This study investigated the effects of a pregroup motivational intervention for domestic abuse perpetrators. Men presenting for treatment at a community domestic violence agency (N = 108) were assigned to receive either a two-session intake using the techniques of motivational interviewing (MI) or a structured intake (SI) control. All participants were then referred to a cognitive behavioral treatment (CBT) program in groups homogeneous with respect to intake condition. The motivational intake led to more constructive in-session behavior during the early phase of group CBT, greater compliance with group CBT homework assignments, higher late session therapist ratings of the working alliance, and more help seeking outside of the domestic violence program. No significant effects of intake condition were found on session attendance, self-reports of readiness to change abusive behavior, or client reports of the working alliance. Partner reports of abusive behavior outcomes during the 6 months after group CBT revealed a marginal effect favoring the MI condition on physical assault. The findings suggest that motivational interviewing can increase receptivity to partner violence interventions.

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Objective To examine the effectiveness of the Safe Environment for Every Kid (SEEK) model of enhanced pediatric primary care to help reduce child maltreatment in a relatively low-risk population. Methods A total of 18 pediatric practices were assigned to intervention or control groups, and 1119 mothers of children ages 0 to 5 years were recruited to help evaluate SEEK by completing assessments initially and after 6 and 12 months. Children’s medical records and Child Protective Services data were reviewed. The SEEK model included training health professionals to address targeted risk factors (eg, maternal depression), the Parent Screening Questionnaire, parent handouts, and a social worker. Maltreatment was assessed 3 ways: 1) maternal self-report, 2) children’s medical records, and 3) Child Protective Services reports. Results In the initial and 12-month assessments, SEEK mothers reported less Psychological Aggression than controls (initial effect size = −0.16, 95% confidence interval [95% CI] −0.27, −0.05, P = .006; 12-month effect size = −0.12, 95% CI −0.24, −0.002, P =.047). Similarly, SEEK mothers reported fewer Minor Physical Assaults than controls (initial effect size = −0.16, 95% CI −0.29, −0.03, P = .019; 12-month effect size = −0.14, 95% CI −0.28, −0.005, P =.043). There were trends in the same positive direction at 6 months, albeit not statistically significant. There were few instances of maltreatment documented in the medical records and few Child Protective Services reports. Conclusions The SEEK model was associated with reduced maternal Psychological Aggression and Minor Physical Assaults. Although such experiences may not be reported to protective services, ample evidence indicates their potential harm. SEEK offers a promising and practical enhancement of pediatric primary care.

WHAT'S KNOWN ON THIS SUBJECT:It is well established that risk factors such as maternal depression are prevalent and jeopardize children's health and development. Pediatric primary care offers an opportunity for helping address such psychosocial problems that are connected with child abuse and neglect. WHAT THIS STUDY ADDS:Results of this study indicate that the Safe Environment for Every Kid model helps pediatric health professionals address targeted psychosocial problems. The study is one of the first to examine change in pediatric private practices concerning the management of psychosocial problems. abstract OBJECTIVE: To examine whether the Safe Environment for Every Kid (SEEK) model of enhanced primary care would improve the attitudes, knowledge, comfort, competence, and behavior of child health care professionals (HPs) regarding addressing major risk factors for child maltreatment (CM). METHODS:In a cluster randomized controlled trial, 18 private practices were assigned to intervention (SEEK) or control groups. SEEK HPs received training on CM risk factors (eg, maternal depression). The SEEK model included the parent screening questionnaire and the participation of a social worker. SEEK's impact was evaluated in 3 ways: (1) the health professional questionnaire (HPQ), which assessed HPs' attitudes and practice regarding the targeted problems; (2) observations of HPs conducting checkups; and (3) review of children's medical records. RESULTS:The 102 HPs averaged 45 years of age; 68% were female, and 74% were in suburban practices. Comparing baseline scores with 6-, 18-, and 36-month follow-up data, the HPQ revealed significant (P Ͻ .05) improvement in the SEEK group compared with controls on addressing depression (6 months), substance abuse (18 months), intimate partner violence(6and18months),andstress(6,18,and36months),andintheircomfort level and perceived competence (both at 6, 18, and 36 months). SEEK HPs screened for targeted problems more often than did controls based on observations 24 months after the initial training and the medical records (P Ͻ .001). CONCLUSIONS:The SEEK model led to significant and sustained improvement in several areas. This is a crucial first step in helping HPs address major psychosocial problems that confront many families. SEEK offers a modest yet promising enhancement of primary care.

Objective: This study explores trauma exposure, posttraumatic stress disorder (PTSD) symptoms and diagnosis, and PTSD symptom associations with key presenting problems in male intimate partner violence (IPV) perpetrators. The goal is to elucidate the implications of trauma and PTSD for understanding the presenting clinical problems of partner violent men. Method: Male IPV perpetrators (n = 293) at a community-based agency completed assessments of their past traumatic event exposures; current PTSD symptoms; depression; alcohol problems; illicit drug use; relationship problems; and perpetration of physical assault, psychological aggression, injury, sexual coercion, and general (nonrelationship) violence. Results: Seventy-seven percent of participants reported past trauma exposure, 62% reported multiple trauma exposures, and 11% screened positive for a probable diagnosis of PTSD. PTSD symptom levels were significantly correlated with depression, alcohol and drug use, general violence, and all indicators of relationship maladjustment and abuse. In multivariate analyses, PTSD symptoms uniquely predicted relationship dysfunction and relationship abuse over and above the influence of alcohol problems, drug use, and depression, and all 3 PTSD symptom clusters had some unique associations with relationship abuse scales. Conclusion: Trauma exposure and PTSD symptoms should be routinely assessed in IPV perpetrator treatment. More research is needed to determine whether PTSD symptoms influence treatment response and to investigate trauma-informed interventions for this population.