Domestic Violence Intervention Treatment in the State of Washington - PowerPoint PPT Presentation

Domestic Violence Intervention Treatment in the State of Washington An Overview of Changes in the Standards WAC 388‐60A Amie Roberts, LMHC, CPM Children’s Administration Domestic Violence Intervention Treatment Program Manager 1

Behavioral Levels of Tx Assessment Treatment Treatment Plans Requirements Quality Management 2

Acronyms in these slides… WAC = Washington Administrative Code IPV = Intimate Partner Violence DVIT = Domestic Violence Intervention Treatment Tx = Treatment Bx = Behavior Hx = History MH = Mental Health TBI = Traumatic Brain Injury 3

4 0 4 0 0 1 1 0 1 5 0 5 2 2 0 1 18 0 15 4 4 0 3 0 0 1 1 0 0 3 3 0 0 1 1 1 0 7 https://www.dshs.wa.gov/ca/domestic‐violence/certification‐process  86 Certified DVPT Programs 4

Quick Reference List for Draft WAC 388‐60A WAC Section Standards 388‐60A‐00 Administrative (Definitions, purpose, advisory committee, program records and department records) 388‐60A‐0100 Certification and Application Requirements (Certification requirements, application process, documentation for certification and recertification, policies and procedures, facility requirements and quality management) 388‐60A‐0200 Direct Treatment Staff Requirements (Personnel records, minimum staff requirements, staff disclosures, trainee, staff, and supervisor requirements, supervisor responsibilities, continuing education and adding direct treatment staff) 388‐60A‐0300 Program and Participant Standards (Referral screening, non‐discrimination, treatment focus, group treatment, treatment practices, participant requirements, co‐occurring treatment, participant rights and confidentiality, releases of information and participant contracts) 388‐60A‐0400 Treatment Requirements (Behavioral assessment and interview criteria, treatment planning, placement criteria, required cognitive and behavioral changes, minimum treatment periods and requirements, re‐offenses and non‐compliance, completion criteria, core competencies and discharging participants) 388‐60A‐0500 Department Reviews and Actions (On‐site reviews and plans of correction, complaint investigations and program or staff 5 status changes)

Statewide Perceptions Before the WAC Change • One Size Fits All • Wide Assessments & Treatment Variations • Efficacy & Trust 6

Purpose of WAC 388‐60A  Increase accountability and competency ‐ a pathway to achieve the following: 1. To responsibly and as accurately as possible, assess the risks, needs and responsivity for perpetrators of IPV; 2. To increase victim safety ; and 3. Use evidence‐based and promising practices to hold participants accountable for achieving core competencies, including: • Documentation of their cognitive and behavioral changes ; and • Documentation of their personal accountability 7

Levels of Tx 8

Treatment: One Size Does NOT Fit All Entitled L e a r n e d TYPOLOGIES: Battering, Intimate terrorism, Coercive controlling, Situational, Mutual POWER CULTURE 9

The assessment, third party and collateral contacts will help us answer:  How deeply engrained are current thought and behavior patterns?  Motivations for change: What can we work with? Is there cognitive dissonance?  Levels 1‐3 the core material stays the same – Individualization and how long will it take to establish new patterns and break the abusive pattern? … Levels of care.  High risk (critical factors) and criminogenic needs must be included in the treatment plan and addressed in group or individual sessions. 10

4 Levels of Treatment (Placement Criteria for weekly treatment) No DVIT Level 1 Level 2 Level 3 Level 4 Low Med High High Risk Risk Risk Risk • Hx and • Critical • Med to • IPV Bx • Not a Fit Pattern Factor High • Low risk • Not IPV of IPV Bx Level of • Anti‐ and or Psycho‐ • Little or social lethality • Victim pathy no Crim. Traits • Early Services Needs • Crim. inter‐ Referral Needs vention 12 Month Min. 6 Month Min. 9 Month Min. 18 Month Min. 11

What used to be an ‘Intake’ is replaced with a… Behavioral Assessment 12

Gather Information Interview Asses Behavioral assessment Risk Probation Lethality Background checks Needs 911 tapes CPS information Motivations Guardian Ad Litem Strengths Victim Degree of patterns Cognitive & behavioral indicators Family members Other treatment Police or incident report Testing Level of Treatment General responsivity Specific responsivity Individualized goals Individualized interventions 13

