Gender, Psychology, and Justice: The Mental Health of Women and Girls in the Legal System - Linda Wolfe 2014

Women, Domestic Violence, and the Criminal Justice System: Traumatic Pathways
Women and Girls in Various Justice Settings

Lenore E. A. Walker and Carlye B. Conte

We met Wanda, a thirty-six-year-old woman, awaiting trial in jail and accused of battery on a law enforcement officer. Her attorney had asked us to evaluate her, as she had no recollection of assaulting the officer. Prior to her arrest, Wendy had received a letter from the parole board saying that the man who had attacked and killed her fiancé and kidnapped and attempted to kill her was about to be released from prison. Wanda, who had been substance free for several years, was so upset that she began drinking again as a way to calm herself and take away the pain that she was experiencing. The night of her arrest, she had been driving erratically and was stopped by the police. Apparently, Wanda resisted arrest, which is why she was charged and held in jail. While in jail, she attended a group that we ran for victims of domestic violence and other forms of trauma. During these groups, she realized that it was necessary to address not only her most recent traumatic experience but also the domestic violence and the physical and sexual abuse she experienced during childhood and in an earlier marriage. As a survivor of multiple traumatic experiences, Wanda needed trauma-specific treatment, not punishment for battery on a police officer or purely substance abuse treatment for her DUI. She had previously participated in psychotherapy and alcohol and other drug treatment; however, neither intervention dealt specifically with her trauma. She knew that being a victim of an attempted homicide and seeing her fiancé killed was definitely shocking; it was so distressing that it overshadowed the abuse she had experienced during childhood and with her former husband. When she learned that the attacker was about to be released from prison after serving his time, she became so upset that she began drinking to calm down her fears and anxiety. When stopped by the police for driving under the influence, she panicked and probably began experiencing dissociative symptoms as she thought the police officer was her attacker who had come back to kidnap and kill her. Not until she began trauma-specific treatment in jail was she able to both identify and start to heal from both the domestic violence and the other traumas she had experienced. Rather than going to trial and possibly receiving a prison sentence, Wanda was referred to a mental health court where the judge deferred her prosecution and sent her to a halfway house to receive trauma-specific treatment.

While women in the criminal justice system differ in demographic characteristics—race, ethnicity, socioeconomic status, and educational level—like Wanda, most share a history of physical, sexual, and emotional abuse (Green et al. 2005; Lynch et al. 2012). Additionally, posttraumatic stress disorder (PTSD), substance abuse, and other forms of mental illness are prevalent among justice-involved women who have experienced various forms of gender-based violence (James and Glaze 2006; Harlow 1999; DeHart et al. 2014). The intersection of economic disadvantage, untreated mental illness, self-medication, including substance abuse, childhood maltreatment, domestic violence, and trauma accounts for women’s elevated risk of entering the justice system not only as victims but also as offenders (Bloom, Owen, and Covington 2004; Walker 2009).

This chapter will describe the pathways that lead to battered women’s involvement in multiple arenas of the justice system and the compounded burden they experience as a result of their interaction with family, juvenile, civil, and criminal courts. Throughout this chapter, the literature on domestic violence will be reviewed and interspersed with personal research and clinical experience from working with battered women in a variety of contexts over the years. The legal framework of domestic violence will be analyzed through a discussion of social and legal reforms, feminist activism, and the passage of laws such as the Violence Against Women Act (VAWA). A historical and intersectional lens will be used to examine criminal justice responses to domestic violence and to highlight the benefits and consequences of justice reforms, such as mandatory arrest and no-drop policies, in the lives of diverse battered women. Lastly, this chapter will discuss the need for interventions that are gender-responsive and culturally sensitive. In particular, a feminist and trauma-informed therapeutic model will be proposed, based on the theoretical principles of survivor therapy. This survivor-focused, trauma-informed therapy model is supported by extensive and ongoing research that demonstrates its effectiveness in promoting healing, empowerment, and psychological well-being in the lives of battered women.

Domestic Violence, Intimate Partner Violence, and Gender Violence: Definitions and Prevalence

Definitions of domestic violence, intimate partner violence, and gender violence vary across disciplines, and these terms are often used interchangeably. “Gender violence” refers to all forms of violence against women, including sexual assault, rape, child sexual abuse, sexual exploitation by people in power or authority, sexual harassment in schools or workplaces, and human trafficking (United Nations 1993). “Domestic violence” or “intimate partner violence” is defined as physical, sexual, and/or psychological abuse that is committed by a former or current intimate partner (Centers for Disease Control 2014). Domestic violence can take many forms, but the underlying motivation is the same—power, control, and domination over the victim.¹

Although both males and females can be victims and perpetrators of domestic violence, research has shown that the majority of domestic violence victims are female, and the majority of offenders are male (Truman and Morgan 2014). This pattern holds true across all time periods and all forms of domestic violence (Tjaden and Thoennes 2000). Data collected from the National Violence Against Women Survey (NVAW) indicated that there are approximately 4.8 million acts of physical and sexual assault committed against women by an intimate partner each year in the United States (Tjaden and Thoennes 2000). Although this translates to approximately one in four women who experience intimate partner violence at some point in their lifetime, it is likely that the true rate of violence against women goes vastly underreported. For example, approximately one-fifth of sexual assaults and one-fourth of all physical assaults are actually reported to the police (Tjaden and Thoennes 2000). Of the domestic violence incidents that are reported, around one-fifth involve the use of weapons, which significantly increases the risk for fatality (Truman and Morgan 2014). The rate of homicide related to domestic violence occurs at twice the rate for females as it does for males, with women making up 70 percent of victims killed by an intimate partner (Catalano et al. 2009).

