Analysis of Facts helps Reduce Harm to victims of DV

DOMESTIC VIOLENCE REVIEW BOARDS
WESTBOROUGH, MA  January 5, 2018 As we begin to make program recommendations for reducing intimate partner violence it is worth noting that change comes very slowly in protecting those who are most at risk. There is still a paucity of protective measures in place to assess and contain those who are most violent in our society. Retired New Braintree Police Sergeant Michael Sefton was in Augusta, Maine in October 2011 providing testimony about the results of the psychological autopsy conducted by Michael Sefton, Ph.D. Brian Gagan of Scottsdale, AZ, and Ron Allanach, Ed.D. of Conquitlam, BC, Canada and former Chief of Police Joseph Laughlin of Portland, ME.  Dr. Sefton, who holds a doctorate in psychology and is a licensed psychologist provider in Massachusetts provides neuropsychological and forensic consultation on domestic violence including domestic violence homicide and assessment of risk.  The report that was filed came up with over 50 recommendations directly related to reduced intimate partner violence. The report was cited over 12 times in a recent Maine Law Review publication on proposed Conditions of Bail.
PUBLIC INFORMATION
The testimony provided to the domestic violence review board offered details about a hideous case of family violence that ended with the homicide of 4 members of the same family and was culminated by an attempt to burn the bodies after the murders and the killer shooting at police officers responding to the missing victim. But they were too late. Their research was conducted over a 3 month period following the homicide deaths of Amy Lake and her children.  The team conducted interviews with over 60 persons with direct knowledge of Amy Lake, the victim, her two children, Monica and Cody, and the murderer Steven Lake.

Maine Law Review

“Although Maine’s statute lists these prohibitions, it lacks the enforcement tools to protect victims against violence associated with guns and other weapons, which is a major factor in Maine’s domestic violence deaths.” Nicole Bissonnette, 2012
Most researchers agree it is nearly impossible to predict when DVH will occur.  However, the psychological autopsy provides many obtrusive red flags that offer clues to an impending emotional conflagration. The problem in this case was two-fold.  First, the requirement for bail was not seriously considered because Lake had no criminal history – and yet Mr. Lake had demonstrated an unwillingness to adhere to the legal mandates of the order of protection and violated the court order at least 4 times over the year before he killed his family. Given this reality, he should have been held for a hearing on potential dangerousness.  And secondly, the cache of firearms that Lake was known to have kept was not surrendered to police nor was an effort made to obtain the 22 weapons Lake owned by members of law enforcement.
It is not uncommon that red flags are often present early in the relationship.  Many people we spoke to were aware something agregious was going to happen.  These include obsessional jealousy, threats of death, sexual aggression, unwillingness to integrate into extended family, any use of a weapon, and others.  In the course of their research Sefton and Gagan interviewed Dale Preston who was convicted of DVH in 1982 and served 18 years in Maine State Prison for the murder.  When asked what may have stopped him from killing his wife, Mr. Preston indicate “there was nothing that could have stopped me…”  In these cases, a greater awareness of risk or dangerousness is essential and in some cases a person must be contained for the safety of others.  Such containment requires NO direct contact with an abusive spouse, GPS monitoring, house arrest, or no bail imprisonment.
The case in Maine occurred in June 2011 – exactly 1 year to the day after the victim obtained a protection from abuse order from her husband.  The murders occurred 2 weeks before the divorce was to be finalized and were likely triggered by the abuser’s anger over not being permitted to attend his son’s 8th grade graduation ceremony.  The Bangor Daily News presented details of the recent psychological autopsy presented recently in Augusta, Maine.  Over 30 states across America have formal homicide review boards.  “To make this general deterrence aim successful, abusers must not have access to their victims nor to potential weapons, and the risk of punishment associated with breaking the law must outweigh the abuser’s urge to commit the conduct.” said Denaes, 2012. Bail is a judicial condition that allows a person to be released from jail with the promise to appear in court to answer to charges. Bail also provides for public safety by keeping violent offenders in jail when necessary.
I make an effort to review those published from New England states.  Vermont has an excellent annual report of domestic violence homicide and publishes all recommendations and changes in statutory requirements following individual cases of DVH.

