Practice blog

Duluth, more than just a perpetrator programme. Risk-led approach, more than just a checklist

I have been thinking about Duluth a lot recently. For those of you young enough that it was before your time (lucky you!), Duluth is a town in Minnesota where the wonderful Ellen Pence and Michael Paymar developed a model of addressing domestic abuse in a holistic way. It required commitment from the whole community and it became known as the co-ordinated community response.

Part of that model was a project which worked with perpetrators of domestic abuse to challenge their behaviour. So when everyone in the UK was so excited at the start of the integrated domestic abuse programme (Idap) which worked with perpetrators, it sometimes got called the Duluth programme. But the Duluth model was so much more than just working with perpetrators. It brought together a package of help from across the community to keep women safe.

Everyone was responsible for tackling domestic abuse

At its simplest, that meant everyone was responsible for tackling domestic abuse. It meant that we, in voluntary services, would work in partnership with statutory agencies and, essentially, the whole community to improve their response to domestic abuse across the board. We would campaign to make statutory services realise that they needed to get better at supporting women who were experiencing domestic abuse. In short, we would make sure these women’s voices were heard.

One thing that has always stuck with me is a video with a perpetrator from Duluth.  He realised he had to confront his behaviour when he felt like the whole community was linking arms and saying: “this isn’t on and we won’t accept it.” That had a real impact on me because it seemed so obvious when I thought about it: why should voluntary services have to solve the issue of domestic abuse on their own? Shouldn’t all services have a part to play in safety?

 And that is one of the reasons why I like the Marac model - it made other agencies take some responsibility for doing the right things to protect victims of domestic abuse and their families. I talked about some of the other reasons I like the risk-led approach in my recent blog which many of you were kind enough to respond to (thanks for that, all responses welcome - we need to have the debate). I wrote then how using tools like the Dash checklist to stop the most serious forms of violence is just one part of a risk-led approach that keeps victims and families safe - in the same way that perpetrator projects like Idap were just one part of the Duluth community response model.

Just as Duluth was more than a perpetrator programme, a risk-led approach is so much more than a checklist.

That’s not rocket science. Anyone who lives with domestic abuse long term is impacted by that in some way - you would have to be superhuman not to be. So of course, people need longer term support to build their resilience and aid their recovery. We need to make sure that this help is there too. That’s why I am so delighted that our new strategy addresses wider issues - like the need for a clear pathway of support to move on from the trauma of domestic abuse. Of course, before anyone experiencing domestic abuse can become safe in the long term, we need to reduce the immediate danger they are in – and that’s where tools like the Dash come in. But just as Duluth was more than a perpetrator programme, a risk-led approach is so much more than a checklist.

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Dash - a tool for empowerment, not just risk

Anyone who works with victims of domestic abuse will know that empowerment is a key part of helping a woman stay safe long-term. This is something we cover with the independent domestic violence advisors (Idvas) we train – how they can use the tools at their disposal to empower clients wherever possible.

 Part of an Idva’s case management system when they work with clients is the Dash risk checklist. The Dash is used to spot when a person is at risk of violence from a partner or family member, and get her the right help as quickly as possible. It is linked to the Duluth power and control wheels  – an earlier tool developed to identify common themes in abusive relationships.

The Dash is a tool that helps women to come to terms with their experiences and to put them into context

One of the questions we ask Idvas on our training is to give four uses of the Dash risk checklist. Of course, we are looking for them to say that it helps them identify who is at highest risk of murder or serious harm, but we don’t expect Idvas to stop there. Because, as you work through the Dash checklist, as well as identifying risk you also establish the nature of the relationship. Is there physical violence? Sexual abuse? Coercive control? The Dash is a tool that helps women to come to terms with their experiences and to put them into context.

Some women, after you explain the results of the Dash to them, respond with “Thank you – it’s such a relief, I thought I was imagining it or overreacting”

It can be a shock for women to move from minimising their experience of abuse or blaming themselves to understanding the reality of it, but that is part of the journey to recovery. I find that some women, after you explain the results of the Dash to them, respond with “Thank you – it’s such a relief, I thought I was imagining it or overreacting”.

