. T. (2005). Intimate partner violence among military veterans and active duty servicemen. Clinical Psychology Review, 25, 862-876. doi:10.1016/j.cpr.2005.05.009
Taft, C. T., Macdonald, A., Creech, S. K., Monson, C. M., & Murphy, C. M. (in press). A randomized controlled clinical trial of the Strength at Home Men’s Program for partner violence in military veterans. Journal of Clinical Psychiatry.
Taft, C. T., Macdonald, A., Monson, C. M., Walling, S. M., Resick, P. A., & Murphy, C. M. (2013). ‘Strength at Home’ group intervention for military populations engaging in intimate partner violence: Pilot findings. Journal of Family Violence, 28, 225-231. doi:10.1007/s10896-013-9496-y
Taft, C. T., Watkins, L. E., Stafford, J., Street, A. E., & Monson, C. M. (2011). Posttraumatic stress disorder and intimate relationship problems: A meta-analysis. Journal of Consulting And Clinical Psychology, 79, 22-33. doi:10.1037/a0022196