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NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.
This report has been reviewed by a group other than the authors according to procedures approved by a Report Review Committee consisting of members of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.
This study was supported by the Carnegie Corporation of New York under contract number B5936, the U.S. Department of Health and Human Services under contract number HPU 940003, and the U.S. Department of Justice under contract 95-1J-CX-0001. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project.
Library of Congress Cataloging-in-Publication Data
Violence in families : assessing prevention and treatment programs / Rosemary Chalk and Patricia A. King, editors ; Committee on the Assessment of Family Violence Interventions, Board on Children, Youth, and Families, National Research Council and Institute of Medicine.
p. cm.
Includes bibliographical references (p. ) and index.
ISBN 0-309-05496-6 (cloth)
1. Family violence—United States—Prevention—Evaluation. 2. Crisis intervention (Psychiatry)—United States—Evaluation. 3. Evaluation research (Social action programs)—United States. I. Chalk, Rosemary A. II. King, Patricia A., 1942- . III. Board on Children, Youth, and Families (U.S.). Committee on the Assessment of Family Violence Interventions.
HV6626.2.V56 1998
362.82'927'0973—dc21 97-45375
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Committee On The Assessment Of Family Violence Interventions
PATRICIA A. KING (Chair),
Georgetown University Law Center
JACQUELYN C. CAMPBELL,
Johns Hopkins University School of Nursing
DAVID S. CORDRAY,
Vanderbilt Institute for Public Policy Studies
DIANA J. ENGLISH,
Office of Children's Administration Research, Department of Social and Health Services, State of Washington
JEFFREY A. FAGAN,
School of Public Health, Columbia University
RICHARD J. GELLES,
Family Violence Research Program, University of Rhode Island
JOEL B. GREENHOUSE,
Department of Statistics, Carnegie Mellon University
THE HONORABLE SCOTT HARSHBARGER,
Office of the Attorney General, Commonwealth of Massachusetts
DARNELL F. HAWKINS,
Departments of African-American Studies and Sociology, University of Illinois, Chicago
THE HONORABLE CINDY LEDERMAN,
Eleventh Judicial Circuit of Florida, Miami
ELIZABETH McLOUGHLIN,
San Francisco Injury Center, San Francisco General Hospital
ELI NEWBERGER,
Family Development Program, Children's Hospital, Boston
JOY D. OSOFSKY,
Department of Pediatrics and Psychiatry, Louisiana State University Medical Center
HELEN RODRIGUEZ-TRIAS, Pediatrician/Consultant in Health Programming,
Brookdale, California
SUSAN SCHECHTER,
School of Social Work, University of Iowa
MICHAEL E. SMITH,
School of Law, University of Wisconsin, Madison
BILL WALSH,
Investigations Unit, Youth and Family Crimes Bureau, Dallas Police Department
CAROLE L. WARSHAW,
Cook County Hospital, Chicago
ROSALIE WOLF,
Institute on Aging, The Medical Center of Central Massachusetts, Worcester
JACK P. SHONKOFF (Liaison),
Board on Children, Youth, and Families
CATHY SPATZ WIDOM (Liaison),
Committee on Law and Justice, Commission on Behavioral and Social Sciences and Education
ROSEMARY CHALK, Study Director
NANCY CROWELL, Staff Officer
KATHERINE DARKE, Research Assistant
SEBLE MENKIR, Research Assistant (through August 1995)
CINDY PRINCE, Project Assistant
NIANI SUTARDJO, Project Assistant (through August 1996)
Board On Children, Youth, And Families
JACK P. SHONKOFF (Chair),
Heller Graduate School, Brandeis University
DAVID V.B. BRITT,
Children's Television Workshop, New York City
LARRY BUMPASS,
Center for Demography and Ecology, University of Wisconsin
FERNANDO A. GUERRA,
San Antonio Metropolitan Health District, Texas
BERNARD GUYER,
Department of Maternal and Child Health, The Johns Hopkins University
ALETHA C. HUSTON,
Department of Human Ecology, University of Texas at Austin
RENEE JENKINS,
Department of Pediatrics and Child Health, Howard University Hospital
SARA McLANAHAN,
Office of Population Research, Princeton University
ROBERT MICHAEL,
Harris Graduate School of Public Policy Studies, University of Chicago
PAUL NEWACHECK,
Institute of Health Policy Studies and Department of Pediatrics, University of California, San Francisco
MARTHA PHILLIPS,
The Concord Coalition, Washington, D.C.