Ronald Allanach et al., Psychological Autopsy of June 13, 2011, Dexter, Maine Domestic
Violence Homicides and Suicide: Final Report 39 (Nov. 28, 2011),
http://pinetreewatchdog.org/files/2011/12/Dexter-DVH-Psychological-Autopsy-Final-Report-112811-
111.pdf.
Nicole R. Bissonnette, Domestic Violence and Enforcement of Protection from Abuse Orders: Simple Fixes to Help Prevent Intra-Family Homicide, 65 Me. L. Rev. 287 (2012).
Available at: https://digitalcommons.mainelaw.maine.edu/mlr/vol65/iss1/12
Johannes N. Denaes, PUNISHMENT AND DETERRENCE 7 (1974) (“General prevention may
depend on the mere frightening or deterrent effect of punishment—the risk of discovery and punishment
outweighing the temptation to commit crime.”).
See id. at 34-35
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Public Awareness Needed for Meaningful Jail Diversion

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“If mental illness drives the violent behavior than all weapons and substance use must be carefully controlled and eliminated.” Sefton, 2017

Westborough, MA December 21, 2017 Jail diversion is a hot topic across the country even here in Massachusetts. Since July, 2017 the Massachusetts Legislature has passed sweeping changes in the Criminal Justice System.  Locally and across the country, the numbers of persons incarcerated for minor offenses and drug crimes has grown in some cases exponentially. Many of these individuals have mental illness or drug abuse in addition to their criminality. The interaction between poly-substance abuse or dependence and exacerbation of underlying mental health symptoms is complex and multifactorial. The interaction of the two is sometime lethal as reported by the Globe Spotlight team It is the focus of mental health advocates and criminal justice experts nationwide as it pertains to jail diversion, alternative restitution and reduced police use of force. In Massachusetts, there is a move away from mandatory minimum sentences for all drug crimes except for those involving the sale and distribution of narcotics. Arguably, the impact on behavioral functioning when persons are gripped with co-occurring illness, such as alcoholism, is a recurrent problem for law enforcement and first responders. I have written about the impact of co-occurring illness such as alcoholism on mental and behavioral health is previously published posts here on Word press Human Behavior (Sefton, 2017). It is difficult to uncover which comes first – the addiction or the diagnosed mental illness and yet these are inextricably linked in terms of the strain on public resources and health risk to those so afflicted. Why is this important?

The importance of treatment for substance dependence and mental illness cannot be understated as violent encounters between law enforcement and the mentally ill have been regularly sensationalized. The general public is looking for greater public safety while at the same time MH advocates insist that with the proper treatment violent police encounters may be reduced and jail diversion may be achieved. The referral and treatment infrastructure needed to provide a continuum of care in this growing population is available in very few places across America.

Yet in places like Bexar County, Texas – including San Antonio and 21 other towns or cities – the county jail population has dropped by over 20 percent as a result of crisis intervention training for police officers and mobile mental health teams to intervene with those in crisis. I have seen this for myself during a visit with the San Antonio Police Department where I rode with two members of the Mental Health Unit – Officers Ernest Stevens and Joseph Smarro. These men are exemplary in their assessment and intervention skill for keeping identified subjects off radar screens and out of the revolving door of the county jail.  It takes ongoing training, medical and psychiatric infrastructure, community compassion, and active engagement with members of the community to fly under the radar and effectively reduce the jail population. When necessary those most in need must have 24-hour availability for detoxification, emergency mental health, and access to basic needs such as food, clothing, and medicine. In San Antonio, they offer so much more including pre-employment training, extended housing, interview preparation including clothes, and opportunity for jobs.

The unpredictability of behavior by those who carry a “dual” diagnosis has emerged as a confounding factor in the criminal justice system raising the specter of frustration over the limitations within the system. Jail diversion programs and treatment options are needed in order to retain public safety goals and provide for needs of the mentally ill and substance dependent. In Massachusetts, cities and towns are grappling with how best to intervene with the mentally ill in terms of alternative restitution for drug-related misdemeanor crimes in lieu of mandatory jail sentences that many crimes currently require. The Massachusetts legislature has taken up Criminal Justice Reform and passed a bill in late 2017 making changes in the mandatory minimum sentencing laws.  Some believe, as much as 20-40 percent of all incarcerated persons suffer with mental health diagnoses and are not getting the treatment they require. To provide a bare bones system would add billions to state and federal dollars spent on the needs of inmates at a time when measurable outcomes for in house care are limited.

