0005~7~x/x0i1201~030I 602 uwo

ASSERTIVE THERAPY FOR BATTERED WOMEN:

A CASE ILLUSTRATION

JUDITH E. MEYERS-ABELL

University of Dayton

and

MARY A. JANSEN

Purdue University

Summary-This article presents a case study of a battered woman who took part in an assertive therapy group at a battered woman shelter in the midwest. The history of the woman is presented along with a transcript from the group illustrating the use of assertive therapy with this population. After remaining at the shelter for approximately 1 month, and participating in an intensive, assertive therapy program, the woman left her husband and achieved a measure of independence. The authors recommend ongoing supportive, assertive therapy as a means of maintaining behavior change.

Although wife beating is not new, it is only in the last few years that the topic has re-

ceived attention. The recent literature suggests that battered women experience feelings of depression, anxiety and anger (Gelles, 1974; Martin, 1976; Nichols, 1976; Prescott and Letko, 1977).

However, the traditional response of the counseling professions to battered women has been inadequate. Counselors, showing more concern for the insecurity of the men than the

well-being of the women and children, have urged the women “to understand and sympathize with the man who beat them” (Joint Strategy and Action Committee, Inc., 1977, p. 4). Further, she is led to believe that because of some innate, masochistic need, she brings on her husband’s rage; that she provokes and therefore deserves the abuse she gets (Martin, 1976; Nichols, 1976; Prescott and Letko, 1977).

While the psychiatric portrayal of the bat- tered wife is that of a dominant, overbearing woman, those who operate shelters have found

the women to be passive, inhibited, dependent, depressed, guilt-ridden and helpless. These women have stayed with their husbands not because they enjoy being abused, but out of fear of their husbands, or for socially deter- mined reasons (i.e. If my marriage fails, I am a failure as a woman). Many also stay because they have no financial resources and no place to go (Gelles, 1974, 1976; Martin, 1976; Nichols,

1976; Prescott and Letko, 1977). In face of constant fear, they have felt unable to act and unable to come up with any effective response.

Several investigators have suggested that assertive therapy would be particularly useful for these women (Langley and Levy, 1977; Martin, 1976; Strauss, 1977). Assertiveness characterizes “. . . behavior which enables a person to act in his own best interest, to stand up for himself without undue anxiety, to express his rights without destroying the rights of others” (Alberti and Emmons, 1974, p. 2).

In order to assess the effectiveness of assertive therapy for battered women, the authors designed

Requests for reprints should be addressed to J. E. Meyers-Abell, Department of Psychology, University of Dayton, Dayton, Ohio 45469, U.S.A. This study was supported in part by a faculty summer research fellowship awarded to the first author by the University of Dayton.

301

302 JUDITH E. MEYERS-ABELL and MARY A. JANSEN

a group assertive therapy program (Jansen and Meyers-Abeli, 1980). Women who entered a battered women shelter program in a midwestern city were randomly assigned to an assertive therapy group or shelter services only group. All women were intensiveiy interviewed and tested with the Beck Depression Inventory (Beck, 1961) and the Adult Self Expression Scale (Gay, Hollandsworth and Galassi, 1975). However, difficulty in getting post-treatment data and in locating subjects for follow-up assessment precluded statements about the relative effectiveness of assertive therapy. A later paper will describe the interview data, testing data, and factors related to return to the abusive environment. The present paper wilt briefly describe the assertive therapy program, and provide a case illustration.

THE PROGRAM

The assertiveness therapy group met in the evenings, three times a week for approximately 2 hr each session. The group was ongoing, with members participating only during their stay at the shelter. Sessions attended ranged from 2 to 15. From 2 to 7 persons participated in each session.

The beginning of each meeting was devoted to sharing experiences that either led the women to the shelter, or that were currently taking place in their lives. This sharing of experiences and the emotional support that followed from the group was viewed as cruciai. Women would discuss personal fears and problems, recognize and interpret their feelings, and offer encouragement to one another.

As a result of these shared experiences, exampies of situations which may have had a more positive outcome had the woman been more assertive oecome apparent. For example, a number of tne women were frustrated in their attempts to ootain welfare benefits or food stamps. The women were aenied services without receiving an adequate expianation and were unable to ask for clarification. Group members were encouraged to suggest aiternative assertive

behaviors that might produce a more favorable outcome. The therapist communicated accept- ance and support of the women while stressing the importance of saying what they think, how they feel and what they want without violating the personal rights of the other person. Role playing of problem situations followed.

The last phase of each group session consisted either of short presentations by the leader about specific skills necessary for assertive behavior, or a group discussion concerning one of the principles of assertiveness. Topics on different evenings included a definition of assertive behavior; differences between assertive, aggressive, passive-aggressive, and timid be- havior; verbal and non-verbal components of assertive behavior; personal rights of individuals; the importance of compromise; making and refusing requests; keeping a conversation on the topic; clarifying messages; and dealing with emotions such as anxiety, guilt, depression and hostility. Group activities which reinforced the learning of the presented materiai followed. These situations were selected to illustrate the special circumstances of battered women. Since the group was ongoing, key concepts had to be repeated as new group members attended.

