We reviewed Volumes 1, 2,
and 4 of Sage Publications 1995 "VIOLENCE" AND ABUSE
(misplaced #3 - sorry! It's probably not very different.) There's a section in
each issue headed, "Psycho-therapeutic Intervention and Treatment." We
found 52 abstracts under that heading. Four described outcomes for victim
treatment in measurable terms.
A few of the other 47
items were theoretical, suggesting how outcome research should be done.
The bulk of material reviewed books, parts of book, and journal articles telling
us all the wonderful and brilliant ways some therapists are treating abuse
victims and suggesting that other therapists do the same. We found little or no
regard for rational measurement of the actual outcomes of all that commitment,
creative energy and money. There were in fact, more hard cover books on how to
do treatment than there were journal articles measuring whether all this
treatment helps anyone at all. Personally, we found it frightening.
When we perused the same
three issues for articles about treating the people who do the victimizing, the
picture was better. Roughly half the books and articles appeared to be anecdotal
and theoretical. The remaining half described specific aspects of offender
personalities in measurable terms or examined and compared the results of
specific treatment approaches. In the 1980's, this kind of research led to the
virtual abandonment of psychodynamic treatment of sex offenders in favor of
cognitive - behavioral approaches that have proved more fruitful.
Before that, as early as the 1950's and 60's, outcome research showed the
futility of psychodynamic treatment of delinquents and highlighted more hopeful
results with the "therapeutic community," or "guided group
interaction" model that is now so widely used.
Why is offender treatment
so much more scientifically refined than treatment available to victims? We, as
a community and a society, tend to feel sympathetic concern for victims, whom we
see as hapless but deserving. We are willing to pay for their treatment with
government funds, charitable contributions, and insurance dollars. With money so
widely available, therapists don't have to be particularly accountable. So long
as a victim enjoys or somehow appreciates the therapeutic hour, relatively few
questions are asked.
In contrast, offenders are
viewed as evil and undeserving. Society is reluctant to do anything for them, so
offender therapists have traditionally had to demonstrate they are doing
something to them - that they are changing behavior. "Cost
Effectiveness," comparing the dollars saved by treatment through crime
reduction to the dollars spent on that treatment, is a currently popular model
for deciding whether offenders will receive treatment. In other words, unlike
victim therapists, offender therapists have to demonstrate results to get paid.
The paradox is that,
although we are much more concerned for victims of crimes than for criminals,
those few criminals who are getting treatment are probably receiving a much more
effective service package than the large numbers of victims whom we treat with
It appears that, if we
really want to minimize further victimization we may be spending our money in
the wrong ways.