SAN DIEGO COUNTY TASK FORCE ON
DOMESTIC VIOLENCE

"TREATMENT AND INTERVENTION STANDARDS"



TABLE OF CONTENTS



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


BACKGROUND


The problem of domestic violence has existed in San Diego County, as elsewhere in the United States, throughout the history of the county and the nation. The periodic historical movements to confront, outlaw, punish or rehabilitate domestic violence and those who perpetrate such acts came to San Diego county in the 1970's.

Although in the late 1600's in Puritan Boston, in the mid 1800's with the women's temperance movement, and in the early 1900's with the Women's Suffrage movement local communities attempted to address the problem in each successive era, the reforms and changes were either insufficient, overwhelmed, or forgotten. Not until the women's movement of the 1960's, in combination with the child abuse treatment and prevention social and legal reforms of the same decade, did San Diego county act to recognize the problems of battered women.

The founding of shelters for the protection and safety of abused women, brought about by the force of the sweeping changes across the nation, began in San Diego County in the 1970's. With the passage of domestic violence laws in the 1980's, violence and abuse of one's marriage partner became a criminal act. The laws were later expanded to include a partner in a cohabiting status, dating partner or former partners. Wife abuse, women abuse and more generically, domestic violence thus became specifically identified as a misdemeanor or felony crime under California's Penal Code.

The result of legislation that made domestic violence a crime was more direct police action and ultimately greater numbers of arrests of perpetrators of domestic violence. The findings of the National Police Foundation study conducted in Minneapolis, Minnesota, in the early 1980's pointed the direction for greater deterrence. The study found perpetrators were deterred from committing future acts of domestic violence when they were arrested and jailed a brief time, from 24 to 48 hours.

The result of greater numbers of perpetrators being handcuffed, booked, fingerprinted, and jailed, was also to prompt prosecutors to act and charge greater numbers of them with misdemeanor or felony charges. In San Diego County, the City Attorney's office acted to appropriately charge greater numbers of perpetrators with criminal charges. This increase in numbers graphically described the acts of violence and abuse. Ultimately, greater numbers of perpetrators were pleading guilty or being convicted.

All of these conditions began to converge in the late 1980's: the reforms, the legislative changes, the City Attorney's shift in prosecution, and the San Diego Navy and Marine Corps Communities' aggressive actions on the problem.

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These community wide actions began forcing the issue of rehabilitation to the forefront.

For both the civilian and military communities the issue of rehabilitation, intervention, and treatment of perpetrators of domestic violence became an increasingly urgent issue. Urgent first, because the diversion model was sending these individuals into a number of and a variety of treatment and intervention programs about whose effectiveness, too little was known or researched. Secondarily, urgent, because the growing numbers of "convicted" and "guilty plea" perpetrators were inundating existing civilian and military intervention and treatment programs.

The founding of the San Diego County Task Force on Domestic Violence in June 1989 recognized the need for a coordinated, community based approach to not only the issue of treatment and intervention for domestic violence perpetrators, but also to the other key issues of the problem of domestic violence in San Diego County. The task force carried forth its work in the following areas: law enforcement protocols and training; hospital emergency room protocols: pro-arrest law enforcement policies; public education programs; and training of professionals from mental health, and social services, and shelters, as well as clergy from community churches in effective responses to the victims and perpetrators. In addition, greater funding for programs were sought and found.

The issue of coordination of the array of shelters for the safety and protection of women and children remains for the task force.

Throughout the movement by the Task Force, the issue of treatment and intervention for perpetrators continued to surface. The Task Force, through the work of the Treatment and Intervention Committee, concluded that effective rehabilitation and education programs were more likely to be carried on if a set of standards guiding and governing such programs was established. The members of this committee also recognized that such standards, to be effective, must be based on the existing state of theoretical and research knowledge. Therefore, the task force members have written and adopted the following STANDARDS FOR THE TREATMENT OF DOMESTIC VIOLENCE PERPETRATORS.

The STANDARDS, as adopted by the Task Force, are to be presented to the Probation Department's, the District Attorney's and the City Attorney's Domestic Violence Units. These three agencies of the San Diego Community's legal system are capable of placing the STANDARDS into effect throughout the County. Together, these agencies can call upon all Intervention and Treatment Programs for Perpetrators of Domestic Violence, who have been court ordered into treatment, to follow these STANDARDS.

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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.

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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

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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.

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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.

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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.

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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

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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.

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(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.

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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.

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(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;

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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.

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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.

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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).

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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.

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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:

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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.

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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:

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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.

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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.

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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.

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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:

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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.

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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.

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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:

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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:

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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.

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VII. TACTICS OF POWER AND CONTROL WHEEL

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VIII NON-VIOLENCE AND EQUALITY WHEEL

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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

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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.

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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.

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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.