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Domestic Violence

Permanent Link: http://ufdc.ufl.edu/UFE0042809/00001

Material Information

Title: Domestic Violence Florida Licensed Mental Health Professionals' Perceived Level of Competence
Physical Description: 1 online resource (147 p.)
Language: english
Creator: KNOWLES,JACQUELINE K
Publisher: University of Florida
Place of Publication: Gainesville, Fla.
Publication Date: 2011

Subjects

Subjects / Keywords: COMPETENCY -- COUNSELOR -- FAMILY -- TRAINING -- VIOLENCE
Human Development and Organizational Studies in Education -- Dissertations, Academic -- UF
Genre: Mental Health Counseling thesis, Ph.D.
bibliography   ( marcgt )
theses   ( marcgt )
government publication (state, provincial, terriorial, dependent)   ( marcgt )
born-digital   ( sobekcm )
Electronic Thesis or Dissertation

Notes

Abstract: There are three separate disciplines in which mental health professionals train in the state of Florida to work with clients facing domestic violence. These are clinical social work, marriage and family therapy, and mental health counseling. In addition, there are three separate accrediting bodies regulating the programs from which graduate training is taught, as well as three separate licenses in the state of Florida, under Chapter 491.004 for these mental health professionals to obtain: Licensed Clinical Social Workers (LCSW), Licensed Marriage and Family Therapists (LMFT), and Licensed Mental Health Counselors (LMHC). This research study surveyed Florida licensed mental health professionals to determine their perceived level of competency in assessing and treating domestic violence. An E-mail survey was distributed to over 8,000 licensed professionals, under Chapter 491.004, in the state of Florida. Research findings failed to show a significant relationship between graduate coursework and practicum/internship training and level of perceived competency when assessing and treating domestic violence. However, research findings did show a significant relationship between postgraduate clinical contact experience, as well as self-initiated learning and perceived level of competency when assessing and treating domestic violence. Furthermore, study results found no significant relationship between discipline (clinical social work, marriage and family therapy and mental health counseling) and perceived level competency when assessing and treating domestic violence, meaning one discipline over another did not report a higher level of perceived competency. Given the findings of this research study, educational policy makers and accrediting bodies should consider evaluating current curriculum requirements for mental health professionals in training, in the area of domestic violence. In addition, licensure boards should consider evaluating licensure requirements as well as continuing education requirements in the area of domestic violence. Implications of this research study suggest improvements to graduate curriculum, as well as graduate clinical training are needed in order to increase levels of competency in assessing and treating domestic violence, among Florida licensed mental health professionals.
General Note: In the series University of Florida Digital Collections.
General Note: Includes vita.
Bibliography: Includes bibliographical references.
Source of Description: Description based on online resource; title from PDF title page.
Source of Description: This bibliographic record is available under the Creative Commons CC0 public domain dedication. The University of Florida Libraries, as creator of this bibliographic record, has waived all rights to it worldwide under copyright law, including all related and neighboring rights, to the extent allowed by law.
Statement of Responsibility: by JACQUELINE K KNOWLES.
Thesis: Thesis (Ph.D.)--University of Florida, 2011.
Local: Adviser: Echevarria-Doan, Silvia C.

Record Information

Source Institution: UFRGP
Rights Management: Applicable rights reserved.
Classification: lcc - LD1780 2011
System ID: UFE0042809:00001

Permanent Link: http://ufdc.ufl.edu/UFE0042809/00001

Material Information

Title: Domestic Violence Florida Licensed Mental Health Professionals' Perceived Level of Competence
Physical Description: 1 online resource (147 p.)
Language: english
Creator: KNOWLES,JACQUELINE K
Publisher: University of Florida
Place of Publication: Gainesville, Fla.
Publication Date: 2011

Subjects

Subjects / Keywords: COMPETENCY -- COUNSELOR -- FAMILY -- TRAINING -- VIOLENCE
Human Development and Organizational Studies in Education -- Dissertations, Academic -- UF
Genre: Mental Health Counseling thesis, Ph.D.
bibliography   ( marcgt )
theses   ( marcgt )
government publication (state, provincial, terriorial, dependent)   ( marcgt )
born-digital   ( sobekcm )
Electronic Thesis or Dissertation

Notes

Abstract: There are three separate disciplines in which mental health professionals train in the state of Florida to work with clients facing domestic violence. These are clinical social work, marriage and family therapy, and mental health counseling. In addition, there are three separate accrediting bodies regulating the programs from which graduate training is taught, as well as three separate licenses in the state of Florida, under Chapter 491.004 for these mental health professionals to obtain: Licensed Clinical Social Workers (LCSW), Licensed Marriage and Family Therapists (LMFT), and Licensed Mental Health Counselors (LMHC). This research study surveyed Florida licensed mental health professionals to determine their perceived level of competency in assessing and treating domestic violence. An E-mail survey was distributed to over 8,000 licensed professionals, under Chapter 491.004, in the state of Florida. Research findings failed to show a significant relationship between graduate coursework and practicum/internship training and level of perceived competency when assessing and treating domestic violence. However, research findings did show a significant relationship between postgraduate clinical contact experience, as well as self-initiated learning and perceived level of competency when assessing and treating domestic violence. Furthermore, study results found no significant relationship between discipline (clinical social work, marriage and family therapy and mental health counseling) and perceived level competency when assessing and treating domestic violence, meaning one discipline over another did not report a higher level of perceived competency. Given the findings of this research study, educational policy makers and accrediting bodies should consider evaluating current curriculum requirements for mental health professionals in training, in the area of domestic violence. In addition, licensure boards should consider evaluating licensure requirements as well as continuing education requirements in the area of domestic violence. Implications of this research study suggest improvements to graduate curriculum, as well as graduate clinical training are needed in order to increase levels of competency in assessing and treating domestic violence, among Florida licensed mental health professionals.
General Note: In the series University of Florida Digital Collections.
General Note: Includes vita.
Bibliography: Includes bibliographical references.
Source of Description: Description based on online resource; title from PDF title page.
Source of Description: This bibliographic record is available under the Creative Commons CC0 public domain dedication. The University of Florida Libraries, as creator of this bibliographic record, has waived all rights to it worldwide under copyright law, including all related and neighboring rights, to the extent allowed by law.
Statement of Responsibility: by JACQUELINE K KNOWLES.
Thesis: Thesis (Ph.D.)--University of Florida, 2011.
Local: Adviser: Echevarria-Doan, Silvia C.

Record Information

Source Institution: UFRGP
Rights Management: Applicable rights reserved.
Classification: lcc - LD1780 2011
System ID: UFE0042809:00001


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1 DOMESTIC VIOLENCE: FLORIDA LICENSED MENTAL HEALTH PROFESSIONALS PERCEIVED LEVEL OF COMPETENCE By JACQUELINE KIRKWOOD KNOWLES A DISSERTATION PRESENTED TO THE GRADUATE SCHOOL OF THE UNIVERSITY OF FLORIDA IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY UNIVERSITY OF FLORIDA 2011

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2 2011 Jacqueline Kirkwood Knowles

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3 This dissertation is dedicated to all mental health professionals who work with victims of domestic violence with the hopes of inspiring and promoting continued education and research.

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4 ACKNOWLEDGMENTS I would like to acknowledge and thank all those who helped in completing this research project. I am most grateful to Dr. Silvia EchevarriaDoan, for being my chair and keeping me on track. Dr. Doan thank you for your valuable contributions, guidance, and commitment to my dissertation research. You went above and beyond usual practices to review my work during week ly meetings at Starbucks across the summer semester You also challenged me to dig deep for what was motivating me to complete this dissertation. Thank you again to my committee member Dr. David Miller, for your assistance and guidance wit h my statistical analysis Thank you to my other committee members Dr. Ellen Amatea and Dr. Peter Sherarrd for your feedback and contributions to my research study. Thank you to Joyce Dolbier for your editorial services and agreeing to take on my dissertation. T hank you to Candy Spires, throughout the years of my graduate education (which have been too many); you have helped me tremendously. Personally, I would like acknowledge my parents, Kevin and Elaine Kirkwood, for their continued support and words of encouragement. Thank you Mom and Dad for all the sacrifices you have made for me, for being great role models and s howing me hard work is rewarded. Thank you to my sister, Kristine Simone, for your words of encouragement throughout the years. Thank you to my husband, Bart for all the sacrifices you have made and the late night trips to Starbucks. And thanks to my children, C ale (8) and Reese (5), who cannot quite understand why Mommy sits in front o f her computer for hours each night; but one day you will. I could only hope to inspire you to dream big and recognize that with

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5 commitment, hard work and perseverance you too can accomplish anything you set your mind to.

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6 TABLE OF CONTENTS page ACKNOWLEDGMENTS .................................................................................................. 4 LIST OF TABLES ............................................................................................................ 9 ABSTRACT ................................................................................................................... 11 CHAPTER 1 INTRODUCTION .................................................................................................... 13 Need for Study ........................................................................................................ 15 Clinical Social Workers ........................................................................................... 17 Mental Health Counselors ....................................................................................... 18 Marriage and Family Therapists ............................................................................. 20 Purpose and Significance of Study ......................................................................... 23 Theoretical Framework ........................................................................................... 26 Critical T heory .................................................................................................. 26 Jurgen Habermas ...................................................................................... 27 Donald E. Comstock .................................................................................. 28 Domestic Violence ............................................................................................ 29 Michele Bograd .......................................................................................... 29 Virginia Goldner ......................................................................................... 30 Richard Gelles and Murray Straus ............................................................. 31 Neil Jacobson and John Gottman .............................................................. 32 Research Question ................................................................................................. 33 Quantitative Methodology and Critical Research .............................................. 33 Definition of Terms ........................................................................................... 34 Accrediting Bodies .................................................................................................. 36 Council on Social Work Education (CSWE) ..................................................... 36 Council for Accreditation of Counseling and Related Education Programs (CACREP) ..................................................................................................... 37 Commission on Accreditation for Marriage and Family Therapy Education (COAMFTE) .................................................................................................. 37 Licensing Board ...................................................................................................... 38 Licensed Clinical Social Worker ....................................................................... 38 Licensed Mental Health Counselor ................................................................... 39 Licensed Marriage and Family Therapist .......................................................... 40 Graduate Training Clinical Hours ............................................................................ 41 Clinical Social Work .......................................................................................... 41 Mental Health Counseling ................................................................................ 41 Marriage and Family Therapy ........................................................................... 42 Organization of Study ............................................................................................. 42

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7 2 REVIEW OF LITERATURE .................................................................................... 44 Overview ................................................................................................................. 44 Prevalence of Domestic Violence ........................................................................... 45 Conceptualization of Domestic Violence ................................................................. 46 Michele Bograd ................................................................................................ 46 Rhea Almeida ................................................................................................... 49 Virginia Goldner ................................................................................................ 51 Lenore Walker .................................................................................................. 53 Alan Jenkins ..................................................................................................... 55 Neil Jacobson and John Gottman .................................................................... 57 Richard Gelles and Murray Straus ................................................................... 59 Treatment Recommendations for Domestic Violence and Implications for Training Mental Health Professionals .................................................................. 61 Introduction ....................................................................................................... 61 Virgina Goldner ................................................................................................ 62 Rhea Almeida ................................................................................................... 63 Lenore Walker .................................................................................................. 64 Power and Control Wheel ................................................................................. 66 Alan Jenkins ..................................................................................................... 67 Neil Jacobson and John Gottman .................................................................... 69 Richard Gelles and Murray Straus ................................................................... 71 Summary ................................................................................................................ 72 3 METHODOLOGY ................................................................................................... 73 Statement of Purpose ............................................................................................. 73 Research Question ................................................................................................. 73 Hypotheses ............................................................................................................. 73 Sampling and Population ........................................................................................ 74 Research Design and Relevant Variables .............................................................. 7 5 Instrumentation ....................................................................................................... 77 Data Collection ....................................................................................................... 81 Data Analysis .......................................................................................................... 83 4 RESULTS ............................................................................................................... 86 Participants and Demographic Characteristics ....................................................... 87 Item Analysis and Reliability (Coursework) ............................................................. 89 ANOVA (Coursework) ............................................................................................. 91 ChiSquare Test (Coursework) ............................................................................... 92 Item Analysis and Reliability (Practicum/Internship) ............................................... 93 ANOVA (Practicum/Internship) ............................................................................... 94 ChiSquare Test (Practicum/Internship) .................................................................. 95 ChiSquare Test (Postgraduate Clinical Contact Experience) ................................ 96 ChiSquare Test (CE/Licensure) ............................................................................. 97 ANOVA (Level of Competence) ............................................................................ 100

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8 Tukey HSD Post Hoc ............................................................................................ 101 Summary of Reliability .......................................................................................... 103 5 DIS CUSSION ....................................................................................................... 106 Restatement of Purpose ....................................................................................... 106 Discussi on of Results ............................................................................................ 106 Graduate Coursework Training ...................................................................... 106 Graduate Practicum/Internship Training ......................................................... 107 Postgraduate Clinical Contact Experience ..................................................... 108 CE/Licensure Requirements ........................................................................... 109 Self Initiated Learning .................................................................................... 110 Perceived Competency by Discipline .................................................................... 111 Implications for Training Florida Licensed Mental Health Professionals ............... 111 Recommendations for Future Research ............................................................... 113 Limitations of Research Study .............................................................................. 114 Response Rate ............................................................................................... 116 Nonresponse Error ......................................................................................... 117 Coverage Error ............................................................................................... 118 Conclusion ............................................................................................................ 118 APPENDIX A DOMESTIC VIOLENCE PERCEIVED COMPETENCY SURVEY ........................ 120 B COVER LETTER .................................................................................................. 137 C POWER AND CONTROL WHEEL ....................................................................... 138 D EQUITY WHEEL ................................................................................................... 139 REFERENCES ............................................................................................................ 140 BIOGRAPHICAL SKETCH .......................................................................................... 146

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9 LIST OF TABLES Table page 4 1 Characteristics of Respondents (N=618) ............................................................ 88 4 2 Coursework: Reliability Statistics ........................................................................ 90 4 3 Coursework: Item Statistics (N=580) .................................................................. 90 4 4 Coursework: Item Discrimination ........................................................................ 90 4 5 Coursework: Scale Statistics (N=14) .................................................................. 90 4 6 BetweenSubject Factors (Coursework) ............................................................. 91 4 7 Tests of BetweenSubjects Effects (dependent variable= Coursework) ............. 91 4 8 ChiSquare Test for Graduate Coursework T raining (N = 584) .......................... 92 4 9 Practicum/Internship: Reliability Statistics .......................................................... 93 4 10 Practicum/Internship: Item Statistics (N=569) ..................................................... 93 4 11 Practicum/Internship: Item Discrimination .......................................................... 93 4 12 Practicum/Internship: Scale Statistics (N=4) ....................................................... 93 4 13 BetweenSubject Factors (Practicum/Internship) ................................................ 94 4 14 Tests of BetweenSubjects Effects (dependent variable= Practicum/Internship) .......................................................................................... 94 4 15 ChiSquare Test for Graduate Practicum Training (N = 572) .............................. 96 4 16 ChiSquare Test for Graduate Internship Training (N = 573) .............................. 96 4 1 7 ChiSquare Test for Postgraduate Clinical Contact Experience (N = 586) ......... 97 4 18 ChiSquare Test for Licensure Requirem ents (N = 568 & 576) .......................... 99 4 19 ChiSquare Test for Continuing Education Requirements (N = 584) ................ 100 4 20 Tests of BetweenSubjects Effects. (dependant variable=How do you rate your own level of competence in assessing and treating domestic violence?) 100 4 21 Tukey HSD Test: Level of competence in assessing and treating domestic violence and Graduate Coursework/Clinical Training ....................................... 101

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10 4 22 Tukey HSD Test: Level of competence in assessing and treating domestic violence and Postgraduate Clinical Contact Experience .................................. 102 4 23 Tukey HSD Test: Level of competence in assessing and treating domestic violence and Continuing Education Credits/Licensure Requirements .............. 103 4 24 Tukey HSD Test: Level of competence in assessing and treating domestic violence and Self initiated Learning .................................................................. 103

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11 Abstract of Dissertation Presented to the Graduate School of the University of Florida in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy DOMESTIC VIOLENCE: FLORIDA LICENSED MENTAL HEALTH PROFESSIONALS PERCEIVED LEVEL OF COMPETENCE By Jacqueline Kirkwood Knowles May 2011 Chair: Silvia EchevarriaDoan Major : Mental Health Counseling There are three separate disciplines in which mental health professionals train in the state of Florida to work with c lients facing domestic violence. These are clinical social work, marriage and family therapy and mental health counseling. In addition, there are three separate accrediting bodies regulating the programs from which graduate training is taught, as well as three separate licenses in the state of Florida, under Chapter 491.004 for these mental health professionals to obtain: Licensed Clinical Social Workers (LCSW), Licensed Marriage and Family Therapists (LMFT) and Licensed Mental Health Counselors (LMHC). This research study surveyed Florida licensed mental health professionals to determine their perceived level of competency in assessing and treating domestic violence. An Email su rvey was distributed to over 8,000 licensed professionals under Chapter 491.004 in the state of Florida. Research findings failed to show a signif icant relationship between graduate coursework and practicum/internship training and level of perceived com petency when assessing and treating domestic violence. However, research findings did show a s ignificant relationship betw een postgraduate clinical

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12 contact experience, as well as self initiated learning and perceived level of competency when assessing and treating domestic violence. Furthermore, study results found no significant relationship between discipline (clinical social work, marriage and family therapy and mental health counseling) and perceived level competency when assessing and t reating domestic violence, meaning one discipline over another did not report a higher level of perceived competency. Given the findings of this research study educational policy makers and ac crediting bodies should consider evaluating current curriculum requirements for mental health professionals in training in the area of domestic violence. In addition, l icensure boards should consider evaluating licensure requirements as well as co ntinuing education requirements in the area of domestic violence. I mplications of this research study suggest improvements to graduate curriculum, as well as graduate clinical training are needed in order to increase levels of competency in assessing and treating domestic violence, among Florida licensed mental health pro fessionals

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13 CHA PTER 1 INTRODUCTION Domestic violence is a social crisis that affects all cultural and socioeconomic backgrounds. This perv asive and significant issue threatens the safety and security of victims and their families across the United States C urrent statistics show that one in four women will experience domestic violence in her lifetime (Tjaden & Thoennes, 2000). Each day at least three women in the United States die as a result of domestic violence (Bureau of Justice Statistics, 2005). Women are twice as likely to be killed by an intimate partner tha n men (Bureau of Justice Statistics, 2008). Moreover, in 2007, women comprised 70 % of victims killed by an intimate partner, a statistic that has changed very little since 1993 (Bureau of Justice Statistics, 2008). When domestic violence victims leave abusive relationships, finding a safe place to stay is critical. L eaving a violent r elationship is one of the most dangerous times for a victim McKenzie (1995) reports that women who leave marriages and relationships plagued by domestic violence are seventy five percent more likely to be injured or killed by their batterers than the ones who stay (pp. 20 21). Safe s h elter and housing are crucial. Without domestic violence shelters or transitional housing, many victims are faced with the choice of either becoming homeless or returning to their v iolent partner. In addition, medical ex penditures for domestic violence cost the U.S. $3 to $5 billion annually. American business debits another $100 billion in lost wages, absenteeism, sick leave utilization, and nonproductivity according to the Colorado Domestic Violence Coalition, 1991 ( McKenzie, 1995, p. 19). According to the Florida Department of Law Enforcement (2009) there were 113,123 domestic violence offences reported in

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14 2008, just in the state of Florida. The reality is domestic violence affec ts a large population including our schools, our workplace, and our community as a whole. Domestic violence does not discriminate. All races and socioeconomic groups are affected by the social problem of domestic violence. Domestic violence can be physical, psychological, sexual and/ or financial. According to Lenore Walker (2000) d omestic violence is about power and control, about one person controlling another by using the various forms of violence mentioned above. Mental health professionals are often the first responders in assessing and treating domestic violence. According to Jacobson and Gottman (1998), the vast majority of psychiatrist, psychologists, and social workers in the United States have little or no training in the rehabilitation of batterers. Although batterers are treated every day and all too commonly by counselors without such training, batterers provide unique challenges (p. 224). This research study examined how licensed mental health professionals in the state of Florida are prepared to undertake such a task and how competent these professionals feel in doing so. According to curriculum r equirements, little emphasis is seemingly placed on formal instruction and coursework in the area of domest ic violence. Currently, under C hapter 491.004 of the Florida S tatutes, Licensed Mental Health Counselors, Licensed Marriage and Family Therapists and Licensed Clinical Social Workers are not required to take specific coursework or practicum/internship experiences in the area of domestic violence for licensure. Also, the state of Florida only requires these licensed professionals to obtain two hours of continuing education credit every six years in the area of domestic violence. Furtherm ore, the accrediting bodies such as the

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15 Commission on Accreditation for Marriage and Family Therapy Education (COAMFTE), the Council for Accreditation of Counseling and Related Education Programs (CACREP) and the Council on S ocial Work Education (CSWE), all of whom accredit degree programs for these mental health professionals, currently do not have requirements specifying coursework or experiences in the area of assessing and treating domestic violence. T he purpose of this study was to examine how the mental health profession is addressing this social problem of domestic violence S pecifically, this study examine d how Florida licensed professionals in three different mental health disciplines, Marriage and Family Therapy, Mental Health Counseling and Clinical Social Work, are educated and credentialed to assess and treat d omestic vi olence and how they view their own level of competence. Need for Study Domestic violence is a major societal problem. Millions of Americans are affected by domestic violence, yet the subject is often viewed as a private matter. According to the National Violence Agai nst Women Survey (NVAWS), an estimated 5.3 million intimate partner violence victimizations occur on women living in the United States (Center s for Disease Control and Prevention 2003). Research finds violence in virtually all family relat ions victims not only include children and women, but young and elderly parents, siblings, and dating partners (Gelles, 1990, p. 17). R esearch also suggests that v iolence and abuse can be found among truck drivers and physicians, laborers and lawyers, t he employed and unemployed, the rich and the poor. The fact that violence can be found in all types of homes leads some people to conclude that social factors, especially income and employment, are not relevant in explaining family