Research using the Battered Woman Syndrome Questionnaire (BWSQ), an instrument used to collect data on battered women for the last thirty years (Walker 1984, 2006, 2009), has shown that acute battering incidents followed a temporal course. The findings of cross-national studies have supported the development of the cycle theory of domestic violence (Walker 1979), which describes interpersonal aggression as cyclical and fluctuating in intensity over time. Typical battering relationships begin with a period of courtship, and behaviors do not become abusive until the woman has made a commitment to the man in the form of living together or getting married. The abuse starts out slowly, and the first phase of the violence cycle is characterized by the building of tension and the use of tactics aimed at domination and control. Stress, pressure, and conflict escalate such that women feel trapped, hopeless, and afraid of the danger lying ahead. The tension continues to rise until the male partner explodes with anger. It is at this time that battering incidents and physical injuries occur, and that the police are called. Following the battering incident is a period of loving contrition during which the batterer may feel remorse, apologize, and assure that the abuse will never happen again. Alternatively, the abuser may blame the victim for his behavior, and promise that the violence will not reoccur if she does not do whatever it was that caused his acts of aggression. A batterer may also respond by showering his victim with love and affection, thus reminding her of the man he was during the courtship period.

The following quotation from one of our clients illustrates how batterers’ behaviors work to keep their female partners hopeful and willing to stay in the relationship: “If it was all bad I would have left much sooner. I just kept holding on to that 5 percent of the time when he acted like he loved me. That false hope is what kept me in the relationship for so long.” In psychological terms, our client described the process of intermittent reinforcement batterers use to maintain power and control over victims. There are also other reasons why women may stay in abusive relationships. These include the victim’s emotional and economic dependency on the abuser, and her fear that he will follow through on his threats to harm her children or family. In addition, terminating the relationship does not usually stop the abuse. Batterers are likely to use the courts to continue their harassment and psychological abuse, especially if there are young children involved. (See Julie Ancis, chapter 1 in this book).

Mental and Physical Health Outcomes of Domestic Violence: A Trauma-Informed Perspective

Domestic violence is a form of complex trauma that produces psychological and physical distress (Walker 2002). Medical concerns include chronic illness such as cancer and diabetes, sexually transmitted diseases, gynecological and reproductive health problems, motility disability, irritable bowel syndrome, chronic fatigue syndrome, fibromyalgia, chronic pain, neurological complaints, dizziness, memory disturbances, and difficulty with concentration (Coker et al. 2002 Dillon et al. 2013; World Health Organization 2005). More than half of all domestic violence incidents result in some form of physical harm, and in the majority of cases, women do not seek medical treatment. Injuries include facial fractures, dental problems, broken bones, and neurological, internal, and soft tissue damage (Campbell and Boyd 2003; Dillon et al. 2013). Physical assaults can also lead to death, directly or indirectly, from cerebral vascular incidents, cardiac problems, and anoxia.

Trauma is also linked to hopelessness, dependency, and substance use. Battered women are fifteen times more likely than other women to use alcohol and nine times more likely to abuse other drugs (Gilfus 1993; Shipway 2004; Stark and Flitcraft 1996). Together with defense mechanisms (i.e., denial, minimization, rationalization), the use of substances is a strategy to cope with pain, anxiety, and other mental health problems, such as depression and trauma symptomatology, that result not from underlying mental disorders but from exposure to prolonged and relentless abuse (Platt, Barton, and Freyd 2009; Walker 2002). Studies have shown that posttraumatic stress disorder (PTSD) is an outcome of domestic violence, with rates ranging from 31 percent to 84 percent for battered women compared to 3.4 percent for the general population (Golding 1999; Jones, Hughes, and Unterstaller 2001). Anxiety presents in the form of generalized fear, apprehension, and worry. Social isolation, anhedonia, fatigue, appetite disturbances, difficulty concentrating, sadness, hopelessness, and feelings of worthlessness are common depressive symptoms (Nathanson et al. 2012; Walker 2009). Women who experience domestic violence are also more likely to endorse suicidal ideation and make suicidal gestures or attempts (Dillon et al. 2013; World Health Organization 2005).

