Interpersonal Violence: Global Impact and Paths to Prevention

Because a substantial proportion of sexual violence, stalking, and intimate partner violence is experienced at a young age, primary prevention of these forms of violence must begin early. Prevention efforts should take into consideration that female sexual violence and stalking victimization is perpetrated predominately by men and that a substantial proportion of male sexual violence and stalking victimization (including rape, unwanted sexual contact, noncontact unwanted sexual experiences, and stalking) also is perpetrated by men. CDC seeks to prevent these forms of violence with strategies that address known risk factors for perpetration and by changing social norms and behaviors by using bystander and other prevention strategies. In addition, primary prevention of intimate partner violence is focused on the promotion of healthy relationship behaviors and other protective factors, with the goal of helping adolescents develop these positive behaviors before their first relationships. The early promotion of healthy relationships while behaviors are still relatively modifiable makes it more likely that young persons can avoid violence in their relationships.

Poor Start: The Impact of the COVID-19 Pandemic on Early Childhood Development and Subsequent Human Capital Accumulation

Intimate Partner and Sexual Violence Prevention Among Youth: A Community Guide Systematic Review

World report on violence and health: What it means for children and pediatricians

South Africa has some of the highest rates of intimate partner and sexual violence globally, with prevalence ranging from 10% to 21% among adolescent girls and young women (AGYW). Yet, few studies characterize the relationship between violence and resilience. Identifying factors associated with resilience following exposure to violence can guide the development of strength-based interventions that change modifiable protective factors to bolster resilience. Data were derived from a cross-sectional survey of AGYW aged 15 to 24 years in South Africa that took place from 2017 to 2018. This survey was part of a national evaluation of a South African combination HIV intervention for AGYW funded by the Global Fund to Fight AIDS, TB, and Malaria. A sample of 4,399 observations was achieved through a systematic random sampling frame of 35% of households in districts where AGYW were at highest risk for HIV, and where the intervention was implemented. Resilience was assessed using the Connor-Davidson Resilience Scale. Intimate partner and sexual violence were assessed using: (a) an adapted version of a questionnaire from the World Health Organization's 2005 multicountry study on domestic violence against women, and (b) questions on lifetime experience of forced sex/rape. Nearly a third of AGYW (29.6%) reported intimate partner emotional and/or physical and/or sexual violence in the past year. Nearly a quarter of AGYW (23.74%) reported emotional violence, 17.48% reported physical violence, and 6.37% reported sexual violence from intimate partners. Nearly 8% (7.72%) reported forced sex/rape from intimate partners and/or nonpartners. More equitable gender norms, higher social support, and hazardous drinking were positively associated with higher resilience among those who experienced physical or sexual violence. This study addresses a gap in the resilience and violence literature. Future research should focus on the development of resilience-promoting interventions for individuals who have experienced violence.

BackgroundSince the 2008 advent of the smartphone, more than 180 billion copies of apps have been downloaded from Apple App Store, with more than 2.6 million apps available for Android and 2.2 million apps available for iOS. Many violence prevention and response apps have been developed as part of this app proliferation.ObjectiveThis study aims to evaluate the prevalence and quality of freely available mobile phone apps targeting intimate partner violence (IPV) and sexual violence (SV) prevention and response.MethodsWe conducted a systematic search of violence prevention and response mobile phone apps freely available in Apple App Store (iOS; March 2016) and Google Play Store (Android; July 2016). Search terms included violence prevention, sexual assault, domestic violence, intimate partner violence, sexual violence, forensic nursing, wife abuse, and rape. Apps were included for review if they were freely available, were available in English, and had a primary purpose of prevention of or response to SV or IPV regardless of app target end users.ResultsUsing the Mobile Application Rating Scale (MARS), we evaluated a total of 132 unique apps. The majority of included apps had a primary purpose of sharing information or resources. Included apps were of low-to-moderate quality, with the overall subjective quality mean for the reviewed apps being 2.65 (95% CI 2.58-2.72). Quality scores for each of the 5 MARS categories ranged from 2.80 (engagement) to 4.75 (functionality). An incidental but important finding of our review was the difficulty in searching for apps and the plethora of nonrelated apps that appear when searching for keywords such as “rape” and “domestic violence” that may be harmful to people seeking help.ConclusionsAlthough there are a variety of mobile apps available designed to provide information or other services related to SV and IPV, they range greatly in quality. They are also challenging to find, given the current infrastructure of app store searches, keyword prioritization, and highlighting based on user rating. It is important for providers to be aware of these resources and be knowledgeable about how to review and recommend mobile phone apps to patients, when appropriate.