In my practice, I see many cases of co-occurring pain syndromes with other physical debilities such as stroke or traumatic brain injury. Some of these cases are substance dependent and live lonely, chaotic lives.  Generally the emotional impact of two or more diagnosed illnesses yields a greatly reduced capacity for adaptive coping and puts a great stress on the individual system. The importance of addressing co-occurring substance abuse or dependence is now well recognized and with treatment can result in healthy decision-making, growth in maturity, and greater self-awareness. If legislators have a serious desire to reduce statewide numbers of incarcerated persons a comprehensive plan must be considered for both pre-arrest and post-arrest. Programs greater understanding of addiction and added treatment options must be explored through a joint public and private initiative.

Mental and Physical Health Screening

At time of arrest the individual must have some level of mental health assessment if mental illness is suspected or documented. When I was a police officer prior to 2015 we often asked the D.A. to provide a court clinic assessment of the suspect to rule out suicidal ideation or delusional thinking. This must also include a screening for dangerousness especially when a subject is arrested for intimate partner abuse. Next a health history questionnaire should be undertaken to screen for co-occurring illness – both physical and mental. If a diabetic suspect is held without access to his insulin he is at great risk of death from stroke. Similarly, a person arrested for assault who suffers from paranoid ideation is at greater risk of acting violently without access to psychiatric medication. Finally, an alcoholic brought to the jail with a blood alcohol level greater than 250 is at great risk for seizures and cardiac arrhythmias when delirium tremens begin 6-8 hours after his last drink. The risk to personal health in each of the scenarios above must be taken seriously and the obtained data should be factually corroborated. Police departments across the United States are pairing up with private agencies to provide in-house evaluation and follow-up of individuals who fall on the borderline and may not be easily assessed by the officer in the field.

Diversion Safety Plan with Mandated Revocation

Next, the probation and parole department must obtain an accurate legal history prior to consideration for bail. A nationwide screen for warrants and criminal history based on previous addresses is essential. In many places these are being done routinely. In the case of someone being arrested for domestic violence he may have no convictions thus no finding of criminal history. For these individuals the dangerousness assessment may bring forth red flag data needed for greater public safety resulting in protection from abuse orders, mandated psychotherapy, and in some cases, no bail confinement when indicated. Releasing the person arrested for domestic violence without a viable safety plan increases the risk to the victim and her family, as well as the general public – including members of law enforcement.

Bail, Confinement, Mandated Treatment

There is some thinking that higher amounts of bail may lessen the proclivity of some offenders to breach the orders of protection drafted to protect victims and should result in revocation of bail and immediate incarceration when these occur. Mandated treatment may be more successful when legal charges are held as leverage where after 6 months of sober living and regular attendance at 12-step recovery meetings charges can be dismissed or modified to each individual case.  This takes a complete overhaul of the front end of criminal justice system and requires buy-in by judges, district attorneys, and individual family members.

When it comes lack of compliance and repeated domestic violence, I have proposed a mandatory DV Abuse Registry that may be accessed by law enforcement to uncover the secret past of men who would control and abuse their intimate partners. This database would also include information on the number of active restraining orders and the expected offender’s response to the “stay away” order. In cases where the victim decides to drop charges there should be a mandatory waiting period of 90 days. During this waiting period the couple may cohabitate but the perpetrator must be attending a weekly program of restorative justice therapy, 12-step recovery and substance abuse education. Violations of these court ordered services are tantamount to violation of the original protection order (still in place) and victim safety plan and may result in revocation of bail. If the waiting period passes and the perpetrator has met the conditions of his bail than he may undergo an “exit” interview to determine whether or not the protection order / jail diversion plan may be extended or whether he/she has met all requirements.  In any case further police encounters will be scrutinized and prior charges may be re-instated or filed as needed.

