The Cost of Batterer Programs: How Much and Who Pays?
Alison Snow Jones, Johns Hopkins University

Published: Journal of Interpersonal Violence, V. 15 (6), June 2000, 566-586

What is the scope of this study?
The author of this study demonstrates how to evaluate the real costs of batterer intervention programs using cost-effectiveness analysis (CEA). She analyzes and compares the real costs of four different batterer programs, and through this process "illustrates the components and procedures" of a CEA. Difficulties and policy implications of doing CEAs when assessing the effectiveness of batterer intervention programs are briefly discussed.

How are the real costs of batterer programs determined?
To determine the real costs of batterer programs the author of this study uses a concept from economics called "opportunity costs". Opportunity costs are "the value of all goods and services that society must give up to have the program." This includes not only the actual bookkeeping costs ordinarily ascribed to running a program, such as salaries, supplies, office space and equipment, but also includes the monetary value of volunteer time and any other public good or service used as a result of or in support of a program. These latter costs are not usually part of a program's budget, and are often borne by taxpayers. For example, in batterer intervention programs when batterers are not complying with court-ordered treatment, judges may order batterers to appear in court. Public money, not batterer program money, pays for the costs of such court-ordered appearances (i.e., the cost of judges' and other court personnel time, courtroom space, etc). This cost represents a cost to society because funds used in this manner are not available for other goods or services (i.e., more teachers for public schools, road improvements, etc). From an economist's point of view, opportunity costs are a better assessment of the real cost of a program than the "accounting costs" (i.e., bookkeeping records) of a program.

How was this study conducted?
Four batterer programs in different parts of the United States are examined. Their services represented a "continuum" of court involvement, treatment and other services that make up the current standard of care in batterer intervention. All provided group treatment. They also met five additional criteria for inclusion in the study. All programs

1. Were in compliance with their state's standards for batterer treatment programs
2. Collaborated with battered women's programs in their area
3. Used a cognitive-behavioral approach
4. Had been in existence at least 5 years and received 40-50 referrals per month
5. Trained and/or supervised new or "branch" batterer programs.

The author evaluated the costs of serving a random sample of 210 men from each site for the year 1995. Two cost calculations were made: one that did and one that did not include the cost of ancillary services (e.g., services for battered women, volunteer time, court costs). Both the average cost per session of group treatment and the average cost per program participant were determined. From this, the cost to complete each program was calculated (Cost per session X number of sessions required for completion).

What did the study find?
Compared to the cost of "similar outpatient programs for alcohol and substance abuse" or the cost of continued legal sanctions for battering, the cost of batterer intervention programs in this study were low and similar between the four programs sampled.

1. The cost per session of batterer group treatment ranged from $22-$32 for all four programs. When the cost of ancillary services at these programs was subtracted, the cost per session of batterer group treatment ranged from $17-$22.
2. The cost of program completion at all four sites ranged from $264-$864 per batterer. This compares with outpatient alcohol and substance abuse treatment costs ranging from $496-$6800 per patient for completion (French et. al, 1997- cited in study).
3. Batterer program completion costs approximated the cost of probation and fines for continued battering estimated at $261 per year, and were significantly lower than the cost of incarceration estimated as $2000 per month.
4. From 50% (Site 1) to 100% (Site 4) of program costs were paid for by the batterers themselves.

Several factors that affected cost estimates

1. Overall program costs were affected by the low completion rates of program participants. Drop-out rates of 30%-50% at all four sites may have deflated real average program costs.
2. Low costs per session at Site 4, the site with the most comprehensive services, may reflect cost savings that resulted from that site's exclusive use of subcontracting for mental health counseling.
3. Indirect costs (i.e., costs borne by the batterer and his family such as "psychic" costs, the value of travel time and time spent in treatment) were not included in the cost analysis.

What are the implications of this study for future evaluation of batterer intervention programs?
The retrospective design of the study was a shortcoming. For example, because of retrospective data collection some cost figures (e.g., indirect costs, court costs at three of the sites) were not available. The author recommends that future studies use a prospective design to better document and assess court, ancillary program and indirect costs of batterer intervention programs. She advocates for the inclusion of a cost-effectiveness analysis (CEA) when evaluating batterer intervention programs because CEAs provide policy makers with information about how program structure and range of services relates to both program costs and outcomes.

Reviewed by Priscilla Schulz, LCSW
Center for Trauma Recovery
University of Missouri - St. Louis
November 6, 2001

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