Mindfulness-based interventions for women victims of interpersonal violence: A systematic review

South Africa (SA)'s high rate of interpersonal violence persists as a leading public health problem for the country. The first South African Comparative Risk Assessment Study (SACRA1) in 2000 quantified the long-term mental and physical health burden attributable to interpersonal violence by supplementing the direct injury burden of disease attributable to interpersonal violence injuries with the substantial contribution of mental health, behavioural and reproductive health consequences accruing from exposure to intimate partner violence (IPV) and child sexual abuse. To revise and improve these estimates by including the additional burden from other forms of child maltreatment, community violence, sexual violence by non-partners, and bullying victimisation in SA for 2000, 2006 and 2012, and trends over time. We used comparative risk assessment methods to calculate population attributable fractions (PAFs) for interpersonal violence. This method requires inputs on the prevalence of exposure to the interpersonal violence risk factor subtypes, namely child maltreatment, bullying, IPV, sexual violence by non-partners and other community violence; the burden of related health outcomes (mortality and morbidity); and relative risks of health outcomes in individuals exposed to the risk factor v. those unexposed. We estimated the PAF for the combinations of all interpersonal violence subtypes together to estimate the burden attributable to interpersonal violence overall for 2000, 2006 and 2012. Between 2000 and 2012, there was a decrease in interpersonal violence age-standardised attributable death rates from 100 to 71 per 100 000. In the second South African Comparative Risk Assessment Study (SACRA2), estimates of the attributable disability-adjusted life years (DALYs) for interpersonal violence for the year 2000 were revised, from 1.7 million to 2 million DALYs, taking into account attributable mortality and disability from additional forms of violence. There was a decrease in DALYs attributable to interpersonal violence from 2 million in 2000 to 1.75 million in 2012, accounting for 8.5% of the total burden for SA, ranking second highest, after unsafe sex, among 18 risk factors evaluated in 2012. Overall, interpersonal violence-attributable DALYs decreased substantially but remain high. The reduction in age-standardised attributable death rates indicates that some policy and social intervention aspects are effective. Further strengthening of existing laws pertaining to interpersonal violence, and other prevention measures, are needed to intensify the prevention of violence, particularly gender-based violence. Additional forms of violence included in this analysis have improved our understanding of the interpersonal violence burden, but the attributable burden in males, although exceedingly high, remains an underestimate. There is a need to improve the epidemiological data on prevalence and risks for the different types of interpersonal violence, particularly for males.

