Showing posts with label Susan Cayouette. Show all posts
Showing posts with label Susan Cayouette. Show all posts

Thursday, December 29, 2016

The Emerge Model - An Overview

When I started working at a domestic violence agency on Long Island (The Retreat), one of the first pieces of community feedback I heard from my executive director was from another batterer intervention program in the area who had heard that I had revamped my program to begin using the Emerge Model. He warned my ED that he had never heard of the "Emerge Model" and attempted to attack my work at the agency and undermine our program.

This is not an uncommon response, sadly. While Emerge is the first agency in the world to start batterer intervention, the history of the work and the variety of models available for use is not a commonly understood part of domestic violence intervention. Most agencies in the United States use what is known as a "Duluth-like" model. The Domestic Abuse Intervention Program (commonly known as the Duluth Model) is most commonly known due to the proliferation of the "Power and Control Wheels." For many individuals and agencies, it is the only model that is known.

It is unfortunate that there is not more discussed and known about the many models that are a part of this history (such as Men Stopping Violence, Oakland Men's Project, ManAlive, AMEND, RAVEN) and since I worked at Emerge for nearly eight years, I was exposed to and interacted with people doing this work all over the world - many of whom were using different ways of intervening with domestic violence offenders.

In 2002, David Adams and Susan Cayouette (Co-Directors of Emerge) wrote an article outlining the approaches Emerge takes as a part of its model of intervention. As I began working there in 2002, I was able to see the evolution in action, and grew to appreciate how Emerge has constantly pushed their work forward.

I have always experienced Emerge as an "organic" model of intervention. The techniques used by facilitators adapt based on individuals in the classes, the group dynamics as they shift, and make considerations on how co-facilitator teams work together. There is no stronger example for this than how Emerge approaches intakes for new participants.

Most agencies I have experienced have conducted intakes by using individual interviews of new class members. These interviews ask about background, use collateral information (such as police reports or child protective service plans) as a part of understanding the individual, do simple psychological testing (such as the MAST/DAST or an adapted Lethality/Risk Assessment). These appointments tend to last from 60-90 minutes, and for some agencies these also serve as the full assessment or "evaluation" for a referral source.

Practices like this may be helpful in mental health or substance abuse settings, where individual treatment plans are created, and insurance may be billed (requiring diagnosing of the client), but this is neither the purpose of BIP/DVIP, nor is it likely that such layered belief systems behind a choice to hurt self and family is going to be revealed in a first time meeting.

Instead, Emerge takes a group educational approach to intakes. Initial paperwork orientation collects basic info on each participant (which they tend to fill out on their own, with an orientation worker reading through the answers and asking follow up questions as needed), and has the Danger Assessment scale intermixed with questions about background and history. Initial Emerge paperwork also includes a "Violent and Controlling Behavior Checklist," a simple check-off the box and circle the items instrument that is a simple identification and reflection on personal choices and behavior (prospective Emerge facilitators must also fill this form out to demonstrate awareness of their own hurtful patterns).

The real work of the intake is the eight class "First Stage" wherein eight educational lessons are discussed in a group setting. The lessons are designed to be interactive, and engage participants to consider where they fit without pushing them to admit to specific behavior. Lessons include the following:

  1. What Counts as Violence
  2. Self-Talk
  3. What Counts as Abuse
  4. Quick-Fixes vs. Long-Term Solutions
  5. Effects of Domestic Violence on Children
  6. Disrespectful Communication
  7. Respectful Communication
  8. Effects of Domestic Violence on Women
Each lesson provides a background on the impact of harms, identification of a build-up of hurtful behavior, individualizing and understanding the context of harms, and discussing alternative behavior that might lead to repairs and amends. Throughout these eight sessions, individuals are also tasked with discussing their day-to-day interactions with their partner and children, conflict and challenges, identifying their thoughts behind behavior, and humanizing their family members by naming them (this is referred to as a "Short Check-In"). This works to integrate each individual into the classes and humanize them and their behavior.

At the end of Stage One, an individual is required to complete a "Long Check-In" where they must identify their most recent hurtful behavior, and their "worst" hurtful behavior, as well as the history of their relationships, in brief. This activity helps to build Emerge's "Assessment Report" wherein each individual receives a written report that details the quality and content of their participation, how they describe their hurtful behavior, concerns about the individual's patterns, and recommendations.