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16 violence (Gelles, 1993 p. 33). The r esearch conducted by Todahl, Linville, Chou, a nd Maher Cosenza (2008), reported that domestic violence was quite prevalent in the United States and it was reasonable to assume that many family therapy clients have endured mild, moderate, or severe violence at some point in their lives, including during the course of therapy (pp 28 29). These findings furthermore underscore the need for mental health professionals to be competent in assessing and treating domestic violence. Even with more awareness and education about the issue, domestic violence continues to be a prevalent and pervasive problem that warrants further research. The news media often report on the daily occurrences of domestic violence. Domestic violence does not discriminate; lower socioeconomic classes are not the only ones affected by domestic violence, like some may think. Celebrities, politicians, and other prominent individuals in our society are all too often individuals affected by domestic violence, either as victim or perpetrator. In the United States, law enforcement, court, social services and healthcare systems are inundated with victims and perpetrators of domestic violence. The statistics on domestic violence clearly illustrate how significant a social proble m this really is in our country: An estimated 1.3 million women are victims of physical assault by an intimate partner each year (Centers for Disease Control and Pr evention, 2003, p. 14). Acco rding to Straus and Gelles (1986), young boys who witness domestic violence in the home are twice as likely to become perpetrators of violence as an adult toward their own family. In survey research conducted by Tjaden and Tho ennes (2000) it was found that 4.8 million American women were victims of domestic violence. Based on

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17 these findings, researchers concluded that domestic violence was not only a significant criminal justice problem facing America, but also a serious threat to our nat ions public health (Tjaden & Thoennes, 2000). For these reasons, it would seem important to evaluate how licensed mental health professionals in the state of Florida are being trained to work with domestic violence, in terms of formal education, licensure and continuing education. According to Tjaden and Thoennes (2000), the mental health community should receive comprehensive training on the appropriate treatment of stalking victims (p. 14). Tjaden and Thoennes (2000) found that over 25% of stalking victims seek counseling. As a result, mental health professionals should be trained in the area of stalking and be educated about the specific needs of stalking victims, in order to better s erve this population (Tjaden & Thoennes, 2000). In addition, Bograd and Mederos (1999) argue that the clinical assessment of whether domestic violence exists requires specific skills and knowledge (p. 292). Based on the literature presented, all Florida licensed mental health professionals should have the skills and knowle dge to assess and treat domestic violence. For these reasons, this study examined how licensed professionals in each discipline licensed under Chapter 491.004 of the Florida Statutes (i.e. clinical social workers, mental health counselor s, and marriage and family therapists ), perceived their own competency in assessing and treating domestic violence. This study also examined if o ne discipline over another felt more prepared or competent in assessing and treating domestic violence. Clinic al Social Workers According to the Council on Social Work Education Standards ( CSWE ) (2001), the purpose of the social work profession is to promote human and community well -

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18 being. Guided by a person and environment construct, a global perspective, respect for human diversity, and knowledge based on scientific inquiry, social works purpose is actualized through its quest for social and economic justice, the prevention of conditions that limit human rights, the elimination of poverty, and the enhancement of the quality of life for all persons (p. 1). There are 10 core competencies the CSWE Standards (2001) establish that graduate students must achieve: (a) I dentify [yourself] as a professional social worker and conduct self accordingly, (b) A pply social work ethical principles to guide professional practice, (c) A pply critical thinking to inform and communicate professional judgments, (d) E ngage diversit y and difference in practice, (e) A dvance human rights and social economic justice, (f) E ngage i n researchinformed practice and practice informed research, (g) A pply knowledge of human behavior and the social environment, (h) E ngage in policy practice to advance social and economic well being and to deliver effective social work services, (i) R espond to contexts that shape practice, and (j) E ngage, assess, intervene, and evaluate individuals, families, groups, organizations, and communities (p p 3 7). None of these competencies specifically address the need for training and education in the area of domestic violence. Mental Health Counselors Training for mental health counselors is guided by the Council for Accreditation of Counseling and Related Educational Programs or CACREP. The mission of this council is to provide leadership and to promote ex cellence in professional preparation through the accreditation of counseling and related education programs. As an accrediting body, CACREP is committed to the development of standards and procedures that reflect the needs of a dynamic, diverse, and compl ex society. The CACREP is dedicated to encouraging and promoting the continuing development and improvement

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19 of preparation programs, and preparing counseling and related professionals to provide service consistent with the ideal of optimal human developme nt ( www.cacrep.org/mission, 05/28/ 2008) in addition to developing guidelines for professional counselor development. Specific guidelines are established by this council in terms of developing curriculum for Ment al Health Counselors. CACREP identifies eight common core curriculum areas which are required for mental health programs; Professional Orientation and Ethical Practice; Social and Cultural Diversity; Human and Growth Development; Career Development; Helpi ng Relationships; Group Work; Assessment; and Research and Program Evaluation (CACREP S tandards, 2009). I n the core area of Human Growth and Development, CACREP requires mental health counselors in training to have an understanding of the effects of cris es, disasters, and other traumacausing events o n persons of all ages (CACREP S tandards, 2009). However, there is no core area that specifically addresses the study of domestic violence. In addition to the eight core areas, CACREP identifies additional knowledge and skills needed for students preparing to work as Mental Health Counselors. There is specific mention of substance abuse, professional issues, management of services, and ethical and legal considerations in the practice of mental health, and n ot domestic violence (CACREP S tandards, 2009). A ddition ally students are required to have a specific understanding of the impact of crises, disasters, and other traumacau sing events on people (CACREP S tandards, 2009, p. 29) however, again there is no mention of students needing experience or knowledge in the area of domestic violence. Although CACREP also accredits Marriage

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20 and Family Counseling programs in CACREP accr edited programs, this study focus ed on the accrediting body that each of the three professions identify with most strongly from an organizational standpoint. Marriage and Family Therapists Marriage and family therapy programs that are accredited by the American Association for Marriage and Family Therapy, Commission on Accreditation for M arriage and Family Therapy Education, or COAMFTE are guided by six core co mpetencies The six primary competencies are: (a) Admission to treatment, (b) C linical assessment and diagnosis, (c) T reatment planning and c ase m anagement, (d) Therapeutic i nterventions, (e) L egal issues, ethics and s tandards and (f) R esearch and p r ogram evaluation (AAMFT, 2004 p. 1 ). In addition, there are five secondary competencies which outline specific skills and knowledge a Marriage and Family Therapist must develop. Thes e five competencies are Conceptual, Perceptual, Executive, Evaluative, and Professional. Under Clinical Assessment and Diagnosis, it is outlined that Marriage and Family Therapists will develop the skill and knowledge to screen and develop adequate safet y plans for substance abuse, child and elder maltreatment, domestic violence, physical violence, suicide potential and dangerousness to self and other (AAMFT, 2004, p. 3). Also under Legal Issues, Ethics and Standards, it is specified that therapists wi ll develop safety plans for clients who present with potential self harm, suicide, abuse, or violence (AAMFT, 2004, p.5). In addition, CACREP addresses Marriage and Family Therapists as needing additional knowledge and skills in the area of understandi ng family development and the life cycle, sociology of the family, family phenomenology, contemporary families, family

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21 wellness, families and culture, aging and family issues family violence and related family concerns (CACREP S tandards, 2009, p. 35). The need for specialized training in the area of domestic violence is evident i n the statistical data presented: Considerable research on battered women has been conducted over the past two decades. Both the 1980 and 1985 National Family Violence Survey s revealed approximately 12% of women in the United States are physically abused by their husbands or partners annually (Straus et al 1980; Straus & Gelles, 1990 as cited in OKeefe, 1997, p p. 1 2). According to Stalans and Lurigio (1995), about 1.8 million women experience at least one of the more serious forms of violence, such as being kicked, punched, choked, or attacked with a weapon (p.387). Victims are seeking out mental health professionals to assist them in coping with their trauma. It was reported in one study that 60% of domestic violence victims sought assistance from mental health professionals, whereas 20% sought assistance from law enforcement, clergy, physicians and crisis centers (Campbell, Raja, & Grining, 1999). Also in this study conducted by Campbell, Raja, and Grining (1999), it was found that 14% of mental health professionals had no formal training in the area of domestic violence. Additionally, of those 14% of mental health professionals with no formal training, 48% had actually treated domestic violence survivors (Campbell et al., 1999). Mental health professionals need to be knowledgeable about theories of violent relationships, risk factors, assessment, interventions and treatment approaches when w orking with survivors of relationship violence. In 1994 Walker stated that research was beginning to show how many women had been sexually and physically abused: Victims can be expected to appear in the average therapists practice (p. 4). As a result,

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22 virtually any mental health practitioner who works with women needs to have some understanding of the different forms of violence against women and the assessment and treatment effects of such violence (Walker, 1994, p. 4). Goldner (1998) states: violen t men and battered women can present a paradoxical and confusing picture of their relationship. Extreme polarities like love and hate, remorse and cynicism, blame and over responsibility, are characteristic of their interactional process, and, as a result, these men and women often send contradictory messages to outsiders about the status of their relationship, about their goals for therapy, and about the need for social control. Thus it should not be surprising that professionals working with these clients tend to react to them in extremes. (pp 263 264) Furthermore, Margolis and Rungta (1986) state a recurring theme in the literature is that counselors working with populations different from themselves experience discomfort and consequently are less effec tive than they would ordinarily be (p. 642). In addressing dual diagnosis, counselors in training need to be particularly aware of the impact of violence in relationships, in terms of t he treatment of substance abuse: Counselors who provide services to women need to first screen all women for potential domestic violence (Training Initiative, 2005, p. 3). For those women who do screen positive for domestic violence, their treatment plan must include issues of safety for themselves and their children a nd treatment for trauma ( Tra ining Initiative, 2005, p. 3). Most graduate level programs for mental health professionals only provide a general overview for working with clients involved in violent relationships and usually in one course. Yet most mental health professionals begin their counseling career working with families, couples, and individuals facing issues of domestic violence. Mental health professionals in training need formal instruction on relationship violence to provide them with the essent ial foundation for working with this specialized population. In addition, they need experience working with clients experiencing

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23 relationship violence in a faceto face, supervised capacity. Without this specialized training, mental health professionals are more likely to respond to victims in a blaming or insensitive manner resulting in further traumatization, also known as secondary victimization. Campbell, Raja, and Grining (1999) state that secondary victimization could be avoided by training ment al health counselors on issues of violence in relationships. Purpose and Significance of Study The purpose of this study was to examine the perceived level of competency in assessing and treating domestic violence of mental health professionals who are licensed in the state of Florida as clinical social workers, mental health counselors or marriage and family therapists. The United States government recognizes that domestic violence is a social problem. On January 5, 2006, the Violence Against Women Act of 2005 was signed into law by then President Bush, reauthorizing original legislation passed in 1994. This bill allocated monies in the amount of $3.9 million to be spent on programs supporting victims of domestic violence and sexual assault (Harris & Musso, 2006). Victims of domestic violence seek treatment from mental health professionals, such as social workers, mental health counselors and marriage and family therapists: Of the estimated 5.3 million rapes, physical assaults, or stalking incidents by intimate partners each year, nearly 1.5 million result in some type of mental health counseling (Centers for Disease Control and Prevention 2003, p. 18). It would seem plaus ible that m ental health professional s would benefit from preparation and training to work with victims and perpetrators of domestic violence. According to research conducted by Lee and Nichols (2010), recent trends show mental health professionals are not just working in

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24 clinic settings. More often, mental health professionals are working with business institutions, hospitals, schools and within the court system. As a result, mental health professionals are increasingly required to assess, treat, teach and provide consultation in areas such as domestic violence (Lee and Nichols, 2010). Education and training in the area of domestic violence is important and needed. According to the literature, the financial strain that domestic violence places on our society is significant. Recognizing the economic costs of domestic violence can underscore the need for programs for victims and families of domestic violence. The CDC (2003) estimated domestic violence costs the United States $5.8 billion annually. Accordi ng to the CDC (2003), U.S. women lose nearly 8.0 million days of paid work each year because of violence perpetrated against them by current or former husbands, cohabitants, dates, and boyfriends, which is equivalent of 32,1 14 full time jobs each year (p 19). Most of the costs of domestic viol ence were related to health care, due to victims being phys ically abused (CDC, 2003). R esearching c osts associated with domestic violence illustrates the prevalence of this problem to policy makers who are ultimat ely responsible for funding programs that assist victims of domestic violence. In a research study conducted by Todahl, Linville, Chou, and Maher Cosenza (2008), 2nd year masters level graduate students in a COAMFTE accredited family therapy training progr am reported struggling with and having concerns with screening for domestic violence during clinical encounters. Specifically, this study reported that these graduate students had a lack of confidence in conducting the actual screening for violence, as we ll as having a lack of confidence in how to assist a client if in fact domestic violence was reported. Further findings of this study found that these

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25 graduate student participants reported personal reactions of feeling stunned, depressed, overwhelmed, or inadequate when conducting assessments for domestic violence (Todahl et al., 2008, p.38) : O ne participant described her personal reaction as inhibiting her ability to be an effective clinician (Todahl et al., 2008, p. 38). Mental health professionals have a duty and responsibility to be competent when assessing and treating domestic violence. By examining Florida licensed mental health professionals current level of competence in assessing and treating domestic violence, this study hopes to provide a better understanding of the specific educational and training needs in the area of domestic violence. What are the experts saying is needed in the area of domestic violence education and training? According to research conducted by Greene and Bogo (2002) the history of family therapy is tarnished by our inability to detect and adequately respond to women who were being brutalized by their partners (p. 464). Bograd and Mederos (1999) suggests therapists should assume risk for domestic violence in all c ouples or families that present for therapy until it is ruled out (p. 294). Bograd (1999) also argues that the literature on domestic violence is changing. She reflects on her own work and concludes, I privileged the dimension of gender over others because it seemed to offer a parsimonious explanatory power and clinical direction. I believed that gender sensitive models of domestic violence were universal (Bograd, 1999, p. 276). More recently, however, Bograd (1999) has argued that family therapists and other mental health practi ti oners should absolutely consider the impact of class race, gender and sexual orientation as they relate to domestic violence. Furthermore, Bograd (1999) initially assumed that theories of domestic violence unintentionally forced those whose

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26 experiences differed from the mainstream to the margins (pp 2 79280). Now Bograd (1999) suggests that family therapy practi ti oners and other mental health professionals must be free from socially constructed stereotypes of domestic violence (1999, p. 280). She contends that domestic violence is very complex and that mental health practi ti one rs must consider the notion of intersectionality or the idea that factors affecting domestic violence are multidimensional. Race, class, gender, and sexual orientation influence how domestic violence is experienced by the individual (Bograd, 1999). Intersectionalities color the meaning and nature of domestic violence (Bograd, 199 9, p. 276) Theoretical Framework Critical Theory From a Critical Theory approach, the role of researcher is not neutral; the researchers values are known. The researchers goal is a call to action, motivating oth ers to act. It is the belief of this researcher that one cannot remain neutral when conducting research. Our values influence how we make sense of the world around us. We construct our understanding of meaning a nd reason for why things happen: Social values, struggles, and interests influence the questions, concepts, and strategies of education science (Popkewitz, 1990, p. 50). As stated by Comstock (1982) t he function of critical so cial science is to increase the awareness of social actors of the contradictory conditions of action which are distorted or hidden by everyday understandings (p. 371) All men and women are potentially active agents in the construction of their social w orld and their personal lives: that they can be the subjects, rather than the objects of sociohistorical processes (Comstock, 198 2, p. 371).

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27 For these reasons, critical t heory is the underlying theoretical framework guiding the research in this disserta tion. From a critical t heory approach, it is assumed that having active interaction with ones values and not remaining neutral, w ill ultimately promote change: Rather than look for the universal and necessary features of social scientific knowledge, Cri tical t heory has instead focused on the social relationships between inquirers and other actors in the social sciences (Stanford Encyclopedia of Philosophy, 2005, p. 20). As stated by Popketw itz ( 1990), H uman possibility, it is believed, occurs through understanding how the boundaries and structures are formed through struggle rather than as given as an inevitable and unaltered present (p. 49). Values influence research: Because humans are constructions, paradigms inevitably reflect the values of their human constructors. They enter into inquiry at choice points such as the problem selected for study, the paradigm within which to study it, the instruments and the analytic modes used, and the interpretations, conclusions, and recommendations made (Guba 1990, p. 23). Once individuals gain awareness, change can then occur: The task of inquiry is, by definition, to raise people (the oppressed) to a level of true consciousness. Once they appreciate how oppressed they are, they can act to transform the w orld (Guba, 1990, p. 24). Jurgen Habermas Jurgen Habermas is considered to be one of the most significant philosophers of Critical Theory. He is thought to have bridged the gap between theory and practice, when applying a critical theory approach (Redig er, 1996). According to Rediger (1996), Habermas basic tenet is that human beings are unnecessarily oppressed by the hidden values of ideologies and can be freed from this oppression through self reflection and action based on the realization o f alternatives (p. 128). An important

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28 competence for mental health professionals to have is an awareness of his or her own values and also, an awareness of how those values play a part in the therapy services they provide. Mental health professionals must be conscious of how their approach or philosophy of helping others is influenced greatly by their own views and how they make sense of the world. According to Rediger (1996), mental health professionals engaged in family therapy have similar goals as c ritical theorists, tha t is, therapy is about change: One way to conceptualize change is as a movement from constricting individual and relational life experience to an experience that is free from oppressive constraints. The change family therapy seeks i s emancipatory ( p. 127). As with working with domestic violence, mental health professionals are working with victims to free them from their batterers control. Habermas notion of emancipation clearly speaks to the social issue of domestic violence and how the mental health professional may work with a victim toward reaching emancipation. In empowering the victim of domestic violence to recognize patterns of abusive behavior, Habermas holds that the method of self reflection is the key to the healing of the social sciences and the way to progress out of the regression that has followed positivism (Rediger, 1996, p. 130). Habermas believes it is only through methodologys own self reflective process that the rational project of human beings can be f urthered (Rediger, 1996, p. 129). Donald E. Comstock According to Comstock (1982), T he function of a critical social science is to increase the awareness of social actors of the contradictory conditions of action which are distorted or hidden by everyday understandings (p. 371). From a critical approach, it is believed that all individuals construct their social realties (Comstock, 1982).

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29 Individuals in society act as subjects in the construction of their realities and not as objects (Comstock, 1982) From a critical approach, society is viewed as a human construction which is altered through peoples progressive understanding of historically specific processed and structures (Comstock, 1982, p. 372). Critical theorists look at human action: Sin ce humans are self defining agents who reflect on and interpret their actions, and since all fundamental social change is the product of innovation in both meanings an social practices, future conditions and regularities are not predetermined (Comstock, 1 982, p. 375). Comstock also states Critical social science sees society as humanly constructed and, in turn, human nature as a collective self construction ( p. 375). According to Comstock (1982), the purpose of critical research is to promote action by providing adequate knowledge of the historical development of social conditions and meanings and a vision of a desirable and possible future (p. 386). With that focus in mind, this study can serve as a starting point in the assessment of practitioners own views of personal preparedness and competence in assessing and treating clients dealing with domestic violence. In other words, findings should point to suggestions for future planning in the training and supervision of clinical social workers, marria ge and family therapists, and mental health counselors (in the state of Florida). Domestic Violence Michele Bograd Bograd (1988) refers to domestic violence as wife abuse, in which a man uses physical force against a woman. As in critical research, Bograd (1988) defines wife abuse as a pattern that becomes understandable only through examination of the social context (p. 14). Bograd also states, As feminists, we believe that the social institutions of marriage and family are special contexts that may pr omote, maintain, and

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30 even support mens use of physical force against women ( p. 12). Bograd (1988) argues that feminists seek to find answers to wife abuse more so on a global level and not individual. They are not so much interested in why a particular man physically abused his wife, but rather why men, in general, in our society use physical for ce and power to control women: Wife abuse is not a private matter, but a social one (Bograd, 1988, pg. 15). However, Bograds more recent work illustrates a change in perspective. Bograd (1999) recognizes that domestic violence cannot be v iewed only from a feminist lens; there are other factors like race, class, sexual orientation, as well as gender, that influence how we understand domestic violence. She r ecommends that therapists should assume risk for domestic violence in all couples or families that present for therapy until it is ruled out (Bograd & Mederos, 1999, pp 293 294). She considers couples treatment as a viable approach for treating domesti c violence. There are certain criteria that must be met in order for couples therapy to be considered an appropriate treatment modalit y for domestic violence such as spouses must freely agree to therapy; the mans violence must be considered minor, not resulting in injury and be infrequent; the mans psychological abuse of the woman must also be infrequent and not severe; there must not be a risk of escalated violence from the man; the woman cannot be afraid of escalated violence; and lastly, the man mus t take responsibility for his abusive behaviors (Bograd & Mederos, 1999). Virginia Goldner Goldner, along with her colleagues at the Ackerman Institute, a rgue that it is helpful to understand male violence as simultaneously an instrumental and expressive act. Its instrumentality rests on the fact that it is a powerful method of social control, a

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31 strategy that a man consciously chooses. At another level of violence can be understood as an impulsive, expressive act. Male violence represents a conscious st rategy of control and a frightening disorienting loss of control (Goldner, Penn, Sheinberg & Walker, 1990, p. 346). Goldners approach to domestic violence i s to treat the couple together : We do believe that couples therapy, grounded in feminist concerns for justice and safety, should be a credible treatment option when violence is the presenting problem (Goldner, 1998, pp. 264265). Goldner (1998) argues that the currently dominant approach, gender specific group treatment for offenders has not been s hown empirically to be safe or more effective than other methods, including couples treatment that focuses on violencereduction (p. 265). Goldner (1998) also supports the idea of the therapist both maintaining a neutral stance in couples therapy as wel l as acting as an advocate for the victim of domestic violence. She suggests maintaining this neutral stance by allowing the victim to speak truthfully about the violence relationship. At th e same time, the therapist should also recogniz e the perpetrator as the offender and possi bly a past victim in which has yet been disclosed. The role of the therapist is to make the couple client feel comfortable to talk about the abuse, past and present. Richard Gelles and Murray Straus As a point of contrast, Richard Gelles and Murray Straus are discussed in this chapter. The research of Gelles and Straus is considered classic and landmark in terms of their contributions in the area of domestic violence research. For these reasons, discussion of their research fi ndings are presented in this dissertation. Gelles and Straus are sociologists that believe social structural factors lead to domestic violence (Bograd, 1988). They stated, We believe that violence in the family is more a