CLINICAL ILLUSTRATION

The following case illustrates the use of assertive therapy with a battered woman.

Mrs. R. was an 18-yr-old woman with three small children. She married her husband 4 yr earlier because she was pregnant and wished to leave her mother’s home. Although she and her husband came from homes where the fathers physicaliy abused the mothers, in their own relationship before marriage there was no indication of violence.

The physical abuse began 2 months after her marriage, and consisted of being punched, pushed and kicked, resulting in cuts and bruises. In addition, her husband screamed at her, called her various names and threatened her life.

Several conflict areas appeared to trigger the violence: arguments over Mr. R.‘s inability and

ASSERTIVE THERAPY FOR BATTERED WOMEN 303

lack of desire to keep a job; difficulties over money; jealousy; problems with his mother. Both partners had much difficulty in com- municating their wants and needs in this relationship. Mr. R. would blame his wife for all their problems while Mrs. R. felt that talking to her husband about their problems was useless.

Being in this abusive relationship, Mrs. R. became distrustful of men and fearful. She was afraid to be alone in her house fearing that someone would break in and hurt her.

Mrs. R. has tried leaving her husband several times, but was without money and a place to go. She had no friends to turn to (her husband never allowed her to make friends), her mother refused to help, and the police could do little. She stayed in the marriage hoping he would change, fearing to be alone, feeling it was best for the children, and believing that divorce meant failure. She coped by trying to ignore him, and by saying as little as possible to him.

Upon arriving at the shelter, she felt the marriage was over. She no longer had any love or affection for her husband. She wished to get a place of her own, obtain employment and raise her children.

Initial test results on Mrs. R. showed her to be mildly depressed (19 on the Beck Depression Scale) and non-assertive (60 on the Adult Seif

Expression Scale).

Mrs. R. was atypical of the women in the group, as she acted aggressively at times and needed help to control her anger. The following is an excerpt from a session dealing with the problem of jealousy. Not only was Mr. R.

jealous of any man or women she spoke to, but Mrs. R. was also jealous of her husband’s attention to other women,

Client. We would be sitting there. His eyes just followed her every littie move. Now, it really made me mad. Therapist. You could ask him to pay less attention to her, if you iike. Could you do that? Why don’t you say that to me? I’m your husband and I’m over here watching an

attractive woman go by. What do you want to say to me? Client. I’ll say-Are you having fun looking at that girl? Therapist. What’s going to happen when you say that? Client. He’ll say I’m not looking at her. I’m just watching her because I think she’s fascinating. She’s not all there.

Therapist. O.K. That might be true, too. Client. He said she doesn’t act all there, so

I just politely tipped the glass of pop on him. Therapist. Which really was not polite and not assertive either. Client. I never did know what assertive was, I’d just fly off the handle. Therapist. But that’s what you don’t want to do. You’ve got his attention and he looks back. Now change that to an assertive statement. Say how you feel and what you want. That’s what makes up an assertive statement. bent. (Role playing) I don’t appreciate very well you sitting there and staring at that girl as she walks by because it’s embarrassing me very much. I would want you to quit it right now. Therapist. O.K. Your words are perfect. However, your tone of voice says-You’d better stop or else I’m going to tip this glass in your lap. Before we go on, let me just say that the thing that assertiveness is based on is your rights as well as the rights of other people. You have the right to say how you feel, what you want, and what you think but other people have rights, too. When you are sarcastic or when you are aggressive, like demanding that somebody stop-like either you do this or I’m going to dump the glass in you lap-that is really taking away the rights of other people.You have the right to ask, you certainly have the right to say what you want, but you really don’t have the right to demand-Can you see that? But you don’t agree, right?

Client. I don’t know. It just used to hurt my feelings.

304 JUDITH E. MEYERS-ABELL and MARY A. JANSEN

Therapist. You felt threatened, and that’s natural. But he really does have the basic right to look at whoever he wants to because you also have that right to follow with your eyes anyone you want to. If he tried to take that right away from you you would resent it. Client. I don’t know because if someone hurts me, like he would flirt in front of me, it hurts my feelings.

you to think. No more do they have the right to do that to you than you have the right to impose what you want on them. All you can do is say what you will do with your life- namely, I will leave.

The role play continued until Mrs. R. felt comfortable asking her husband not to flirt with other women.

Therapist. When you get mad you want to shout, you want to strike out at somebody, right? What do the rest of you think? Other member. I think she ought to tell him

she doesn’t like him doing it and if he does it again, she’ll leave.