The advantage of this approach is that it can create more buy-in to the discussions and allow for reflection over time that may influence a report of harm. I think of it this way - when I meet someone for the first time, I am highly unlikely to tell them about my worst and most embarrassing secrets. Yet in BIP/DVIP, not only is this sometimes expected during a first interview, but is expected each week that someone directly name the reason they are in the classes. This is a shame-based approach that may lead to compliance, but may not lead to work toward changing thinking and behavior.

Emerge's "Second Stage" is more dynamic, and consists of the remaining 32 class sessions (Massachusetts' state requirement by the Department of Public Health mandates all BIP/DVIP to be 40-sessions long). During this time, individuals are tasked with joining in discussions, giving feedback to each other, continuing to disclose the challenges and patterns in their ongoing lives, and to eventually complete an individual activity. The "Relationship History" is the most commonly used exercise where an individual (typically completed somewhere between sessions 25-35) outlines 14 patterns in their relationships. This can be a way for the individual to discover things they had not previously considered, a method of having others in the class see where their patterns may be similar, and can be a great place of practicing respectful and healthy feedback.

Each participant also completes a "Goals" activity in one of their final sessions where their activity is reviewed and they are given an opportunity to outline 5-6 goals for improving their life and relationships while the group separately comes up with 5-6 ideas on goals that might be good for that individual. It is a shared experience that again can expose shared patterns but also is work toward accountability for the future.

Throughout the 40-sessions, Emerge also attempts to conduct "partner/victim contacts" where an advocate initially interviews an abuser's partner or ex-partner by asking for their experiences, then group facilitators check in directly with the partner/ex-partner halfway through the program, and at the end of the participant's time in the classes. All of these contacts involve providing referrals to resources as well as informing about the process of the class sessions and how they work.

One of the distinguishing characteristics of Emerge is that it has a much different approach to the Duluth Model in discussing hurtful behavior. Emerge does not use "Power and Control Wheels" in favor of  considering the continuum of harm - how irritating and alienating behavior shift into controlling behavior, which can then shift into abuse or violence. Instead of categorizing harm by type, Emerge takes the approach that any behavior can be hurtful, and the harm is based on the context of the relationship, the history of the partnership, and individual factors that may be involved.

Another major difference focuses on Duluth's primary component: their Community Coordinated Response. This works well within the Duluth city and region, as their population is approximately 250,000 residents and systems can effectively be coordinated to work together and follow similar protocols. Emerge is in Cambridge, MA where the catchment area includes approximately 4.5 million people. With over a dozen probation offices, and about as many individual child protective service offices, it is impossible to create protocols that everyone follows consistently. Emerge follows more of what I think of as a "inside-out" approach, where their reports to referral sources show the values of respect and health, of accountability and responsibility. Facilitators talk to these referral sources on an ongoing basis, answering questions and expressing concerns to hold abusers accountable.

Emerge is a model which engages domestic violence offenders through discussion, like almost all models. There is mindfulness within the agency and model to apply Motivational Interviewing techniques (understanding how to roll with resistance, humanizing interventions, working to understand hurtful behavior patterns that are individualized to the abuser), and their "inside-out" approach provides the ability to interact with community on several levels without coordinating an entire region. Educational activities are designed to be grounded in the complications of relationship issues, while differentiating "normal" human behavior from abuse and violence. Individual activities address unique patterns of harm that may fit for each participant, but have overlap with others.

The agency has also been a national leader in LGBTQ+ interventions in domestic violence, and has both a lesbian and gay men's group. They have been consistent in creating community and cultural specific groups to address varying language and cultural barriers to ending domestic violence. The Emerge model has the advantage of being flexible in how it addresses individual patterns of behavior, as well as considering where unique cultural challenges might need to be addressed in more specific groups. Emerge has a process for developing such groups, and this process involves direct consultation with the communities in question, as well as assessing support and counseling for victims/survivors within the community well before providing services for abusers.

Challenges with the model include the need for facilitators to be conscious of time and agenda setting weeks in advance so that each participant has time to do all the activities in the Second Stage, the need for facilitators to be flexible in discussing topics beyond standard lesson plans, and the need to allow time for weekly check-ins without allowing them to dominate the entire class time. There tend to be more thoughtful and detailed report writing involved as a part of the model as well, which can lead to necessary work outside of classes themselves.