“Battered Woman’s Syndrome” (BWS), a subcategory of PTSD, is the term used to describe the constellation of symptoms that victims experience as a result of domestic violence (Walker 2006): (1) intrusive recollection of the traumatic events; (2) hyperarousal and high levels of anxiety; (3) avoidance behavior and emotional numbing (e.g., minimization, dissociation, depression); (4) disrupted interpersonal relationships; (5) body image distortions and somatic complaints; and (6) issues with sexual intimacy. The definition of BWS now includes a new group of symptoms that are equivalent to the negative alterations in cognition and mood of the PTSD diagnosis in the DSM-5. BWS has been used to understand victims’ perceptions of themselves, their relationships, and their abuser. For example, the belief that the abuser is omnipresent and omniscient is characteristic of women with BWS. Catherine, a forty-year-old woman who was on trial for the murder of her abusive spouse, explained to the jury that at the time of the events she was terrified of her partner because he had put a loaded gun to her head and threatened to shoot her before passing out from too much drinking. He lay down on the bed, put the gun on the night table, and ordered her to lie next to him. Certain that he was going to kill her, she grabbed the gun and shot him. She did not think the bullet would incapacitate him, so she took a knife and stabbed his dead body repeatedly. BWS explains why Catherine believed her abusive husband could still harm her even after she had shot him dead.

Psychological abuse, like physical abuse, produces significant harm to victims’ cognitive, emotional, and behavioral functioning. It involves the use of methods to isolate the victim, to induce debilitating exhaustion, to monopolize perceptions, to degrade and humiliate, to control the mind, and occasionally to induce hope that the abuse will end (Amnesty International 1975). We have worked with many women who described the long-lasting and damaging effects of abusive tactics such as threats, bullying, name calling, administration of drugs, and use of force. Compared to acts of physical violence (e.g., pushing, shoving, hitting, punching, kicking, hair pulling), psychological abuse and coercive control “erode a woman’s self-esteem, self-confidence, and self-respect” (Williamson 2010) and produce feelings of helplessness that make it more difficult for women to leave an abusive relationship.

Barriers to Legal and Psychological Help: An Intersectional Perspective

At the domestic violence shelter where we provide trauma-specific psychotherapy services, diverse women participate in weekly group meetings designed to help them overcome the effects of past abuse and trauma. Their stories indicate how the intersection of gender, race, ethnicity, religion, and socioeconomic status makes their experience of intimate partner violence unique rather than universal. Leah, an African American woman, said it took a long time to disclose the abuse. She explained that she was ashamed to tell her family, and afraid that she would not be taken seriously if she contacted the criminal justice system because her spouse was Caucasian. Nadia was a German woman who had immigrated to the United States and married a Latino man. She reported that her husband’s family told her the use of violence was “normal” in their culture, and it was her “duty” to be submissive. Nadia had no relatives in the United States; her husband’s family was her only source of social support. She feared that if she disclosed the abuse she would lose custody of her children and be deported. Growing up, Ming, an Asian woman who spoke little English, had learned to be subservient. She believed that it was her responsibility as a wife to endure the violence inflicted upon her by her husband. She spent many years in the United States unaware of the support services available to victims of domestic violence.

The intersection of race, class, gender, religion, sexual orientation, and immigration status creates barriers that prevent many women from coming forward with allegations of abuse (Bograd 1999; Kasturirangan, Krishnan, and Riger 2004). Perpetrators of domestic violence may instill feelings of insecurity in their victims by emphasizing the importance of cultural values and by providing constant reminders that punishment, including hostility from the criminal justice system and ostracism from the community of origin, is more severe for members of ethnic, racial, religious, and sexual minorities (Brown 2012). The barriers to seeking legal and social help also develop from individuals’ commitment to cultural norms and values. For example, a Latina woman may feel bound to cultural values such as familismo (family loyalty, solidarity, and cohesion), machismo (masculine ideals of superiority, strength, duty, honor, and respect) and marianismo (feminine ideals of subservience, submissiveness, nurturance, and purity) (Edelson, Hokoda, and Ramos-Lira 2007; Vidales 2010).

Alternatively, barriers may stem from the fear that pressing charges will validate existing stereotypes and bring shame to the community, or from collective distrust of the police and the courts (Anderson and Aviles 2006). For example, African American women may be reluctant to become involved with a criminal justice system that has participated in the reproduction of racism and failed to protect black communities (Goodman and Epstein 2008). Nikki’s story below also shows that poverty and geographic location restrict women’s ability to leave abusive relationships and survive on their own (Kasturirangan, Krishnan, and Riger 2004).

In group therapy, Nikki, a young single mother, spoke about the economic and physical barriers she faced during her marriage, after she moved out to a rural area with her husband and small children. Instead of things getting better, as he had promised, their relationship—and the abuse—got progressively worse. Nikki and her children were now geographically isolated and miles away from the nearest neighbor. Nikki’s abuser quickly befriended members of their small community, making it impossible for Nikki to turn to others, including the local police, for help and protection. Nikki’s abuser would often leave her and the children for days on end, with no access to transportation, a phone, money, or even food.