Once we have the information from the Dash, we use it to complete the individual safety and support plan. This addresses the person’s safety along with any other issues we have identified  from coping strategies developed during difficult times that are hampering her ability to move forward, to difficulties left over as a result of financial abuse. When we train Idvas, we make sure that they consider how they can use the tools at their disposal to empower clients wherever possible, never doing something that a woman could do for herself. She won’t feel like the plan is hers if it is written by the Idva alone – she needs to own it herself.

Completing the Dash and safety planning are both important to reduce the risk a woman faces from domestic abuse, but they are also steps towards helping her to take back control of her life. As I’ve said before, identifying risk is a step towards empowerment.

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Since when did safety stop being a need?

When I first started working with women nearly 20 years ago, we didn’t talk about a risk-led approach. That isn’t to say we weren’t making decisions based on risk, we were – all the time. With only so many hours in the day, and lots of women needing our help, we made choices about who to call, which partners to involve, who needed extra support, whether to share information or not and so on.

We came from a place of wanting to empower women and make sure they stayed in control of their lives and their information. We still do, I hope.

We went to bed on a Friday night, hoping we had made the right decisions. Hoping that the incredible women we had met that week would be safe. And sometimes we got it wrong, and something bad happened.

As a domestic abuse worker you live with this reality. But, my God, that’s easier when you have some evidence to back up your decisions and it isn’t all just based on your gut feeling. That’s why I still stand by a risk-led approach.   

Recently, I have heard people say that it was a mistake to go to a risk-led rather than needs-led approach and that, with hindsight, victims’ needs are getting missed.

This seems to me like a misunderstanding of the risk-led model. Our basic needs are inextricably linked to physical safety. I have trained Idvas for years using the concept of Maslow’s hierarchy of needs because it explains it so clearly:

Maslow's hierarchy of needs, domestic violence and the risk-led approach

Maslow suggested that you have to work your way up the pyramid and we are all motivated to do this. But the catch is that you can’t move up until you have met all the needs below.

So, to me, the risk-led model is just about starting on the bottom rungs. And the further down the pyramid you start, the more help you might need because these aren’t things you can go without.

My partner is a youth worker. He points out that if a young person comes in and says they have been told they will be evicted today because their housing benefit hasn’t been paid, the worker rings the housing benefit office for them. Quickly. Later on, they will work with them to develop the skills necessary so that they can fix this stuff themselves. But, right now, that young person needs to be warm and dry tonight.

It isn’t either advocacy or empowerment. It is one step at a time.  

At North Devon Women’s Aid, we developed a programme from the US called Pattern Changing, which was about empowering women to achieve the top rungs of the pyramid. I don’t think we will ever really stop domestic abuse until we can offer something like this more widely – to help victims recover after abuse and be the person they want to be. But it is also just part of the solution: women can’t join a group and focus on their needs if they are terrified when they walk to and from their car.

On my office wall I have a quote from Mahatma Gandhi: “There are people in the world so hungry, that God cannot appear to them except in the form of bread.”  

There are victims of abuse who aren’t safe tonight. Victims who don’t have food and shelter for themselves and their kids tonight. We can’t meet women’s needs unless we help them get safe – starting by reducing the risk they face of being murdered or seriously harmed.

So let’s stop focussing on semantics. Let’s help women to get safe and feel safe and then let’s talk about developing their self-esteem – as part of an holistic set of interventions that don’t just stop the abuse, but help women get their lives back – on their own terms.

After all, since when did safety stop being a need?

A week in the life of an Idva service

Up and down the country, Idva services work tirelessly to make sure victims of domestic abuse can be safe. The work they do is complex and varied – so we asked one of our Leading Lights services to give us a flavour of what goes on. Here, Zoe Jackson from Aurora New Dawn in Hampshire talks us through a week in the life of her service.

Monday

Monday is a particularly busy day for our Idva service, spent catching up with referrals from the weekend and getting up to date with developments on our existing cases. After a quick catch-up, someone makes the first round of tea and it’s straight down to business.