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32 social problem than a psychologic al problem (Straus, Gelles & Steinmetz, 1980, p. 202). Gender neutral terms are used to describe domestic violence. Straus et al. (1980) refer to domestic violence as abusive violence, that is, an act which has the high potential for injuring the per son being hit (p. 22). They too believe that domestic violence does not discriminate, that abuse is found at every socioeconomic level (Straus, Gelles, & Steinmetz, 1980). As sociologists, Straus and Gelles believe that violence is a learned behavior, t hat the majority of todays violent couples are those who were brought up by parents violent towards each other (Straus et al. 1980, p. 100). As a result of their many studies, Straus et al. (1980) concluded that violence is used as a means of control. Neil Jacobson and John Gottman Another point of contrast is the work conducted by Neil Jacobson and John Gottman. Jacobson and Gottman (1998) reported on their study of 201 couples involved in violent marriages. They found unexpected results regarding how batterers responded to the violence in their marriage. From their study, batterers were categorized as either Type I or Type II. Type I batterers were described as being antisocial, sadistic, manipulative and emotionally independent (Jacobson & G ottman, 1998). T ype II batterers were described as being insecure, jealous, emotionally dependent and fearful of being alone or abandoned by their partner (Jacobson & Gottman, 1998). Their research looked to develop a typology for perpetrators of domestic violence (Jacobson & Gottman, 1998). Jacobson and Gottman argue that until marital interactions of batterers and their partners are better understood, one can only speculate about how violence unfolds in these relationships, the function that violence serves, or the communication patterns associated with violence (Jacobson,

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33 Gottman, Walkz, Rushe, Babcock and HoltzoworthMunroe, 1994, p. 982). Implications of their study findings suggest that mental health professionals should take into account these ty pologies when treating perpetrators of domestic v iolence (Jacobson & Gottman, 1998). Research Question How do licensed Clinical Social Workers, Mental Health Counselors, and Marriage and Fam ily Therapist s in the state of Florida perceive their level of com petence in assessing and treating domestic violence? Quantitative Methodology and Critical Research Quantitative methodology has its place in critical research. Even those who often criticize quantitative methods, also recognize their value. Feminist res earcher Kersti Yllo discusses the value of quantitative research, specifically work conducted by social science researchers: Statistical data generated by the Conflict Tactics Scale, developed by Murray Straus and his colleagues, and now widely used, are taken most seriously (Yllo & Bograd, 1988, p. 40). Survey methodology was chosen for this research study because survey results can gather a significant amount of information in a relatively short period of time. Th is research study provided information on mental health professionals perceived level of competency in assessing and t reating domestic violence. The findings of this research study can provide a foundation for additional qualitativ e research. Fur ther qualitative research may provide a more fruitful response in terms of what is needed in the area of assessing and treating domestic violence. Survey methodology remains a viable way to conduct research from a critical theory approach. Survey methods allow the researcher to collect data in a sound and

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34 efficient manner in which results can be applied to larger populations. For these reasons, survey methodology was utilized in an E mail delivery format: Email has become the standard method for communi cating in most work organizations and for many individuals (Dillman, Smyth, & Christain, 2009, p. 9). According to Dillman et al. mos t people prefer to respond via E mail, and for the most part E mail has replaced standard mail. Even when telephone mes sages are left for individuals, most respond back with an E mail. Internet surveys are cost effective, that is no postage has to be paid, no copies made or paper supplies or ink cartridges refilled and lastly, responses to survey require less field time (Dillman et al., 2009) However, researchers using E mail survey methods should keep in mind that in order for web surveys to be scientifically sound as a basis for generalizing results to a larger population, all members of a carefully defined populat ion need to be given a known chance of being selected to participate (Dillman, Tortora, Conradt, & Bowker, 1998). In sum, the characteristics of millions of people can be estimated with confidence by collecting information from only a few hundred or thousand respondents (Dillman, et al., 2009, p. 1). Definition of Terms To even attempt to define domestic violence is compl icated. Just referring to the act of violence as domestic viol ence carries with it bias that others may criticize. There are a variety of terms used to describe how one person can hurt another. For the purpose of this research study the term domestic violence will be used. On the surface this term may seem to describe the same thing; however there are variations in meaning worthy of identifying. For clarification purposes, variations of meaning will be discussed in this study. It should be noted that theorists, researchers, and practi ti oners do not agree on how domestic violence is defined. Some believe a particular definition

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35 is t oo broad, others, too narrow. Some may define certain experiences of violence differently. The following is an attempt to discuss how the legal system in the state of Florida as well as theorists, researchers and practi ti oners define domestic violence. Domestic Violence: According to the 2009 Florida state statute, Chapter 741.28 domestic violence is defined as any assault, aggravated assault, battery, aggravated battery, sexual assault, sexual battery, stalking, aggravated stalking, kidnapping, false imprisonment, or any criminal offense resulting in physical injury or death of one family or household member by another family or household member ( http://www.leg.state.fl.us retrieved 12/13/2009 ). McKenzie (1995) defines domestic violence encompassing emotional abuse and physical attacks within the family context. Thus, domestic violence affects the entire family constellation including children, parents, grandparents, extended kin of all ages groups, and other persons anchored within the family network, who may not be relat ed by blood or marriage (p. 8). M cKenzie also states, Spousal battery is a choice men exercise intentionally and purposefully to resolve conflict and achieve their goals of dominance, and coercive c ontrol of women ( p. 8). According to Lenore Walker (1979), the slow emotional torture which produces invisible scars is as abusive as the quick, sharp physical blows (p. 72). Domestic violence is physical assaults, sexual assaults, social isolation, humiliation, economic deprivation, and controlling behavior (Walker, 1979). Walker (1979) also describes domestic violence as occurring in cycles. These cycles of violence explain how battered women become victimized, how they fall into learned helplessness behavior, and why they do not attempt to escape (Walker, 1979, p. 55).

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36 From a feminist perspective, Bograd (1988) defines domestic violence, or what is referred to as wife abuse as the use of physical force by a man against his intimate cohabitating partner(p. 12). Bograd states, This force can range from pushes and slaps to coerced sex to assaul ts with deadly weapons. Although many women suffer psychological abuse from their partners, we focus primarily on physical abuse (Bograd, 1988, p. 12). Straus, Gelles and Steinmetz (1980) describe domestic violence as abusive violence: Abusive violence is an act which has the high potential for injuring the person being hit, acts where people punched, kicked, or bit a family member, hit the person with a hard object, beat up another person, or shot, or tired to shoot, stabbed, or tried to stab, another family member (Straus, Gelles, & Steinmetz, 1980, p. 22). For the purposes of this study, the following definition of domestic violence will be used. Domestic violence is the physical, psychological or sexual abuse of one family or household member by another family or household member. Physical abuse includes, but is not limited to, hitting, slapping, kicking, punching, with or without a weapon, which causes pain or injury. Psychological abuse includes, but is not limited to, stalkin g, humiliation, verbal abuse, false imprisonment, social isolation, economic deprivation, or any other controlling type behavior. Sexual abuse includes but is not limited to any unwanted, coerced, forced, or threat of forced sexual acts or attempted sex ual acts. Accrediting Bodies Council on Social Work Education ( CSWE ) This organization, the Council on Social Work Education, is a nonprofit national organization which regulates graduate and undergraduate level programs of social work. The CSWE uses the Educational Policy and the Accreditation Standards (EPAS)

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37 for the accreditation of social work programs and was founded in 1952. Currently there are 470 accredited bachelor level programs and 195 accredited masters level programs ( http://www.CSWE.org/CSWE retrieved 05/28/2008). Council for Accreditation of Counseling and Related Education Programs ( CACREP ) C ACREP, which refers to the Council for Accreditation of Counseling and Related Educational Programs, was established in 1981 (Adams, 2005). CACREP is the accrediting body which develops procedures and guidelines for educational programs in the counseling field for both masters a s well as doctoral level studies. CACREPs mission is to promote the professional competence of counseling and related practi ti oners through the development of preparation standards, the encouragement of excellence in program development and the accredi tation of professional preparation programs (www.cacrep.org/misson.html 3rd paragraph, retrieved 0 5/28/2008). Cur rently, there are 62 accredited masters level programs in mental health counseling. Commi ssion on Accreditation for Marriage and Family Therapy Education ( COAMFTE ) COAMFTE, which refers to the Commission on Accreditation for Marriage and Family Therapy Education, was established in 1978. This accrediting body regulates masters level, doctoral level, and post graduate level programs in the area of marriage and family therapy. According to COAMFTE, specialized accreditation of marriage and family therapy programs is a public service that aims to encourage programs to continue their own self st udy and development and indicate that programs are meeting established standards and their own stated objectives ( www.aamft.org/about/comafte, 3rd paragraph, retrieved 05/28/2008).

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38 Licensing Board In the st ate of Florida, one board regulates licensing for mental heal th professionals under Chapter 491.004 of the Florida Statutes and under Rule 64B4 o f the Florida Administrative Code. T he Board of Clinical Social Work, Marriage and Family Therapy and Mental H ealth Counseling regulate these three disc iplines in Florida Licensed Clinical Social Worker According to 2009 Florida Statute, Chapter 491.004 the practice of clinical work is defined as: T he use of scientific and applied knowledge, theories, and met hods for the purpose of describing, preventing, evaluating, and treating individual, couple, marital, family, or group behavior, based on the personin situation perspective of psychosocial development, normal and abnormal behavior, psychopathology, uncons cious motivation, interpersonal relationships, environmental stress, differential assessment, differential planning, and data gathering. The purpose of such services is the prevention and treatment of undesired behavior and enhancement of mental health. Th e practice of clinical social work includes methods of a psychological nature used to evaluate, assess, diagnose, treat, and prevent emotional and mental disorders and dysfunctions (whether cognitive, affective, or behavioral), sexual dysfunction, behavior al disorders, alcoholism, and substance abuse. The practice of clinical social work includes, but is not limited to, psychotherapy, hypnotherapy, and sex therapy. The practice of clinical social work also includes counseling, behavior modification, consult ation, client centered advocacy, crisis intervention, and the provision of needed information and education to clients, when using methods of a psychological nature to evaluate, assess,

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39 diagnose, treat, and prevent emotional and mental disorders and dysfunctions (whether cognitive, affective, or behavioral), sexual dysfunction, behavioral disorders, alcoholism, or substance abuse. The practice of clinical social work may also include clinical research into more effective psychotherapeutic modalities for the treatment and prevention of such conditions ( www.leg.state.fl.us retrieved 11/03/2009). Licensed Mental Health Counselor According to 2009 Florida Statute, Chapter 491.004 the practice of mental health counseling is defined as: T he use of scientific and applied behavioral science theories, methods, and techniques for the purpose of describing, preventing, and treating undesired behavior and enhancing mental health and human development and is based on the personi n situation perspectives derived from research and theory in personality, family, group, and organizational dynamics and development, career planning, cultural diversity, human growth and development, human sexuality, normal and abnormal behavior, psychopathology, psychotherapy, and rehabilitation. The practice of mental health counseling includes methods of a psychological nature used to evaluate, assess, diagnose, and treat emotional and mental dysfunctions or disorders (whether cognitive, affective, or b ehavioral), behavioral disorders, interpersonal relationships, sexual dysfunction, alcoholism, and substance abuse. The practice of mental health counseling includes, but is not limited to, psychotherapy, hypnotherapy, and sex therapy. The practice of ment al health counseling also includes counseling, behavior modification, consultation, client centered advocacy, crisis intervention, and the provision of needed information and education to clients, when using methods of a psychological nature to evaluate, assess, diagnose, treat, and prevent emotional and mental disorders and

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40 dysfunctions (whether cognitive, affective, or behavioral), behavioral disorders, sexual dysfunction, alcoholism, or substance abuse. The practice of mental health counseling may also i nclude clinical research into more effective psychotherapeutic modalities for the treatment and prevention of such conditions ( www.leg.state.fl.us retrieved 11/03/2009) Licensed Marriage and Family Therapist Ac cording to 2009 Florida Statute, Chapter 491.004 the practice of marriage and family therapy is defined as: T he use of scientific and applied marriage and family theories, methods, and procedures for the purpose of describing, evaluating, and modifying marital, family, and individual behavior, within the context of marital and family systems, including the context of marital formation and dissolution, and is based on marriage and family systems theory, marriage and family development, human development, normal and abnormal behavior, psychopathology, human sexuality, psychotherapeutic and marriage and family therapy theories and techniques. The practice of marriage and family therapy includes methods of a psychological nature used to evaluate, assess, diagnose, treat, and prevent emotional and mental disorders or dysfunctions (whether cognitive, affective, or behavioral), sexual dysfunction, behavioral disorders, alcoholism, and substance abuse. The practice of marriage and family therapy includes, but is not limited to, marriage and family therapy, psychotherapy, including behavioral family therapy, hypnotherapy, and sex therapy. The practice of marriage and family therapy also includes counseling, behavior modification, consultation, client centered advocacy crisis intervention, and the provision of needed information and education to clients, when using methods of a psychological nature to evaluate, assess, diagnose, treat, and

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41 prevent emotional and mental disorders and dysfunctions (whether cognitive, affective, or behavioral), sexual dysfunction, behavioral disorders, alcoholism, or substance abuse. The practice of marriage and family therapy may also include clinical research into more effective psychotherapeutic modalities for the treatment and prevention of such conditions ( www.leg.state.fl.us retrieved 11/03/2009). Graduate TrainingClinical Hours Clinical Social Work According to the Council of Social Work Education (2001), the purpose of the social work pr ofession is to promote human and community well being (p. 1). Social workers take a global approach to their work of social and economic justice, seeking equality for all. Educational requirements for a degree in social work are a minimum of 400 hours o f education for bachelors degree and 900 hours of education for masters (Council on Social Work Education 2001, Education Policy and Accreditation Standards). Mental Health Counseling Current education requirements for a masters degree in clinical ment al health counseling are a minimum of 54 semester hour s in the program. Students are required to have practicum experiences, with a minimum of 100 clock hours, and an internship experience, with a minimum of 600 clock hours. Also, mental health counselor s are re quired to obtain two years post masters supervised clinical experience. Education requirements for doctoral degrees require a minimum of 96 semester hour s in the program and a minimum of 600 clock hours of doctor al level counseling internships (Cou ncil for Accreditation of Counseling and Related Educational Programs, 2009, Standards)

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42 Marriage and Family Therapy Marriage and family therapists are mental health professionals trained in psychotherapy and family systems, and licensed to diagnose and treat mental and emotional disorders within the context of marriage, couples and family systems ( www.aamft.org/faqs retrieved 05/28/2008). Education requirements for a masters degree in marriage and family therapy require : A minimum of 72 semester hour s in the program which also requires a minimum of 500 clock hours of internship, of which 250 hours must be with couples or families present in the therapy room. They must also have 100 hours of face to face supervi sion. Also, required for licensure are two years of post masters supervised clinical experience. On the doctoral level, students must complete a minimum of 1,000 hours of direct client contact. Organization of Study In the following chapters, this research study is discussed in detail. Chapter one provides an overview of what will be studied and its purpose. Significant terms are defined. Theoretical frameworks are discussed and overall argument of why this researcher should evaluate Florida licensed m ental health professionals perceived level of competence in assessing and treating domestic violence. Chapter T wo contains a review of relevant literature related to the social issue of domestic violence. The prevalence of domestic violence is discussed. Also in this chapter, experts in the field of assessing and treating domestic violence are presented in terms of current training and what is needed for future training. Chapter Three presents the methodology used in this research study, to include relevant variables, population, instrumentation, data collection, data analysis and argument for using quantitative methodology with a critical

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43 approach to research. Chapter Four examines the results of data collected. And finally, Chapter F ive includes dis cussion of the res ults of this research study as well as conclus ions. Methodological limitations are presented in C hapter Five as well as implications and recommendations f or future research.

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44 C HAPTER 2 REVIEW OF LITERATURE Overview Violent relationships are unique in terms of the dynamics, power inequities and the role of gender. Because of the prevalence of relationship violence in United States, most mental health professionals will have contact with survivors of domestic violence at some point in time in their career (Campbell, Raja, & Grining, 1999, p.1010). How are mental health graduate programs preparing professionals to work with this special population? In a study conducted by Campbell, Raja, and Grining (1999) results found that mental health professionals did not receive training on domestic violence i n graduate school but rather postgraduate, in which they sought elective training on their own. Campbell et al. (1999) question whether therapists are receiving adequate training to address the needs of victims of domestic violence. What defines domestic violence? There are many definitions which constitute violence and are at times, conflicting. According to Gordon (2000), many advocates and scholars conceptualize domestic violence as an array of physical, and verbal acts used to achieve domination and control over an intimate partner and argue that the proper referent for domestic violence directed at women should not be episodes of specific acts of physical, psychological, and sexual violence but, rather, a pattern of behavior and experiences of violence and abuse within a relationship (p. 747). The criminal justice system tends to define relationship violence in terms of physical acts, like hitting, kicking and pushing. Research has broadened this definition to include psychological, sociological, as well as economic perspectives w hen defining violence. As cited in Gordon (2000), landmark studies conducted by Murray Straus, Richard

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45 Gelles and Lenore Walker have paid careful attenti on to measurement and sampling issues to obtain generalizable results on domestic violence (p. 748). Researchers now recognize that domestic violence is not one dimensional: A growing number of researchers and government agencies contend that violence against women is multidimensional in nature and that definitions and research should recognize that many womens lives rest on a continuum of unsafety (Stanko, 1990 as cited in Dekeseredy, 2000, p. 729). This continuum involves not just the physical aspects of violence, but the psychological or emotional aspects as well, which can be just as painful (Dekeseredy, 2000). Consequently, there is no consensus among researchers or practitioners as to how broad or narrow the de finition of violence should be or as to how to define the specific components of any definition (e.g., violence, neglect, rape, or psychological abuse) (Gelles, 2000, p. 786). Prevalence of Domestic Violence P eople in all walks of life can be victims of domestic violence or harassment, abuse, or life endangering situations It occurs in all socioeconomic groups and across all cultural groups. In a study conducted by Silverman, Raj, Mucci, and Hathaway (2001), approximately 1 in 5 adolescent girls (18% 20%) reported being physically and/or sexually hurt by a dating partner (pp 576577). In another study, researchers found violence to be the leading cause of injury to women ages 15 through 44 years (Novello Rosenberg, Saltzman & Shosky, 1992, p. 3132). Furthermore, married women were found to be at great risk for being victims of domestic violence: Each year 1.6 million wives in the United States are severely assaulted by their husbands and about 13% of al l murders are husband killing their wives (Straus & Gelles,1986; Ohrenstien, 1977, as cited in Gottman, Jacobson, Rushe, Shortt, Babcock, La Taillade & Waltz,

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46 1995, p. 227). According to the Bureau of Justice Statistics (2005), about seven in ten female rape or sexual assault victims stated the offender was an intimate, other relative, a friend or an acquaintance. Mental health professionals seek continuing education and post graduate training to improve their knowledge and skills in the area of domestic violence. Wingfield and Blocker (1998) state, Academici an awareness needs to be heightened for adding domestic violence interventions course work into existing curriculums (p. 92). Through workshops, externships, certificate programs and institutes s pecializing in educating professionals in the area of domest ic violence, mental health professionals seem to be seeking knowledge and practice outside of traditional academic graduate schools. Conceptualization of Domestic Violence Michele Bograd Saunders (1988) states A key element of feminist theories of woman abuse is that men use physical violence to maintain male dominanc e in the family ( p, 90). From a feminist perspective, domestic violence is referred to as wife abuse and defined as the use of physical force by a man against his intimate cohabitating partner ( Bograd, 1988, p 12). The focus is primarily on the physical abuse and not as much on the psychological abuse. Reasons for referring to domestic violence as wife abuse is because feminists feel generic terms ignore the context of the violence, its nature, and consequences the role obligations of each family member and the different mechanisms or transactional sequences that lead to various forms of abuse (Bograd, 1988, p. 13). Feminist theorists tend to focus more broadly in terms of answering the question, why did that man beat his wife? Feminist are more concerned with why do men in general use physical force against their partners and what functions this serves

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47 for a given society in a specific historical context(Bograd, 1988, p. 13). From a feminist perspective, m en in the United States oppress women in many social positions, however the use of physical violence to control women is the most overt means in doing so. Like critical theorists, feminist theorists argue that one cannot be value free when conducting research. From a feminist perspective, there is no such thing as true neutrality in social science, since we can never function completely independently of dominant ideologies and belief systems (Bograd, 1988, pp 20 21). Actually, feminists encourage women researchers to examine their values and speak out about their experiences from their own perspective. Bograd (1988) states Feminists suggest that it is crucial that researchers make explicit the values that g uide their work ( p. 21). Earlier work by B ograd (1999) focused on informing others of the prevalence of domestic violence. Bograd examined domestic violence through a feminist lens in which she believed that battered women were being implicated by the concepts, practices and interventions used by mental health professionals. Her later worked discovered that there are other factors like race, socioeconomic status and sexual orientation that play a part in conceptualizing domestic violence (Bograd, 1999). She stated We exist in social contexts c reated by the intersections of systems (e.g. race, class, gender, and sexual orientation) and oppression. Intersectionalities color the meaning and nature of domestic violence, how it is experienced by self and responded to by others, how personal and soc ial consequences are represented, and how and whether escape and safety can be obtained ( p. 276). Therefore, according to Bograd (1999) theoretical conceptualizations and interventions of domestic violence must not

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48 remain universal, a onesize fits all a pproach does not work. Not everyone experiences domestic violence in the same manner and as a result, theories and interventions should be sensitive to the social contexts that influence domestic violence (Bograd, 1999). Bograd (1999) suggests that domes tic violence does not have a singular impact on families (p. 283) and mental health professionals need to recognize that social contexts shape how people experience domestic violence. Bograd (199 9) argues it is the responsibility of the mental health pro fessional to incorporate the notion of intersectionalities into theory and practice: It is incumbent upon those of us in the field who already have power and prestige to shoulder the responsibility of expanding our models, examining our practices, and gi ving voice to those who are si lences among us ( p. 286). Bograd (1999) identifies preconditions that need to be met in order to conduct an assessment of domestic violence, as well as treatment of domestic violence. Those preconditions are that the mans participation is voluntary, special agreements about confidentiality must be established, and an optimal therapeutic stance must be achieved (Bograd, 1999, p. 294). During couples therapy, which is the mo de in which Bograd suggests t reat ment of domestic violence, the therapist must be frank and clear about the allocation of responsibility and the inappropriateness of abusive behavior regardless o f circumstances ( p. 296). In couples therapy Bograd (1999) suggests the therapist maintain an attitude of s upportive skepticism that constantly questions the depth of the batterers resolve and realism (p. 296). Both individual sessions as well as couples sessions should be employed when treating domestic violence, with the first

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49 session being a couples int erview (Bograd, 1999). In addition, Bograd recommends to treat the disclosure to domestic violence with care, as it may not be disclosed in the initial couples session. According to Bograd, the therapist will have a better understanding and be more infor med after the initial individual session regarding the potential existence of domestic violence. Furthermore, in order for couples therapy to be an effective mode of treatment for domestic violence, it is essential that both spouses freely agree to coupl es counseling (Bograd, 1999, p. 303). Rhea Almeida Rhea Almeida examines domestic violence by utilizing a Cultural Context Model (Almeida & Durkin, 1999). Almeida defines culture as the accumulation of social traditions and practices as well as rich an thologies of art, music, dance, food, and language that are passed down through the generations to bind the interior of family life with different societies. Within the interior walls of all culture exist many oppressive practices that may appear to be necessary and fundamental to maintaining that particular culture (Almeida & Durkin, 1999, p. 314). She argues that culturally expanded definitions of both battered woman and batterer are necessary for ethical intervention when treating domestic violence (Almeida & Durkin, 1999, p. 315). The basic tenets of the Cultural Context Model include that credibility begins in the therapeutic process with the victims personal narrative. This does not mean that the batterer provides his narrative in a similar fas hi o n to level the playing field his work is based on the victims experience of violence (Almedia & Durkin, 1999, p. 316). In this model, a tenet is for batterers, identifying and dismantling the structures of power and control that promote violence i s a lifelong process passing nonviolence on to the next generation through internalization (Almeida & Durkin, 1999, p. 316).

