(PS12-23) Examining Therapeutic Working Alliance and Predictors of Intimate Partner Violence in Two Treatments: Fathers for Change and the Batterer Intervention Program

Abstract Text: Intimate partner violence (IPV) is a serious public health problem that has detrimental effects on the well-being of women and children. The current therapeutic standard for fathers who engage in IPV is the Batterer Intervention Program (BIP), which is a psychoeducational and supportive group program. A recently developed intervention for IPV, Fathers for Change (F4C), is a cognitive-behavioral treatment that incorporates individual sessions followed by family intervention. In a preliminary randomized controlled trial comparing F4C and an individualized version of BIP (BIP-I), significant reductions in IPV were reported in both treatments. Avoidance, rigidity, cognitive-emotional processing, and self-efficacy significantly predicted IPV outcomes at posttreatment only in F4C. None of these variables predicted IPV outcomes in BIP-I. Working alliance between therapist and client, which encompasses the bond between both parties, mutually agreed-upon goals, and collaboration on tasks, may be associated with these change processes, but this has not yet been examined. This study aims to understand the relationship between working alliance and the four process variables of interest—avoidance, rigidity, cognitive-emotional processing, and self-efficacy—in F4C and BIP-I. Sixty fathers with a recent history of IPV were referred by child protective services to participate in this study and were randomly assigned to receive F4C (n = 30) or BIP-I (n = 30). Therapeutic change processes were rated using the CHANGE observational coding system, and the therapeutic alliance was rated using the Working Alliance Inventory-Observer Form. We coded the individually-focused sessions from F4C and the BIP-I sessions from the same time period. Bivariate correlations were conducted to investigate associations between total working alliance scores and each therapeutic change process in both treatments. In the BIP-I group, stronger working alliance was associated with less avoidance (r = -.612, n = 24, p = .001) and rigidity (r = -.668, n = 24, p < .001) and more cognitive-emotional processing (r = .773, n = 24, p < .001) and self-efficacy (r = .538, n = 24, p = .007). In the F4C group, stronger working alliance was associated with less rigidity (r = -.440, n = 26, p = .025). Together, these results suggest that working alliance is more impactful for BIP-I than for F4C. This is consistent with BIP-I’s emphasis on psychoeducation and support. F4C focuses on skills and utilizes specific strategies to help fathers regulate their emotions. The alliance in F4C was associated with less rigidity, and perhaps more flexibility. These findings suggest that working alliance might be particularly important in treatments for IPV that focus more on support than skills training. A strength of this study is that the sample includes a diverse group of men from various racial and ethnic backgrounds. Additionally, this study includes research with an understudied population: fathers who use IPV. Overall, this study provides preliminary support for the role of working alliance in the treatment of fathers who use IPV, especially in BIP-I. These findings can inform the development and implementation of future IPV treatments to improve the lives of individuals who use IPV and their families.