Michael Sefton


Sefton, M. (2017) Human Behavior Blogpost: https://msefton.wordpress.com/2017/03/30/police-are-building-bridges-and-throwing-life-savers/ taken December 10, 2017

Mentally ill American’s and their proclivity to act out against authority

Westborough, MA December 15, 2017 The popular press is filled with ideas and criticism about what best to do with those afflicted with mental illness.  The resources available to law enforcement are practically nothing in the average community.  I have answered calls in west central Massachusetts where a citizen asked for referrals for counseling for a family member who was addicted to something or other.  Too often I had nothing to offer.  Generally speaking unless someone has money to pay for psychiatric services they are left to languish on the waiting lists of community mental health centers.  In emergencies many show up or a taken by ambulance to the emergency mental health center nearest their place of residence.  This usually ends up costing them thousands of dollars and hours of their time only to be told they must follow-up with a primary care physician. The entire process can be demeaning and inhumane.

In a prior post I have advocated for the use of 12-step recovery programs to help those with substance abuse and dependence.  These are not psychotherapy and are often leaderless meetings. There are have daily meetings in every city and town.  12-step programs teach the understanding addiction and loss of control from addition, coping by taking one moment at a time in order to remain substance free and belief in a higher power. In many cases new members of AA or NA – or any compulsive behavior recovery group – may have a sponsor who comes forth and provide 24/hour support. I encourage family members to attend meetings with their loved one in show of support. Sobriety can begin tonight at the 7 PM meeting in Watertown, Worcester or Anytown, USA.

The interaction of substance abuse and mental illness is complex.  Persons with drug and alcohol addiction must be expected to become sober with the help of substance abuse treatment and family support. The risk of violence and suicide declines when sobriety can be maintained.   Michael Sefton, 2017

“We have to get American police to rethink how they handle encounters with the mentally ill. Training has to change” according to Chuck Wexler, executive director of the Police Executive Research Forum, an independent research organization devoted to improving policing. People carrying a dual diagnosis are at greatest risk for self-destruction – including intimate partner violence and suicide by cop.


Sefton, M (2017) Blog post: https://msefton.wordpress.com/2017/01/16/police-as-therapist-the-inherent-risk-of-unconditional-positive-regard/ Taken 17 November 2017

Police response to Domestic Violence

Police officers are regarded as the front line first responders to family conflict and domestic violence.  For better or worse, the police have an opportunity to effect change whenever they enter into the domestic foray – whether an arrest is made or not.  This affords them a window into the chaos within the effected family system and the opportunity to bring calm to crisis.  In many cases, the correct response to intimate partner violence should include aftermath intervention when the dust has settled from the crisis that brought police to this threshold. At these times the communication between family and police may be operationalized, improved and redefined.  When this is done it establishes a baseline of trust, empathy, and resilience.

Co-occurring Illness: Effecting change at times of crisis

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WESTBOROUGH, MA  – April 24, 2017 There is no magic solution for de-escalating someone who is in “crisis” or emotionally distraught.  The loss of control may signal a failure of reality testing that can signal a diminished capacity to appreciate the consequence of their behavior.  This occurs frequently when people who have mental illness have co-occurring drug and alcohol addiction. It is true that the correctional system has more than its share of mentally ill prisoners but for many being in jail is the only way to stay sober.  The full capability to provide mental health services in the correctional system here in Massachusetts has not been realized.  The courts are reluctant to require that someone receive treatment for mental illness and/or substance abuse in lieu of going to jail.

Criminality and mental illness are not mutually exclusive so there will always be a high number of incarcerated persons with chronic underlying psychiatric diagnoses.  The prevalence of mental illness in the general population may range from 5-15 percent. The degree of mental illness in the correctional system may be as high as 40 percent by some accounting but the number is misleading. One needs to consider treating mental illness when it becomes a barrier to functioning such as in schizophrenia or bipolar depression where the symptom profile interferes with reality testing. Only then may a contract for treatment may be constructed to include medication and psychotherapy depending upon the diagnosis.  In cases where mental illness and co-occurring substance abuse exist a determination about primary diagnoses and treatment options must be considered.

“The consequences of dual diagnosis include poor medication compliance, physical comorbidities, poor health, poor self-care, increased risk of suicide or risky behavior, and even possible incarceration” according to Buckley and Brown, 2006

In many cases of emotional crisis those in need can be diffused with recognition of their struggle – such as death of family member or loss of employment.  By showing empathy for their emotional burden police officers and mental health providers can intervene and make a real difference.  But effecting change takes time and a consistent message that personal responsibility begins at home.  Instead of placing blame on a “system” that is filled with holes individuals need resilience and family support to get the help they require. teachinginprisonBefore I am criticized for being insensitive, I point to the 12-step programs in alcohol and drug recovery.  They are free and in many cases provide 24-hour support and mentoring at times of crisis. I strongly believe that if people can remain clean and sober than the need for crisis intervention will decrease.  Ostensibly, this is a perfect first step toward recovery and will bring forth a palpable reduction in emotion and reduce the potential for violence.  When substance abuse is stopped emotional growth is more able to take hold.  Healthy, more effective problem solving may result from prospering emotional maturity allowing for resilience and enhanced coping.