JULIUS B. RICHMOND,
Department of Social Medicine, Harvard University Medical School
TIMOTHY M. SANDOS,
National Digital Television Center, Littleton, Colorado
DEBORAH STIPEK,
Graduate School of Education, University of California, Los Angeles
DIANA TAYLOR,
Women's Health Program, Department of Family Health Care Nursing, University of California, San Francisco
GAIL WILENSKY,
Project Hope, Bethesda, Maryland
ELEANOR MACCOBY (Liaison),
Commission on Behavioral and Social Sciences and Education
RUTH T. GROSS (Liaison),
Board on Health Promotion and Disease Prevention, Institute of Medicine
DEBORAH A. PHILLIPS, Director
ROSEMARY CHALK, Deputy Director
ANNE BRIDGMAN, Program Officer for Communications
DRUSILLA BARNES, Administrative Associate
This page in the original is blank. |
Tables and Figures
TABLES
S-1 |
Total Number of Quasi-Experimental Evaluations of Family Violence Intervention by Service Sector, 1980-1996 |
|||
1-1 |
Array of Interventions by Type of Family Violence and Institutional Setting |
|||
1-2 |
Total Number of Quasi-Experimental Evaluations of Family Violence Interventions by Service Sector, 1980-1996 |
|||
2-1 |
Past Year Rates of Family Violence (per 1,000 persons) |
|||
2-2 |
Array of Services for Family Violence by Service Sector and Purpose |
|||
2-3 |
Federal Programs That Provide Services or Sponsor Research Relevant to Family Violence |
|||
2-4 |
Estimated Annual Costs of Family Violence |
|||
3-1 |
Interventions by Type of Strategy and Relevant Quasi-Experimental Evaluations, 1980-1996 |
|||
3-2 |
Reviews of Multiple Studies and Evaluations |
|||
3-3 |
Outcome Measures Used in Evaluations of Family Violence Interventions |
4-1 |
Expected Outcomes of Social Service Interventions for Child Maltreatment |
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4-2 |
Range of Family Support Interventions |
|||
4-3 |
Responses to Reports of Child Maltreatment by Child Protective Services |
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4-4 |
Expected Outcomes of Social Service Interventions for Domestic Violence |
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4A-1 |
Quasi-Experimental Evaluations of Parenting Practices and Family Support Services |
|||
4A-2 |
Quasi-Experimental Evaluations of School-Based Sexual Abuse Prevention |
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4A-4 |
Quasi-Experimental Evaluations of Intensive Family Preservation Services |
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4A-5 |
Quasi-Experimental Evaluations of Child Placement Services |
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4A-6 |
Quasi-Experimental Evaluations of Individualized Service Programs |
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4B-1 |
Quasi-Experimental Evaluation of Shelters for Battered Women |
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4B-3 |
Quasi-Experimental Evaluations of Advocacy Services for Battered Women |
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4B-4 |
Quasi-Experimental Evaluations of Domestic Violence Prevention Programs |
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4C-2 |
Quasi-Experimental Evaluation of Training for Caregivers |
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4C-3 |
Quasi-Experimental Evaluation of Advocacy Services to Prevent Elder Abuse |
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5A-3 |
Quasi-Experimental Evaluations of Court-Mandated Treatment for Child Abuse Offenders |
|||
5A-4 |
Quasi-Experimental Evaluations of Treatment for Sexual Abuse Offenders |
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5B-3 |
Quasi-Experimental Evaluations of Arrest Procedures |
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5B-4 |
Quasi-Experimental Evaluations of Court-Mandated Treatment for Domestic Violence Offenders |
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5B-5 |
Quasi-Experimental Evaluations of Criminal Prosecution |
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5B-7 |
Quasi-Experimental Evaluations of Systemic Approaches |
|||
6-1 |
Public Health Strategies for Preventing Violence and Its Consequences |
|||
6A-1 |
Quasi-Experimental Evaluations of Identification and Screening of Child Maltreatment |
|||
6A-2 |
Quasi-Experimental Evaluations of Mental Health Services for Child Victims of Physical Abuse and Neglect |
|||
6A-3 |
Quasi-Experimental Evaluations of Mental Health Services for Child Victims of Sexual Abuse |
6A-4 | Quasi-Experimental Evaluations of Mental Health Services for Children Who Witness Domestic Violence | |||
6A-5 | Quasi-Experimental Evaluation of Interventions of Mental Health Services for Adult Survivors of Child Abuse | |||
6A-6 | Quasi-Experimental Evaluations of Home Visitation and Family Support Programs | |||
6B-1 | Quasi-Experimental Evaluations of Domestic Violence Screening, Identification, and Medical Care Responses | |||
6B-2 | Quasi-Experimental Evaluations of Mental Health Services for Domestic Violence Victims |
FIGURES
1-1 | Family Violence Interventions by Type of Strategy | |||
3-1 | Hierarchy of Strength of Evidence in Research Evaluations | |||
6-1 | Public Health Scientific Method and Its Role in Family Violence Research | |||
7-1 | Examples of Service Integration Initiatives | |||
8-1 | Systems That Influence Family Violence and Interventions to Address Them |
The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Bruce M. Alberts is president of the National Academy of Sciences.