As a wicked problem, intimate partner violence (IPV) is complex, multi-dimensional and global. It is influenced by intersecting social, environmental, and political factors. Therefore, it requires a multifaceted response to minimize the health, economic and social burdens associated with experiences of violence. Given the complexity of the problem of IPV, a 'one size fits all' approach to assessment and response is no longer sufficient. Our efforts must now be focused on advancing nurses' skills to deliver care that is tailored to meet the diverse needs of women and other groups at disproportionate risk of IPV. These nurse-led interventions then need to be strategically implemented and sufficiently resourced within care contexts, where cultural, physical and emotional safety are prioritized. In this Special Issue we use selected examples of the included articles to illustrate how internationally, nurses are leading the development, evaluation, and implementation of healthcare responses to identify and respond to individuals experiencing IPV. However, because of the complexity and tenacity of the problem of IPV, we cannot stand still. Nursing needs to evolve and adapt. With this in mind, we focus on advances in the following areas: improving nurse education on IPV; person-centred and trauma-and violence-informed care; healthcare organization's initiatives to tackling IPV. Global estimates are that one in three women will experience IPV or non-partner sexual violence at least once in their lifetime (World Health Organization, 2021) and that interpersonal violence is associated with negative and serious reproductive, physical and mental health outcomes. In a study to determine the prevalence of dating violence (a risk indicator for future IPV) among nursing students enrolled at a university in Spain, Barroso-Corroto et al. (2023) reported that 53.2% of nursing students had experienced dating violence in the last year, with the same number perpetrating violence, including cyberviolence, against their partner. Given the high prevalence of IPV, we can postulate with a high degree of certainty that all nurses will provide care to a survivor of violence during their career or be a survivor themselves. Yet nursing students and practicing nurses remain woefully unprepared to ask about, and more critically to provide comprehensive nursing care in response to IPV disclosures. In two studies of nursing students from Thailand (Udmuangpia, 2023) and Saudi Arabia (Shaqiqi & Innab, 2023), many participants (40–75%) reported not receiving IPV education; and even in the presence of positive intentions, attitudes or knowledge to ask about IPV, participants consistently reported low perceptions about their intentions to ask, or preparedness to manage IPV disclosures. It is imperative that organizations responsible for the accreditation of nursing education programs develop entry-to-practice competencies for the nursing care of individuals who experience interpersonal trauma across the life course. Moreover, educational opportunities for nursing students and practicing nurses must advance beyond the provision of single workshops focused on the epidemiology and health consequences of IPV. Instead, there need to be comprehensive and regular opportunities to engage in opportunities for skill development, practice and reflection. In their integrative review of community nurse-led interventions to identify and respond to domestic abuse in the postnatal period, one of the key training recommendations proposed by Drake and Murphy Tighe (2023) is for the provision of training that includes refresher updating, supervision, and ongoing mentorship. Nursing needs to move on from a focus on identifying strategies and barriers to recognize or 'screen' for IPV. We know enough about the problem. It is imperative now that the spotlight is on how to create safe environments that facilitate disclosures and appropriate responses that meet the individual needs of people who have a history of past or current IPV. In all care contexts, when individuals disclose experiences of IPV, all nurses need to be prepared to provide the first-line response of LIVES (Listen, Inquire about needs, Validate, Enhance safety and support) as recommended by the World Health Organization (2014). However, there will be certain contexts where a homogenous response to an IPV disclosure is not sufficient, and nurses must have the knowledge and skills to provide care that is tailored to the needs of a specific population. This needs to reflect the type(s) of IPV experienced and include interventions to promote safety, as well as address the health effects of IPV. In this Special Issue, we are pleased to include articles that deepen our understanding of the prevalence, risk indicators and experiences of violence among diverse populations. Awareness and identification of populations at disproportionate risk for IPV are critical for providing person-centred responses to individuals' health and social needs within healthcare contexts. Using data from the Pregnancy Risk Assessment Monitoring System (United States), in a cross-sectional sample of 43,837 individuals with a live birth, respondents with disabilities had 2.6 times the odds of experiencing IPV before pregnancy and 2.5 times the odds of experiencing IPV during pregnancy, compared to individuals in the perinatal period without disabilities (Alhusen et al., 2023). In a systematic review to examine the relationship between IPV exposure and women with breast and gynaecologic cancers, Sheikhnezhad et al. (2023) highlight that women with these types of cancer are at