David and Susan recently wrote an end of year newsletter requesting your support, providing an outline of their work in 2016, and discussing some of their referral sources. Another excellent way to support them is to consider attending one of their trainings, purchasing materials, or contacting them for more information. Emerge can be reached at 617-547-9879 or at

Again, in the interest of full disclosure, since I worked at Emerge from 2002-2009, I have a certain buy-in to their model and their methods (I am fond of their administrative practices as well). However, I have also worked to learn more about other models of intervention and try to incorporate other approaches in my own work when I see their value. I hope you join me in making this work a constantly evolving process, both for the individuals in our groups, but also for ourselves as facilitators. In the future, I will try to offer my experience and insights into other models of intervention. Send me an email if you have any questions or would like to see other topics discussed here.

Monday, November 14, 2016

Reflecting Forward at BISC-MI 2016 Conference (Day Two)

(Most links within this article connect to the Facebook Domestic Violence Intervention and Education group, where I detailed most of the conference. I apologize in advance for the length of this article, the details and information are extensive so I tried to do them justice in brief, which for the content of a blog entry are not brief at all. I hope those who attended can use this to reflect on the presentations you witnessed, and maybe expand your learning beyond the conference itself. Those who did not attend - I hope you can see the content of a BISCMI conference and join us next time!)

Day Two of the BISC-MI conference started with direct grounding in the work, and board member and homemade cookie maker extraordinaire, Jeffrie Cape stated, "we need to remember, the purpose of domestic violence intervention work is to create safety, respect, and health for victims/survivors of domestic violence." This needs to be stressed regularly, and can be an important measure of a program in how much they have a foundation in this idea of victim/survivor safety.

Lori (last name omitted for safety and privacy reasons - important to be aware of with victims/survivors) shared her experience of living with her abuser, and the various ways he worked to isolate her - and many of the reasons she did not identify his behavior as domestic violence. The time she went through pain and fear - and the reason why she justified her suffering as being unimportant, are messages we need to be intimately aware of. Not just for the partners and ex-partners of the abusers we work with, but for understanding the justifications of abusers themselves.

In my direct work with abusers, I am thankful for the ongoing interactions I have with victims and survivors through the Facebook DVIE group. Listening to stories, providing referrals, or often just having the ability to listen provides me with a depth of understanding that enhances the interventions I work on with perpetrators. I would like to challenge all of you reading who do BIP/DVIP work to consider your own exposure to these stories, and how you make them real in your practice.

A big part of "reflecting forward" is in reviewing systems that have been in place that overall we need to be more informed about. Scott Miller works extensive to train people on how to use the "Duluth Model," and in doing so is constantly needing to separate out the BIP/DVIP group process part of the model, and bring forward that overall their approach is about engaging with and changing community perceptions and messaging about domestic violence. This "Community Coordinated Response" is key to any interventions using the Duluth Model, yet very few groups and individuals using their model fully implement this critical component.

Praxis International, an agency that works closely with Domestic Abuse Intervention Program (DAIP, the "Duluth Model") has worked for some time to counter claims against its work, and to try and raise understanding about both their groups, their community work, and the plethora of "Duluth-like" BIP/DVIP groups who use Power and Control wheels, but do not accurately follow their model. Scott discussed in his presentation that BIP/DVIP should be designed to hold abusers accountable - not just in groups, but within community, by community members including law enforcement, but also connected systems that might be influential in guiding an abuser toward respect and health (examples may be businesses, schools, places of worship, etc).

Scott also brought forward that research on BIP/DVIP sometimes states that the Duluth Model does not work, and base that conclusion on studying BIP/DVIP groups who say they use Duluth, but may only do the group sessions for abusers, and these research studies almost never go directly to the source to research DAIP.

Oliver Williams spoke to looking to engaging communities as an essential part of effectively addressing domestic violence. Unfortunately, I stepped out of the conference to prepare a bit more for the AQUILA "Truth Squad" portion and missed his discussion. However, I have seen Oliver present on similar topics in the past, and can say that he spends time addressing the need to understand communities if you want to work with them. This is a lesson that we need to consider on broader levels in community coordinated responses, and how we can move away from imposing changes and instead work with and listen to communities to understand their challenges, as well as their successes and the work they may have been doing to work toward respectful and healthy relationships. If anyone who attended the conference who has notes from Oliver's presentation, and would be willing to share them, please do so in the comments of this post.