Religion and spirituality represent a source of both resiliency and vulnerability (Potter 2007). Some battered women turn to members of their religious community for assistance, whereas others hide the abuse due to lack of support in the congregation or because of conflict with religious beliefs (Barnett 2001). In group therapy, Paula, a Christian woman, stated that divorce was against her religion. She feared ostracism if she disclosed the abuse she was experiencing in her marriage. A member of her church whom she had approached about the issue discouraged her from leaving her husband and from filing for divorce, instead recommending that Paula attend religious counseling services with her spouse.

Immigrant women face help-seeking barriers that make them particularly vulnerable to gender-based violence (Erez and Hartley 2003): racism, stigma, fear of deportation and separation from their children, and lack of familiarity with the legal and social system of a foreign country (Kasturirangan, Krishnan, and Riger 2004). In most cases, immigrant women in abusive relationships live far away from extended family members. They are socially isolated, may not speak English, and thus may not be able to reach out to others for support. In addition, services may not be available in their native language. They experience stressors associated with resettlement and acculturation, including difficulty with employment, which compels them to rely on their spouse economically and psychologically. Cultural norms may also dictate how they respond to domestic violence. Others in their cultural community may encourage them to hide the abuse and resolve interpersonal conflict without legal interventions (Erez and Hartley 2003).

Maria, a Haitian woman, married a Haitian preacher who promised he would help her apply for a green card. The abuse started and Maria’s husband withheld important information about her application for immigration status. The abuse escalated, and Maria became so terrified that she chose to leave the relationship and face the risk of deportation. Her husband contacted immigration services, and Maria was arrested and sent to a detention center. Fortunately, she was able to contact an attorney and used the Violence Against Women Act (VAWA) to petition for legal status. With the help of a psychologist who testified on her behalf, she successfully obtained a divorce and U.S. citizenship.

Unlike Maria, however, many immigrant women struggle to understand and navigate the intricacies of the U.S. legal system. They are unaware of the legal mechanisms they can use against abusive partners who threaten to report them to Immigration and Customs Enforcement (ICE), to withdraw immigration petitions, and to have them deported and lose custody of their children (Erez, Adelman, and Gregory 2009). These threats are a form of coercive control that forces immigrant women to suffer in silence and to comply with the demands of the abuser (Erez, Adelman, and Gregory 2009).

Homophobia and gender stereotyping intensify the harm victims experience in abusive same-sex relationships (Mallicoat 2012). The view that lesbian, gay, bisexual, transgender, or queer (LGBTQ) individuals are “unnatural, deviant, a threat to the status quo of existing gender relations in families and societies” (Hassouneh and Glass 2008, 311) makes it difficult to detect abuse in same-sex relationships. It also supports restricted access to social and legal support for sexual and gender-nonconforming minorities. A qualitative study of female same-sex intimate partner violence (FSSIPV) (Hassouneh and Glass 2008) highlighted the difficulty of identifying domestic violence in same-sex relationships based on a heteronormative view of violence. It also found that gender stereotypes—in particular the belief that women are inherently nonviolent—shapes our perceptions of female same-sex violence as less serious than heterosexual violence. Victims of FSSIPV may not call the police because they are worried their abusive partners will manipulate the responding officers into thinking they are the victim and not the aggressor. The police often use gender stereotypes to determine who the offender is: Their decision is based on their perception of the partners’ emotionality, passivity, size, strength, and masculine presentation (Breci 2014; Hardesty et al. 2011).

How Battered Women Come in Contact with the Legal System

As providers of mental health services in a domestic violence shelter, we have worked with many battered women who were involved in various legal settings simultaneously, including civil, family, dependency, and criminal courts. These women attended the weekly support group we facilitated and talked about the stress they experienced as a result of continued contact with their abuser in multiple arenas of the justice system. For example, Sarah, a young mother, described the emotional, psychological, physical, and economic costs of participating in criminal proceedings against her abusive spouse, who had been arrested and who was facing deportation on criminal grounds because he was not a U.S. citizen. Sarah explained that her abuser’s family attended every hearing and pleaded with her to not testify against him. They also were petitioning for custody of her one-year-old son, claiming that Sarah was an “unfit mother.” In addition, Sarah was in the process of filing for divorce, and could not afford an attorney. In our support group, she discussed the difficulty of navigating the civil court system on her own.

Prior to her court appearances, Sarah felt extremely anxious, and had trouble sleeping and eating. Seeing her abuser on the stand elicited trauma symptoms such as flashbacks. Following her court appearances, she became severely depressed and had trouble getting out of bed. She described the extensive arrangements that were necessary for her to appear in court: taking time off work, arranging childcare for her one-year-old son, and finding transportation to the courthouse. She described her legal experience as “never-ending,” and despite the strength it took for her to continue with the proceedings, she stated that she felt “disempowered and weak” every time she left the courtroom. At times Sarah would be so distressed that she was unable to attend a hearing. And even when she did go to court, she often could not understand what the judge was asking her. Sarah told her therapist that the judge and her lawyer were frustrated with her and that she was facing contempt charges.