the greatest risk of psychological IPV and that maintaining a relationship with the perpetrator negatively influenced their use and access to treatment and quality of life during treatment. In addition to recognizing violence perpetrated against women and children, nurses have a responsibility to understand the types of IPV experienced by people from sexual and gender minority populations. In a qualitative descriptive study, Choi et al. (2023) provide a rich and in-depth analysis of the varied types of sexual violence, including chemsex, stealthing and image-based violence, as experienced by Chinese men who have sex with men who use dating 'apps' in Hong Kong. Acceptance or 'normalization' of sexual violence, along with experiences of stigmatization and discrimination, provides insights on how experiences of violence subsequently influence their health behaviours, including reticence to obtain HIV post-exposure prophylaxis (Choi et al., 2023). Nurses' understanding that experiences of different types of IPV necessitates different nursing responses is also critical. In their commentary on nurses' experiences in identifying and responding to IPV among gay and bisexual men, Callan et al. (2023) challenge the profession to recognize that applying heterosexual paradigms to capture different experiences/types of abuse in gay and bisexual populations may be problematic, and that differential tools and tailored responses are needed. Individual nurses cannot be expected to practice within a vacuum. Comprehensive organizational support is essential for ensuring that IPV training initiatives are sustained and that nursing approaches to IPV assessment and intervention are implemented and consistently delivered. In Spain, Maquibar Landa et al. (2023) explain that the enactment of the 'Andalusion Protocol for Healthcare Response to Gender Based Violence' has enabled the establishment of a supportive legal framework and health system to address IPV, and that this has created a care context where nurses are able to implement evidence-informed practices for caring for women who have experienced IPV. At a practical level, organizational support should at minimum consist of an investment of time and resources to provide nurses with high-quality reflective and clinical supervision, the identification of IPV practice 'champions' to role model best practices, the development and implementation of care pathways, protocols and the establishment of partnerships between service organization to facilitate interagency referrals (Drake & Murphy Tighe, 2023; Jack et al., 2023). With strong leadership and organizational support, nurses are better able to provide the person-centred and trauma-and violence-informed nursing care that are required. We consider it important that nurses move beyond the often-standard processes of identifying IPV and then referring onto other specialized supports, to delivering interventions that address the social or health effects associated with exposure to violence or traumatic stress. In home visitation programmes, where nurses provide health promotion supports and services to pregnant individuals or families with young children, findings from a systematic review and qualitative meta-synthesis, indicate that nurses have specialized roles in conducting risk assessments to inform the development of tailored safety plans, promoting child safeguarding and coordinating services (Adams et al., 2023). Researchers in nursing and health services are actively engaged in developing and evaluating new interventions to address the health effects associated with violence exposure. For pregnant women who have experienced IPV, the provision of 12 sessions of trauma-and violence-informed cognitive behavioural therapy by a clinical nurse specialist is showing promise as an intervention to identify potential triggers in pregnancy, develop appropriate coping strategies and advocate for their needs to best cope with their stressors and pain (Mantler et al., 2023). Similarly, for nurses working with perpetrators of violence, a nurse-led, 15-session videoconference-delivered cognitive behavioural group therapy is also showing promise as an intervention where participants report high levels of satisfaction and completion (Nesset et al., 2023). For women who receive care after non-fatal strangulation in an emergency department, forensic nurse examiners have a critical role in assessing symptoms and injuries, communicating diagnoses, validating patient experiences and ensuring a thorough and objective documentation of their findings (Patch et al., 2023). By its very nature, a wicked problem is difficult to solve, but nursing makes a considerable contribution to addressing IPV. The articles in this Special Issue attest to the cutting-edge work happening within the profession and we are delighted to showcase such work within JAN. However, if nursing is to continue to make the required strides and impacts, we have highlighted the imperative to improve nursing education on IPV and for nursing care to be person-centred and trauma-and violence-informed. We have also called for healthcare organizations to provide the resources and infrastructure that are required to support nursing's contribution to tackling IPV. All authors agreed the parameters of the editorial and were involved with the handling of the submitted manuscripts. SJ led on the analysis of the included articles and preparation of the first draft of the manuscript. CB-J edited the manuscript and agreed on the final version. None. There was no funding to support this work. The authors declare no conflicts of interest.

