Monday, June 6, 2022

Developing Ownership of Your DV Treatment & Your Future: What is Your Explanatory Model?

  This sounds CRAZY!!!  But... THIS IS YOUR LIFE... right???  This week's Module is about You. This week's lesson is about you taking ownership of YOUR DV Treatment.    Ownership???  Say Wha....???  

  In Business, a Sense of Ownership can be defined as: "the level of attention that an owner focuses on their business. A sense of ownership is the differentiated mentality of people who want to see their company thrive, ensuring stability, profits and growth." (Source).  

  Whereas, in DV Offender Treatment, the term "Ownership" means: 'The level of attention that a DV Client focuses on his or her progress in DV Treatment.  A sense of Ownership is the differential mentality of DV Treatment Consumers who want to see themselves thrive, ensuring stability, good fortune and growth -- particularly in terms of his or her relationships.'   

  The idea here today is intended to facilitate the following about Your Treatment: 

 --- For Dr. B to be able to Explain the treatment in a way that makes sense to you;

 --- For us (both you and Dr. B) to set positive expectations about your DV treatment;

 --- For us to set realistic expectations for DV treatment;

 --- For us to Address key concerns about your DV Offense; and

 --- For us to counteract any catastrophic expectations that you might have about your DV Offense and subsequent Treatment.  (Source)

Why does any of this matter?  
  In order to truly Engage in DV Treatment and to get the most out of DV Treatment a person needs to develop a sense of Ownership about his or her Treatment; and this will lead to a deeper and more thorough understanding of their DV Offense and their DV Treatment.  
  In short, this process is designed to help you get the most out of your DV Treatment by helping you develop a sense of familiarity and ownership of your DV Treatment -- as well as better sense about ways to prevent DV in the future.

What is My Explanatory Model?  

  Or better still: What is your Explanatory Model for your DV Offense and Subsequent Treatment?  An Explanatory Model can be defined as: "A useful description of why and how a thing works or an explanation of why a phenomenon is the way it is. The explanatory model is used as a substitute for "the full explanation" of the thing in question: because the full explanation is unavailable. (Source)

  In Healthcare, an Explanatory Model can be viewed as: "the manner in which patients explain their health conditions and consequences. Much theoretical work has been done in health psychology/behavior medicine on this topic, and it has been applied to prediction of patient coping and adherence with treatments and to prediction of disease outcomes" (Source).

Likewise, an Explanatory Model for Dr. B's DV Treatment can be as follows: The Purpose of Dr. B's DV Offender Treatment is to help a person get to where they are less likely than before, to ever again have DV-Type Thinking, DV-Type Feeling or DV-Type Behaving in their life.  Additionally, the purpose includes that idea that should a person find himself or herself again at-risk for  DV-Type behavior, he or she will have resources that are intended to help him or her get the help they need in order to prevent any future DV Offenses.  In this way, a primary purpose of DV Offender Treatment is to help people never again fall victim to; have to witness; or to be charged with a DV-type Offense. 

  So what's all this about "Explanatory Models"?  

  Well, in 1978, Kleinman and associates (1978) published a paper that discussed the importance of the explanatory model.  They wrote:

“Eliciting the patient’s (explanatory) model gives the physician knowledge of the beliefs the patient holds about his illness, the personal and social meaning he attaches to his disorder, his expectations about what will happen to him and what the doctor will do, and his own therapeutic goals.

Comparison of patient model with the doctor’s model enables the clinician to identify major discrepancies that may cause problems for clinical management. Such comparisons also help the clinician know which aspects of his explanatory model need clearer exposition to patients (and families), and what sort of patient education is most appropriate. And they clarify conflicts not related to different levels of knowledge but different values and interests. Part of the clinical process involves negotiations between these explanatory models, once they have been made explicit.” (Source). 

"Psychiatrist and anthropologist Arthur Kleinman’s theory of explanatory models (EMs) proposes that individuals and groups can have vastly different notions of health and disease. Kleinman proposed that instead of simply asking patients, “Where does it hurt,” the physicians should focus on eliciting the patient’s answers to “Why,” “When,” “How,” and “What Next.” (Source).

"Kleinman suggests the following questions to learn how your patient sees his or her illness" (Source).

  (Now, go back to the previous passage about Kleinman's work, and re-read the passage.  But this time; every time you find terms such as "health conditions and consequences" and "disease" and "illness"; consider instead substituting the phrases "Domestic Violence Offense", "Ways of DV-type thinking", "Deep-Rooted Destructive Emotions that lead to DV", and/or "Behavior Patterns that lead to DV Offenses").


Kleinman's Eight Questions as a way to bring forth a Client's Explanatory Model:

   Now, please consider this modified Example of "Arthur Kleinman's Eight Questions" (below).  Now it is 11 (Eleven) Questions, as Adapted by Dr. B for DV Offender Treatment and DV Prevention.  Give each question a shot to help develop your own Explanatory Model.  Dr. B's Eleven Questions for Persons in DV Offender Treatment are as follows:

  I know different people have different ways of understanding the Challenges that a DV Offender Faces — please help me understand how you see things.

1.  What do you call DV and/or your DV Offense?
  • What name does it have?
2.  What do you think causes DV and/or caused your DV Offense?

3.  Why do you think DV and/or your DV Offense started when it did?

4.  What does DV and/or your DV Offense do to you?  
  • How does it work?
5.  How severe is (or was) your DV Offense?
  • Will it have a short or long Impact on your life?                                             
  • Will it have a short or long Impact on the lives of others? 
6.  What do you fear most about DV and/or your DV Offense?

7.  What are the chief problems that DV and/or your DV Offense have caused for you?

8.  What kind of treatment do you think you should receive?

  • What are the most important results you hope to receive from treatment?

                  9.  What experiences do you feel that your Partner (the "victim") has had                                                       in relation to your DV Offense?

                10.  What experiences do you feel that your Children and/or your family have had                                         in relation to your DV Offense?

                11.  What experiences do you feel that your Community has had                                                                      in relation to your DV Offense?


             Owning Your DV Treatment Worksheet ***




Sources and Further Reading:  
  • The APA's "Cultural Formulation Interview" (Source).
  • The Respect Model (Source).
  • "Dr. B's Eleven Questions for persons in DV Offender Treatment" --   Adapted from, Kleinman A., Eisenberg L., Good B. Culture, illness, and care: clinical lessons from anthropological and cross-cultural research. Ann Intern Med 1978;88:251–88.
  • *** Other sources may be listed above in Link-form, just click on any of the "Source" links above to go to their original pages.
This Article was Originally Published 11/9/2020

(c. 2020, All information on this Blog, Affiliated Blogs and linked Worksheets (Except where otherwise noted); are the intellectual                                                    and/or photographic and/or digital property of Dr. William T. Beverly, L.C.S.W., DVOMB Approved Offender Treatment Provider.)

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