Sarah’s story illustrates the complexity of battered women’s interactions with the justice system, beginning with the arrest of the perpetrator and continuing with the woman’s participation in criminal proceedings as a witness against the domestic violence offender (Hartley 2003). Concurrently, women may come in contact with civil or family courts when they file for divorce or a civil order of protection (Heise 2011) and in cases of child custody and visitation (Saunders, Faller, and Tolman 2011). They may also be charged with failure to protect their child(ren) and therefore have to fight against the termination of their parental rights in dependency courts (Lemon 1999). In the criminal justice system, battered women who have retaliated against their abuser in response to prolonged and severe abuse may face criminal charges for domestic violence or even homicide. They may also become involved in criminal proceedings as codefendants if they participated in criminal activities with their abusive partner (Welle and Falkin 2000). Abuse and trauma increase the likelihood that they will falsely assume responsibility for a crime they did not commit for fear of reprisal, or because they wish to protect the abuser (Grabner et al. 2014; Conte, Grabner, and Walker 2015). For example, Carmen falsely confessed to abusing her three-year-old child, Julio, and told the police what her batterer asked her to say because she was afraid of further harm. She covered up for the perpetrator, believing the police would establish that it was he and not she who had killed her child. However, both Carmen and the batterer were charged with homicide.

Battered women who commit crimes under the coercive influence of an abusive partner become entrapped in what has been called a “romantic codefendant” relationship that makes them vulnerable to both personal and legal punishment, as they are “dually policed” by both the abuser and law enforcement personnel (Welle and Falkin 2000). Their restricted access to economic resources and their financial dependence on the abuser are key factors that account for their continued participation in criminal activities, including drug offenses and prostitution (Gilfus 2002; Mallicoat and Ireland 2014; Richie 1996). In most cases, it is the abusive partner who introduces the victim to drugs and provides her with substances that will feed and maintain her addiction and dependence on the batterer (Bennet 1998) before coercing her into prostitution to support the substance use (Farley 2003). Lynch and colleagues (2012) found that women with domestic violence histories were nearly four times as likely to engage in commercial sex work and twice as likely to engage in drug crimes compared to other incarcerated women. Drug use and prostitution represent battered women’s efforts to survive their abuse; however, because they are also defined as criminal offenses, they increase battered women’s risk of being further involved in the criminal justice system (Chesney-Lind and Pasko 2013).

The Legal Framework of Domestic Violence: Justice Responses and Unintended Consequences

Historically, men’s violence towards their spouse was socially sanctioned, and women’s access to legal protection severely restricted (Edwards 1996; Schechter 1982), making them vulnerable to various forms of domestic abuse (World Health Organization 2009; California Council on Gender 2013). Feminist activism in the United States has helped to reframe domestic violence as a social and public concern, rather than a private issue (Mallicoat 2012). In the 1980s, the Battered Women’s Movement raised public awareness of gender-based violence and was critical in bringing about social, legal, and political reforms (Schechter 1982; Walker 2006). Battered women’s shelters were created to provide refuge and protect both women and their children from further violence (Walker 2002). Until the 1970s, intimate partner abuse was not perceived as a criminal matter, and in the absence of significant injury, legal intervention was not deemed necessary (Erez 2002). To address police inaction on calls of domestic violence, mandatory arrest, pro-arrest, and preferred arrest laws were adopted (American Bar Association 2010; Han 2003; Hirschel et al. 2007; Sherman and Berk 1984). Mandatory arrest laws were intended to ensure that police would systematically respond to domestic violence calls (Miller and Meloy 2006), while preferred and pro-arrest laws allowed greater police discretion (Hirschel et al. 2007). In 1994, a year after the United Nations (1993) declared violence against women a human rights violation, Congress passed the Violence Against Women Act (VAWA) to “remedy the legacy of laws and social norms that serve to justify violence against women” (U.S. Department of Justice 2011). The reauthorization of VAWA in 2000 and again in 2005 strengthened the provisions of the original act, offering battered women increased protections and access to resources (U.S. Department of Justice 2011).

The social and legal reforms of the 1970s, 1980s, and 1990s have resulted in the criminalization of domestic violence and the development of new justice practices that have been criticized for being counterproductive and unduly traumatizing to victims (Hoyle and Sanders 2000). The legal system has been described as “biased, unsupportive, and underfunded,” and personnel are often not trained to identify how domestic violence intersects with other forms of oppression and inequality (Barnett 2000; Hart 1996; Huisman, Martinez, and Wilson 2005). The system is fraught with many barriers that can make battered women feel unprotected and that can lower their motivation to engage in legal proceedings. When survivors pursue legal action, they often experience victim blaming, confusion, and conflict in ways that reduce their ability to seek help. In addition, the lack of support they receive from the justice system can delay or even prevent their healing from abuse and trauma.