Behavioral Assessment & Interview 1 Assessment vs. Screening High Risk Substance Use 2 Factors (S) (A) 7 More Testing Mental Health standardized (A/S) (S/A) and also 3 more robust 6 Environ‐ment Belief System (A) (A) & costly TBI (S) 4 5 14

Behavioral Assessment & Interview  Summary  Social & legal history  Degree of cognitive & behavioral patterns  Behaviors to target in treatment  Level of accountability  Ongoing  Motivations & readiness to change  Results of testing  Level of treatment, rationale & referrals 15

Victim Contact Initial Call At Assessment And Within 14 Days Of Enrollment  Who you are and the purpose of the assessment  Inform them of victim service programs in their area  Participant is accepted into or rejected from program  Primary objective of DVIT: To help increase safety of the victim and children & hold participant accountable  Core competencies and minimum treatment completion “Is there anything criteria you would like us to  They (victims) are not expected to participate know?”  Limitations of treatment  Program’s mandated reporting and duty to warn 16

Treatment Plans 17

Treatment Plans Measurable Behavior Changes Update When There Are:  Significant changes  Factors with victim safety  A change in risks, needs, goals or objectives  Moving to a different level of Tx 18

Treatment Requirements 19

From ‘Topics’ to Cognitive and Behavioral Changes This is a major change to our treatment approach and delivery style  Unique Forensic Counseling Skillset 20

Cognitive and Behavioral Changes & Documentation The goal is to affect cognitive and behavioral change , which must be shared by the participant in group and documented in the participant’s individual record. 21

Cognitive & Behavioral Changes (Levels 1‐3) Forms of Abuse Belief Systems Respectful Relationships Impact on Children Financial & Legal Obligations Cultural & Family Dynamics Accountability Empathy Defense Mechanisms Healthy Support System Indicators / Red Flags Cognitive Distortions Autobiographical Motivations for Abuse Relationship History 22

A Sense Of Entitlement A Belief That I Should Have Insecurity And The Power & Fear Control Over My Partner & MOTIVATIONS Children FOR ABUSIVE BEHAVIORS Learned The Need To Be Experience – Right Or Win At Abuse Gets Me All Costs What I Want 23

Areas of Focus NOT Found in WAC 388‐60A WAC is the minimum standard. The provider will add topics, discussions, lessons, exercises or assignments that meet the individual treatment needs of the S participant. t a c k i n S c a n n i n g g 24

Completion Criteria For levels 1‐3 Required Goals and Required Co‐ Assignments, Objectives in Minimum Contract occurring Exercises, and Treatment Treatment Requirements Treatments or Cognitive / Plan Period Classes Behavioral (Bx Changes) Changes 25

Core Competencies For levels 1‐3 • Change in Beliefs • Takes • Knows Personal and No Violence Accountability Primary or Threats Motivations for • In Compliance with (min. Six months) Abuse & Alt Ways Accountability Plan to Meet Needs Documented Documented Documented 26

Treatment Delivery Exceptions for participants to attend via live video need to be requested by the program on the participant’s behalf. • More than 45 miles • Physical disability • Other good cause • Confidential and HIPAA compliant live video attendance program Level 4 treatment groups must be kept separate. Otherwise, the program is tailored to the participant’s needs and program’s abilities. 27

Quality Management 28

Treatment Outcomes For Participants • Demographics • Quantitative and qualitative questions • Core competencies • Program feedback 29

Quality Management How T w The e Program m Prov ovides ides: Evide idence- ce-base based o or Promisi ising P g Pract actices ces 1. Co 1. Cognit itiv ive-behaviora oral A Approaches ches 2. Motivation onal I Inter tervie iewing wing Or Or S Similar lar Clie ient-cente tered A d Appr pproaches ches 3. Trau 3. auma-infor -informe med B d Behaviora oral I Inter terventions ons 4. Str Streng ngth-b th-based Str Strategies 5. Posit 5. sitive Beh Behaviora oral R Reinfor inforcement S t Stra rateg tegies es 30