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A large-scale (n=500) National Institutes of Health (NIMH)-funded SBIR Phase II randomized clinical trial (R44 MH65828, D. Levesque, PI) assessed the efficacy of a computerized TTM-based multimedia intervention for adult male domestic violence offenders. The aim of the intervention, designed as an adjunct to traditional batterer treatment, is to increase readiness to use a range of healthy strategies (e.g., communicating with one’s partner clearly and respectfully, not abusing drugs or alcohol, controlling anger) to stay violence-free. The tailored treatment group, at program intake, 2 and 5 months follow-up, received computer-administered assessments and feedback matched to stage of change and other TTM variables. The tailored treatment group also received a manual with stage-matched information and exercises. The standard care group received assessments at intake and 5 months follow-up.

Data from the first 197 subjects in their final computer session suggest that the intervention promotes progress through the stages of change. Compared to standard care participants, participants assigned to the TTM intervention were significantly more likely to be in the Action stage (37% vs. 12%). The intervention also increased use of all 11 violence cessation strategies examined, especially help-seeking outside of group. For example, compared to standard care participants, intervention group participants were more likely to talk to clergy (27% vs. 11%), talk to a medical professional (40% vs. 22%), seek one-on-one counseling (40% vs. 31%), attend couples’ counseling (25% vs. 12%), and attend other group counseling (36% vs. 18%). Based on reports of the first 74 victims who completed a 6-month assessment by mail or phone, offenders in the TTM treatment group were less likely to engage in threats of violence (48% vs. 68%) and violence (33% vs. 47%) at follow-up. These effect sizes exceed those found in two meta-analyses of batterer treatment outcome studies relying on victim reports of recidivism (Babcock, Green, & Robie, 2004; Levesque, 1998). In the NIMH-funded study, the intervention appears to have its largest effect on men who drop out of the traditional programs. Among dropouts who did and did not receive the TTM intervention, rates of threats were 40% vs. 88%, and rates of physical violence were 20% vs. 88% based on victim reports at 6 months follow-up (Levesque et. al, 2005).