Differences Between U.S. Substance Abuse Treatment Facilities That Do and Do Not Offer Domestic Violence Services

Abstract

Objective: Victimization by and perpetration of domestic violence are associated with co-occurring mental and substance use disorders. Methods: This study used data from the National Survey of Substance Abuse Treatment Services to examine differences in organizational factors, treatment approaches offered, and client-level factors among 13,342 substance abuse treatment facilities by whether or not they offered domestic violence services. Results: Only 36% of the facilities offered domestic violence services. Those that offered such services were more likely than those that did not to treat clients with co-occurring disorders. Principal-components analysis reduced eight treatment approaches to two factors: psychosocial services and traditional substance abuse services. Regression models indicated that the frequency with which psychosocial services were offered depended on the percentage of clients with co-occurring disorders who were being treated in the facility and whether or not that facility offered domestic violence services. Specifically, facilities that did not offer domestic violence services and that had a high percentage of clients with cooccurring disorders were more likely to offer psychosocial services than facilities that offered domestic violence services. A larger proportion of facilities offering domestic violence services offered traditional substance abuse treatment services, compared with facilities not offering domestic violence services, but this relationship was not contingent on the percentage of clients with co-occurring disorders at each facility. Conclusions: Improved efforts should be made to tailor treatments to accommodate the links between domestic violence, mental disorders, and substance abuse.

Healthcare Utilization Patterns for Patients with a History of Substance Use Requiring OPAT

“…While WWUD access treatment less frequently [ 18 ], they maintain equal success once in treatment [ 19 ]. Perhaps SNFs provided a stabilizing environment for women, as drug use is entangled with social instability, including intimate partner violence [ 20 , 21 ], substance use with sexual partners, and lack of autonomy over substance use for WWUD [ 19 ]. However, WWUD often struggle to complete treatment outside the home due to lack of childcare and fear of losing custody of their children [ 21 ].…”

How and How Much: Combined Services for Domestic Violence and Substance Abuse

“…Recent studies of SA organizations suggest a substantial minority of programs include attention to DV (Capezza et al, 2015;Cohn & Najavits, 2014). Data from the National Survey on Substance Abuse Treatment Services (NSSTS) suggest nearly 40% of SA providers report offering services for "domestic violence-family or partner violence services (physical, sexual, and emotional abuse)" (Cohn & Najavits, 2014, p. 505).…”

“…To quantify the number of populations organizations serve, we asked whether organizations included "programs or activities specifically intended" for the following groups: survivors/victims of DV, perpetrators of DV, women with SA issues, and men with SA issues. We grouped SA organizations by service population gender based on research suggesting an association between a primary focus on women and offering DV services (Cohn & Najavits, 2014) and growing emphasis on gender-responsive SA treatment models (Center for Substance Abuse Treatment [CSAT], 2015). The ISP, which has a possible range of 0-4, is the arithmetic sum of the four variables produced by the original item; higher scores reflect services for more populations.…”

“…We suspect they also differ in other ways and that some of these differences shape their ability to engage both issues. While recent research has begun to explore differences between organizations that address both issues and those that do not, this has been limited to the SA field (Capezza et al, 2015;Cohn & Najavits, 2014). One priority for future research involves identifying differences between organizations that address both DV and SA-especially those that do so at high levels-and those focused on either DV or SA.…”

“…Best practices guidelines for addressing both issues, often developed from the work of geographically specific groups, are also available (Bland & Edmund, 2008; Center for Substance Abuse Treatment [CSAT], 1997;DV/SA Interdisciplinary Task Force, 2005;Patterson, 2003). While many programs appear to include some attention to the other issue (Capezza et al, 2015;Cohn & Najavits, 2014;Timko et al, 2012), studies offer little insight into the nature of these efforts.…”