Using the Behaviour Change Wheel to design an intervention for partner abusive men in drug and alcohol treatment

Abstract

Background We aimed to establish what core elements were required in a group therapy programme for men who disclose perpetrating intimate partner abuse in a substance use setting and develop, and test the feasibility of delivering an intervention in this setting. Methods We describe the theoretical development and feasibility testing of an integrated substance use and intimate partner abuse intervention (‘ADVANCE’) for delivery in substance use services. We employed a comprehensive eight-stage process to guide this development applying the ‘COM-B’ (‘capability’, ‘opportunity’, ‘motivation’ and ‘behaviour’) model for intervention design which specifies the following: (1) define the problem, (2) select the target behaviour, (3) specify the target behaviour, (4) identify what needs to change, (5) identify intervention functions, (6) identify policy categories, (7) select behaviour change techniques, and (8) design a mode of delivery. The development was informed by primary research conducted by the authors, consulting with organisation steering groups and by those with personal experiences. The identified targets for intervention and mode and method of delivery were then refined over 4 intervention development meetings, using the nominal group technique with the ADVANCE experts, then further refined following consultation with service user groups and wider expert groups via a learning alliance meetings. Results Our final intervention, the ADVANCE intervention consisted of a group intervention comprising of up to four pre-group individual interviews, followed by 12 × 2-h group sessions supported by integrated safety work for victim/survivors, and risk and safety support and integrity support for the professionals. The main targets for change were personal goal planning, self-regulation, and attitudes and beliefs supporting intimate partner abuse. The intervention was regarded as very acceptable to both staff and clients in substance use services, with group attendees reported positive behaviour changes and development of new skills. Conclusion We have demonstrated the ability to employ a structured eight-step process to develop an integrated intervention to address substance use-related intimate partner abuse that is acceptable to staff and clients in substance use services. This led to a feasibility study (ISRCTN 79435190) involving 104 men and 30 staff at three different locations across the UK was conducted to assess the feasibility and acceptability of the intervention and to refine the content and approach to delivery (BMC Public Health, 21: 980, 2021).

Trends in outcomes used to measure the effectiveness of UK-based support interventions and services targeted at adults with experience of domestic and sexual violence and abuse: a scoping review

“…80 studies from 111 reports were included in this review (see figure 1). Data extracted from the included studies are summarised in online supplemental appendix 4 and figure 2 51 68–177…”

Participants in Court-mandated Intervention Programs for Intimate Partner Violence Perpetrators with Substance Use Problems: A Systematic Review of Specific Risk Factors

“…For example, a systematic review conducted by Gilchrist et al (2015) of the effectiveness of cognitive behavioural therapy with anger management components for IPV perpetrators who used alcohol showed promising results in the short term and suggested that more research is needed to match this group of IPV perpetrators with specific intervention programs that address their individual needs. Enhancing distress tolerance for perpetrators who use substances has been shown to promote positive behaviour change and skills development ( Gilchrist, Johnson, et al, 2021 ; Gilchrist, Potts, et al, 2021 ).…”

Evaluating the programme and behavior change theories of a community alcohol education intervention in rural Sri Lanka: a study protocol

“…Developed to identify the intervention components most appropriate to effect the desired change, the BCW has previously been used for intervention development and evaluation and to structure reviews – including in interventions focusing on alcohol [ 57 , 58 ]. For example, Gilchrist et al used the BCW during the theoretical development and feasibility testing of an intervention addressing substance use and intimate partner violence [ 59 ]. Of note, pre-specifying the behaviour change mechanisms in the design phase allowed us to, not only develop the intervention, but also to adapt it to the changing environment following COVID-19 and the financial crisis.…”