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The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy's purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Bruce M. Alberts and Dr. William A. Wulf are chairman and vice chairman, respectively, of the National Research Council.
Preface
In May 1993, a group of 35 research scholars, state and federal officials, and representatives from law enforcement, social services, and health care systems met at the Wingspread Conference Center in Racine, Wisconsin. The purpose of this meeting was to examine whether it would be feasible to synthesize the body of research knowledge that had emerged in the past few decades regarding the development, implementation, and effectiveness of interventions designed to treat and prevent family violence. The participants agreed that efforts are needed to bridge the gap that now exists between research resources and policy needs in addressing the problem of family violence, and that one way to address this gap is to synthesize the rigorous evaluations of public-sector programs designed to treat or reduce incidents of child and spousal abuse and abuse of the elderly. They emphasized that, although no single strategy for prevention or treatment has yet proven to be effective in the research literature, the existing evaluations of relevant program interventions should be identified and analyzed to disseminate important lessons learned from past efforts to reduce family violence.
In response to the guidance of the Wingspread meeting participants, the Board on Children, Youth, and Families of the Commission on Behavioral and Social Sciences and Education (CBASSE) of the National Research Council (NRC) and the Institute of Medicine (IOM) established a Committee on the Assessment of Family Violence Interventions in August 1994. Funding was provided by several agencies within the U.S. Department of Health and Human Services (DHHS) and the U.S. Department of Justice (DOJ). The sponsoring agencies within DHHS include the Centers for Disease Control and Prevention, the Administration for Children and Families, the Office of Maternal and Child
Health, the National Institute of Mental Health, and the Substance Abuse and Mental Health Services Administration. The National Institute of Justice was the DOJ sponsor. Funding was also provided by the Carnegie Corporation of New York. The Office of Health Promotion and Disease Prevention within DHHS served a valuable administrative role in coordinating the DHHS agency contributions for this project.
This study is the latest in a series of reports by the NRC that examine the emerging social science research base on violence and families. It builds on five earlier NRC publications related to this topic.
Understanding and Preventing Violence—Volume 1 (National Academy Press, 1993). This report is a comprehensive review of America's experience of violence, taking an interdisciplinary approach to examining the causes and consequences of interpersonal violence. The report includes a chapter on violence in families that describes the array of family violence interventions, research findings about police interventions and battered women's shelters, and the difficulties of evaluating and comparing interventions in this area.
Understanding and Preventing Violence—Volume 3: Social Influences (National Academy Press, 1994). This volume includes four background papers that review research on violent victimization; violence between spouses and intimates; gender and interpersonal violence; and the role of alcohol and psychoactive drugs in violent events. The paper on spousal and intimate violence by Jeffrey Fagan and Angela Browne examines the state of empirical and theoretical knowledge on violence between adult partners and presents a social epidemiology of intimate violence, characteristics of victims and assailants, and an assessment of risk markers for marital violence.
Understanding Child Abuse and Neglect (National Academy Press, 1993). This report presents a research agenda for studies of child maltreatment. It reviews the state of research on different forms of child maltreatment, including physical and sexual abuse, emotional maltreatment, and neglect. The research agenda emphasizes the importance of studies that address the nature and scope of child maltreatment, its causes and consequences, the assessment of prevention and treatment interventions, and the need for a science policy to guide the development of research in this field.
Violence and the American Family (National Academy Press, 1994). This workshop report presents a summary of the Wingspread meeting that called for the development of an in-depth analysis of the state of knowledge regarding family violence interventions.
Understanding Violence Against Women (National Academy Press, 1996). The result of a study requested by Congress in the 1994 Omnibus Crime Prevention Act, this report presents an agenda for research on intimate partner violence and sexual assault. The study identifies gaps in the knowledge base in this area and recommends a strategy for building comprehensive and interdisciplinary
studies that can examine the causes and consequences, nature and scope, and prevention and intervention for violence against women.
These NRC reports provide important insights into what is known about interventions in the field of family violence. But their assessment of rigorous evaluation studies of treatment and prevention programs is limited. In this study, our committee sought to extract knowledge from research concerning the evaluations of family violence interventions as well as insights reported in other assessments of selected interventions. The committee met six times over a 24-month period to identify major conceptual themes and to review the relevant knowledge base in formulating its conclusions and recommendations. This synthesis of research and program evaluation knowledge was augmented by expert opinion through two workshops, commissioned papers, consultant reports, and five site visits designed to draw on the experiences and insights of service providers in the health, social service, and legal communities. The study also included a review of the methodological issues associated with research in areas characterized by weak conceptual clarity and immature measurement (Institute of Medicine, 1994).