Stress can engulf individuals and families for a variety of reasons and should not be judged. People cope with stress differently and in many cases achieve emotional relief by having someone to talk to.  Some clinicians believe great personal change may be possible when coping skills are most frail.  But in too many instances, drug and alcohol abuse present a confounding variable when working with person’s diagnosed with mental illness. At the same time this raises the risk to law enforcement exponentially. Why?

One response to stress is the increase in substance use and with that increase there is often a worsening of any underlying mental health disorder such as depression and anxiety.  “There could be a common factor that accounts for both, primary psychiatric disorder causing secondary substance abuse, primary substance abuse causing secondary psychiatric disorder, or a bidirectional problem, where each contributes to the other.” (Buckley and Brown, 2006) Unemployment, early childhood trauma, financial burdens, and random emotional baggage result in a range of actions that foreshadow regression and failure of coping mechanisms that put us all at risk.  Some people are able to endure extreme levels of stress with little to no outward sign of distress while others boil over at the first sign of conflict or emotional ripple.

JAIL DIVERSION

There is a growing push toward alternative restitution and jail diversion for those with mental health and substance abuse problems.  In San Antonio, TX, the Bexar County jail had been filled to capacity for many years.  As a jail diversion and mental health program evolved the population dropped by 20-25 percent from 5000 inmates to 3800.  Data suggests that over one quarter of all prisoners may experience mental illness or substance dependence/abuse and are not receiving treatment.  But here in Massachusetts the systems are not available to make this innovation an effective reality in any scale.  Many departments are using jail diversion options such as drug treatment and counseling but here in Massachusetts psychiatric treatment cannot be court mandated. Arrest may not be indicated simply because a person is in crisis but those in crisis may be involved in some type of criminality such as assault, criminal threatening, domestic violence and property crimes. So what options are available? The drop out rate for patients suffering from major mental illness is quite high. They often stop taking prescribed medication and do not attend counseling sessions.

MENTAL ILLNESS, CRIMINALITY AND RESTORATIVE JUSTICE

bigstock-Mental-illness-in-word-collage-072313As a police officer I found jail diversion a discretionary tool that was used a great deal. Nevertheless there are times when arrest is the proper course of action but jail diversion remains a possible negotiating point for those charged with some crimes.  The correct response to intimate partner violence should include aftermath follow-up and intervention when the immediate crisis has settled from the events that brought police to this dangerous threshold. Arrest is mandated by state statute when one spouse has visible injuries. Whenever possible using a restorative justice model – often limited to incarcerated individuals – may allow those arrested for crimes against persons to reconstruct their encounters with police and gain concrete understanding of events and the impact substance abuse may have had on the actions taken by themselves and law enforcement. Some never attain empathy for victims, family members including action taken by police and wind up behind bars.  Police encounters with persons having co-occurring mental health and substance abuse are frequently violent and often result in charges for assault on a police officer and more. In the aftermath of these encounters offenders may be sent to treatment in lieu of formal charges with the understanding that sobriety and psychotherapy are indicated.  In cases of treatment avoidance police have the option to file charges later on.

Techniques for understanding mental illness may facilitate mutual understanding and establish the needed bridge to facilitate treatment as published in 2015 (Sefton, 2015). Those seeking diversion from incarceration must demonstrate the willingness to change and take responsibility for their actions.  The relationship between law enforcement and community agencies is one that requires a strong foundation and mutual understanding of the framework for reducing recidivism, criminality, and managing mental illness.


Buckley, P. F., & Brown, E. S. (2006). Prevalence and consequences of dual diagnosis. The Journal of clinical psychiatry, 67(7), e01-e01.