An Idva’s diary is constantly changing. We prioritise our work based on risk, so diaries often have to be re-organised in the event of an emergency. For one Idva this is exactly what happens this morning. A police officer has left a message to say the perpetrator in one of our cases was arrested overnight. The client doesn’t want to make a statement and although the police have managed to hold her partner until this morning, he will be released imminently. The Idva contacts the client straight away – she wants to leave, has packed her things and is ready to go. The Idva calls some local refuges but they don’t have space, so arranges to meet the client in 30 minutes at the local housing department. The rest of the team continue through their emails and new referrals. At lunchtime the Idva who went to support their client at the housing department checks in – accommodation has been found and the client is on their way there.

As she arrives back, another Idva leaves for a pre-arranged visit. She meets a woman at her workplace: she has recently been granted a non-molestation order and her employers are supporting her well. Before, the perpetrator had turned up at the workplace and we had incorporated work-based safety procedures into the client’s individual safety and support plan. At the client’s request, the Idva has arranged to meet with both her and her manager to offer guidance on safety in the workplace.

Tuesday

This morning one of our Idvas attends a multi-agency public protection meeting for a perpetrator who is known to the service. In the past we have worked with some of his victims whose cases are now closed, but we attend the meeting to provide domestic violence expertise and ensure that we know about any developments. At today’s meeting it becomes apparent that the individual is in a new relationship, so the meeting agrees plans to make sure the new partner is safe.

Back in the office, another member of the team receives a call from a current client. We haven’t been able to get hold of her over the last couple of weeks. She discloses that further incidents have taken place which she hasn’t reported to the police. The Idva takes her through a review of her risk assessment (which always happens after further incidents) and explains that the case will be re-referred to Marac. The Idva works with the client to update her individual safety and support plan and arranges to visit her at a safe location later in the week, when the perpetrator is at work.

Wednesday

It’s Marac day: a key part of any Idva’s role. There are Maracs running in two locations today. Our service covers both, so two of our Idvas are out of the office.

On Marac days the rest of the team covers the phones – teamwork is a crucial part of any Idva service. They update the database with any client contact and email the absent members of the team to keep them up to date. By 3.30pm both Idvas are back. I have a quick chat with one of them about a particularly complex Marac case. We run through possible actions and record the discussion and actions on the client’s file.

Thursday

One of the Idvas this morning gets a particularly high-risk, possible honour-based violence referral. They flag it with management, and the Idva and I review the referral paperwork together. One of the other Idvas who has particular expertise around honour-based violence joins the discussion and we think about what we need to explore with the client so that we understand the risks she faces. Her first language is not English so the allocated Idva finds a telephone interpreter and heads upstairs to call her.

Meanwhile, the other Idvas are updating clients about yesterday’s Marac meeting, ensuring they feel part of the process. In the afternoon we have the first of this month’s case reviews: I sit with one member of the team to talk through her cases and agree actions for the next four weeks. The Idva handling the honour-based violence case from this morning is now busy uploading their paperwork to the database, having been on the phone to the client and various other professionals throughout the day.

Friday

This morning it’s the monthly Aurora team meeting: a chance for everybody to catch up and update the rest of the team on developments. There’s a slot for recent ‘good news’ stories: one of the Idvas shares a positive experience where they worked with a local police officer to obtain a particularly robust restraining order for a client. The Idva was impressed by the officer and we agree that we’ll write to their superior to highlight their efforts.

We are a team member down at the meeting – one Idva is at court with a client who is representing themselves at a return hearing for a non-molestation order. They call in at 11am to say the court has granted the order.

After the meeting, there is an update on yesterday’s honour-based violence case – the client has been placed in a hotel temporarily. The Idva plans a joint visit with social care for next week and will call the client again later.

The team continue to work through their caseloads, calling any remaining clients before the weekend so that they have access to all the safety planning and support information they need. We are fortunate to have a volunteer-run helpline available from Friday evening to Monday morning, so the last thing the team do before leaving the office is to divert the phone to the helpline.