Mandatory arrest laws, in particular, have produced adverse consequences for victims of domestic violence (Miller and Meloy 2006). Dual arrest is a probability when the police have difficulty differentiating between the perpetrator and the victim. One study showed that dual arrest occurs in approximately 2 percent of all domestic violence incidents and that the dual arrest rate is nearly twice as high when domestic violence arrests are mandated rather than preferred or discretionary (Hirschel et al. 2007).

Battered women who fight back in self-defense may also be wrongfully identified as the primary aggressor and arrested. The following story provides an example. Casey was a young mother with three children under the age of six. She was living in a low-rent apartment, barely making enough money to pay for daycare. She had left her children’s father, Victor, but the latter kept harassing her, coming to the apartment to see the children—or so he said. He would show up unannounced, cause trouble, and use physical violence; yet, no one intervened, including Casey’s landlord and neighbors and the security personnel of the community where she lived, until Casey, for the first time, tried to defend herself. The security guards heard both Casey and Victor scream, and called the police. When the police arrived, Casey appeared agitated and upset. The police determined that Casey had inflicted intentional physical harm on Victor, rather than that she tried to protect herself. Both Casey and Victor were arrested and taken to the police station, and the children placed under the custody of child protective services. Casey pleaded guilty after the judge told her she would go home and get her children back if she did so. Although there was strong evidence that this was a self-defense case, Casey decided not to contest her charges in order to protect her children. Casey now had a criminal record that prevented her from applying for a license to work as a nurse practitioner. In addition, she was mandated to attend a batterer’s intervention program.

Like Casey, battered women who are misidentified as the primary aggressor or dually arrested for domestic violence face criminal charges. If they plead guilty to avoid additional time in jail and to return home to their children, they may be required to participate in batterer intervention programs that are often inappropriate, unwarranted, and designed for male abusers (Walker and Shapiro 2003). Once they are labeled as violent offenders, they lose access to protection services and victim assistance (Miller and Meloy 2006) and encounter increased stigmatization and marginalization (Moe 2007). Criminalizing a nonoffending woman who has experienced abuse not only invalidates her status as a survivor and reduces the likelihood that she will seek help from the criminal justice system but also exacerbates her trauma symptoms, in particular feelings of guilt, shame, powerlessness, and vulnerability.

No-drop policies are another form of legal intervention with unintended negative outcomes for the victims of domestic violence. They mandate the prosecution of individuals arrested for battering, whether or not the victim has agreed to press charges. They are designed to reduce attrition in domestic violence cases when victims choose not to participate in criminal prosecution (Corsilles 1994). However, these policies also define victims as noncooperative and draw attention to victims’ disposition rather than the systemic barriers that account for their reluctance to engage in legal proceedings (Erez and Belknap 1998).

Legal interventions based on mandatory arrest laws and no-drop policies are intended to promote victim safety; however, they disempower survivors of domestic violence by taking away their ability to make choices (Goodman and Epstein 2008; Mallicoat 2012). They may also increase their vulnerability if, despite the need for legal protection, battered women do not call the police for fear that they will be forced to take legal action against the abuser (Novisky and Peralta 2015). When battered women participate in legal proceedings, they experience other forms of disempowerment, such as the reduction of criminal charges that minimize the severity of the crime and the harm caused to the victim (Hart 1996; Hartley 2003). Interactions between battered women and justice officials, such as prosecutors and judges, often reproduce the dynamics of abusive relationships by challenging women’s self-sufficiency and personal control (Hart 1996; Hartley 2003). Battered women who testify against their abusers in court come upon legal restrictions that prevent them from describing the full extent of the abuse (Hartley 2003). They are also the target of victim-blaming tactics—such as questioning a woman on the stand as to why she would stay with an abuser or calling into question her mental health to undermine her credibility (Hart 1996; Barnett 2000).

Multiculturally and Gender-Responsive Strategies for Criminal Justice Interventions

The way survivors of domestic violence experience legal interventions can have a long-lasting impact on their psychological well-being (Barnett 2000). Therapeutic jurisprudence (TJ), which combines legal and psychological principles, provides a framework for maximizing the therapeutic effects of justice programs for victims of domestic violence (Cattaneo and Goodman 2010; Wren 2010). A TJ approach to domestic violence emphasizes access to services to help litigants solve their problems and minimize their continued involvement with the legal system. For example, domestic violence courts, which operate on the principles of therapeutic jurisprudence, ensure the safety and psychological well-being of women and their children while holding DV offenders accountable for their actions. Referral to treatment rather than incarceration is often recommended; however, if DV offenders do not comply, their case is sent back to regular court, or probation is revoked and prison time is ordered. The TJ approach to domestic violence also encourages cultural competence and survivor empowerment when working with diverse women at all stages of the judicial process. This includes culturally appropriate interactions between survivors and justice officials and the promotion of an active and empowering role for survivors during legal proceedings (Erez and Hartley 2003). In sum, the principles of therapeutic jurisprudence support the creation of conditions that make women feel safer when they come forward and seek legal assistance and thus promote positive social and psychological outcomes by taking women’s plight seriously and by fostering their sense of power and control over the legal proceedings (Cattaneo and Goodman 2010).

