“Strength at Home” Intervention for Male Veterans Perpetrating Intimate Partner Aggression

Abstract

Veteran and active duty populations evidence higher rates of intimate partner aggression (IPA) than comparable civilian groups, perhaps due in part to their unique service-related experiences. IPA offender treatment programs that take military background into consideration are not widely available, and it is unclear to what extent there is a perceived need for them among clinicians who serve service members and Veterans. Strength at Home (SAH) is a promising 12-session cognitive-behavioral group intervention designed to address IPA perpetration in military populations. While clinical support for SAH is emerging, the extent to which service members and Veterans find it appropriate and helpful is not yet known. Goals of the current study were threefold: (a) assess the perceived need for a military-specific IPA program among Veterans Administration and community domestic violence (DV) program providers; (b) conduct a pilot study to examine the feasibility and preliminary effectiveness of SAH in a sample drawn from a diverse, multicultural community; and (c) conduct focus groups to obtain participant feedback on the SAH protocol. Findings from the provider survey suggested a need for specialty programs to treat military personnel who perpetrate IPA of mildtomoderate severity. Results of the SAH pilot study (n = 6) indicated decreased psychological aggression and increased anger control from baseline to 6-month follow-up. Focus group feedback indicated participants found the program to be helpful and appropriate across a wide variety of ethno-cultural variables. As more service members and Veterans of the Iraq/Afghanistan war era reintegrate into our communities, it will become increasingly important for providers in both private and public sectors of care to understand the unique needs of this treatment population, and to have access to effective IPA treatment programs.

Suicidal ideation among young Afghanistan/Iraq War Veterans and civilians: Individual, social, and environmental risk factors and perception of unmet mental healthcare needs, United States, 2013

“…These factors can also increase risk of suicidal outcomes (Boscarino, 2006; Ilgen et al, 2010c) and therefore could somewhat confound the association between drug problems and suicidal ideation that was discovered in this study. Nevertheless, services that help treat substance abuse and the potential underpinnings of substance abuse might especially benefit young Veteran populations (Chen et al, 2015; Love et al, 2015). …”

Sex differences in orbitofrontal connectivity in male and female veterans with TBI

“…Gallaway and colleagues studied active duty Army soldiers and found that male soldiers reported significantly more minor and severe physical aggression (e.g., throwing something at someone, pushing, shoving, hitting, or, less frequently, using a knife/gun on someone) compared to female soldiers (Gallaway et al 2012 ), whereas an investigation by Afari and colleagues examined self-reported aggression and found that male and female veterans report similar levels of aggressive behavior (Afari et al 2015 ). Another challenge to understanding aggressive behavior in veterans and service members is that research in this area includes individuals with behavioral diagnoses such as intimate partner violence (Tharp et al 2014 ; LaMotte et al 2014 ; Love et al 2014 ; Bradley 2007 ), irritable depression, and PTSD (Campbell et al 2015 ; Flanagan et al 2014 ; Reardon et al 2014 ; Karairmak and Guloglu 2014 ; Angkaw et al 2013 ; Elbogen et al 2013 ). Indeed, the co-occurrence of TBI and PTSD has raised considerable debate in recent years with a number of investigators arguing that the two diagnoses frequently co-occur, however blurred the directionality of the etiology may be (Brenner et al 2010 ; Carlson et al 2011 ; King 2008 ; Morissette et al 2011 ; Shandera-Ochsner et al 2013 ).…”

Rapid Review of Men’s Behavior Change Programs

“…Figure 2 details the selection process for included articles, with 13 eligible for inclusion in this review. These articles identified 10 MBCPs: Contexto Program (Carbajosa, Catalá-Miñana, et al, 2017), Domestic Abuse Program (Blatch et al, 2016), Facing Up (Gray, Lewis, et al, 2014), Stopping the Violence (Gray, Broady, Gaffney, Lewis, & Mokany, 2014), Taking Responsibility (Broady, Gray, & Gaffney, 2014; Broady et al, 2015; Gray, Broady, Gaffney, & Lewis, 2015; Gray, Broady, Gaffney, Lewis, & Mokany, 2014; Gray, Lewis et al, 2014), Group Cognitive-Behavioral Therapy (Semiatin et al, 2013), High-Intensity Family Violence Prevention Program (HIFVPP) (Connors et al, 2013), REAL Fathers Initiative (Ashburn et al, 2017), Standard Batterer Intervention Program (Lila et al, 2018), and Strength at Home (SAH; Love et al, 2015). The final report for Project Mirabal—DVPP is included here; however, specific DVPP details were not included in this report (Kelly & Westmarland, 2015).…”

“…Of all the articles, six articles evaluate Australian MBCPs (Blatch et al, 2016; Broady, Gray, & Gaffney, 2014; Broady, Gray, Gaffney, & Lewis, 2015; Gray, Broady, Gaffney, & Lewis, 2015; Gray, Broady, Gaffney, Lewis, & Mokany, 2014; Gray, Lewis, et al, 2014), two articles evaluate US MBCPs (Love et al, 2015; Semiatin et al, 2013), two articles evaluate MBCPs in Spain (Carbajosa, Catalá-Miñana, et al, 2017; Lila et al, 2018), and the remaining three articles individually evaluate MBCPs in the United Kingdom (Kelly & Westmarland, 2015), Canada (Connors et al, 2013), and Uganda (Ashburn et al, 2017). Of the 10 interventions, 7 describe the theoretical approaches and models to support the programs, including motivational interviewing (Lila et al, 2018; Semiatin et al, 2013), cognitive and behavioral psychology (Blatch et al, 2016; Carbajosa, Catalá-Miñana, et al, 2017; Love et al, 2015; Semiatin et al, 2013), risk-need-responsivity (Blatch et al, 2016; Connors et al, 2013), social cognitive theory (Ashburn et al, 2017), social learning theory (Ashburn et al, 2017), and theory of change (Ashburn et al, 2017). Three interventions (Facing Up, Stopping the Violence, and Taking Responsibility) do not specify the theoretical approaches used to underpin the programs.…”

“…Three interventions (Facing Up, Stopping the Violence, and Taking Responsibility) do not specify the theoretical approaches used to underpin the programs. Two identified MBCPs target specific male populations, HIFVPP (Connors et al, 2013) is a program for incarcerated male offenders, and SAH (Love et al, 2015) is a program for male military personnel and veterans. None of the articles reported the use of program logic models to underpin the evaluation and performance monitoring planning.…”