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Silence is a key enabler for men perpetrating violence against women. If women’s voices aren’t heard nothing changes and the violence goes on.

But change is happening because survivors of sexual and domestic violence, and their supporters, are increasingly speaking out.

Whether the issue is about better protecting women from sexual assault, freeing women from the coercive control of abusive men or researching interventions that seek to work with perpetrators – the perspective of survivors is central.

The voices of survivors need to be heard if policy responsive and interventions are to be effective.

Grace Tame, a survivor advocate for the reform of victim-gag legislation that prevented survivors from publicly telling their stories, was recognised as the 2021 Australian of the Year.

Her courage and example has led others such as Brittany Higgins to speak out about the rape she alleges she was subjected to in a federal ministerial office in Parliament House.

As the various narratives unravel about the extent to which senior government and politicians knew and covered up, or failed to support her through this trauma, her strong voice and ability to speak ‘truth to power’ is creating waves for change at Parliament House – which currently lacks basic accountabilities like an independent complaints body or a Human Resources Department.

By holding onto her agency through this process, by waiting to make a formal statement to the police so that those in power cannot hide behind ‘this is a police matter and we cannot answer any questions’, has taken intelligence, support and courage.

Similarly, the voices of survivors will be crucial in better protecting women from coercive control – a form of psychological abuse including monitoring and threats.

Advocates like Nicole Lee – a disability and family violence activist – have been vocal in arguing that legislation simply criminalising coercive control may not be the answer unless there are changes in a criminal justice system where victims are too often “brushed off or ignored.”

A further area of debate lies in the area of research and the outcome of clinical trials.

How can we tell if an intervention to reduce domestic violence is actually working if you aren’t asking the women who are living with it day in and day out? How can you know if it is getting better if you just ask the men perpetrating it?

Brittany Higgins’ courage in going public with her allegation puts the spot light on the lack of Parliament’s accountability. 

This is the central problem with the the ReINVEST clinical trial, which is seeking to measure whether taking an anti-depressant can reduces incidents of violence and rearrest among men with histories of domestic violence and impulsiveness.

The authors of the study claim estimated reductions in violence of 30 per cent. As international experts in domestic violence, we applaud the effort to explore new tools to intervene with domestic violence perpetrators, but the design of this study is deeply flawed and potentially dangerous.

While the study does look at re-conviction rates and measures against a comparison group, the main design flaw is that it fails to systematically include the experience of the partners and ex-partners in the study – the women being abused.

Self-report by men who perpetrate violence is a poor indicator of whether and in what form they are likely to continue their violence and abuse.

The study doesn’t explore whether the partners of the participants have an increased sense of safety or control over their own life, and whether any children involved are similarly safer.

Imagine creating a clinical trial for a new medication to treat a disease that causes severe disability in a patient without actually studying whether the patients’ abilities improve in response to the intervention. In the case of domestic violence, it is the adult and child survivors who are the target ‘patient’, and must show improved outcomes, not the perpetrator.

The need to listen to survivors takes on even greater importance given concerns that the use of antidepressants may be linked to increased levels of violence for some people.

We must seriously question any results of a study that doesn’t systematically measure the changes that matter. In this case, the study isn’t measuring any changes in the ‘symptoms’’ that matter, the survivors’ experience of safety and improved freedom.

Proposed interventions are flawed if they aren’t based on the experiences of the women subjected to violence and abuse. 

Framing domestic violence as a problem of impulsivity in the perpetrator also glosses over the responsibility of the perpetrators for the choice they make to carry out domestic violence.

For example, many domestic violence perpetrators only attack their family members demonstrating the choices that they are actually able to make in terms of who they target.

It is possible to design studies that centre the experience of survivors even when the intervention is with the perpetrator. The Mirabal study in the UK looked at the effectiveness of men’s behaviour change programs.

They centred on the experience of survivors by asking them what they considered to be success and then measuring those specific changes against survivor experience of a perpetrator intervention.

In the list of six measures identified, the more important one was “expanded space for action”, meaning a reduction in the sense of being controlled by their partner – something not easily cured with a pill.

In our own current study with NSW Health, where we are attempting to improve how health workers can respond to domestic violence, we are asking survivors to provide feedback on the interventions offered to the family.

Prescribing medication may be helpful to the health and well-being of domestic violence perpetrators, and may indirectly support positive change for many of them. But this area needs to be explored in ways where the voices of survivors are the primary measure of effectiveness.

The survivor voice can no longer be ignored if we are to make progress in the area of violence against women.

The advocacy of survivors such as Brittany Higgins, Grace Tame and Nicole Lee are leading the way providing the foundations for other women to come forward to tackle this ubiquitous and “wicked problem”.

1800 RESPECT (ph. 1800 737 732) for national information, counselling and support.