Sefton, M. (2015) Emotionally distraught – nearly one-quarter of all officer-involved shootings go fatal. https://msefton.wordpress.com/2015/07/01/emotionally-distraught-nearly-one-quarter-of-all-officer-involved-shootings-that-go-fatal/. Taken March 5, 2017.

Police are building bridges and throwing life savers

WESTBOROUGH, MA  – March 30, 2017  Police officers are being trained in crisis intervention techniques across the country and Canada. This training offers plenty of practice role-playing scenarios that come directly off of the call sheets affording a reality-based training opportunity. I recently spent time riding with members of the San Antonio PD mental health unit and have the greatest respect for the officers with whom I rode.  In contrast, some departments regularly have highly trained clinicians riding with officers bringing expertise in mental illness and abnormal behavior across the thin blue line.  It is thought that by sharing knowledge at working with unpredictable, drugged out, psychotic and delusional and angry who police encounter on a daily basis better outcomes may be achieved. No single model is best and all are still in the growing stages of establishing protocols for bringing those most disturbed individuals in from the margins. More and more officers are receiving CIT training every year.

The important part of crisis intervention training comes in the interdisciplinary relationships that are forged in by this methodology. Trust and respect between the police and its citizens builds slowly one person at a time.  Community policing is not a new concept but fiscal priorities often prevent its full implementation.  Just the same, there must be trust and respect between the police and the purveyors of crisis intervention and mental health risk assessment including doctors, nurses, and health care practitioners. This also takes time and training and the shared belief in the model.


“When officers are faced with a deadly situation, when there is a gun pointed at a cop, there is no time to go into mental health measures,” according to Grace Gatpandan, spokesperson for the San Francisco Police Department


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Michael Sefton, Ph.D. in 2017 photograph

The use of force continuum belies each officer contact and guides the process when police are called upon to defuse a dangerous encounter. It is best that a mental health contact be made long before violent threats are made – long before terminal rage erodes personal judgment. The community policing doctrine affords this front end contact and encourages officers to know the people living on the beat.

POLICE ENCOUNTERS WITH MENTALLY ILL CITIZENS

The Boston Globe Spotlight series on police encounters with the mentally ill cites one distraught parent who was quoted “I only wanted the police to disarm him not shoot him dead.” Unfortunately for this family, when faced with lethal violence it is the behavior of the subject that drives the ship in terms of what will or will not happen.  “When faced with a deadly situation, when there is a gun pointed at a cop, there is no time to go into mental health measures”. All too often people fail to see the cause – effect relationship between citizens with guns or other lethal weapons and the police officer response.  The use of force continuum follows the principle of causation by guiding police decision making based on the level of threat.

What came first the threat or the police action?  It is the primary action of the citizen the evokes the lethal response by police.  If citizens dropped weapons and listened to police officer directives during these high energy and chaotic events there would be fewer deaths.  To say they lack training in mental health is preposterous.  Almost as preposterous as saying if they were better parents the mentally ill subject might not aim his gun at police or threaten his mother with a knife.  No, the responsibility lies with the mental decision-making and subsequent behavior of the subject himself.  If mental illness drives the violent behavior than all weapons and substance use must be carefully controlled and eliminated.  When people attend psychotherapy sessions and 12-step recovery programs the proclivity for violence is greatly reduced.  Inevitably, drug abuse is a co-morbid factor that alters perception and fuels underlying anger and violent tendencies.  Who is responsible for this? When drug addition or alcoholism begin – all emotional growth including adult “problem solving” begins to fail until it is fraught with uncontrolled, impulsive violence. Rather than placing blame, greater emphasis on sobriety, counseling and developing emotional resiliency should be encouraged.


Lowery, W. (2015) DISTRAUGHT PEOPLE, DEADLY RESULTS: Officers often lack the training to approach the mentally unstable, experts say. http://www.washingtonpost.com/sf/investigative/2015/06/30/distraught-people-deadly-results/?utm_term=.86e44d33dfab Taken March 5, 2017

What are “collateral consequences” in domestic violence?

WESTBOROUGH, MA March 21, 2017 When working as a police officer I was asked to take the statements of women who were asking for protection from an abusive spouse or intimate partner.  These requests were usually granted by the on-call judge – especially if children were at risk or a history of physical abuse was suspected.  But these orders only last a short time – perhaps a weekend.  In order to have restraining orders extended the victim is expected to go to the district court and swear testimony that specifies the reasons for an order of protection including threats or actual physical harm, forced sexual contact, pathological jealousy – whatever.  Sometimes this happens and protection orders are extended usually for 6 months. During this time the couple is expected to sort out their differences and engage the help of a family therapist, if possible.  This rarely happens.