Mrs. R. participated in 10 group sessions during her 1 month stay at the shelter. In the group she demonstrated her ability to behave more assertively in outside interactions. For example, while in a grocery store a person knocked her cart over without apologizing. Instead of reacting aggressively, as she would have previously, Mrs. R. requested help in picking up the items and continued her shopping.

Upon leaving the shelter Mrs. R. was retested. Her assertiveness score had increased to 104, within the assertive range while the Beck Depression Scale had dropped to 7 indicating no depression.

Therapist. That’s the assertive thing to do. Client. Yeah, but if you say that, he’ll say to leave. That’s what I did this last time.

Therapist. I personally don’t feel you have the right to hit him, or to dump coke on him, or do anything else, no matter what he says or does to hurt you emotionally. What I’ve drawn here is a behavior continuum. (On board.) All that means is a line of behavior. On one end you have timid behavior which is what you did (indicating group member) when your husband flirted and you just sat down and took it. In the middle you have assertive behavior which is what you said (indicating another member)-If you do this, I’ll leave. And over here you have aggressive behavior, which is what you did--Stop it, or else 1’11 dump something on you. The timid and aggressive behaviors are as bad. This is the only one (assertive) that is really acceptable. . . An individual has the right to do anything he or she wants to do, and in this case we’re talking about him going out on you or cheating on you, but then you have the right to say I won’t tolerate that and I’m leaving. You have the right to say what you want and what the consequences will be if you don’t get what you want. But you don’t have the right to demand. You can only control you. You really can’t beat someone over the head which is what your husbands have done to you trying to get you to think what they want any assertive therapy for battered Lvomen.

One year later Mrs. R. was given a follov- up interview. When she left the shelter, Mrs. R. moved into her own apartment with the children. However, her husband found her, moved in with her, and after 6 months began drinking and beating her once more. Suffering 2 months of further physical abuse, Mrs. R. asked her husband to leave. The divorce is pending. Rc-testing during the follow-up interview revealed a score of 160 on the ASES and a score of 10 on the Beck Depression Scale.

DISCUSSION Assertive therapy may be a valuable tool for

helping battered women deal with their feelings of depression and guilt, learn basic communica- tion skills, and recognize alternative options. However, the authors realize that in chronic situations, if a woman suddenly tries to be more assertive with her husband, this may aggravate him and lead to further abuse. Preparing the woman to deal with possible negative outcomes must be an integral part of

ASSERTIVE THERAPY FOR BATTERED WOMEN 305

Additionally, the authors believe that while it supportive, assertive therapy group after leaving

is necessary to provide assertive therapy pro- the shelter is recommended.

grams to battered women living in a shelter, REFERENCES it is also imperative that follow-up supportive

services be provided. Assertive therapy for Alberti R. and Emmons M. (1974) Your Perfect Right.' A

Guide to Asserfive Behavior. Impact Publishers, San Luis Obispo, California. women who live in a shelter environment can

only begin to address the real world problems they face when they leave. Those who do not return to their husbands face the often times overwhelming prospect of applying for and living on welfare, seeking vocational training and job placement, following through with divorce proceedings, and coping with a world about which they know very little. Those women who choose to return to their husbands are faced with the task of trying to put into practice what they learned while in the assertive therapy group at the shelter. This can be next to im- possible without continued support from the group because situations which arise as a result of their new found assertive skills may be totally different from what was anticipated during the group sessions. In either case, without reinforcement for their attempts at assertive- ness, the women may slip back into older, more comfortable ways of responding which were ineffective in the past. Thus, participation in a

Beck A., Ward C., Mendelsohn M., Mock _I. and Erbaugh J. (1961) An inventory for measuring depression, Archs Gen. Psychial. 4,561-57 1.

Gay M. L., Hollandsworth J. G. and Galassi J. P. (1975) An assertiveness inventory for adults, J. Counsel. Psychol. 22,340-344.

Gelles R. (1974) The Violen/ Home: A Study of Physical Aggression Belween Husbands and Wives. Sage Publica- tions, Beverly Hills, California.

Gelles R. (1976) Abused wives: Why do they stay? J. Marr. Family 38,659-668.

Jansen M. A. and Meyers-Abel1 J. F. (1980) Assertive training for battered women: A pilot program, Sociai Work, In press.

Joint Strategy and Action Committee (1977) The battered wife, Grapevine 9, 1-6.

Langley R. and Levy R. (1977) Wife Beating: TheSilent Crisis. Pocket Books, New York.

Martin D. (1976) Battered Wives. Glide Publications, San Francisco.

Nichols J. (!976) The abused wife problem, Social Case- work 51,27-32.

Prescott S. and Letko C. (1977) Battered women: A social psychological perspective. In Bartered Women (Ed. by Roy M.), Van Nostrand Reinhold Cal., New York.

Strauss M. (1977) A sociological perspective on the preven- tion and treatment of wifebeating. In Battered Women (Ed. by Roy M.), Van Nostrand Rheinold Cal., New York.