Helping Ella – or, how Insights data helped us create a better service for the whole family

130,000 children live with high-risk domestic abuse in England and Wales – and nearly two-thirds of these children are also directly harmed.

Fleur Buechler is the service manager at Stop Abuse for Everyone (Safe) in Exeter, and explains how SafeLives’ Insights data helped Safe get better at helping the whole family.

For an audio version of this blog, scroll down to the bottom of the page or visit our Soundcloud profile.

When 5 year old Ella* was referred to us in December 2014, she was terrified to leave her mum’s side. Last year, she watched her mum’s new partner break into their home. After smashing a window and slashing the sofa, Ella saw him threaten to kill her mum with a knife.

When Ella came to us, she refused to sleep in her own bed. She was increasingly aggressive towards her mum, Sarah*, and had begun to talk about what had happened at school.

 

Living with domestic abuse causes huge harm to children. Children who have lived with domestic abuse often display symptoms of trauma, as well as other behavioural and cognitive problems, and depression or anxiety. Children can become aggressive or withdrawn, or experience separation anxiety. Some even lose previously learnt developmental skills, like the ability to speak.

One of the reasons children are so badly affected is because the abuse invades all aspects of their lives. Violence can become normality. One young person told us: “I’ve really missed out on my childhood. People say it is the most carefree part of your life. This wasn’t true for me. It was the worst part of my life – constantly living in fear.”

Stop Abuse for Everyone (Safe) has been running a community family service for children and their parents since October 2014. In April 2015, we reviewed the service because of what SafeLives’ Insights data analysis told us about our clients: 61% had children who lived in or regularly visited the household, and two-thirds of those families were currently involved with children’s social services. Adults supported by our Idva service are typically at significant risk of harm - so it was likely that the children within these households were also at risk.

We set about adapting our service to reflect this. Now, all families discussed at the East and Mid Devon Marac are offered support by our new community family service.

The community family service helps parents understand the impact domestic violence has on children, and support them to improve family bonds. We also work with children to build their self-esteem and confidence, giving them a safe space to explore and express their feelings and identify healthy ways to manage conflict.

 

When she came to us, Ella’s mother Sarah wanted to strengthen the bond between the two of them, but she also wanted to be able to have clear boundaries and make decisions in the best interests of her daughter.

We started by helping the family repair the damage to their house, so they could feel safe again. Ella and our family worker drew a “helping hand” of safe places and people she could speak to, and together they practised dialling 999. A dreamcatcher helped with her nightmares. Through art sessions, Ella began to explore her emotions and what to do about them – like thinking before hurting someone, or who she can talk to when she gets scared.

The team worked with Sarah to understand Ella’s developmental milestones, so she could see what was normal behaviour and what was being altered by the trauma she had experienced. We helped her think about her parenting style – and encouraged her to use tools like a reward chart with Ella.  We helped Sarah get a place on the Freedom parenting course and she’s also planning to join our pattern changing programme later in the summer. The programme helps women like Sarah to recognise healthy and unhealthy traits in intimate relationships, and aims to improve their self-esteem and confidence.

Now, Ella is able to sleep through most nights. She told us that she no longer feels frightened at home, and knows her mum is keeping her safe. Sarah feels  empowered to make decisions about how she parents her daughter – like allowing Ella to sleep with her until she felt safe enough to sleep on her own, regardless of what other family members might say. Both of them are doing better, and moving on from the abuse they suffered.

 

Without the initial spur of looking at the analysis of our data provided by the Insights team at SafeLives, we might have been slower to recognise the need to work with the whole family to recover from the trauma of abuse. We’re proud of the work that our community family team does to help families in Exeter live their lives safely again.

One of our family workers sums it up: “Every day I hear the pain of people affected by domestic violence and abuse. Yet despite this I see brave people wanting to change and grow, saying no to violence. These people are my inspiration."

Thank you to the Big Lottery Fund for its continued support of Insights – helping services understand how to better support families in their local area.

 

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