The comparative effectiveness of Integrated treatment for Substance abuse and Partner violence (I-StoP) and substance abuse treatment alone: a randomized controlled trial

Abstract

BackgroundResearch has shown that treatments that solely addressed intimate partner violence (IPV) perpetration were not very effective in reducing IPV, possibly due to neglecting individual differences between IPV perpetrators. A large proportion of IPV perpetrators is diagnosed with co-occurring substance use disorders and it has been demonstrated that successful treatment of alcohol dependence among alcohol dependent IPV perpetrators also led to less IPV. The current study investigated the relative effectiveness of Integrated treatment for Substance abuse and Partner violence (I-StoP) to cognitive behavioral treatment addressing substance use disorders including only one session addressing partner violence (CBT-SUD+) among patients in substance abuse treatment who repeatedly committed IPV. Substance use and IPV perpetration were primary outcome measures.MethodPatients who entered substance abuse treatment were screened for IPV. Patients who disclosed at least 7 acts of physical IPV in the past year (N = 52) were randomly assigned to either I-StoP or CBT-SUD+. Patients in both conditions received 16 treatment sessions. Substance use and IPV perpetration were assessed at pretreatment, halfway treatment and posttreatment in blocks of 8 weeks. Both completers and intention-to-treat (ITT) analyses were performed.ResultsPatients (completers and ITT) in both conditions significantly improved regarding substance use and IPV perpetration at posttreatment compared with pretreatment. There were no differences in outcome between conditions. Completers in both conditions almost fully abstained from IPV in 8 weeks before the end of treatment.ConclusionsBoth I-StoP and CBT-SUD+ were effective in reducing substance use and IPV perpetration among patients in substance abuse treatment who repeatedly committed IPV and self-disclosed IPV perpetration. Since it is more cost and time-effective to implement CBT-SUD+ than I-StoP, it is suggested to treat IPV perpetrators in substance abuse treatment with CBT-SUD+.Trial registrationClinicalTrials.gov: NCT00847873

Safety for Aboriginal Women in Couples Counseling Where There is a History of Intimate Partner Violence

“…In couple counseling, the emphasis is on agreement (Raj et al, 2005), including personalized social attitudes about women (Coker et al, 2005;Young-Wolff et al, 2013) and their contribution to decisions made to stay together (Bent-Goodley, 2007). In addition, there were similarities between the participants in the present study and the literature on safety regarding the role of substance abuse in risk (Kraanen et al, 2013a(Kraanen et al, , 2013b. Both participants and the safety literature attended to the roles of financial independence and independent residential support (Pavao et al, 2007;Buzawa & Buzawa, 2013;Chen et al, 2013).…”

“…Internalized cultural and family pressures may be present, focused on male privilege or the importance for a couple to stay together (Bent-Goodley, 2007). Personal as well as perceived societal attitudes toward women with disability (Coker, Smith, & Fadden, 2005), mental health difficulty (Young-Wolff et al, 2013) or substance abuse (Kraanen, Vedel, Scholing, & Emmelkamp, 2013a, 2013b contribute to her reliance on a partner.…”

Increase of perceived frequency of neighborhood domestic violence is associated with increase of women's depression symptoms in a nationally representative longitudinal study in South Africa

“…While the search for effective mental health care strategies to reduce recidivism among perpetrators is ongoing, treatment of alcohol use disorders may be emerging as a method of reducing male perpetration (Kraanen et al, 2013; Stuart et al, 2013). …”

Physicians' Experiences with Male Patients Who Perpetrate Intimate Partner Violence

“…Research suggests that treating underlying comorbidities, such as alcohol dependence 32,33 and posttraumatic stress disorder, 34 can reduce IPV perpetration, but this may not address the underlying causes of IPV. Our study suggests that integrated behavioral health systems may be helpful in addressing these comorbidities, which is consistent with research that has shown that integrated behavioral health systems result in improved outcomes for patients with depression and anxiety.…”