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50 Almeida agrees that assessment for domestic violence should be an integral part of the screening process in couples therapy (Almeida & Durkin, 1999, p. 318). In addition, similar to Bograd, Almeida suggests that the initial session should be conducted with the couple, followed by initial individual sessions: This sequence offers the therapist the opportunity to obtain specific information regarding power and control dimensions and to screen for domestic violence without compromising the safety of the woman and/or entering into a power struggle with the man ( p. 317). Almeida suggests that if domestic violence exists, prior to couples therapy, the batterer should participate in group therapy that emphasizes accountability, socioeducation, and sponsorship (Almeida & Durkin, 1999, p. 316). Almeida & Durkin (1999) suggest therapists should incorporate into the group th erapy process, cultural accountability, intersectionality of gender, race, class, culture, and sexual orientation, as well as partnering batterers with men who support nonviolence in relationships. Batterers should participate in group therapy as well as victims, in a separate group therapy (Almeida & Durkin, 1999). In these group therapies, batterers are separated into socioeducational groups called cultural circles to heighten their consciousness regarding sexism and other forms of privilege and oppression (Almeida & Durkin, 1999, p. 319). As batterers gain awareness, they are filtered into the larger group, with multiple cultures and with continued support from their sponsor (Almeida & Durkin, 1999). According to Almeida & Durkin (1999), once the bat terer has successfully completed group therapy, couples therapy can then begin: Couples treatment should

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51 only occur with men who have been educated about, and made substantive changes in, their destructive forms of power and control over partners and chi ldren ( p. 32). Virginia Goldner Like Bograd and Almeida, Goldner also employs couples therapy as a mode of treatment for domestic violence. According to Goldner (1998), there are conditions that must be present and met, most importantly, that the violenc e has stopped and that the man take full responsibility for the abuse in order for couples therapy to be utilized. Goldner (1998) merges both feminist and systemic approaches in treating the violence, which may seem contradictory and has received some cri ticism in the past. Goldner states, Clearly, placing a violent man and his victim in close quarters and inviting them to address contentious issues in their relationship has the potential to revictimize the woman physically and psychologically and to provide the offender with a platform for self justification. However, we do believe that couples therapy grounded in feminist concerns for justice and safety, should be a credible treatment option when violence is the pres enting problem ( p p 264 265). Goldn er (1998) also argues that gender specific group therapy has not proved to be any safer or more effective than couples therapy, in the treatment of domestic violence. Goldner (1998) suggests that intense attachment keeps the violent couple together: Bo th partners in these relationships know that the violence is a terrible thing, and that no one should stay in a relationship if they are harming another person or being harmed by them, however, this intense attachment compels them to stay engaged despite t he risks, the shame and the d estructiveness ( p. 265). Furthermore, Goldner (1998) argues that there is overwhelming evidence to show women who leave violent relationships are at greater risk of further violence than women who stay. She

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52 supports her argument with a U.S. Justice Department Report (1994) that found woman were six times more likely to be victims of violence if they left a violent relationship, than those that stayed in a violent relationship (Goldner, 1998). Goldner (1998) employs couples t he rapy with multiple perspectives: intellectual, political and psychological. The goal of therapy according to Goldner (1998) is to develop the most comprehensive understanding of abuse and victimization, without compromising a clear moral vision regarding issues of accountability, that is, without blaming the victim, shaming the victim, or allowing the perpetrator to misuse psychological insight to avoid taking responsibili ty for his actions (p. 268). Goldner (1998) suggest the role of the therapist in couples therapy is both neutral and advocate, when treati ng domestic violence: The art of multiplicity rests on the belief that it is not only possible, but also necessary, to carry both positions into the treatment situation so that their truths can pl ay in counterpoint, each an implicit commentary on the other ( p. 269). According to Goldner (1998), violence is the presenting problem and primary focus of treatment, not other issues, in order to keep focus of responsibility on the perpetrator. However, Goldners approach to couples therapy does emphasize responsibility and acc ountability for both partners: Women in these relationships must take some responsibility for protect ing themselves ( p. 279). One of Goldners colleges from the Ackerman Institute for the Family, Gillian Walker, also takes a feminist perspective when conceptualizing domestic violence. She refers to domestic violence as wife beating and identifies wife abuse as an assault, not interaction gone wrong (Walker, 1990, p. 48). Furthermore, she proposes that the violence is against the woman and not the family, that violence is a crime and men

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53 should take full responsibility: Men beat their wives because they are per mitted to do so (p. 48). Walker (1990) suggests that wife beat ing is a social issue and we are all responsible for making changes in the way society conceptualizes women: The lack of protection given to an assaulted woman is an important part of that social permission: violent husbands quickly learn that they can g et away with assault ing their wives ( p. 48). Wife beating is not a private matter, but rather a community matter, in which the community should join efforts to eliminate the violence (Walker, 1990). Walker strongly supports the notion of referring to the violence as wife beating and not family violence. She argues that referring to the violence as family violence or domestic violence takes the responsibility off the man and shifts the focus, its a matter of how men treat women (Walker, 1990, p. 6 5). Walker (1990) further argues that the violent acts of men, as well as the suffering of the women, are minimized when referring to the violence as family violence. Walker made great efforts with the Canadian government to examine violence against women with the support of the United Way (Walker, 1990). Results of her research found that attitudes of social service professionals toward wife beating, as well as those of the medical professionals, often times resulted in secondary victimization: Tradit ional attitudes towards the privacy of the family and lack of formal training on the issue to family violence are named as the basis of the inadequacy of professional response from the medical, mental health, and social service systems ( p. 186). Lenore Wa lker Lenore Walker (1979) defines domestic violence as physical abuse, sexual abuse, economic deprivation, social isolation, and humiliation. Walker presents the theory of learned helplessness as a way to explain domestic violence (Walker, 1979; Walker,

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54 2000). She refers to learned helplessness as a psychological rationale that provides an explanation of why the battered woman becomes a victim in the first place and how the process of victimization is perpetuated to the point of psychological paralysis (Walker, 1979, p. 43). According to Walker (1979), the theory of learned helplessness has three components: w hat actually happens in a given situation, the thoughts or beliefs about what will happen, and the reaction to what really does happens. Walker states, Once we believe we cannot control what happens to us, it is difficult to believe we can ever influence it, even [if] later we experience a f avorable outcome ( p. 47). She continues to provide further explanation as to why women stay in violent relationships: Once the women are operating from a belief of helplessness, the perception becomes reality and they become passive, submi ssive, helpless ( p. 47). Walker (1979) proposes battering does not occur constantly but rather occurs in phases. S he i dentifies three phases, (a) tension building stage, (b) t he acute battering incident, and (c) k indness and contrite loving behavior. In phase one, there may be a few incidents of battering, in which the victim will do whatever necessary to prevent the bat terer s anger from escalating (Walker, 1979; Walker 2000). Walker stated, During the initial stages of this first phase, they indeed do have some limited control (Walker, 1979, p. 57). However there are often times external factors that upset this d el icate balance result in increased and escalated tension (p. 58) Walker continues, Once the point of inevitability is reached, the acute battering will take place ( p. 59). This is the shortest of the three phases and could last between two to twenty f our hours, typically (Walker, 1979). The batterers anger is out of control as he beats his victim. According to Walker (1979), batterers do not accept responsibility for their abusive behavior and

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55 typically blame excessive drinking or being overly stres sed as reasons for the abusive behavior. Most women do not seek help during this phase, they feel no one can protect them from their mens violence (Walker, 1979, p. 64). The last phase is characterized by the batterer being loving and caring toward the victim, according to Walker (1979). Usually the batterer feels sorry for his abusive behavior (Walker, 1979): The batterer truly believes he will never hurt the woman he loves, he believes he can control himself from now on. He also believes he has taught her such a lesson that she will never again behave in such a manner, and so he will not be tempted to beat her ( p p 65 66). Walker argues that helping battered women should be a collaborative community effort. According to Walker (1979), it involves educating the public through a collaborative effort among law enforcement agencies, the court system, the correctional system, domestic violence shelters, mental health agencies and professionals, medical professionals and hospitals. Alan Jenkins Jenkin s (1990) argues that most models for assessing and treating domestic violence strive to find a causal explanation for why the violence occurs, which he proposes, promotes an avoidance of responsibility by the perpetrator and an acceptance of responsibilit y by the victim (p. 13). Jenkins states, Responsibility for the abuse may be attributed to external events and stresses, the actions of others or medical/psychological conditions, over which the perpetrator feels he has little influence or control (Jenkins, 1990, p. 13). As a result, victims of domestic violence often feel responsible for the violence. By focusing on an explanation for the violence, it allows

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56 the abuser to be preoccupied with the search for a cause and generally do little to take r esponsibility for and cease their abusive behavior (Jenkins, 1990, p. 3). Jenkins (1990) advocates a narrative approach to conceptualizing domestic violence, focusing on developing new constructions to existing problems. He proposes employing the the or y of restraint (Jenkins, 1990): This theory is based on the assumption that males will relate respectfully, sensitively and nonabusively with others, unless restrained from doing so ( p. 32). H e defines these restraints as the traditions, habits, an d beliefs which influence the ways that abusive males make sense of and participat e in the world ( p. 32). Jenkins (1990) further argues just because certain restraints are present in a mans life, does not necessarily mean he will act upon those habits or beliefs: If he does abuse, however, there is potential for the development of restraining ideas which foster the attribution of responsibility for his actions to ex ternal factors (p. 32). In addition, Jenkins (1990) proposes that restraints are prese nt within certain contexts: sociocultural, developmental, interactional and individual. From a theory of restraint perspective, Jenkins (1990) argues that abuse and exploitation are perpetrated in a context where the mans sense of entitlement overrides his sense of social emotional responsibility in relation to others (p. 56). Jenkins (1990) approaches treating abusive men with the notion that they do not want to hurt or abuse others and that they do want caring and respectful relationships (p. 57). By taking this approach, the therapist is able to stop searching for an explanation of the violence and invite the abusive man to examine and challenge restraints. These restraints may range from socio cultural and developmental traditions and blueprints by which he may have been

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57 unwittingly sucked in and patterns of interaction whereby he has relied on others to face social and emotional responsibilities and take responsibility for his abusive behavior, to restraining individual habits, beliefs and misguided attempts to deal with abuse (Jenkins, 1990, p. 57). Neil Jacobson and John Gottman Gottman and Jacobson were the first to study the observational, psychophysiological and self report perspectives in severely violent couples (Gottman Jacobson, Rushe, Sh ortt, Babcock, La Taillade, & Waltz, 1995, p. 243). Jacobson and Gottman (1998) examined martial interactions of severely violent batterers and victims. They conducted a study that observed the actual violent arguments of the batterer and victim, and not just reports of the violent arguments, as well as observing the emotional experience during these arguments: By directly observing arguments rather than simply asking people to report on them, we can verify the accuracy of their per ceptions and judge how trustworthy their accounts of violent altercations are (p. 20). Couples were interviewed about the violence while being monitored with electronic sensors to evaluate their physiological response. Jacobson and Gottman found that batterers could be classified into typologies, Type I and Type II batterers (Jacobson & Gottman, 1998). The Type I batterer had a lowered heart rate as they became engaged in a violent argument, they were calm, focusing their attention, while striking sw iftly at their wives with vicious verbal aggression (p. 29). Jacobson and Gottman (1998) referred to this type of batterer as a Cobra. The Type II batterer had an increased heart rate as they became engaged in a violent argument, they exhibited anger a s a kind of slow burn, gradually increasing it in a domineering and threatening fashio n (p.29). Type II batterer was referred to as a Pit Bull (Jacobson & Gottman, 1998). Furthermore, results

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58 from their study characterize the Type I batterer as more bell igerent and contemptuous tha n the Type II batterer (Gottman et al., 1995). Jacobson and Gottman (1998) describe Type I batterers as antisocial, sadistic, manipulative, criminal and emotionally independent. They found Type I batterers to also be violent towards other people in their lives and not just their wives. Type II batterers they found to be insecure, often jealous, emotionally dependent, and more than likely, learned their violent behaviors from their fathers. Type II batterers abuse was mostly t oward their wives, not others and tended to dominate their wives for fear of being left alone and abandoned (Jacobson & Gottman, 1998). Jacobson and Gottman evaluated what function violence serves in an abusive relationship (Jacboson, Gott man, Waltz, Rush e, Babcock, & Holtzworth Munroe, 1994). Based on their research, Jacobson et al. speculate that violence is used by abusive men to control women and that violence used by women is used for self defense (Jacobson et al., 1994). Specifically, these researchers examined the affect, psychophysiology and verbal content of arguments in the arguments of couples with a violent husband (Jacobson et al., 1994, p. 982). Through their research it was found that batterers use violence as a form of psychological and social control, to instill fear in their victims (Jacobson et al., 1994). In addition, it was found that women victims used violence as a self defense response to their husbands violence (Jacobson et al., 1994). Furthermore, this study also found that abused wives were just as angry as their abusive husbands, but that they were also more sad, tense and fearful (Jacobson et al., 1994).

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59 As a result of their studies, Jacobson and Gottman (1998) developed conclusions about abusive relationships. They found that not all batterers are alike, that batterering is a choice and that womens violence is a response to the abuse from men and is a for m of self defense (Jacobson & Gottman, 1998). They also found that batterers were likely to have substance abuse probl ems (Jacobson and Gottman, 1998). Through their research, Jacobson and Gottman (1998) believed that legal sanctions should be imposed on batterers, as well as treatment interventions. And most importantly, Jacobson and Gottman (1998) felt that men who acc epted responsibility for their abusive behavior must genuinely feel responsible, in order for the abuse to truly end. Richard Gelles and Murray Straus Gelles (1993) proposes that a comprehensive approach to explaining domestic violence must consider the attributes of the family as a social institution (p. 31). Attributes like age, sex, social structure position, race, and ethnicity all affect people and their behavior, according to Gelles. Through his studies, Gelles implies that domestic violence is a phenomenon of youth and highest for those between the ages of 1830 years old (Gelles, 1993, p. 31). Gelles (1993) also suggests that men are typically the offenders of domestic violence and women, the victims. He further argues that those in lower socioeconomic classes are under more stress and as a result, resort to violence more often (Gelles, 1993). Gelles (1993) further suggests that minorities experience a higher rate of domestic violence. Gelles and Straus conducted two landmark studies in the area of domestic violence by utilizing the Conflict Tactics Scales (CTS), which was designed to measure conflicts a mong family members (Straus & Gelles, 1986). Again, because of their significant contribution in the field of domestic violence research, res ults of their

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60 research is presented in this chapter. The CTS examines reasoning, verbal aggression, and physical aggression or violence (Straus, 1990a). The first study was conducted in 1975 and noted as the earliest attempt to measure the incidence of violence in America (Straus, 1990a, p. 3). The second study was conducted in 1985 and provided researchers with the ability to move beyond the individual pathology model of family violence and to investigate underlying social causes (Straus, 1990a, p. 3). Based on their studies, Gelles and Straus found that domestic violence was a result of the American culture and the notion of male dominance in our society as well as in our f amilies (Straus, 1990a, p.7): We believe that violence in the family is m ore a social problem than a psychological problem (Straus, Gelles, & Steinmetz, 1980, p. 202). Gelles and Straus define violence as an act carried out with the intention or perceived intention of physically hurting another person. The hurt can range f rom the slight pain caused by a slap or a spanking to harm that results in severe injury or even death (Gelles, 1990, p. 21). However, Gelles (1990) agrees there is a lack of continuity when defining domestic violence, and often times, terms are used int erchangeably and may not always have the same meaning to all: The field of family violence must continue to improve upon the definitions of abuse, violence, and the family. Until such time as the majority of investigators are employing similar definitions for the central concepts in the field, confusion and contradiction will dominate the study o f family violence ( p. 28). Straus (1990b) discusses possible causes of domestic violence and suggests a link between stress and family violence. He suggests t hat the family tends to be a group with an inherently high level of confl ict and stress ( p 182). Furthermore, Straus

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61 (1990b) proposes that violence is just one of the possible responses to stress. Based on his studies, Straus (1990b) concluded that fathers who physically punish and hit their children, teach their children to respond to stress by using violence; that physical violence is an appropriate behavior when responding to their wife or child; that men are more likely to be violent if they do not value their marriage; that education is not directly related to stress and violence, however, low socioeconomic status could be related because it is viewed as being more stressful; and men who have dominant roles in their marriage are more violent than m en who have more equal roles in their marriage; and lastly, men who were socially isolated were more violent than men who were connected with social networks. In research conducted by Straus, Gelles and Steinmetz (1980) it was found that violence is used by one family member to control another family members behavior. They found that wife beating occurred more in families in which men were dominant in the marriage (Straus et al., 1980): It seems that violence is used by the most powerful family member as a means of legitimizing his or her dominant position ( p. 193). Treatment Recommendations for Domestic Violence and Implications for Training Mental Health Professionals Introduction What are the experts in the field recommending to mental health professionals as appropriate and effective treatment interventions for domestic violence? Well, it seems as though most experts vary in terms of recommended treatment interventions for domesti c violence. In addition, most experts have difficulty agreeing on what intervention is most appropriate and effective in treating domestic violence

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62 appropriately. Various treatment approaches will be presented and discussed in this chapter Virgina Goldn er Goldner has conducted most of her work at the Ackerm an Institute for the Family in New York City. This institute provides couples and family therapy, as well as training for mental health professionals. At the Ackerman Institute, the goal of therapy i s to harness and strengthen family resources, and help family members work collaboratively towards solutions to their problems ( http://www.ackerman.org/treatment ). While at the Ackerman Institute, Goldner conducted the Gender and Violence Project, over a 12 year period (Goldner, 1999). The goal of this project involved conceptualizing and treating domestic violence within a feminist informed, conjoint framework (Goldner, 1999, p. 325). Goldner (1999) arg ues that psychotherapy, specifically couples therapy is the appropriate treatment for domestic violence and not criminal sanctions or punishment. In addition, Goldner (1999) argues that mental health professionals should take a neutral stance toward both partners, since both are struggling with an overwhelming emotional process (p. 325). Goldner (1999) further suggests that mental health professionals who focus on just power and inequality in treatment miss crucial elements of the relational bond (p. 326). Goldner (1999) proposes that no singular paradigm has offered effective and appropriate conceptualization and treatment of domestic violence. Goldner (1999) recommends mental health professionals approach treating domestic violenc e from multiple per spectives: The clinical challenge is to develop a language that can contain theses multiple perspectives, or that can speak to the psychological aspects of moral conflicts and the moral aspects of psycholog ical

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63 conflicts ( p. 328) She continues, The c hallenge is to bring these multiple discourses into dialogue ( p. 329). By employing multiplicity, the mental health professional can incorporate multiple perspectives at once while retaining each persp ectives unique characteristics (Goldner, 1999). As a particular perspective begins to bring certain themes into focus, the interview will begin to shape along that axis until, like a kaleidoscope, another framework starts coming into focus, and the therapist begins to hear the material in another discoursi ve register ( p. 329). Rhea Almeida Rhea Almeida currently practices at the Institute for Family Services (IFS) with a group of family therapists in Somerset, New Jersey. At IFS, they also train postgraduate students and mental health professionals in the area of Cultural Context Model nationally and internationally ( http://www.instituteforfamilyservices.com 2010). The philosophy of IFS is to embrace the resilience that all families and individuals bring to therapy and create a landscape of strength toward resolving lifes struggles ( http://www.instituteforfamilyservices.com 2010). The Cultural Context Model is employed in their work with cl ients as well as training mental health professionals. At IFS, Approximately 45% of IFSs clientele are families with problems of domestic violence, sexual abuse, and addictions ( http://www.institu teforfamilyservices.com 2010). The IFS measures their effectiveness and success in treating clients by their track record, and over the past 21 years of providing therapy services there have been only two incidents of hospitalization and less than five percent of their clientele on psychotropic medication ( http://www.instituteforfamilyservices.com 2010). Almeida recommends for mental health professionals to approach the treatment of domestic viol ence from a Cultural Context Model (Hernandez, Almeida, & Dolan -

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64 Delvecchio, 2005). By employing the Cultural Context Model, the therapist incorporates gender, race, culture, class and sexual orientation into the broader conceptualization of domestic viol ence (Almei da & Durkin, 1999). The goal o f Cultural Context Model is to raise consciousness of the batterer and victim, regarding gender, race, cultural, class and sexual orientation with regards to domestic violence (Almedia & Durkin, 1999). Mental health professionals can incorporate the use of cultural circles to heighten their consciousness regarding sexism and other forms of privilege and oppression (Almedia & Durkin, 1999, p. 319). Ultimately, the goal of this model is to have all family members take responsibility by increasing their understanding and awareness: By addressing critical consciousness, empowerment, and accountability, therapists exercise their therapeutic responsibility to bring social justice to the ways that they attend to families suffering (Hernandez et al., 2005, p. 116 ). Lenore Walker Walker reports her experience in worki ng with domestic violence has not changed in the last 15 years: T he most sought after goal that she (the victim) wants is for the therapist to somehow to fix the man by helping her to change her own behavior (Walker, 2000, p. 154). Walker does support couples therapy as a mode of treatment for domestic violence, however initially requires individual therapy for both the man and the woman, in which the man must take full responsibility for abusive behavior (Walker, 2000). Once the violence has stopped, responsibility is taken and the man begins to make behavioral changes, then couples ther apy can be employed (Walker, 2000). Walker advises mental health professionals to establish a trusting relationship with victims of domestic violence. Establishing rapport, building trust and believing the victims story are crucial in assessing for domestic violence (Walker, 2000). Validating

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65 experiences, developing a safety plan, and identifying the woman as a battered woman should be employed during the evaluation interview (Walker, 2000): Label her as a battered woman at some point in the interview, so that she has a name for the symptoms she is experiencing ( p. 162). Walker recommends the use of checklists to assess the frequency and severity of the violence. In addition, she supports the idea of victims discussing details about abusive incidents: T rauma theory makes it clear that it is important for victims to repeatedly talk about their experiences so that they can gain mastery over the emotions raised and gain new cognitive schemas that give the trauma a different meaning (Foa, Rothbaum, R iggs, & Murdock, 1991; Kolodny, 1998; as cited in Walker, 2000, p. 162). Walker employs the Survivor Therapy Model when treating victims of domestic violence (Walker, 2000). The original model identified five stages in the treatment of domestic violence, however in 1998 it was expanded to include seven stages, 1. Identifying, assessing and labeling the abuse and its effects, 2. Helping the woman find safety and protection, 3. Regaining cognitive clarity, 4. Helping heal the PTSD and physiological effects psychological effects, 5. Addressing the psychological impact from prior experiences including childhood issues, 6. Rebuilding interpersonal relationships, and 7. Integrating the trauma into the life pattern and becoming a survivor (Walker, 2000, p. 172). Walker concludes the most effective response to changing violent relationships is to change the structure of society. If women had equal status with men in social, political, economic, educational, and family areas, then they would be less likely to liv e with spouse abuse (Walker, 2000, p. 155).