The committee benefited from an inter-agency working group organized to help guide the early stages of development and the dissemination of this study and to share agency research resources. Program officers from the sponsoring agencies also participated in the committee workshops. We are grateful to each of these officials for their thoughtful contributions over the course of the study: Bernard Auchter and Christy Visher from the National Institute of Justice; Ashley Files, Matthew Guidry, and James Harrell from the Office of Health Promotion and Disease Prevention; Lynn Short from the Centers for Disease Control and Prevention; Frank Sullivan from the Substance Abuse and Mental Health Services Administration; Audrey Yowell from the Office of Maternal and Child Health; Malcolm Gordon from the National Institute of Mental Health; William Riley from the Administration for Children and Families; and Michael Levine from the Carnegie Corporation of New York.
The committee's study identification and data collection effort required an extensive staff effort; these studies appeared in dozens of journals and had not been previously assembled into a research database. Study director Rosemary Chalk and research assistants Katherine Darke and Seble Menkir, in consultation with committee member David Cordray, identified search strategies and citation indexes to gather the appropriate studies. The results of their effort are presented in Tables 3-1 and 3-2. Katherine Darke provided an important contribution in the preparation of the individual research review tables that are included in Chapters 4 through 6.
The committee held two workshops in Washington, D.C. to inform its deliberations. The first workshop was designed to elicit expertise and perspective from service providers associated with treatment and prevention interventions in child maltreatment, domestic violence, and elder abuse. Background papers
prepared by the workshop participants were published in an interim report by the committee (Service Provider Perspectives on Family Violence Interventions, 1995). The participants observed that much of the information regarding family violence programs does not appear in the research literature, and that reforms in community-based interventions have not been studied in a systematic manner.
The second workshop focused on evaluation methods and research designs associated with the assessment of family violence interventions. The participants included researchers who had studied selected interventions in health care, social services, and law enforcement settings. They reviewed specific methodological challenges and creative strategies that have been used in the selection and retention of research subjects, the ethical and legal concerns associated with research in this field, and the quality of data that is associated with administrative records in public agencies.
The site visits were coordinated by Katherine Darke, who contacted local organizations and developed comprehensive itineraries for committee members and staff in each of the five cities that served as the subjects of these meetings (Boston, Dallas, New York City, Miami, and Seattle). A detailed listing of these organizations is included in Appendix A.
Several consultants provided background information that was very helpful to the committee's work. Jodi Short and Joseph Youngblood contributed materials on the nature and scope of family violence and federal intervention programs (Chapter 2). Anne Flitcraft, Patti Culross, Patricia Mrazek, and Michelle Forcier prepared background materials on health care interventions for domestic violence (Chapter 6). Terry Fulmer and Georgia Anetzberger prepared a research review on elder abuse interventions that informed several chapters. The material in Chapter 3 that pertains to client referrals, screening, and baseline assessment benefited from a publication prepared by Georgine Pion and David Cordray (Cordray and Pion, 1993). Chapter 5 benefited from contributions by Diane Juliar and Juliana Blome and a research paper on legal interventions for family violence developed by Alissa Pollitz Worden. The committee is grateful to all these contributors.
The committee also benefited from the tremendous support of the staff of the Board on Children, Youth, and Families and the Institute of Medicine: Cynthia Abel, Nancy Crowell, Katherine Darke, Seble Menkir, Faith Mitchell, Deborah Phillips, and Michael Stoto contributed careful readings, draft chapters, and literature searches that identified relevant materials throughout the development of the project. Lauren R. Meader, Julie Walko, and Susan M. Fourt of the National Research Council Library provided invaluable assistance in identifying and collecting research materials. Special thanks are due to senior project assistants Niani Sutardjo and Cindy Prince who provided administrative support during the study, including the organization of meetings, workshops, and the preparation of several drafts of the report. Project assistants Karen Autrey and Roger Butts helped to prepare the final draft for publication. Communications director Anne
Bridgman was particularly helpful in the final stages of preparing the report and planning its dissemination. We also thank our editors Rona Briere and Christine McShane, whose efforts contributed significantly to the organization and presentation of the panel's views. Most of all, thanks and acknowledgment of extraordinary effort are due to the members of the committee and our study director Rosemary Chalk.
Patricia A. King, Chair
Committee on the Assessment of Family Violence Interventions