Addressing the needs of diverse battered women prior to their involvement with the criminal justice system is ideal, yet not always realistic. As indicated throughout the chapter, many suffer in silence and come in contact with the criminal justice system as a result of the violence they have experienced. Legal interventions for battered women are often the first line of “treatment,” and for this reason it is critical that they take into consideration the psychological, emotional, and physical consequences of abuse. When these are left unaddressed, jails and prisons become revolving doors for victims of domestic violence. The provision of treatment for substance abuse and mental health problems has increased, but the adoption of trauma-informed care in correctional facilities has lagged behind. Although several evidence-based trauma treatment programs are currently available and have been shown to be effective, the wide-scale adoption of these interventions throughout the criminal justice system has yet to be implemented. In the following sections, we discuss the main components of these treatment approaches and describe a strength-based and trauma-focused program that has been implemented with positive outcomes in both the community and correctional facilities in Broward County, Florida.

Trauma-Informed Treatment Approaches

The Substance Abuse and Mental Health Services Administration (2015) recommends the implementation of trauma-informed care for women with a history of abuse and with co-occurring substance-related and mental disorders. Principles of trauma-informed care include safety, trustworthiness, transparency, peer support, collaboration, mutuality, and empowerment (SAMHSA 2015). Effective treatment approaches are comprehensive and multidisciplinary, and address both the mental health consequences of domestic violence and the structural barriers that prevent escape from abuse. Battered women should be informed of the resources available to them in the community, such as safe housing and victim advocacy services. The provision of viable community resources is necessary so that women have options other than returning to the home of the abuser. Mental health interventions should be evidence-based, trauma-informed, sensitive to gender and cultural diversity, and based on principles of empowerment. To provide effective treatment, gender-sensitive and culturally competent training as well as interdisciplinary collaboration are critical and should include victim advocates, justice personnel, and mental health practitioners.

The Survivor Therapy Empowerment Program (STEP)

The Survivor Therapy Empowerment Program (STEP) is an evidence-based treatment model based on the principles of Survivor Therapy. Survivor Therapy is a strength-based and trauma-informed treatment approach to victims of domestic violence that is guided by feminist principles (Walker 2002). The overarching goal of Survivor Therapy is “re-empowerment”; it is achieved by (1) ensuring safety; (2) helping women explore alternatives to abuse; (3) validating their thoughts, feelings, and actions; (4) helping them regain cognitive clarity and judgment; (5) promoting personal decision-making abilities; (6) helping them heal from the effects of trauma; (7) helping them reestablish a sense of boundaries; (8) helping them develop supportive interpersonal relationships; (9) fostering an understanding of the broader sociocultural bases of oppression; and (10) modeling an egalitarian relationship in which both therapist and client work together to formulate and implement goals (Walker 2002).

STEP can be used as an individual or group intervention with women and girls in the community and in custody (Walker 2009). The program consists of twelve steps, and each two-hour session is divided into three parts: The first part involves a discussion of different trauma-related topics; it is followed by an examination of how the information applies to the personal experience of group members; lastly, women participate in skill-training exercises to practice and strengthen the tools they have gained during the psychoeducational part of the meeting.

The topics discussed in each session are defining gender violence; identifying physical, sexual, and psychological abuse; assertiveness training and relaxation therapy; clarifying cognitive confusion; regulating emotions; understanding the role of trauma triggers and learning to cope with PTSD symptoms; the impact of domestic violence on children and the introduction of positive parenting skills; letting go of old relationships and beginning new, positive, nonviolent relationships; and dealing with legal issues. Women receive information about the cycle of violence, learn to name the abuse, and develop assertiveness and relaxation skills. They also learn to separate thoughts, feelings, and actions, and to recognize what makes true friendships and intimacy. Women explore issues related to cultural diversity, substance abuse, and sexuality, together and openly. The facilitators are careful not to push women to talk before they are ready; they also monitor how discussion time is shared among group members.

The STEP program has been implemented in a battered women’s shelter and several jails in Broward County, Florida. Quantitative data collected before and after each session provided evidence that women who participated in more sessions experienced lower levels of anxiety and better overall functioning (Groth et al. 2014). Qualitative data collected at the end of each session indicated that women enjoyed their participation in the group, left the sessions feeling supported and empowered, and viewed the program as instrumental to their healing and recovery.

As funding for justice and mental health programs has become increasingly scarce, it is necessary to identify cost-effective ways to support battered women both in the community and in the criminal justice system. The STEP program was developed, implemented, and evaluated with the resources of a major local university. At this university, students in the medical residency, forensic psychology, and mental health counseling programs provide trauma-informed multimodal services under the supervision of the faculty, in the local jails, in a battered women’s shelter, and in the general community. Thanks to interdisciplinary collaboration, they have served hundreds of women and children who have survived domestic violence. In times of limited financial resources, it is possible to do more with less, when interprofessional networks are formed and maintained.