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66 Power and Control Wheel Another approach for conceptualizing and treating domestic violence is the Power and Control Wheel (see Appendix C) developed by the Domestic Abuse Intervention Project (DAIP), located in Duluth, Minnesota (Yllo, 1993): The wheel connects physical and sexual violence to the hub of power and control with a number of spokes ( p. 54). The spokes are identified as minimizing, denying and blaming; the use of children; the use of male privilege; the use of economic deprivation; the use of coercion and threats; the use of intimidation; the use of emotional abuse; and the use of isolation (Yllo, 1993). The DAIP characterizes domestic violence as a pattern of actions that an individual uses to intentionally control or dominate his intimate partner ( www.theduluthmodel.org 2010). The Power and Control Wheel describes the tactics or behaviors that men engage in while battering their victim (Yllo, 1993). This wheel illustrates the power imbalances between batterer and victim. The therapist can use this wheel to identify the types of abuse tha t occur and how it relates to power and control : By naming the power differences, we can more clearly provi de advocacy and support for victims, accountability and opportunities for change for offenders, and system and societal changes that end violence against women ( www.thduluthmodel.org 2010). Furthermore, an Equit y Wheel (see Appendix D) was developed to illustrate the changes batterers need to make in order to become a nonviolent partner. The spokes of this wheel include nonthreatening behavior; respect; trust and support; honesty and accountability; responsi ble parenting; shared responsibility; economic partnership; and negotiation and fairness ( www.duluthmodel.org 2010).

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67 Alan Jenkins Jenkins (1990) proposes taking a narrative approach to treating domestic violence. Specifically, he suggests a constructivist perspective to working with perpetrators of domestic violence. Jenkins proposes inviting the man to take responsibility for his violent behavior by having him discover and clarify his own goals in the relations hip; address his own violence; reconsider the issue of responsibility for his violence; and to challenge restraints to accepting responsibility for the violence (Jenkins, 1990, p. 62). Jenkins (1990) recommends a model for engagement designed to locate responsibility for the mans realizations and achievements within himself, so that he can more readily own an incorporate his capacity for change (p. 62). In this model of engagement there are nine steps according to Jenkins. The steps are as follows; invite the man to address his violence; invite the man to argue for a non violent relationship; invite the man to examine his misguided efforts to contribute to the relationship; invite the man to identify time trends in the relationship; invite the man to externalize restraints; deliver irresistible invitations to challenge restraints; invite the man to consider his readiness to take new action; facilitate the planning of new action; and to facilitate the discovery of new action (Jenkins, 1990, p. 63). An example of inviting the man to address his violence may begin with the therapist asking why the man is in therapy. The man may respond with I was told to come or I dont know, you tell me (Jenkins 1990, p. 64). Jenkins suggests that the man may direct the therapists attention to other problems in his marriage to avoid discussing the issue of violence, weve got communication problems or shes got the problem, she should be here (p. 64). According to Jenkins (1990), often times the man make s attempts to minimize the violence or to avoid responsibility and blame external

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68 factors as reasons for the violence, such as stress. Jenkins (1990) recommends asking the man to talk about the events that led up to their scheduled appointment. The therapist can invite the man to address his violence by avoiding criticism of his explanation; apologizing for interruptions and the need to ask so many questions; explaining the therapists lack of knowledge about the situation and the need to understand more fully before being able to know how s/he can best offer help or comments; and asking permission to ask further questions about the event ( p. 66). Furthermore, Jenkins (1990) argues that if the therapists asks the man if he can handle discussing a par ticular issue, the therapist in fact, is asking permission in a way that invites the man to take responsibility for what is going to be discussed and challenges the mans ability to talk about sensitive issues (Jenkins, 1990). For example, the therapist would ask, Are you sure you can handle talking about your violence?; or It isnt easy it takes a lot of courage to face up to the fact that you really hurt someone you love; or How does it effect you to talk about your violence? ( p. 66). During this p rocess, Jenkins (1990) recommends the therapist continue to interrupt attempts to avoid responsibility by extending invitations, seeking to challenge the client discretely and indirectly. Jenkins (1990) is a proponent of the initial therapeutic session bei ng individual. Individual therapy is helpful in the man emphasizing his responsibility for the violence ( p.103). Once the man has accepted responsibility, then gender group therapy and/or couples therapy can be employed, if the couple both desire to st ay in the relationship. In couples therapy, the woman is invited to consider taking responsibility for her safety and to challenge restraints to taking responsibility for her partners violence and the man is

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69 invited to accept responsibility for his violence and challenge restraints to responsibility ( p.104). Jenkins suggests that therapists should establish a context for safety and self responsibility by monitoring each partners readiness to discuss openly sensitive issues ( p. 104). According to Jenkins, in couples therapy both partners are invited to externalize and challenge their own restraints to the man accepting responsibility for his violence ( p. 105). The man is encouraged to externalize his restraints to accepting violence and not externalize the violence itself. Once couples are ready, they are invited to consider ideas for taking new actions, to consider possible obstacles to these new actions and to develop criteria to evaluate the success of implementation of these new actions (Je nkins, 1990). Neil Jacobson and John Gottma n Jacobsons approach to treating domestic violence specifically looks at interpretations of marital dynamics with a feminist lens (Jacobson, 1994, p. 81). He describes his approach as feminist, scientific, an d contextual and admits that some may view these positions as contradictory ( p. 82). He views wife abuse as a result of the patriarchal structure of traditional marriages (p.82). Jacobson (1994) suggests as a contextualist, that human behavior in some sense is governed by factors external to that person (p.82). Furthermore, he argues that it is important to understand the environment context when treating dom estic violence ( p. 82). He disagrees with couples therapy as a mode of treatment to domestic violence mostly because couples therapy would imply that it is a relationship problem, when in fact, battering is the batterers problem and his alone ( p. 82). From a scientific perspective, Jacobson (1994) proposes that the goal of basic researc h must be controlled, systematic, and dispassionate and that researching

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70 domestic violence must not compromise the safety of the subjects (p. 83). Jacobson further proposes that research from a contextual perspective is oriented toward identifying fac tors that predict and influence the onset, offset, intensification, deintensification, frequency, and duration of violence ( p. 84). He suggests that having an understanding of these factors has direct treatment implications ( p. 84). Jacobson and Gottman fully agree with the notion that batterers must be held fully accountable in any t reatment modality (Jacobson & Gottman, 1998). They feel that swift criminal sanctions must be employed for batterers, and not to offer mental health treatment as an altern ative to sanctions (Jacobson & Gottman, 1998): If one truly wants to determine how motivated batterers are to stop the violence, we recommend never mandating treatment, or offering it as an alternative to prison. Make it voluntar y (J p. 225). Jacobson and Gottman (1998) strongly disagree with using couples therapy as a mode of treating domestic violence. Jacobson and Gottman (1998) argue that couples therapy is employed to solve problems that are caused by the dynamics of the marriage. With bat tering, the violence is most definitely not caused by marital dynamics. Battering is not about the relationship, it is about the batterer (p. 226). Therefore, Jacobson and Gottman suggest mental health professionals utilize coordinated community response (CCR) as a model for treating domestic violence, similar to the Duluth Model and recommendations by Lenore Walker. They state, CCR relies on community organization and links together the criminal justice system, advocacy work and the education of batter ers and involves the coordinated efforts of education groups for batterers, support groups for battered women, shelters, police practices, and prosecut orial tendencies (Jacobson & Gottman, 1998, p. 231). Mental

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71 health professionals should focus on batt erers accepting responsibility f or their violence (Jacobson & Gottman, 1998). According to Jacobson and Gottman (1998), treating batterers for domestic violence in a group modality is well established and almost universally accepted (p. 232). Furthermore, Jacobson and Gottman (1998) argue that counselors should work with batterers to change their attitudes, so they no longer see violence as an acceptable response in any situation (p.232). Richard Gelles and Murray Straus According to Gelles (1993), a sociological approach offers the most comprehensive explanation of domestic violence. By examining social structures and social institutions, a sociological perspective is able to offer a more complex formulation for the varied phenomena of violence a nd abuse between intimates and is applicable to a wider range of victimization than is feminist theory (Gelles, 1993, p. 43). However, Gelles (1993) does admit because a sociological perspective is so complicated, it does not lend itself to simple solut ions, either in clinical or practice settings. One cannot easily use a sociological theory to inform clinical practice (p. 43). Gelles and Straus do suggest a structural family systems approach for mental health professionals when treating domestic viol ence. By employing a structural approach, the therapist challenges the familys pattern of interacting, forcing the members to look beyond the symptom of the family dysfunction (the family pattern of violence) and to examine the covert rules governing the familys tran sactional patterns (Gelles & Maynard, 1995, p. 247). The goal of the structural therapist is to establish clear boundaries. Gelles and Maynard (1995) suggest employing structural techniques of creating, joining and restructuring with the goal of restructuring the family in a way

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72 which eliminates the violence, implements new patterns of communicating and establishes clear boundaries. Summary Based on the literature presented, there are certainly various schools of thought regarding the mos t appropriate approach in assessing and treating domestic violence. Feminist, psychological, and sociological perspectives are discussed; all vary in terms of conceptualizing domestic violence, suggested research methodologies for studying domestic violence, as well as practice and treatment implications for mental health professionals. Experts in the field studying domestic violence offer recommendations for mental health professionals in assessing in treating domestic violence. The goal of this researc h study is to examine how competent mental health professionals licensed in the state of Florida feel imparting their knowledge and skills in assessing and treating clients affected by domestic violence.

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73 C HAPTER 3 METHODOLOGY Statement of Purpose As discussed in the review of relevant literature, domestic violence is a prevalent social problem. Mental health professionals frequently work with clients facing issues of domestic violence. Often, mental health professionals are the first responders to d omestic violence. The purpose of this research study is to examine how these mental health professionals perceive their level of competency in assessing and treating domestic violence: s pecifically, mental health professionals licensed under the Florida Board of Cli nical Social Work, Marriage and Family Therapy and Mental Health Counseling Cha pter 491.004 Research Question RQ1: How do l icensed Clinical Social Workers, Marriage and Family Therapists and Mental Health Counselors in the state of Florida perceive their level of competency in assessing and treating domestic violence? Hypotheses Based on the review of relevant literature, review of graduate education curriculum and accrediting bodies, current state licensing requirements as well as continui ng education requirements it is believed that: HO1 : There are no significant differences in levels of perceived competency by discipline based on graduate coursework training in assessing and treating domestic violence. HO2 : There are no significant differences in the levels of perceived competency by discipline based on graduate practicum and/or internship training in assessing and treating domestic violence.

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74 HO3 : There are no significant differences in the levels of perceived competency by discipline bas ed on post graduate clinical contact experience in assessing and treating domestic violence. HO4 : There are no significant differences in the levels of perceived competency by discipline based on licensure requirements or continuing education requirements i n assessing and treating domestic violence. Sampling and P opulation The population surveyed in this research study was mental health professionals, licensed under Chapter 491.004 of the Florida Statute. Specifically, Licensed Clinical Social Workers, Licensed Marriage and Family Therapists and Licensed Mental Health Counselors were surveyed. These professionals were all licensed under the Florida Board of Clinical Social Work, Marriag e and Family Therapy and Mental Health Counseling. All licensed mental health professionals surveyed at the time of this research study held active licenses within the state of Florida. Being actively licensed under Chapter 491.004 Florida Statute was the only criteria required for individuals to participate in this research study. A list of licensed mental health professionals was obtained by contacting by phone the Florida Department of Health, Division of Medical Quality Assurance. The requested lis t was E mailed to the resear cher. Included in this list were license number, profession or discipline original issue date, expiration date, current license status, full name, mai ling address, phone number and E mail address (when provided) of all active and inactive licensed professionals. According to the Division of Medical Quality Ass urance, as of 2010, there were a total of 16,033 actively licensed mental health professionals in the state of Florida, under Chapter 491.004 However, not all 16,033 lice nsed professionals provided an E mail address to the Division of Medical Quality Assurance. The Division of Medical

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75 Quality Assurance does not require licens ed professionals to provide an E mail address when applying for or renewing their professional lic ense. As a result, only 8,866 E mail addresses were obtained by this researcher, specifically 3,786 Licensed Clinical Social Workers, 820 Licensed Marriage and Family Therapists and 4,260 Licensed Mental Health Counselors. Therefore, this survey was sent to the 8,866 licensed professionals for which individual email addresses were obtained. It was determined that if a larger sample were to be needed, an E mail invitation to participate in this survey would have been sent to the Counselor Education and Supervision Network ( CESNET ) listserv for Mental Health Counselors, the National Association of Social Workers ( NASW ) Advocacy listserv for Social Workers and the National Council on Family Relations ( NCFR) listserv for Marriage and Family Therapists Furthermore, the email invitation would clearly state that this survey was intended for mental health professionals licensed in the state of Florida, under Chapter 491.004 only. The type of sampling method used in this research study is referred to as census method. With census sampling, everyone in a population is surveyed (Dooley, 2001). This study employed a census of the Florida Department of Health list of actively licensed mental health professionals, under Chapter 491.004 Based on the comprehensive list of actively licensed mental health professionals obtained by t he Florida Department of Health, it is assumed that a representat ive sample was obtained. Research Design and Relevant Variables The approach selected for this research wa s quantitative, specifically descriptive research, in which licensed mental health professionals in the state of Florida were surveyed by E mail. This study proposed to establish an association between perceived

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76 levels of competency and various independent v aria bles. Q uantitative approach was used in order to generalize to a larger population, specifically, to the mental health profession as a whole. This research study examined the professionals competency in assessing and treating domestic violence as perceived by the mental health professionals themselves. As mentioned in the review of current literature, mental health professionals receive minimal training in assessing and tr eating domestic violence. This research study identified how professionals f eel about their ability to assess and treat domestic violence. The advantage of using a quantitative approach in critical research is the ability to ge neralize to a larger population, as well as the ability to collect large amount of data with relative ea se, in a relatively short period of time. The population to whom this study will be generalized is all mental health professionals practicing in the United States. A cross sectional survey design was implemented in this research study. Cross sectional des ign refers to gathering data all at one point in time, as opposed to a longitudinal survey design which collects data multiple times, over a period of time (Dooley, 2001). I n this research study, data was collected immediately after the survey was adminis tered. For the purposes of this research study, the dependent variable was the perceived competency of the Florida licensed mental health professional under Chapter 491.004 in the area of domestic violence. The independent variables wer e graduate coursew ork training, graduate internship and/or practicum training, postgraduate clinical contact experience and licensure and continuing education requirements of Florida licensed

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77 mental health professionals, in the area of assessing and treating domestic violence. Again, this research study looked for associations between perceived competency and the various independent variables. Instrumentation Based on the review of relevant literature, the Domestic Violence Perceived Competency Survey was developed and use d to evaluate the levels of perceived competency of these mental health professionals (see Appendix A). This cross sectional survey was specifically designed for this research study. Cross sectional surveys are used to obtain and collect data from one point in time (Dooley, 2001). Approval to conduct this research study and distribute the Domestic Violence Perceived Competency Survey was obtained from the Institutional Review Board (IRB), at the University of Florida. The Domestic Violence Perceived Comp e tency Survey was delivered by E mail and was self administered. Questions were closedended with four unipolar ordinal scale categories Ver y Competent, Competent, Slightly Competent, and Not Competent Other scales included Very Aware, Aware, Slightly Aw are, and Not Aware. According to Dillman, Smyth and Christian (2009), unipolar ordinal scales measure graduation along one dimension where the zero point falls at the one end of the scale (p. 135). Questions were also construct specific, making it easi er for the respondent to identify his or her level of perceived competency. Construct specific questions require the researcher to clearly define the construct of interest (Dillman et al., 2009, p.138). Dillmen et al. (2009) argue that construct speci fic questions in a survey can decrease acquiescence response bias as well as cognitive burden (p. 138) making it easier for the participant to respond. Dillman,

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78 Smyth and Christian (2009) emphasize the importance of developing good survey questi ons. In doing so, the researcher should strive to develop questions that every potential respondent will be willing to answer, will be able to respond to accurately, and will interpret in the way the survey or intends (Dillman, Smyth & Christian, 2009, p. 67). Survey content for the Domestic Violence Perceived Competency Survey was chosen after a lengthy review of current and relative literature. As a result of this review, certain themes and issues repeatedly emerged among various theorists and social scient ists regarding the issue of domestic violence. Recommendations from experts in the field such as Lenore Walker, Virginia Goldner and Michele Bograd contributed to the content of this survey. In addition, review of current research in the area of domesti c violence illustrated a need to promote and further investigate training practices for mental health professionals working with clients affected by domestic violence. The f irst page of the survey included the purpose statement, contact information of res earcher and researchers supervisor as well as the informed consent. Item 1 asked respondents to select I Agree or I Do Not Agree to the statement, I have read and understand the procedures outlined for participating in this survey. I voluntarily agree to participate in this survey. The second page included instructions for completing the survey, including the number and type of questions being aske d. On this page respondents were asked to reflect on their training and work experiences. There are a total of 39 questions on the Domestic Violence Perceived Competency Survey, nine of which are questions regarding demographic information of the

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79 responden t. The term domestic violence was defined on page three of the survey for clarification pu rposes. This researcher defined domestic violence as: T he physical, psychological, or sexual abuse of one family or household member by another family or household member. Physical abuse includes but not limited to hitting, slapping, kicking, punching, with or wit hout a weapon, which causes pain or injury. Psychological abuse includes, but is not limited to stalking, humiliation, verbal abuse, false imprisonment, social isolation, economic deprecation or any other controlling type behavior. Sexual abuse includes, but not limited to any unwanted, coerced, forced, or threat of forced sexual acts or attempted sexual acts. Respondents were asked to evaluate their perceived level of competency in assessing and treati ng domestic violence as Very Competent, Competent, Slig htly Competent, or Not Competent Respondents could only make one selection. Items 215 asked respondents to evaluate their knowledge of concepts an d theories of domestic violence; t heir ability to identify signs of domestic violence; knowledge of facts and myths of domestic violence; knowledge of interpersonal dynamics in a violent relationship; knowledge of domestic violence treatment approaches and their ability to implement domesti c violence treatment approaches; knowledge of how gender, race, class, and sexual orientation influence their understanding of domestic violence; how their own culture influence their percepti ons of domestic violence; knowledge of the cycles of violence, knowledg e of typologies of perpetrators; ability to identify risk factor and assess for violence during a therapy session, as well as their ability to provide safety planning for clients and refer to agencies that provide victim assistance. Items 16 20, asked respondents to evaluate their practicum and/or internship training as it related to domestic violence. Respondents evaluated their perceived level of competency by responding to their awareness of domestic violence during practicum and/or internship training. Respondents could only make one selection, Very Aware,

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80 Aware, Slightly Aware, or Not Aware. Respondents were asked how aware they were of domestic violence during faceto face client contact practicum experience, faceto face client contact internship experience, individual supervision experience, and group supervis ion experience. Respondents were also asked how aware the site staff was of domestic violence during their practicum and/or internship experience. In item 21, respondents were also asked if they were trained by their faculty advisor to assess and treat for domestic violence. Respondents replied Yes or N o to item 21. In item 22, respondents were provided the opportunity to comment on additional information regarding their domestic violence training and clinical experience, in an open text box. I n item 23, respondents were asked in a Yes or N o format, if Florida licensure requirements promoted competency in assessing and treating for domestic violence. Respondents were then asked to reflect on their graduate school experiences in terms of evaluating their competency in assessing and treating domestic violence. Item 24 asked how many courses were taken specific to domestic violence. I tems 2526 asked how many client contact hours they obtained during practicum and internship training. Finally, in items 27 28 r espondents were asked since postmasters graduation, how many client contact hours were obtained with clients facing issues of domestic violence and how many continuing education hours had they completed. Item 29 asked respondents to rate their over all level of competence in assessing and treating domestic violence. If respondents rated themselves High, Above A verage, or Average, respondents were then asked what mostly likely attributed to their level of perceived competency.