Lisa Nitsch furthered the conversation about working in community, particularly her experience of being a white woman working in a predominantly Black community. She started with a historical perspective of Baltimore and addressed ways the city has been oppressive to People of Color overall, and methods used to divide communities - and specifically how those tactics and historical political decisions have led to Baltimore being the most segregated city in the United States. Lisa made a point to highlight the work of Kimberle Crenshaw to address the intersectionality of oppressions faced by Black women, and where "white feminism" has created invisibility for Women of Color in the differences they experience with domestic and sexual violence within our society. This point is important in exploring her work within Baltimore, as her status as a white woman needed to be considered in how she worked within her community.

Lisa used several examples of the need to consider intersectionality of oppressions in work to end domestic violence, and to do community coordination. Some important points for BIP/DVIP work include considerations of your facilitators matching the demographic breakdown of the community, having a curriculum that speaks to those differences if they exist, the need to cross-train staff on self-care issues that may overlap with hurtful, controlling, abusive, and violent behavior (such as looking at employment issues, connections that abusers have within community, etc), how feedback from group members is incorporated into the program, and making sure that administrators with power and privilege are not making decisions about programming and community engagement without the involvement of the community itself.

Next Ricardo Carrillo brought forward perspectives from his work with the Mexican Latino community, and described some of the unique challenges to addressing domestic violence. He described how many men he has worked with have grown up as children in environments which equated love with pain, a sense of moral correction to match values that stressed male dominance, and a concept of a spirit/soul wound that can create imbalance, internalized oppression, and ongoing harm in relationships. He brought forward how such childhood experiences may lead to difficulties for men in creating healthy attachments, and leading to dismissing behavior in relationships (as a part of being anxious from modeling behavior witnessed in childhood) or a preoccupied, ambivalent attachment in adult relationships (partially based on conflicting emotions from experiences in childhood).

As a result of these experiences, and in a need to address the hurtful connections men he has worked with have developed in their lives and relationships, Ricardo discussed the need to discuss and develop healthy connections in these men's lives. To discuss childhood experiences as a part of exploring internal coping strategies that can build to abusive and violent behavior in relationships. He also spoke to making cultural connections to health and respect that can be found throughout Mexican and Latino culture, and the use of parables, stories, legends, and history to create repairs and internal reflection.

Hoda Amine presented on the Muslim community responses to domestic violence, and referenced the Muslim Code of Behavior that puts forward community rules that overlap with respectful and healthy behavior discussions that often are a focus of BIP/DVIP groups overall. Some examples of this code include truthfulness, sincerity, unselfishness, humility, patience, forgiveness, purity and cleanliness, honesty, goodness and kindness to others, courage, consideration and respect for others, moderation, and cheerfulness. These values and behavior guidelines can be critical for all discussions during group sessions, but can also be a way to discuss specific movement toward ending domestic violence with Muslim men.

TA Bashir followed up by reviewing history of the Islamic faith, and the challenges that came from moving a people toward new patterns of worship and community value. Many patterns of behavior by men toward women stayed with older traditions that were oppressive and destructive, and these traditions are still coming out today hundreds of years after the formation of the religion. TA talked about creating connections to a womanist tradition, and guiding men to be more aware of the history behind their faith, and the challenges in working toward health and respect.

In looking at how faith can inform and transform change in men who are abusive, Chris Moles engaged the audience in methods of analyzing belief systems without judgment. He states that, "we do what we do because we want what we want," then further described, "we want what we want because we think what we think." This distillation of motive and reason behind abusive and controlling behavior allows for critical viewing of selfishness and a lack of value for family and self. He describes himself as a complementarian, but in a fashion which sees the natural balance and equality of men and women, and how relationships involve working together. Christianity and church services, he explained, have often become gatherings of performance art and socializing with little room for growth of respectful and healthy belief systems - and engaging abusers in their beliefs behind their faith, and their values behind their relationships can be excellent angles for interventions.

Staff from Emerge (Susan Cayouette, Ted German, and Erika Robinson) finished the day by detailing their work with Lesbian, Gay, Bisexual, Trangender, and Queer domestic violence offenders, as well as their work with heterosexual female perpetrators and anger management clients. This work has helped in better informing their work with heterosexual male domestic violence offenders as they have struggled to consider differences in power dynamics, levels and overlaps of entitlement, and has grown knowledge of the need to analyze reactive violence within male heterosexual abusers.

In the next post, I will be finishing up my summarization of the BISC-MI conference by detailing the third day. Again, feel free to visit the DVIE group on Facebook or visit the DVIntervention Twitter feed for links and more information. For links to conference materials, including presentations, click here.