Conclusion and Recommendations

Battered women become involved in multiple arenas of the justice system as a direct or indirect result of domestic violence. The intersection of gender, race, ethnicity, class, sexual orientation, and socioeconomic status influences all aspects of their interactions with law enforcement and court officials, and creates unique barriers that account for many women’s reluctance to pursue charges and seek help. Instead of receiving support, victims of domestic violence are often criminalized or stigmatized. Legal interventions and interactions further traumatize and disempower survivors of domestic violence.

The American Psychological Association (APA) has proposed a set of guidelines for mental health practitioners, to enhance gender and cultural sensitivity and address the specific treatment needs of women (2007). In line with feminist principles, APA highlights the importance of viewing the issues faced by women within a sociopolitical context and addressing the systemic and institutional biases within society that discourage women’s initiative and empowerment. Practitioners must recognize how bias, oppression, and discrimination negatively impact the mental and physical health of women and how sex-role socialization reinforces power differentials. Interventions must be culturally sensitive, gender responsive, and evidence based; take into consideration women’s intersecting identities; and promote self-sufficiency, recovery, and empowerment. APA emphasizes the role of trauma and other stressors faced by women in society and acknowledges the need for trauma-informed treatment strategies to address the unique experiences of women. For these strategies to be effective in both community and justice settings, it is essential that they adhere to the following recommendations.

Recommendation #1: Ensure physical and psychological safety.

In order to provide a therapeutic atmosphere that promotes psychological growth and healing, it is essential to first ensure the physical safety of each woman who has been abused. Physical safety can be ensured through the use of safety planning, collaboration with community agencies that provide victim advocacy or safe housing, or referrals to medical or legal professionals. Once physical safety is ensured, mental health providers should demonstrate hope, empathy, and positive regard, and develop an egalitarian relationship with each survivor in order to support psychological healing and maximize psychotherapeutic benefits.

Recommendation #2: Programs must acknowledge gender-specific issues and women’s intersecting identities.

It is important for treatment programs to address the gender-based impact of violence along with the social, cultural, racial, and sexual biases that shape women’s experiences. In order to provide validation and normalization, the unique experiences of each woman must be acknowledged and used to inform treatment approaches. In addition, it is necessary for society to recognize the systemic and institutional biases that prevent diverse women from seeking help within the mental health and legal arenas. Not only must services be culturally sensitive and gender responsive; there must be increased access to such services for women from marginalized and disadvantaged groups.

Recommendation #3: Treatment should be trauma-informed and promote traumatic healing.

Treatment programs must facilitate trauma processing in order to validate trauma reactions and address the cognitive, affective, and behavioral responses to traumatic experiences. For example, the trauma-processing component of the STEP program is augmented with skill building, which includes the introduction of techniques (e.g. cognitive restructuring, emotion reregulation, relaxation training) designed to facilitate adaptive coping skills and promote traumatic healing. Additionally, psychoeducation is utilized throughout STEP to provide women with insight into various types of abuse, in addition to normalizing the emotional, psychological, and behavioral manifestations of posttraumatic reactions.

Recommendation #4: Treatment should be strength-based and emphasize women’s empowerment.

A survivor-focused approach, which emphasizes the woman’s strengths and adaptive abilities, is necessary to promote empowerment and allow each woman to regain a sense of control over her life. Existing positive coping strategies should be accentuated and new coping skills should be introduced that allow the woman to overcome current obstacles within the various domains of her life with the goal to live a violence-free life.

Recommendation #5: Address the complex pathways of trauma through the provision of comprehensive mental health services.

Treatment should address the complexity of issues faced by survivors of domestic violence. Co-occurring issues such as substance abuse, the impact of abuse on parenting and children, mental health concerns, legal involvement, and the need for social services should be addressed and integrated into treatment according to the needs of the women seeking services.

Although these recommendations encompass the main tenets of trauma-informed treatment for survivors of domestic violence, it is important to remember that no two women are alike and that strategies may need to be adapted to address the unique experiences of each survivor. Furthermore, the pathways to healing are complex and go beyond the alleviation of PTSD and BWS; survivors may need additional assistance in overcoming barriers and rebuilding resiliency, self-sufficiency, and a sense of physical, psychological, and emotional well-being.

Note

1 Justice officials tend to refer to women who have experienced domestic violence as “victims,” advocates prefer the term “survivor,” and mental health professionals use the term “survivor” to describe women who were formerly victimized by a domestic partner but have made changes to protect themselves. One woman explained to us that her view of herself as a victim transitioned to that of a survivor after she left her abusive relationship and sought safety at a battered woman’s shelter. Throughout this chapter, the terms “victim” and “survivor” are used interchangeably, although it is important to note that these labels have different meanings for different women.

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