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81 Finally, in items 31 39 respondents were asked questions regarding their demographic information, such as gender, age, license status, highest level of education, year degree(s) were received, licenses held, how many years practicing, number of years licensed, and which discipli ne they identify wit h most, if multiple licenses were held. Data Collection The use of the I nternet for data collection has increased greatly in the last decade (Dillman, Smyth & Christian, 2009). The ability to access large populations with relative ease and minimal costs to the researcher has made I nternet surveys very appealing (Dillman et.al, 2009). For these reasons, this researcher chose E mail survey for the method of collecting data. The Domestic Violence Perceived Competency Survey was created using SurveyMonkey By using SurveyMonkey the researcher was able to design a survey, collect responses and analyze results all within a secure environment ( http://www.surveymonkey.com ). Detailed survey templates are provided on SurveyMoneky.com as well as 15 options for survey themes ( http://www.surveymonkey.com ). The Yellow Metal template was selected for clarity and ease of reading with the goal of reducing nonrepsonse error. SurveyMonkey reports using th e most advanced technology for I nternet security. Secure Sockets Layer (SSL) is used to protect respondent information using both server authenticati on and data encryption. Survey Monkey requires the researcher to create a unique username and password that must be used each time the researcher logs on. In addition, Survey Monkey is hosted in a secure environment that utilizes firewalls and other technology to prevent access from outside intruders. The dat a

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82 center is monitored 24 hours daily and is highly protected with multiple level s of restricted physical access ( http://www.surveymonkey.com ). The Domestic Violence P erceived Competency Survey was E mailed to all a ctively l icensed Cl inical Social Workers, Marriage and Family Therapists and Men tal Health Counselors in Florida. Again, E mail addresses of all licensed professionals were obtained by the Florida Department of Health, Division of Medical Quality Assurance. The E mail survey was sent from a Y ahoo account created by this researcher, specifically for this survey. The account name was domesticviolencesurvey@yahoo.com This E mail included a cover letter (see Appendix B) introducing the survey to the potential respondent. In addition, a link to https://www.surveymonkey.com/s/3NJD25Y was provided in the cover letter, which immediately directed the potent ial respondent to the survey. For the purposes of testing the instrument and increasing reliability, a pilot study was conducted. Four subjects with a background in domestic violence were recruited as pilot respondents. All respondents met the criteria of being actively licensed mental health professionals, under Chapter 491.004 Each respondent was E mailed the Domestic Violence Perceived Competency Survey, as well as the cover let ter introducing the survey. Three of the four respondents recruited for the pilot study responded and completed the survey. According to Cone and Foster (1993), pilot work is important because what you plan to do may look good on paper but not work out very well when you actually try it out with real subjects (p. 201). Data collected from the pilot test was not included in the results of this research study.

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83 Results of the pilot study identified a few issues with the wording of some questions on the surv ey. In addition, feedback regarding the order of the survey questions was discussed by pilot respondents. A s a result of this feedback, some revisions were made to the Domestic Violence Perceived Competency Survey. Revisions involved the specific wording of some questions as well as the order of questions on the survey. All revisions were made to increase clarity of questions and reduce uncertainty. In addition, all revisions made to the instrument were approved by the Institutional Review Board (IRB) All pilot study respondents reported a need for research in the area of domestic violence competency. One pilot study respondent in particular commented on the thoroughness of the survey questions asked regarding competency in assessing and treating domestic violence. In addition, pilot study respondents felt that more rigorou s scientific studies were needed regarding domestic violence competency and that some professionals may be practicing by the seat of their pants when it comes to assessing and treating domestic violence. Data Analysis The dependent variable in this research study is the perceived competency of the mental health professional in assessing and treating domestic violence. The independent variables are graduate coursework training, graduate practicum and/or internship tr aining, postgraduate clinical contact and licensure and continuing education requirements. Cohen (1992) emphasizes the importance of the researcher addressing the issue of power analysis and sample size when conducting research. According to Cohen (1992), the statistical power of a significance test is the long term probability, given the

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84 population ES (effect size), x (criterion), and N (sample size) of rejecting the Ho(null hypothesis)(p. 156). Based on Cohens (1992) requirement s for using ANOVA analysis with three groups (clinical social workers, marriage and family therapists, and mental health counselors) the necessary sample size per group is 52. The total minimum sample size needed is 156, to attain a power = .80 and a medium effect size with a probability level = .05. When using the ChiSquare test, to detect a medium degree of association in the population w ith a probability level = .05, minimum sample size needed is 121 for three degrees o f freedom a nd 87 for one degree of freedom (Cohen, 1992). A nalysis of variance (ANOVA) was us ed with most of the data collected. ANOVA is designed to test the significance of group differences. Specifically, ANOVA was used to test differences among each discipline, clinical social work, marriage and family therapy and mental health counseling. Data fr om ea ch of these disciplines were analyzed to see if one group over another reported higher levels of competency in assessing and treating domestic violence. The assumptions for ANOVA are: that (1) the population is normal, (2) the sample is randomly selected and independent and (3) the populations have equal standard devi ations or variances (Schact & Aspelmeier, 2005; Iversen & Norpoth, 1987). If assumptions are not met, the researcher runs the risk of a Type I error, rejecting the null hypothesis when in fac t it is true or a Type II error, not rejecting the null hypothesis when i n fact it is false (Schacht & Aspelmeier, 2005). The Tukey HSD post hoc analysis was also used for those ANOVA items resulting in statistical significance. ChiSquare test was also used in this research study to analyze data. The Chi Square is a statistical t e st in which categorical variables are analyzed (Schacht &

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85 Aspelmeier, 2005). Chi Square examines whether two random variables are independent (Schacht & Aspelmeier, 2005). S pecifically, ChiSquare was used to compare graduate coursework training, graduate practicum a nd/or internship training, post graduate clinical contact experience, and continuing education and licensure requirements by discipline, and levels of perceived competency. Chi Square determines if there is a statistically significant difference between expected versus observed rel ative frequencies (Schacht & Aspelmeier, 2005, p. 259). The data coll e cted in this research study was analyzed using the Statistical P ackage for Social Sciences (SPSS ) Version 18. Data was downloaded from SurveyMonkey.com and transferred to SPSS for analysis. Results of this analysis are presented in Chapter 4 and conclusions based on these results are discussed in Chapter 5.

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86 C HA P T ER 4 RESULTS The purpose of this research study was to evaluate the perceived level of competency in assessing and treating domestic violence among Florida licensed mental health professionals. Additionally, this study sought to determine if one discipli ne over another reported feeling more competent in the assessment and treatment of domestic violence and if so, what factors contributed to this increased perceived level of competence. This chapter describes the results of this study. The Domestic Violence Perceived Competency Survey was developed specifically for this research study. A pilot study was conducted to test the reliability of this instrument. This cross sectional survey was created using SurveyMonkey.com and distributed by E mail to all p otential respondents. Data were collected through SurveyMoneky.com and then analyzed by transferring collected data to SPSS (Version18). This chapter begins with the presentation of d emographic characteristics of the respondents who participated in thi s research study Next, item statistics are presented as well as discussion on reliability. Results of this research study are organized by research question for the remainder of this chapter The first research question addresses the level of perceived competency based on the professionals graduate coursework training. The second question addresses the level of perceived competency based on the professionals graduate practicum and internship training in terms of their awareness of domestic violence during practicum and internship training The third question examines level of perceived competency based o n postgraduate clinical contact experience. T he last question addresses perceived competency based

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87 on licensure and continuing education requirements. Chapter 5 will provide discussion regarding significant findings and implications for future research based on the results presented in this chapter. Participants and Demographic Characteristics Participants for this research study were obtained from a list of Florida mental health professionals, licensed under Chapter 491 Florida Statute. This list was obtained from the Florida Department of Health. As of 2010, there were a total of 16,033 licensed professionals. However, onl y 8,866 professionals provided E mail addresses to the Florida Department of Health when apply ing for or renewing their professional license. All 8,866 professionals were E mailed an invitation to participate in this study by means of completing the Domestic Violence Perceived Competency Su rvey. Only one invitation was E mailed to each licensed professional. A total of 618 licensed professionals responded to the survey. Of those, 591 respondents fully completed the sur vey. Of the 8,866 invitations E mailed, 573 were returned due to invalid E mail addresses. The Florida Department of Health di d not have a correct record of E mail addresses for some mental health professionals In addition, 36 respondents E mailed the researcher and declined to participate in the study. Reasons given by respondents for declining the survey included not hav ing time to complete the survey, not having interest in the subject matter, and not having clinical encounters with clients affected by domestic violence. Of the 8,866 potential respondents, 618 actually responded to the E mail invitation and participated in the Domestic Violence Perceived Competency Survey. This number resulted in a response rate of 7 5%.

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88 As shown in Table 41, the demographic characteristics of respondents reported were l icense status, gender, age, highest degree held, license type, and number of years in practice. In terms of licensed status, 589 respondents (99.8%) held active licenses, and 1 respondent (.2%) held an inactive license. Of the 618 respondents, 143 Table 4 1. Characteristics of Respondents ( N =618) Characteristic N % Licenses status Active 589 24.2 Inactive 1 0.2 Gender Male 143 24.4 Female 444 75.6 Age 18 28 years old 1 0.2 29 39 years old 76 13 40 49 years old 129 22 50 59 years old 229 39.1 60 69 years old 135 23 70+ years old 16 2.7 Highest degree held Masters Degree 448 76.8 Specialist Degree 25 4.3 Doctoral Degree 110 18.9 License type LCSW 254 43.3 LMFT 69 11.8 LMHC 286 48.7 Years as licensed professional less than 1 year 0 0 1 5 years 91 15.7 6 10 years 130 22.4 11 20 years 230 39.6 more than 20 years 130 22.4

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89 (24.4%) were male and 444 (75.6%) were female; 31 respondents skipped this questi on. Age was reported in ranges: 1 (.2%) was 1828 years old, 76 (13%) were 2939 years old, 129 (22%) were 4049 years old, 229 (39.1%) were 5059 years old, 135 (23%) were 6069 years old, 16 (2.7%) were 70 or older and 32 respondents skipped this question. In terms of highest degree achieved, 448 (76.8%) reported holding a Masters Degree, 25 (4.3%) reported holding a Specialist Degree, 110 (18.9%) reported holding a Doctoral Degree, and 35 respondents skipped this question. Regarding type of license held, 254 (43.3%) reported being licensed as a Clinical Social Worker (LCSW), 69 (11.8%) reported being licensed as a Marriage and Family Therapist (LMFT), 286 (48.7%) reported being licensed as a Mental Health Counselor and 31 responden ts skipped this question. L astly, regarding number of years in practice as a licensed professional, 0 (0%) reported less than one year, 91 (15.7%) reported in practice for 15 years, 130 (22.4%) reported in practice for 610 years, 230 (39.6%) reported in practice for 1120 years, 130 (22.4%) reported in practice for over 20 years and 37 respondents skipped the question. Item Analysis and Reliability (Coursework) T he influence of graduate coursework training is presented in this analysis as Coursework (items 215). Reliability analysis was conducted by using Cronbachs alpha which was .942 when n=14. Calculation of Cronbachs alpha is shown in Table 42. Item statistics for Coursework are presented in Table 43 when N=580. The item total sta tistics are presented in Table 44 and the scale statistics (m ean, variance, and standard dev iation) are presented in Table 45.

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90 Table 42 Coursework: Reliability Statistics Cronbachs alpha N of items Coursework .942 14 Table 43 Coursework: Item Statistics (N=580) Item Mean SD Knowledge of concepts and theories of domestic violence 1.66 .591 Ability to identify signs of domestic violence during client contact 1.59 .591 Knowledge of facts and myths of domestic violence 1.56 .595 Knowledge of the on going interpersonal dynamics between individuals in a violent relationship 1.63 .603 Knowledge of domesti c violence treatment approaches 2.05 .716 Ability to implement these domestic violence treatment approaches 2.08 .780 Knowledge of how gender, race, class and sexual orientation influence your understanding of domestic violence 1.81 .671 Knowledge of how ones own culture Influences perceptions of domestic violence 1.67 .638 Knowledge of cycles of violence 1.52 .620 Knowledge of typologies of perpetrators of domestic violence 2.02 .746 Ability to assess for domestic violence, during a therapy session 1.64 .644 Ability to identify risk factors for domestic violence 1.55 .602 Ability to provide safety planning for clients experiencing domestic violence 1.73 .712 Ability to refer clients experiencing domestic violence to agencies that provide victim assistance 1.43 .597 Table 44 Coursework: Item Discrimination Item corrected item total correlation Knowledge of concepts an d theories of domestic violence .729 Ability to identify signs of domestic violence during client contact .742 Knowledge of facts and myths of domestic violence .742 Knowledge of the on going interpersonal dynamics between individuals in a violent relationship .761 Knowledge of domestic violence treatment approaches .774 Ability to implement these domestic violence treatment approaches .756 Knowledge of how gender, race, class and sexual orientation influence your understanding of domestic violence .692 Knowledge of how ones own culture influ ences p erceptions of domestic violence .675 Knowledge of cycles of violence .698 Knowledge of typologies of perpetrators of domestic violence .680. Table 45 Coursework : Scale Statistics (N=14) Mean Variance SD 23.93 47.764 6.911

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91 ANOVA (Coursework) The influence of graduate coursework training was then examined by discipline using ANOVA. Did one discipline over another report a higher level of competency in assessing and treating domestic violence, based on respondents graduate coursework training? An ANOVA analysis was conducted to test the significance of group differences. Table 46 presents the betweensubject factors and Table 47 shows the test of between subjects effects. Results showed no statistical significance for Lic ense d Clinical Social Workers, F (1,576) =.214, p = .644, Licensed Marriage and Family Therapists, F (1,576) = .041, p = .839 and Licensed Mental Health Counselors, F (1,576) =.052, p = .819 and perceived level of competency in assessing and treating domestic violence, based on graduate coursework training. There was not one Table 46. BetweenSubject Factors (Coursework) N LCSW 244 LMFT 68 LMHC 279 Note: LCSW=Licensed Clinical Social Worker, LMFT=Licensed Marriage and Family Therapist and LMCH=Licensed Mental Health Counselor. Table 47. Tests of Between Subjects Effects (dependent variable= Coursework) Source Type III SS d f MS F Sig. Corrected Model .191 a 3 .064 .297 .827 Intercept 1282.547 1 1282.547 5986.8222 .000 LCSW .046 1 .046 .214 .644 LMFT .009 1 .009 .041 .839 LMHC .011 1 .011 .052 .819 Error 123.396 576 Total 6864.378 580 Corrected Total 123.587 579 aR squared = .002 (Adjusted R Square = .004) discipline over another that reported higher levels of perceived competency based on graduate coursework training. The conclusion is to fail to reject the null hypothesis and

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92 conclude there are no significant differences in levels of perceived competency by discipline based on graduate coursework training in assessing and treating domestic violence. Chi Square Test (Coursework) Item 24 asked respondents how many courses were taken that specifically related to domestic violence. The influence of graduate coursework training was examined by discipline using the Pearson Chi Square Test. The Chi Square analysis was used to test whet her two categorical variables were independent of each other. Did one discipline over another report a higher level of competency in assessing and treating domestic violence, based on their graduate coursework training? Table 48 presents results for the Chi Square test examining graduate coursework by discipline. Results showed no statistical significance between Lic ensed Clinical Social Workers, X2 ( 3, N=584) = 5.566, p = .135, Licensed Marriage and Family Therapist s, X2 ( 3, N=584) = .409, p = .938 and Licen sed Mental Health Counselors, X2 ( 3, N=584 ) = 7.430, p = .059 and graduate coursework training. The conclusion is to fail to reject the null hypothesis and conclude that there is no significant difference in levels of perceived competency by discipline based on graduate coursework training in assessing and treating domestic violence. Table 48 ChiSquare Test for Graduate Coursework T raining (N = 584) X 2 d f p LCSW 5.566 3 .135 LMFT .409 3 .938 LMHC 7.430 3 .059 Note : LCSW = Licensed Clinical Social Worker, LMFT = Licensed Marriage and Family Therapist and LMHC = Licensed Mental Health Counselor.

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93 Item Analysis and Reliability (Practicum/Internship) The influence of graduate practicum and/or internship training is pr esented in this analysis as Practicum/Internship (items 1619). Reliability analysis was conducted using Cronbachs alpha which was .911 when n=4. Calculation of Cronbachs alpha is shown in Table 49. Item statistics for Practicum/Internship are presented in Table 410 when N=569. The item total statistics are presented in Table 411 and the scale statistics (mean, variance, and standard deviation) are shown in Table 412 Table 49 Practicum/Internship: Reliability Statistics Cronbachs alpha N of items Practicum/Internship .911 4 Table 410. Practicum/Internship: Item Statistics (N=569) Item Mean SD Face to face client contact practicum experience. 2.06 .873 Face to face client contact internship experience. 2.05 .838 Individual supervision experience. 1.93 .820 Group supervision experience. 2.04 .835 Table 411. Practicum/Internship: Item Discrimination Item C orrected item total correlation Face to face client contact practicum experience. .757 Face to face client contact internship experience. .826 Individual supervision experience. .832 Group supervision experience. .775 Table 412. Practicum/Internship: Scale Statistics (N=4) Mean Variance SD 8.08 8.936 2.989

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94 ANOVA (Practicum/Internship) The influence of graduate practicum and/or internship training was then examined by discipline. Did one discipline over another report a higher level of competency in assessing and treating do mestic violence, based on graduate and/or internship training? Did respondents have an awareness of domestic violence during their practicum and/or internship training? An ANOVA analysis was conducted to test the significance of group differences. Table 413 presents the betweensubject factors and Table 414 shows the test of between subjects effects. Table 413. BetweenSubject Factors (Practicum/Internship) N LCSW 237 LMFT 69 LMHC 274 Note: LCSW=Licensed Clinical Social Worker, LMFT=Licensed Marriage and Family Therapist and LMHC=Licensed Mental Health Counselor. Table 414. Tests of BetweenSubjects Effects (dependent variable= Practicum/Internship) Source Type III SS d f MS F Sig. Corrected Model .887 a 3 .296 .528 .663 Intercept 925.666 1 925.666 1653.351 .000 LCSW .046 1 .400 .714 .398 LMFT .009 1 .885 1.580 .209 LMHC .011 1 .374 .668 .414 Error 316.328 565 .560 Total 5370.938 569 Corrected Total 317.215 568 aR squared = .003 (Adjusted R Square = .002) Results show no statistical significance for Li censed Clinical Social Workers F (1,565) = .714, p = .398, Licensed Marriage and Family Therapists F (1, 565) = 1.580, p = .209, and Lic ensed Mental Health Counselors F(1,565) = .668, p = .414 and perceived level of competency, based on practicum and/or internship training. There was not one discipline over another that reported higher levels of perceived competency

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95 based on graduate practicum and/or internship training. The conclusion is to f ail to reject the null hypothesis and conclude that there are no significant differences in levels of perceived competency by discipline based on graduate practicum and/or internship training in assessing and treating domestic violence. Chi Square Test (Pr acticum/Internship) Item 25 asked respondents how many contact hours had been obtain ed with clients facing issues of domestic violence while respondents completed practicum training. The influence of graduate practicum training was examined by discipline using the Pearson Chi Square Test. The Chi Square analysis was used to test whether two categorical variables were independent of each other. Did one discipline over another report a higher level of competency in assessing and treating domestic violence, based on graduate practicum training? Table 415 presents results for the Chi Square test examining graduate practicum training by discipline. Results showed no statistical significance between Lic ensed Clinical Social Workers, X2 (3, N=572) = 3.620, p = .306 Licensed M arriage and Family Therapist s, X2 (3, N=572) = 2.605, p = .457 and Licensed Mental Health Counselors, X2 (3, N=572) = 4.482, p = .214 and graduate practicum training as it relates to perceived level of competency. Items 26 asked responden ts how many contact hours had been obtain ed with clients facing issues of domestic violence while respondents completed internship training. The influence of graduate internship training was examined by discipline using the Pearson Chi Square Test. The Chi Square analysis was used to test whether two categorical variables were independent of each other. Did one discipline over another report a higher level of competency in assessing and treating domestic v iolence, based on graduate internship training? T able 416 presents results for the Chi Square test

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96 examining graduate internship training by discipline. Results showed no statistical significance between Lic ensed Clinical Social Workers, X2 (3, N=573) = 6.484, p = .090, Licensed M arriage and Family Therapists, X2 (3, N=573) = .414, p = .937 and Lice nsed Mental Health Counselors, X2 (3, N=573) = 6.346, p = .096 and graduate internship training as it relates to perceived level of competency. The conclusion is to fail to reject the null hypothesis and conclude that there is no significant interaction between graduate practicum and/or internship training and perceived level of competency in assessing and treating domestic violence by discipline. Table 415. ChiSquare Test for Graduate Practicum T raining ( N = 572) X 2 d f p LCSW 3.620 3 .306 LMFT 2.605 3 .457 LMHC 4.482 3 .214 Note: LCSW = Licensed Clinical Social Worker, LMFT = Licensed Marriage and Family Therapist and LMHC = Licensed Mental Health Counselor. Table 416. ChiSquare Test for Graduate Internship T raining (N = 573) X 2 d f p LCSW 6.484 3 .090 LMFT .414 3 .937 LMHC 6.346 3 .096 Note : LCSW = Licensed Clinical Social Worker, LMFT = Licensed Marriage and Family Therapist and LMHC = Licensed Mental Health Counselor. Chi Square Test (Postgraduate Clinical Co nt act Experience) Does post graduate clinical contact experience have any influence on the mental health professionals perceived level of competency in assessing and treating domestic violence? The null hypotheses states there are no significant differences in levels of perceived competency by discipline based on post graduate clinical contact experience in assessing and treating domestic violence.

