Substance abuse and intimate partner violence: treatment considerations

Abstract

Given the increased use of marital-and family-based treatments as part of treatment for alcoholism and other drug disorders, providers are increasingly faced with the challenge of addressing intimate partner violence among their patients and their intimate partners. Yet, effective options for clinicians who confront this issue are extremely limited. While the typical response of providers is to refer these cases to some form of batterers' treatment, three fundamental concerns make this strategy problematic: (1) most of the agencies that provide batterers' treatment only accept individuals who are legally mandated to complete their programs; (2) among programs that do accept nonmandated patients, most substance-abusing patients do not accept such referrals or drop out early in the treatment process; and (3) available evidence suggests these programs may not be effective in reducing intimate partner violence. Given these very significant concerns with the current referral approach, coupled with the high incidence of IPV among individuals entering substance abuse treatment, providers need to develop strategies for addressing IPV that can be incorporated and integrated into their base intervention packages.

Advances in Management of Alcohol Use Disorders and Intimate Partner Violence: Community Reinforcement and Family Training

“…Thus, it appears that treating alcohol abuse also may be effective in reducing IPV (Klostermann, 2006).…”

“…In addition, those patients who engage in formal addiction treatments are usually not (adequately) assessed for IPV (Klostermann & FalsStewart, 2006). Coerced treatment may be another option (Collins & Allison 1983), but alcohol patients with co-occurring IPV are rarely mandated by the criminal justice system to engage in domestic violence intervention programs to target IPV (Klostermann, 2006). So the question remains as to how substance-using IPV perpetrators should be induced to enter formal treatment.…”

Helping Students to Understand the Link Between Substance Use and Intimate Partner Violence

“…Couples treatment of IPV is controversial primarily due to the inability to protect the victim from the perpetrator outside of the treatment relationship. However, experts in the addictions field are recommending treatment for IPV be a component of substance abuse treatment (Fals-Stewart & Clinton-Sherrod, 2009;Fals-Stewart & Kennedy, 2005;Klostermann, 2006;McLellan & Meyers, 2004). Klostermann (2006) noted that in most substance abuse treatment facilities, screening for IPV either was absent or inadequately assessed.…”

“…However, experts in the addictions field are recommending treatment for IPV be a component of substance abuse treatment (Fals-Stewart & Clinton-Sherrod, 2009;Fals-Stewart & Kennedy, 2005;Klostermann, 2006;McLellan & Meyers, 2004). Klostermann (2006) noted that in most substance abuse treatment facilities, screening for IPV either was absent or inadequately assessed. This is remarkable considering over 60% of men entering treatment reported being the perpetrator of IPV (Fals-Stewart & Clinton-Sherrod, 2009).…”

“…Second, conjoint therapy promotes open and forthright disclosure by the couple. This type of communication could lead to additional conflict and escalate to violence after the session ends (Klostermann, 2006). Addiction treatment professionals are advocating for behavioral couples therapy (BCT) to be used when IPV and substance abuse are present.…”