Using an integrative, Cognitive Analytic Therapy (CAT) approach to treat intimate partner violence risk

Published date10 April 2017
Date10 April 2017
AuthorRuth J. Tully,Alex Barrow
Subject MatterHealth & social care,Criminology & forensic psychology,Aggression, conflict & peace,Sociology,Gender studies,Gender violence,Political sociology, policy & social change,Social conflicts,War/peace
Using an integrative, Cognitive Analytic
Therapy (CAT) approach to treat
intimate partner violence risk
Ruth J. Tully and Alex Barrow
Purpose There is limited research on Cognitive Analytic Therapy (CAT) in forensic contexts; this case study
therefore significantly contributes to the knowledge base. The purpose of this paper is to present the
assessment and treatment of an adult male offender with a diagnosis of schizophrenia. The clients offence
involved intimate partner violence and was committed at a time of acute psychiatric relapse.
Design/methodology/approach In total, 12 sessionsof cognitive behavioural therapy and CAT informed
treatmentwere individually designedto meet the needs of the client, delivered in an in-patientsetting in the UK.
The clients progress was assessed usingpsychometric, observational, andnarrative/descriptive methods.
Findings Psychometric evidence was limited by distorted responding. However, narrative/descriptive
assessment indicated that progress had been made in some areas. Recommendations for further treatment
were made.
Practical implications In total, 12 sessions did not meet all of the clients needs. The use of CAT as a
model that his team could use in understanding his violence was conducive to risk management.
Overall, insight gained through CAT-based psychological intervention contributed to risk reduction.
Originality/value This case study demonstrates the applicability of CAT to forensic settings.
Keywords Violence, Risk, Treatment, Intimate partner violence, Offender, Cognitive analytic therapy
Paper type Case study
Intimate partner violence (IPV)
Pro-feminist theories view IPV as a reflection of the patriarchal organisation of society as a whole,
where men use violence when they feel their dominance is threatened (see Gondolf, 1998).
Pence and Paymar (1993) discuss this in the context of Duluth power and control wheelwhere
power dynamics linked to socialisation are proposed to link to IPV. However, pro-feminist theory
has been criticised for over-emphasising socio-cultural factors, resulting in exclusion of individual
factors. For example, Dutton (1994) critically enquires how men can be held individually
accountable for their IPV if it is a result of patriarchal society and Lawson (2003) questions how
pro-feminist theory accounts for IPV within a same-sex relationship.
Family systems theory views the family as a dynamic organisation, with interdependent
components, where the recurrence of behaviour of a family member is affected by other family
membersresponses. This theory promotes a family-level approach to IPV intervention
(Gelles and Maynard, 1987) this approach may promote the view that the victim is to blame.
Attachment theory, which places an emphasis on the reciprocity between individuals in
a relationship, provides the perspective that IPV can be seen as an exaggerated response of a
disorganised attachment system linked to disorganised attachment in infancy (Fonagy, 1999).
Cognitive behavioural theory puts forward that behaviour modification requires change in
perception and interpretation (Beck and Weishaar, 2008) and can be used to frame IPV.
Received 28 August 2016
Revised 10 October 2016
27 October 2016
Accepted 27 October 2016
Ruth J. Tully is a Consultant
Forensic Psychologist at
Tully Forensic Psychology Ltd,
Nottingham, UK and Assistant
Professor at the Centre for
Forensic and Family Psychology,
The University of Nottingham,
Nottingham, UK.
Alex Barrow is a Clinical
Psychologist at the
Nottinghamshire Healthcare
NHS Trust, Nottingham, UK.
VOL. 9 NO. 2 2017, pp.128-140, © Emerald Publishing Limited, ISSN 1759-6599 DOI 10.1108/JACPR-08-2016-0244

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