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97 The influence of post graduate clinical contact experience is presented in this analysis. Speci fically, item 27 addresses post graduate clinical contact experience as it relates to competency in assessing and treating for domestic v iolence. The influence of post graduate clinical contact was examined by discipline using the Pearson Chi Square Test. The Chi Square analysis was used to test whether two categorical variables were independent of each other. Did one discipline over another report a higher level of competency in assessing and treating domestic violence, based on their post graduate clinical contact experience? Table 417 presents results for the ChiSquare test examining post graduate clinical contact experience by discipline. Results showed no statistical significance between Lic ensed Clinical Social Workers, X2 (3, N=586) = 2. 083, p = .555, Licensed Marriage and Family Therapist s, X2 (3, N=586) = 4.962, p = .175 and Lice nsed Mental Health Counselors, X2 (3, N= 586) =1.774, p = .621 and post gradua te clinical contact experience as it relates to perceived level of competency. The conclusion is to fail to reject the null hypothesis and conclude that there is no significant interaction between post graduate employment experience and perceived level of competency in assessing and treating domestic violence by discipline. Table 417. ChiSquare Test for Postgraduate Clinical Contac t E xperience (N = 586) X 2 d f p LCSW 2.083 3 .555 LMFT 4.962 3 .175 LMHC 1.774 3 .621 Note: LCSW = Licensed Clinical Social Worker, LMFT = Licensed Marriage and Family Therapist and LMHC = Licensed Mental Health Counselor. Chi Square Test (CE/Licensure) Does licensure and continuing education requirements have any influence on the mental health professionals perceived level of competency in assessing and treating

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98 domestic violence? The null hypotheses states there are no significant differences in levels of perceived competency by discipline based on licensure and continuing education requirem ents in assessing and treating domestic violence. The influence of licensure and continuing education requirements is presented in this analysis. Items 23 and 28 specifically address mental health professionals perceptions about licensure requirements an d continuing education requirements, as it relates to competency in assessing and treating domestic violence. Item 23 asks if respondents feel the state of Florida promotes competency in assessing and treating domestic violence when they are obtaining and maintaining a professional license. The influence of licensure requirements was examined by discipline using Pearson Chi Square test. This analysis is used to test whether two categorical variables were independent of each other. Did one discipline over another report a higher level of competency in assessing and treating domestic violence, based on requirements to obtain and maintain professional license? Table 418 presents results for the Chi Square test examining licensure by discipline. Results show a statistical significance between Licensed Clinical Social Workers, X2 (1 N= 568) = 6.723 p = 010 and Licensed Mental Health Counselors, X2 (1 N=5 68) = 5.080, p = .024 and requirements to obtain professional license, as it relates to promoting competency. However, results showed no statistical significance between Licensed Marriage and Family Therapist s, X2 (1 N=5 68) = .000 p = 1.000 and requirements to obtain professional license, as it relates to promoting competency. In addition, results show no statistical significance between Licensed Clinical Social Workers, [X2 (1, N=576) = 1.142, p = .285], Licensed Marriage and Family Therapists [X2 (1, N=576) = .000, p = 1.000] and Licensed Mental

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99 Health Counselors [ X2 (1, N=576) = .188, p = .665 ] and r equirements to maintain professional license, as it relates to promoting competency. Item 28 asks how many continuing education hours had been obtained specifically about domestic violence, since obtaining Florida licensure. The influence of continuing education requirements was examined by discipline using the Pearson Chi Square Test. The Chi Square analysis was used to test whether two categorical variables were independent of each other. Did one discipline over another report a higher level of competency in assessing and treating domestic violence, based on continuing education requirements? Table 419 presents results for the Chi Square test examining continuing education requirements by discipline. Results showed no statistical significance between Licensed Clinical Social Workers, X2 (3, N=584) = 2.021, p = .568, Licensed Marriage and Family Therapist s, X2 (3, N=584) = 3.149, p = .369 and Lice nsed Mental Health Co unselors, X2 (3, N=584) =2.127, p = .546 and continuing education requirements as it relates to perceived level of competency. The conclusion is to reject the null hypothesis and conclude that there is a significant interaction between licensure requirements or continuing education requirements and perceived level of competency in assessing and treating domestic violence by discipline. Table 418. ChiSquare Test for Licensure R equirements (N = 568 & 576) To obtain license N X 2 d f p LCSW 568 6.723 1 .010 LMFT 568 .000 1 1.000 LMHC 568 5.080 1 024 To maintain license N X 2 d f p LCSW 576 1.142 1 .285 LMFT 576 .000 1 1.000 LMHC 576 .188 1 .665 Note : LCSW = Licensed Clinical Social Worker, LMFT = Licensed Mar riage and Family Therapist and LMHC = Licensed Mental Health Counselor.

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100 Table 419. ChiSquare Test for Continuing Education R equirements (N = 584) X 2 d f p LCSW 2.021 3 .568 LMFT 3.149 3 .369 LMHC 2.127 3 .546 Note: LCSW = Licensed Clinical Social Worker, LMFT = Licensed Marriage and Family Therapist and LMHC = Licensed Mental Health Counselor. ANOVA (Level of Competence) Items 29 asked respondents to rate their own level of competence in assessing and treating dome stic violence as either High, A bove A verage, Average, or Low An ANOVA analysis was conducted to test the significance of group differences. Results are presented in Table 432 for item 29. Licensed Clinical Social Worker is represented as LCSW, Licensed Marriage and Family Therapist is represented as LMFT and Licensed Mental Health Counselor is represented as LMHC. Results show no statistical significan ce for these variables, LCSW F (1,517) =.188, p = .665, LMFT F (1,517) = 1.497, p = .222 and LMHC F (1,517) =.000, p = 999. Table 420. Tests of BetweenSubjects Effects. (dependant variable=How do you rate your own level of competence in assessing and treating domestic violence?) Source Type III SS d f MS F Sig. Corrected Model 67.752 a 11 6.159 13.896 .000 Intercept 291.298 1 291.298 657.191 .000 Coursework 3.052 2 1.526 3.443 .033 Postgraduate Clinical Contact 35.525 2 17.762 40.073 .000 CE/Licensure 3.071 2 1.535 3.464 .032 Self learn 3.619 2 6.810 15.363 .000 LCSW .083 1 .083 .188 .665 LMFT .663 1 .663 1.497 .222 LMHC 1.507E 6 1 1.507E 6 .000 .999 Error 229.159 517 Total 5203.000 529 Corrected Total 296.911 528 aR squared = .228 (Adjusted R Square = .212) Note: Coursework = graduate coursework and clinical training, Postgraduate Clinical Contact = post graduate clinical work experience, CE/Licensure = continuing education credits/licensure requirements, Self Learn = self initiated learning, LCSW = Licensed Clinical Social Worker, LMFT = Licensed Marriage and Family Therapist and LMHC = Licensed Mental Health Counselor.

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101 Also in this ANOVA analysis, graduate coursework and clinic al training are represented as Coursework. Post graduate clinical work e xperience is represented as Postgraduate Clinical Contact C ontinuing education credits and licensure r equirements are represented as CE/Licensure. And S elf initia ted learning is represented as Self learn. Results show a statistical significance for these variables, Coursework, F (1,517) = 3.443, p = .033, Postgr aduate Clinical Contact F (1, 517) = 40.073, p = .000, CE/Licensure, F (1, 517) = 3.464, p = .032 and Self learn, F (1,517) = 15.363, p = .000. Tukey HSD Post Hoc As a result of significant findings in the ANOVA analysis for variables Coursework, Postgr aduate Clinical Contact CE/Licensure and Self learn, a Tukey HDS post hoc analysis was conducted. The Tukeys HSD post hoc analysi s first examined the effect of Coursework in terms of influencing levels of perceived competency, if respondents rated thems elves as High, Above Average or Average. It was determined there was no significant difference between Coursework and Greatly, Somewhat or Not at All attributing to perceived levels of competency. A table of means is presented in Table 433. The conclusion is to fail to reject the null hypothesis and conclude that there is no significant interaction between graduate coursework and clinical training and perceived level of competency in assessing and treating domestic violence. Table 421. Tukey HSD Test: Level of competence in assessing and treating domestic violence and Graduate Coursework/Clinical T raining Coursework attributed to competency N Subset 1 Somewhat 291 3.02 Not at all 163 3.04 Greatly 75 3.17 Sig 140 Note: Based on observed means. The error term is Mean Square (Error) = .443 Uses Harmonic Mean Sample Size = 130.977. The group sizes are unequal. The harmonic mean of the group sizes is used. Type I error levels are not guaranteed. Alpha = 0.05. Coursework = Graduate C oursework/ C linical T raining.

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102 Next, a Tukeys HSD post hoc analysis e xamined the effect of Post Graduate Clinical Contact in terms of influencing levels of perceived competency, if respondents rated themselves as High, Above Average, or Average. It was determined there was a significant difference between Post Graduate Clinical Contact and Greatly attributing to perceived levels of competency. A table of means is presented in Table 434. The conclusion is to reject the null hypothesis and conclude that there is a significant inte raction between postgraduate clinical contact experience and perceived level of competency in assessing and treating domestic violence. Table 422. Tukey HSD Test: Level of competence in assessing and treating domestic violence and Postgraduate Clinical Contact E xperience Employment attributed to competency N Subset 1 2 Not at all 19 2.42 Somewhat 135 2.64 Greatly 375 3.22 Sig .252 1.000 Note: Based on observed means. The error term is Mean Square (Error) = .443 Uses Harmonic Mean Sample Size = 47.843 The group sizes are unequal. The harmonic mean of the group sizes is used. Type I error levels are not guaranteed. Alpha = 0.05. Employment = Postgraduate Work Experience. A Tukeys HSD post hoc a nalysis examined the effect of CE/Licensure in terms of influencing levels of perceived competency, if respondents rated themselves as High, Above Average or Average. It was determined there was no significant difference between CE/Licensure and Greatly, Somewhat or Not at All attributing to levels of perceived competency. A table of means is presented in Table 435. The conclusion is to fail to reject the null hypothesis and conclude that there is no significant interaction between continuing education credits/licensure requirements and perceived level of competency in assessing and treating domestic violence.

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103 Table 423. Tukey HSD Test: Level of competence in assessing and treating domestic violence and Continuing Education Credits/Licensur e R equirements CE/Licensure attributed to competency N Subset 1 Somewhat 280 3.01 Greatly 213 3.07 Not at all 36 3.22 Sig .094 Note: Based on observed means. The error term is Mean Square (Error) = .443 Uses Harmonic Mean Sample Size = 83.232. The group sizes are unequal. The harmonic mean of the group sizes is used. Type I error levels are not guaranteed. Alpha = 0.05. CE/Licensure = Continuing Education Credits/Licensure Requirements. Lastly, a Tukeys HSD post hoc an alysis examined the effect of Self learn in terms of influencing levels of perceived competency, if respond ents rated themselves as High, Above Average, or Average. It was determined there was a significant difference between Self learn and Greatly attributing to perceived levels of competency. A table of means is presented in Table 436. The conclusion is to reject the null hypothesis and conclude that there is a significant interaction between self initiated learning and perceived level of competency in assessing and treating domestic violence. Table 424. Tukey HSD Test: Level of competence in assessing and treating domestic violence and Self initiated L earning Self learn attributed to competency N Subset 1 2 Not at all 13 2.38 Somewhat 149 2.74 Greatly 367 3.19 Sig .063 1.000 Note: Based on observed means. The error term is Mean Square (Error) = .443 Uses Harmonic Mean Sample Size = 34.739. The group sizes are unequal. The harmonic mean of the group sizes is used. Type I error levels are not guaranteed. Alpha = 0.05. Self learn = Self initiated Learning. Summary of Reliability In sum, r eliability is the consistency of a measure or the extent to which a measure reflects systematic or dependable source of variation rather than random error (Dooley, 2001, p. 350). Again, a pilot study was conducted for the purposes of

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104 improving reliability of the Domestic Violence Perceived Competency Survey. Based on feedback from the pilot study, the wording and order of survey questions were revised to increase clarity and to reduce uncertainly of the Domestic Violence Perceived Competency Survey. Cronbachs alpha was used to test for internal consistency in this research study. Results of the reliabi lity statistics, for vari ables Coursew ork and Practicum/Internship ( .942, .911 respectively), confirm that the Domestic Violence Perceived Competency Survey was a reliable indicator of how well various items measured the same concept. The purpose of this study was to evaluate perceived competency levels in assessing and treating domestic violence among Florida licensed mental health professionals Analysis of variance ( ANOVA) and Chi Square test s were conducted to determine associations between independent variables: graduate coursework training, pract icum and/or internship training, post graduate clinical contact experience and licensure and continuing education requirements and the dependent variable, perceived levels of competency in assessing and treating domestic violence. The Domestic Violence Perceived Competency Survey was specifically designed to measure associations between these independent variables and the perceived level of competency of these professionals. Results of the data collected indicate no significant relationship between graduate coursework training, graduate practicum/internship training and perceived level of competency. In addition, results indicate no signif icant relationship between types of license s held/disciplines and perceived level of competence. However, results do indicate a significant r elationship between post graduate clinical contact experience and self initiated learning and level of

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105 perceived competency. Chapter 5 will discuss implications of these significant findings in detail.

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106 C HAPTER 5 DIS CUSSION Restatement of Purpose The purpose of this research study was to examine Florida mental health professionals perceived level of competency in assessing and treating domestic violence. The primary goal of this study was to determine how competent these mental health professionals felt about working with clients affected by domestic violence. In addition, this study examined if one mental health discipline over another reported higher levels of competency in assessing and treati ng domestic violence. The Domestic Violence Perceived Competency Survey was developed by the researcher specifically for this study. The instrument was created after reviewing relevant literature in the area of domestic violence. In addition, a pilot stu dy was conducted, prior to the main study, for the purposes of testing the instrument. Some revisions were made to the survey after receiving feedback from the pilot study. A total number of 8, 866 potential respondents were E mailed an invitation to parti cipate. There were a total of 618 respondents that actually participated in the study, of which 591 fully completed the survey. Discussion of Results Graduate Coursework Training Results of the ANOVA analysis and Chi Square test for the variable of gradua te coursework training indicated no significant difference between their Coursework Training and perceived level of competency among Florida mental health professionals in the assessment and treatment of domestic violence, by discipline. As a result, the conclusion was to fail to reject the null hypothesis that there are no significant

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107 differences in levels of perceived competency by discipline based on graduate coursework training in assessing and treating domestic violence. However, findings are not cons istent with current literature which argues that mental health professionals need specific skills and knowledge in order to appropriately assess and treat domestic violence (Bograd & Mederos, 1999). Furthermore, additional literature suggests academician awareness needs to be heightened for adding domestic violence interventions coursework into existing curriculums (Wingfield & Blocker, 1998, p. 92). Moreover, Campbell, Raja and Grinning (1999) purport that victims of domestic violence are at greater ri sk of secondary victimization, if the mental health professional is not appropriately educated and trained to assess and treat domestic violence. Based on current literature one can infer that more knowledge and training in the area of assessing and treating domestic violence would result in higher levels of perceived competency. However, results of this research study suggest that there is no significant relationship between graduate coursework training and perceived levels of competency among Florida l icensed mental health professionals. That is, the study findings show that Florida licensed mental health professionals that reported a High, Above Average, or Average level of competency in assessing and treating domestic violence did not attributed graduate coursework training to their level of competency. Graduate Practicum/Internship Training R esults of the ANOVA analysis and ChiSquare test for the variable of graduate practicum and/or internship training indicated no s ignificant difference between their Practicum/Internship Training and perceived level of competency among Florida licensed mental health professionals in the assessment and treatment of domestic

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108 violence. As a result, the conclusion was to fail to reject the null hypothesis that there are no significant differences in the levels of perceived competency by discipline based on graduate practicum and/or internship training in assessing and treating domestic violence. Interestingly, findings are consistent with current literature which arg ues that most graduate level programs only provide a general overview for working with clients involved in violent relationships. Only one of the three accrediting bodies of mental health graduate curriculums actually articulate in their core competencies that students must develop specific skills to screen for domestic violence and to have skills and understanding in the area of family violence (CSWE standards, 2001; CACREP standards, 2009; AAMFT, 2004). Often graduate students do not obtain any practi cum and/or internship experience involving clients with issues of domestic violence. Based on the findings of this study Florida licensed mental health professionals that reported a High, Above Average or Average level of competency in assessing and treati ng dome stic violence did not attribute practicum and/or internship training to their level of competency. Again, results of this research study suggest that there is no significant relationship between graduate practicum and/or internship training and per ceived levels of competency by discipline, among Florida licensed mental health professionals. Postg raduate Clinical Contact Experience Results of the Chi Square test, ANOVA and Tukey HSD analyses for the variable of Postgraduate Clinical Contact E xperience do indicate a sig nificant relationship between Postgraduate Clinical Contact and perceived level of competency among Florida mental health professionals in the assessment and treatment of domestic

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109 violence. As a result, the conclusion was to reject the null hypothesis that there are no significant differences in the level of perceived competency based on post graduate clinical contact experience in assessing and treating domestic violence. Findings show that Florida licensed mental health professionals that reported a High, A bove A verage, or Average level of competency, attributed their level of competency to their post graduate clinical contact experience. Again, study results showed a significant relationship between their post graduate clinical contac t experience and perceived level of competency. Findings are consistent with current literature which argues virtually any mental health practi ti oner who works with women needs to have some understanding of the different forms of violence against women an d the assessment and treatment effects of such violence (Walker, 1994, p.4). Because most graduate level curriculums do not require specific coursework in the assessment and treatment of domestic violence (CSWE standards, 2001; CACREP standards, 2009; AA MFT 2004), it seems as though most mental health professionals are obtaining their knowledge and skills through onthe job training in assessing and treating domestic viol ence. CE/Licensure Requirements Results of ChiSquare test indicate a significant difference between Requirements to Obtain L icensure and perceived competency. In addition, results of an ANOV A analysis for the variable to Maintain Licensure and Continuing Education R equirements indicated no s ignificant difference between Licensure and Continuing Education Requirements and perceived level of competency among Florida licensed mental health professionals in the assessment and treatment of domestic violence. As a result, the conclusion was to reject the null hypothesis that there are no si gnificant differences in

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110 the levels of perceived competency by discipline based on licensure requirements or continuing education requirements in assessing and treating domestic violence. Findings show that Florida licensed mental health professionals tha t reported a High, Above Average, or Average level of competency in assessing and treating domestic violence did not attribute licensure and continuing education requirements to their level of competency. However, Licensed Clinical Social Workers and Licensed Mental Health Counselors did report requirements to obtain professional licensure did promote competency in assessing and treating domestic violence. Literature presented in this study is consistent with research findings. The state of Florida only requires two continuing education hours per every six years in the area of domestic violence (2009 Florida state statute, Chapter 491.004 ). In addition, the state of Florida does not have any requirements specific to domestic violence training for professionals seeking licensure as clinical social worker, marriage and family therapist or mental health counselor. Findings in this research study show that mental health professionals do not feel the state of Florida promotes competency in assessing and treating domestic violence based on requirements to maintain professional licensure. Self Initiated Learning Results of the Chi Square test, ANOVA and Tukey HSD analyses for the variable of Self initiated L earning do indicate a sig nificant relationship between Self learn and perceived level of competency among Florida mental health professionals in the assessment and treatment of domestic violence. Results show that mental health professional s who reported a High, Above Average, or Average level of competency, attributed their level of competency to Self initiated Learning. Findings are consistent with literature, which suggest, mental health professionals are not obtaining the

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111 knowledge and s kills needed to assess and treat for domestic violence during their graduate school education (Windfield & Blocker, 1998). Research shows that mental health professionals are seeking knowledge and practice outside of traditional academic graduate school t raining programs. Again, academician awareness needs to be heightened for adding domestic violence interventions coursework into existing curriculums (Wingfield & Blocker, 1998, p. 92). Perceived Competency by Discipline Does one discipline over another report a higher level of competency when assessing and treating domestic violence? The answer is no. Results from the ANOVA analysis show no significant relationship between discipline (clinical social work, marriage and family therapy and mental heal th counseling) and perceived level of competency. One discipline over another did not report a higher level of competency when assessing and treating domestic violence. Implications for Training Florida Licensed Mental Health Professionals Given the findi ngs of this research study it is reasonable to assume that most Florida licensed mental health professionals obtain their knowledge and skills of assessing and treating domestic violence by onthe job training and self initiated learning, such as workshops and seminar s, speci fic to domestic violence. T hat on the job training and self initiated learning contribute to increased levels of perceived competency in assessing and treating domestic violence. In addition, based on research findings one can also inf er that one discipline over another does not better prepare their practi ti oners in assessing and treating domestic violence. There were no significant differences among disciplines studied, clinical social

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112 work, marriage and family and mental health couns eling, in the ir perceived level of competency in assessing and treating domestic violence. Furthermore, one can infer that Florida licensed mental health professionals do not feel that their Graduate Coursework, Practicum and/or Internship Training or Lice nsure and C ontinui ng Education R equirements contributed to their perceived competency level in assessing and treating domestic violence. Results found no significant differences in these variables. Findings of this study suggest current curriculum guidel ines do not require specific knowledge and skills to be obtained in the area of assessing and treating domestic violence. In addition, Florida laws do not articulate that mental health professionals seeking licensure under Chapter 491 .004 have to master s kills specific to assessing and treating domestic violence. Literature presented in this research study certainly makes a case for the need of professionals to be trained in assessing and treating domestic violence. Current statistics show that one in four women will experience domestic violence in her lifetime (Tjaden & Thoennes, 2000). Each day at least three women in the United States die as a result of domestic violence (Bureau of Justice Statistics, 2005). Women are twice as likely to be killed by an intimate partner tha n men (Bureau of Justice Statistics, 2008). Experts in the field recommend various approaches for professionals working with clients facing issues of domestic violence. The mental health profession needs to ensure that practi ti oners in the field are being appropriately educated and trained to work this specialized population.

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113 Based on these research findings, it is recommended that graduate training programs and accrediting bodies evaluate current curriculum requirements for graduate students in the area of domestic violence. Specifi cally, these institutions should examine required course work as well as required cl inical experience specific to domestic violence. Acc rediting bodies should articulate requirements for students to devel op competencies in assessing and treating domestic violence. It is also suggested that graduate programs require students to take course work specific to domestic violence. In addition, g raduate programs could also develop a domestic violence certificate program in which students would be able to obtain specialized training in domestic violenc e theory, assessment, treatment intervention, as well as clinical contact with clients affected by domestic violence. Recommendations for Future Research Results of this research study will bene fit the mental health field as a whole. In addition, education policy makers, accrediting bodies and licensure boards should pay particular attention to the results presented. Based on study findings, Florida licensed men tal health professionals report that their graduate coursework training, graduate practicum and/or internship training as well as licensure and continuing education requirements do not contribute to their perceived level of competency in assessing and trea ting domestic violence. These results raise questions regarding current curriculum requirements in graduate education and well as clinical experience requirements for professional licensure. Results suggest that education policy makers, accrediting bodies and licensure boards should consider reevaluating current guidelines establish ed for education and training in the area of domestic violence.