“Domestic violence is not random and unpredictable. There are red flags that trigger an emotional undulation that bears energy like the movement of tectonic plates beneath the sea.” according to Michael Sefton.  A psychological autopsy should be undertaken to effectively understand the homicide and in doing so contribute to the literature on domestic violence and DVH according to Sefton who with colleagues published the Psychological Autopsy of a case from Dexter, Maine where a father murdered his children, estranged wife and ultimately himself (Allanach, et al, 2011).


More often than not, the victim fails to appear for this process and the protective order goes away without any consequences. Why? In the time between the initial emergency order and the Monday morning when the victim is expected to substantiate her initial claims she may have been bullied by her spouse and worked over by his family, his friends and whomever he can enlist in his camp to get her to let it go. She is made to believe that she cannot function without her abuser.  When children are involved an abusive spouse will usually say that child protective services will take the children for whatever reason he comes up with.  He promises to destroy her credit worthiness, she will be penniless, and he threatens to share lies about her on social media pages for all to see. He may also promise to kill her and cut her to pieces to be used as fish bait – as I have been told in a case being investigated by my former agency. But he swears his love for her always.

This happens over and over.

In some cases the order to extend the restraining order results from elevated risk to the victim and recurring threats of violence. In these cases orders of protection go on for months or years at a time.  This type of bullying is an example of the often secretive coercion that takes place in DV and intimate partner abuse is flagrant and often goes unreported.  It must be considered whenever an initial order is not sustained especially if the victim fails to appear.

In some cases there is more than one order of protection issued to protect one or more intimate partners. This is a red flag and should have bearing on the bail requirements but seldom does. There should be some follow-up with the original complainant by the police department to investigate her reasons for not pursuing the extended order of protection and determine what impact bullying may have played on the victim’s decision.  In rare cases permanent orders are granted because of compelling evidence that the victim and her family remains at risk – usually the result of stalking.

In March 2014, I published a blog in which the Massachusetts Supreme Judicial Court granted a permanent restraining order even though the former spouse was living in Utah and was remarried. In 2014 the Boston Globe did a story on the case written by Martin Valencia essentially raising the spector of the abuser in this case and the current impact the court order has on his day to day life in Utah.

Kevin Caruso was unable to get a job as a youth baseball coach because of a continuing order of protection here in Massachusetts that shows up on his CORI report. He could not own a firearm and was sometimes hassled at airports. The SJC ruled that Kevin Caruso must submit “clear and convincing evidence” that he no longer poses a danger to former girlfriend in a case dating back to 2001.  The Supreme Judicial Court  in Massachusetts has required that Mr. Caruso provide proof that “he has ‘moved on’ from his history of domestic abuse and retaliation”.  It is well-known that male abusers move from one abusive relationship to another.  A colleague Dr. Ron Allanach wrote “In the Caruso case, the Court is proactive, sensing the burden is on the offender rather than the victim; thus, the responsibility for proof that Mr. Caruso has “let it go”, poses no danger to the victim and has done the necessary therapy on his own behavior and to figure strategies to change, rests precisely on the shoulders of the offender where the burden should always remain.” The SJC called the frustration felt by Mr. Caruso the “collateral consequence” of the permanent restraining order put in place initially issued as a result of his threats to kill his former girlfriend.  Time alone and location has no bearing on whether a permanent order is sustained.  No person should live is fear that a former partner is going to appear at her workplace or stand behind her in the line at Starbucks while she thinks about what blend of coffee she might want.

“Substantive decisions about bail or no bail holds will be more reliable by having access to the violent history of domestic violence offenders and the protective orders that have been issued time and time again.” Michael Sefton


Allanach, R. Court is proactive. Personal correspondance. March 2014

Sefton, M. 2014,  https://msefton.wordpress.com/2014/03/11/collateral-consequences-stay-away-orders-that-are-forever/ taken January 21, 2017

Valencia, Milton. SJC rules on Utah man’s permanent restraining order. Boston Globe March 11, 2014, taken March 24, 2017