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114 Future research in the area of domestic violence competency could examine more closely what kind of self initiated learning professionals are seeking. By examining what is being self learned, perhaps educational policy makers and accrediting bodies could implement changes to graduate curriculum programs so practi ti oners would feel more competent in work ing with issues of domestic violence. In addition, future research could examine what kind of post graduate clinical contact experiences contribute to increased levels of competency and consider implementing changes to existing practicum and/or internship guidelines. Lastly, results from this research study reported that current requirements to maintain professional license and continuing education did not increase levels of competency in assessing and treat ing domestic violence. Perhaps further research could be conducted to investigate how the state of Florida could better prepare mental health professionals in working with clients facing issues of domestic violence, by evaluating current requirements to maintain professional license, as well as requirements for continuing education. Limitations o f Research Study Research Design As in most research studies there may be some limitations to the research design itself. One limitation in this research study relates to the population being surveyed. Of the 16,033 actively Florida licensed mental health professionals surveyed, only 8,866 have provided a contact E mail address to the Florida Department of Health. This quantity equates to approximately 55% of the total sample population. The Florida Department of Health currently does not require licensed professionals to provide E mail addresses when applying for or renewing a professional license. As a result, the

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115 Domestic Violence Perceived Competency Survey was only E mailed to those professionals who provi ded E mail addresses to the Florida Department of Health. Sample Size Another limitation of the sample used in this research study is that all disciplines are not equally represented. There are currently 3,786 Licensed Clinical Social Workers (LCSW) and 4,260 Licensed Mental Health Counselors (LMHC) in the state of Florida. However, there are only 820 Licensed Marriage and Family Therapists (LMFT). There are twice as many LCSW and LMHC represented than LMFT. As a result, this researcher will obtain more responses from the disciplines of clinical social work and mental health counseling, than of marriage and family therapy. However, this disparity does seem to be reflective of current trends in professionals seeking licensure in the state of Florida. Soc ial Desirability Asking individuals to evaluate themselves in terms of their knowledge and skills may present as another limitation to this research study. Respondents may want to represent themselves in the most socially desirable way, that is being very knowledgeable and skillful. There is a possibility that respondents in this study may have selected answers in a way that would make themselves appear more competent than they really are in the area of assessing and treating domestic violence. Informati on Recall Also, some limitations may have result ed from the respondent not being able to remember information or experiences accurately. Dillman et al., (2009) found that it may be difficult for some respondents to recall the information the surveyor is asking

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116 due to the fact memory fades over time. For some mental health professionals that have been practicing for many years, they might not be able to recall the exact coursework they had in graduate school or if training on domestic violence was obtained during graduate school or as continuing education, after licensure. As a result, respondents may not be able to answer some questions accuratel y. Quantitative Methodology The quantitative method chosen for this research study may have limitati ons in terms of what results could be produced. For example, item 22 of the Domestic Violence Perceived Competency Survey allowed respondents to comment on their own training and clinical experience i n the area of domestic violence. However, because resp onses were in a narrative format this data was not used in the analysis phase of this research study Perhaps this narrative data collected could be used t o further research competencies in assessing and treating domestic violence from qualitative approach. Qualitative research methods lends itself to more illustrative results by using interview, open questioning, and being more involved in the research. Ov erall this quantitative research study establish ed a fo undation for future research in the area of evaluating practitioner competency in assessing and treating domestic violence. Response Rate Invitations to participate in this research study were E mailed to 8, 866 potential respondents, of which 573 were returned due to invalid E mail address In addition, 36 respondents E mailed the researcher and declined to participate in the study. A total of 618 licensed profes sionals responded to the survey, of which 591 respondents fully completed the survey As a result, a response rate 7. 5% was obtained. This low response rate places limitations on the representativeness of the sample surveyed.

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117 Dillman, Smyth and Christian (2009), suggest researchers lo oking to improve response rates do so by utilizing mixed mode surveys: One of the most important ways that mixedmode surveys have been shown to enhance data quality is by improving response rates (Dillman et al., 2009, p.304); t hat is, offer multiple ways for potential respondents to participate in the study, such as online as well as paper surveys. By offering more than one way to complete the survey, the researcher can improve chances of obtaining a representative sample (Dillman et al., 2009). Nonr esponse Error According to Dillman, Smyth and Christian (2009), paper surveys are preferred by responden ts, as opposed to E mail surveys. Dillman et al. stated, There is no technological barrier with mail surveys in that most people receive and are comfortable wi th open postal mail (Dillman et al., 2009, p. 447). Another limitation to this research study may have been the E mail survey mode in which the survey was distributed. Some potential respondents could have been concerned about opening the E mail invitation from someone they did not know for fear of receiving a virus on their computer. This may have resulted in respondents choosing not to respond to the survey invitation, contributing to the overall low response rate of this study. Nonresponse er ror could have also been related to respondents not receiving the E mail invitation to participate in this research study. Dillman, Smyth and Christian (2009) recomm end sending Individual E mails rather than using bulk mailing options, and not using the CC or BCC fields to avoid the survey being flagged as spam (p. 285). Furthermore, Dillman, Smyth and Christian (2009) recommend researching spam filters to gain the most upto date information, just prior to administering the survey. These tec hnique s were not employed when E mailing the Domestic Violence Perceived

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118 Competency survey and as a result could have prevented a large number of potential respondents from ever receiving the E mail invitation to begin with. In addition, Dillman, Smyth and Chris tain (2009) recommend sending follow up E mails to remind potential respondents to participate in a research study. Reminder E mails were not sent to potential respondents in this research study which may have contributed to the nonresponse error, resulting in a low response rate. Dillman et al. (2009) argue that follow up reminders are the most powerful way of improving response rates (p. 360). Coverage Error Another limitation worth mentioning relates to coverage error. As stated in Chapter 3, as of 2010 there were a total of 16,033 Florida mental professionals, licensed under Chapter 491.004 However, the Department of Health only had E mail addresses for 8,866 of those 16,033 professionals. Therefore, a survey invitation could not be email to 7,167 potential respondents. Again, Dillman, Smyth and Christian (2009) recommend reducing coverage error by administering mixedmode surveys. Mailing addresses were provided by the Department of Health for all 16,033 licensed professionals. Perhaps paper surveys could have been mailed to the 7,167 respondents without E mail addresses, in addition to the 8,866 E mail surveys. Conclusion This quantitative cross sectional research study examined Florida licensed mental health professionals perceived level of competency in assessing and treating domestic violence. Various theoretical frameworks were presented regarding the assessment and treatment of domestic violence. Certainly current research and statistics demonstrate a need to focus on improving our knowledge about domestic violence.

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119 Based on results of this study, it seems as though mental health professionals are obtaining knowledge and skills outside of traditional graduate academia training. Most professionals reported receiving domestic violence training onthe job or through self initiated means, like workshops and seminars. In conclusion, findings of this study demonstrate the need for continued education and research in the area of domestic violence training

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120 APPENDIX A DOMESTIC VIOLENCE PERCEIVED COMPETENCY S URVEY

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137 APPENDIX B COVER LETTER Dear Mental Health Professional I am emailin g you to participate in a research study that I am conducting for my doctoral dissertation at the University of Florida. The purpose of my study is to evaluate mental health professionals perceived level of competency when assessing and treating domestic violence. Specifically, I am surveying all actively L icensed Clinical Social Workers, Licensed Mental Health Counselors and Licensed Marriage and Family Therapists in the state of Florida, licensed under Chapter 491. Results from this survey may provide insight to the mental health professio n, accrediting bodies, licensure boards, educators and policy makers regarding training needs in the area of assessment and treatment of domestic violence. Participation is voluntary and your answers will remain anonymous This survey will only be admini stered online. It should take approximately 1520 minutes to complete. Please click the link www.surveymonkey.com/s/3NJD25Y to access the survey. You will first be directed to the informed consent pa ge. S elect I Agree if you chose to participate in this study. Next you will be directed to the instructions page and then the survey itself. If you have any questions, please feel free to contact me at domesticviolencesurvey@yahoo.com Thank you so much for your time and participation. Sincerely, Jacqui Knowles, Ed.S., LMHC Doctoral Candidate School of Human Development and Organizational Studies in Education University of Florida

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138 APPENDIX C POWER AND CONTROL WH EEL

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139 APPENDIX D EQUIT Y WHEEL

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140 REFERENCES Ad ams, S.A (2005). Does CACREP accreditation make a difference? A look at NCE r esults and a nswers. Journal of Professional Counseling: Practice, Theory, & Research, 33, 6076. Alme ida, R.V. & Durkin, T. (1999). The cultural context model: Therapy for couples with domestic violence. Journal of Marital and Family Therapy, 25, 313324. American Association for Marriage and Family Therapy (n.d). Retrieved 05/28/2008 from http://www.aamft.org American Association for Marriage and Family Therapy (AAMFT) (2004) Marriage and Family Therapy Core Competencies 1 6 American Association for Marriage and Family Therapy (AAMFT) (2005) Commission on Accr editation for Marriage and Family Therapy Education. Accreditation Standards 1 23. Bograd, M. (1988). Feminist perspectives on wife abuse: An introduction. In K. Yllo and M. Bograd (Eds.), Feminist perspectives on wife abuse (pp. 1126). Newbur y Park, CA: Sage Publications, Inc. Bograd, M. (1 999). Strengthening domestic violence theories: Intersections of race, class, sexual orientation, and gender. Journal of Marital and Family Therapy, 25 275289. Bograd, M. & Mederos, F. (1999). Battering and couples therapy: Universal screening and selection of treatment modality Journal of M arital and Family Therapy, 25, 291312. Bureau of Justice Statistics (2005). U.S. Department of Justice, Office of Justice Programs. Bureau of Justic e Statistics (2008). US Department of Justice, Office of Justice Programs. Campbell, R., Raja, S., & G rining, P.L. (1999). Training mental health professionals on violence against women. Journal of Interpersonal Violence, 14, 10031013. Centers for Disease Control and Prevention, CDC. (2003). Costs of Intimate Partner Violence Against Women in the United States National Centers for Injury, Preve ntion and Control. Atlanta, GA: 164. Cohen, J. (1992). A power primer. Psychological Bulletin, 112, 155159.

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141 Comsto ck, D. E. (1982). A method for critical r esearch. In E. Bredo and W. Feinberg (Eds.), Knowledge and values in social and educational r esearch (pp. 370 390). Philadelphia, PA: Temple University Press. Cone, J.D. and Foster, S.L. (1993). Dissertations and Theses From Start to Finish: Psychology and Related Fields Washington DC: American Psychological Association. Council for Accreditation of Counseling and Related Educational Programs (CACREP). Retrieved 05/28/2008 from http://www.cacrep.org CACREP 2009 Standards ,1 63. Council o n Social Work Education (CSWE). Retrieved 05/28/2008 from http://www.cswe.org Council on Social Work Education (CSWE) (2001) Educational policy and accreditati on s tandards 1 16. Retrieved 06/26/2009 from http://www.cswe.org De Keseredy, W.S. (2000). Current controversies on defining nonlethal violence against women in i ntim ate heterosexual relationships Violence Against Women, 6, 728 746. Dillman, D.A., Smyth, J.D. & Christian, L.M. (2009). Internet, mail and mixed mode surveys: The tailored design m ethod, 3rd Hoboken, NJ: John Wiley & Sons, Inc. Dillman, D.A., Tortora, R.D., Conradt, J. & Bowker, D. (1998) Influence of plain vs. fancy design on response rates for web surveys Paper presented at Joint Statistical Meetings, Dallas, Texas. Retrieved 03/03/2010 from http://survey.sesrc.wsu.ed u/dillman/papers/asa98ppr.pdf Dooley, D. (2001). Social Research Methods, 4th ed Upper Saddle River, NJ: PrenticeHall, Inc. The Duluth Model (n.d.). Retrieved 02/10/2010 from http://www.theduluthmodel.org F lorida Department of Law Enforcement. (2009). Crime in Florida, 2008 Florida uniform crime report [Computer Program] T allahassee, FL: FDLE. Florida State Statutes, Chapter 491.004 (2009). Retrieved 11/03/2009 from http://www.leg.state.fl.us Florida State Statutes, Chapter 741.28 (2009). Retrieved 12/1 3/2009 from http://www.leg.state.fl.us

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142 Gelles, R.J. (1990). Methodological issues in the study of family violence. In C. Smith (Ed.), Physical violence in A merican families: Risk factors and adaptations to violence in 8,145 f amilies (p p. 1728). New Brunswick, NJ; T ransaction Publishers. Gelles, R.J. (1993). Through a Sociological Lens; Social Structure and Family Violence. In R.J. Gelles and D.R. Loseke (Eds.), Current controversies on family v iolence (pp. 3146). Newbury CA: Sage Publications. Gelles, R.J. (2000). Estimating the incidence and prevalence of violence against women. Violence Against Women, 6, 784 80 4. Gelles, R.J. & Mayn ard, P.E. (1995). A Structural family systems approach to intervention in cases of family v iolence. In S. M. Smith and M.A. Straus (Eds.), Understanding partner violence: Prevalence, causes, c onsequences, and solutions (pp. 244251). Minneapolis, MN; National Council on Family Relations. Goldner, V. (1998). The treatment of violence and victimization in intimate r elationships. Family Process, 37 263 286. Goldner, V. (1999). Morality and multiplicity: Perspectives on the treatment of violence in intimate life Journal of Martial and Family Therapy, 25 325 336. Goldner, V., Penn, P., Sheinberg, M. & Walker, G. (1990). Love and violence: Gender paradoxes in volatile attachments Family Process, 29 343 364. G ordon, M. (2000). Definitional issues in violence against women: Surveillance and research from a violence research perspective. Violence Against Women, 6, 74778 3. Gottman, J.M., Jacobson, N.S., Rushe, R.H., Shortt, J.W., Babcock, J., La Tiaillade, J.J. & Waltz, J. (1995). The relationship between heart rate reactivity, emotionally aggressive behavior, and general violence in batterers. Jou rnal of Family Psychol ogy, 9, 227 248. Greene, K. & Bogo, M. (2002). The different faces of intimate violence: Implications for assessment and treatment. Journal of M arital and Family Therapy, 28, 455 466. Guba, E. G. (1990). The Paradigm Dialog. Newbury Park, CA: Sage Publi cations. Harris, A. & Musso, M. (2006). Violence against women act 2005; April 2006 update. National Research Center for Women & Families. Retrieved 09/11/2008 from http://www.center4reserach.or g/vawa2005.html Hernandez, P., Almeida, R. & DolanDelvecchio, K. (2005). Critical consciousness, accountability, and empowerment: Key processes for helping families heal. Fam ily Process, 44 105 119.

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143 Hernandez, P. & Siegel, A. & Almeida, R. (2009). The cultural context model: How does it facilitate couples therapeutic change? Journal of Marital and Family Therapy, 35, 97 110. Institute for Family Services.(n.d). Retrieved 02/10/2010 from http://ww w.instituteforfamilyservices.com Iversen, G.R. & Norpoth, H. (1987). Analysis of Variance, 2nd ed Newbury Park, CA: Sage Publications, Inc. Jacobson, N.S. (1994). Rewards and dangers in researching domestic violence. Family Process, 33 8185. Jacobson, N.S. and Gottman, J.M. (1998). When men b atter w omen. New York, NY: Simon & Schuster. Jacobson, N.S., Gottman, J.M., Waltz, J., Rushe, R., Babcock, J. & Holtzworth Munroe, A. (1994). A ffect, verbal content, and psychophysiology in the arguments of couples with a violent husband. Journal of Consultin g and Clinical Psychology, 62, 982988. Jenkins, A. (1990). Invitations to responsibility: The therapeutic engagement of men who are v i olent and a busive Adelaide, South Australia; Dulwich Centre Pub lications. Lee, R.E. & Nichols, W.C. (2010). The doctoral education of professional marriage and family t herapists. Journal of Marital and Family Therapy, 36 259 269. Margolis, R.L. & Rungta, S.A. (1986). Training counselors for work with special populat ions: A second l ook. Journal of Counseling and Development, 64, 642 644. Mckenzie, V.M. (1995). Domestic violence in A merica Lawrenceville, VA: Brunswick Publishing Corporation. Novello, A., Rosenberg, M. Saltzman, L. & Shosky, J. (1992). From the Surg eon General, U.S. Public Health Service, JAMA, 267 3132. O Keefe, M. (1997). Incarcerated battered women: A comparison of battered women who kill their abusers and those incarcerated for other o ffenses. J ournal of Family Violence, 12 1 19. Popkewitz T.S. (1990). Whose future? Whose past? Notes on critical theory and m ethodology. In E.G. Guba (Ed.), The paradigm dialogue (pp.46 66). Newbur y Park, CA: Sage Publications.

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144 Redig er, Sherry L. (1996). Critical theory research: The emancipatory interest in family t herapy. In D.H. Sprenkle and S.M. Moon (Eds.), Research methods in family t herapy (pp.127144). New York, NY: The Guilford Press. Saunders, D.G. (1988). Wife abuse, husband abuse, or mutual combat? A feminist perspective on the empirical f ind ings. In K. Yollo and M. Bograd (Eds.), Feminist perspectives on wife a buse (pp.90 113). Newbur y Park, CA: Sage Publications, Inc. Schacht, S.P. & Aspelmeier, J.E. (2005). Social and behavioral statistics: A user friendly approach, 2nd ed Cambridge MA : Westview Press. Silverman, J.G., Raj, A., Mucci, L.A., & Hathaway, J.E. (2001). Dating violence against adolescent girls and associated substance use, unhealthy weight control, sexual risk behav ior, pregnancy, and suicidality, JAMA, 286 572 579. Stan dford Encycl opedia of Philosophy. (2005). Critical Theory. 1 41. Retrieved 12/09/2009 from http://plato.stanford.edu/entries/critical theory. Straus, M.A. (1990 a ). The national family violence s urveys. In C. Smith (Ed.), Physical violence in A merican families: Risk factors and adaptations to v iolence in 8,145 f amilies ( pp. 316). New Brunswick, NJ; Transaction Publishers. Straus, M.A. (1990 b ). Social stress and marital vi olence in a national sample of A merican f amilies. In C. Smith (Ed.), Physical violence in A merican f amilies: Risk factors and adaptations to violence in 8,145 f amilies (pp. 181201). New Brunswick, NJ; Transaction Publishers. Straus, M.A., Gelles, R.J. & Steinmetz S.K. (1980). Behind closed doors: Violence in the A merican f amily Garden City, NY; Anchor Press/Doubleday. Straus, M.A. & Gelles, R.J. (1986). Societal change and change in family violence from 1975 to 1985 as revealed by two national surveys. Journal of Marriage and Family 48, 465479. SurveyMonkey (n.d.). Retrieved 02/15/2010 from http://www.surveymonkey.com Tjaden, P. & Thoennes, N. (2000). Extent, nature and consequence of intimate partner violence: Findings from the national violence against women survey, 162. National Institute of Justice and Centers for Disease Control and Prevention. Todahl, J.L., Linville, D., Chou, L.Y, & Maher Cosenza, P. (2008). A qualitative study of intimate partner violen ce universal screening by family therapy interns: Implications for practice, research, training and supervision. Journal of Martial and Family Therapy, 34, 28 43.

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145 Training initiative addresses dual diagnosis, domestic violence. (2005). Alcoholism & Drug Ab use Weekly, 17 (3) 3 4. Retrieved 01/10/2009 from Academic S earch Primer database. Walker, G.A. (1990). Family violence and the womens m ovement Toronto, Canada; University of Toronto Press. Walker, L.E. (1979). The battered w omen. New York, NY: Harper Perennial. Walker, L.E. (1994). Abused women and survivor t herapy Washington DC: American Psychological Association. Walker, L.E. (2000). The battered w oman syndrome, 2nd ed N ew York, NY: Springer Publishing Company, Inc. Wingfield, D. & Blocker, L. (1998). Development of a certificate training curriculum for domestic violence counseling. Journal of Addicti ons & Offender Counseling, 18, 8694. Yllo, K. (1993). Through a feminist lens: Gender, power and v iolence. In R.J. Gelles and D.R. Loseke ( Eds.) Current controversies on family v iolence (pp. 4762). Newbur y Park, CA: Sage Publications, Inc. Yllo, K. & Bograd, M. (1988). Femini st perspectives on wife a buse Newbury Park, CA: Sage Publications, Inc.

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146 BIOGRAPHICAL SKETCH Jacqueline Kirkwoo d Knowles was born in Fort Lauderdale, Florida, and is a native Floridian. She was raised in Coral Springs, Florida, by her parents Kevin and Elaine Kirkwood. She has one sister, Kristine Kirkwood Simone. She received her Bachelor of Arts degree from the University o f Florida in 1994, majoring in criminal justice with a minor in business a dministration. Later that same year she attended and completed six months of training at the Institute of Public Safety at Santa Fe Community College (the police academy ) as a police officer recruit. However, she did not pursue a career in law enforcement but instead continue d her education. In January of 1995 she began her graduate studies in the Department of Counselor Education at the University of Florida. She received her Masters/Specialist degree in Marriage and Family Therapy in 1997. After graduation, she began working with the Gainesville Police Department as a Victim Advocate. This position was grant funded and short term. Later that same year in 1997, she began working for the State of Florida, Department of Corrections as a Psychological Specialist. Specifically, she worked in an outpatient mental health clinic at the North Florida Reception Center which served adult male inmates serving prison sentences in the Florida Department of Corrections. Her work included initial psychological assessments for inmates entering the correctional system, individual therapy, group therapy, some inpatient work including suicide observations as well as disciplinary co nfinement evaluations. Inmates varied in terms of sentence and crimes; some were serving one year, one day for burglary and others life sentences for homicide. During that time she obtained licensure from that State of Florida for Mental Health Counselor. In 1998, while working for the Department of Corrections she decided to further pursue studies for her Ph.D. in Mental Health Counseling in the

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147 Department of Counselor Education at the University of Florida. She left the Department of Corrections in 2003, six months after her first child was born, but continued her studies toward her Ph.D. Studies included coteaching a graduate family violence course, as well as undergraduate level counseling courses. She currently lives in Alachua, FL with her husband Bart and two children, Cale and Reese. And after a long road traveled, she will fina lly complete her Ph.D. studies surprising most of her family, friends, professors and mostly, herself.