Back to table of contents Previous article Next article Professional NewsFull AccessFree WPA Curriculum Available on Intimate Partner, Sexual ViolenceMark MoranMark MoranSearch for more papers by this authorPublished Online:17 Oct 2016https://doi.org/10.1176/appi.pn.2016.10b1AbstractThe curriculum is designed for training medical students, psychiatrists in residency programs, and practicing psychiatrists, with increasing levels of competency at each level.A new competency-based curriculum focusing on intimate partner violence and sexual violence against women, issued by the World Psychiatric Association (WPA), seeks to educate medical students, trainees, and practicing psychiatrists about interviewing, assessing, and treating women victims of intimate partner or sexual violence. The WPA’s International Competency-Based Curriculum for Mental Health Care Providers on Intimate Partner Violence/Sexual Violence Against Women, issued in July, is a 55-page document freely accessible on the WPA website. It outlines a wide range of teaching tools—didactic material, PowerPoint slides, case vignettes, and videos. “We owe it to our trainees to help them be up to speed on inter-viewing, assessing, and treating women exposed to intimate partner violence and sexual violence.” —Donna Stewart, M.D.The curriculum was developed by a steering committee of the WPA Section on Women’s Mental Health. Donna Stewart, M.D., co-chair of the committee and University Professor and chair of Women’s Health at the University of Toronto, said that psychiatric educators are welcome to use the resources in whole or in part with attribution.In an interview with Psychiatric News, Stewart said research indicates that few women who experience abuse or violence ever tell a health professional, and few physicians ask about intimate partner or sexual victimization. She said that’s true in mental health settings as well. The major barriers offered by psychiatrists for failing to discuss intimate partner or sexual violence include lack of adequate training about how to ask or respond, lack of knowledge regarding prevalence, skepticism about treatment effectiveness, concern about legal involvement, uncertainty about appropriate referrals, physician discomfort with the issues, time constraints, fear of offending or losing patients, and fear of safety for the women or oneself. “Worldwide the prevalence of intimate partner violence is at least 30 percent,” Stewart continued. “And we know that intimate partner violence and sexual violence dramatically affect mental health.” She added that while it is recognized that men can be victims of intimate partner violence, it is women who are disproportionately on the receiving end of such violence and tend to suffer greater injury.The curriculum is built around observable “competencies”—similar to the core competencies set by the Accreditation Council for Graduate Medical Education—that should be mastered in successive stages. The nine competencies described in the curriculum, each of which is divided into subtopics, require learners to be able to do the following: Define physical, psychological, and sexual intimate partner violence. Discuss prevalence.Be aware of myths and preconceptions.Have knowledge of sequelae. Assess for presence in a clinical setting.Provide psychological first aid.Have knowledge of resources.Communicate and document details of assessment.Manage violence-related psychological trauma.The curriculum offers five forms of resources. These include the World Health Organization’s Guidance on Health for Women subjected to intimate partner violence or sexual violence; links and abstracts of key papers, books, manual, and toolkits; a number of PowerPoint slides on intimate partner and sexual violence; case vignettes and teaching points; and video-based learning vignettes accessible on YouTube.One case vignette, for instance, is on “Treatment of Posttraumatic Stress Disorder After Sexual Violence (or Intimate Partner Violence)”: A family doctor refers a 25-year-old woman who was raped six months ago by an ex-partner to a community psychiatrist for intrusive memories of the assault, distressing dreams, flashbacks, avoidance of being alone, sadness, anxiety, trouble concentrating, hypervigilance, and inability to work. The woman was previously well and has no psychiatric history. The vignette is accompanied by teaching points about diagnosis, the range of treatment options, and documentation. Stewart said that the WPA’s Section on Women’s Mental Health began work on the curriculum three years ago, when the steering committee was selected from international leaders with expertise in intimate partner violence and sexual violence. It was cited as a priority by WPA President Dineesh Buhgra, M.D., Ph.D., of the United Kingdom. The co-chair of the curriculum steering committee is Prabha Chandra, M.D., professor and chair of the Department of Psychiatry at the National Institute of Mental Health and Neurosciences in Bangalore, India. Past APA President Michelle Riba, M.D., a member of the WPA Section on Women’s Mental Health and secretary of scientific publications for the WPA, said the curriculum is being disseminated at psychiatric meetings around the world, including APA’s, and a number of universities and training programs have already begun using it. The curriculum is accompanied by the Position Statement on Intimate Partner Violence and Sexual Violence Against Women, also issued in July, that declares the WPA’s support for public and professional awareness of violence against women as a critical women’s mental health determinant and for research to develop and evaluate the best treatments for women who have been victimized. “As many as 30 percent of our female patients will have experienced intimate partner violence, so we owe it to our trainees to help them be up to speed on interviewing, assessing, and treating women exposed to intimate partner violence and sexual violence,” Stewart said. “And practicing psychiatrists owe it to themselves and their patients to be current as well.” ■The International Competency-Based Curriculum for Mental Health Care Providers on Intimate Partner Violence/Sexual Violence Against Women can be accessed here. The WPA Position Statement on Intimate Partner Violence and Sexual Violence Against Women is available here. ISSUES NewArchived

Neighborhood Effects and Intimate Partner and Sexual Violence: Latest Results

A Systematic Review of Inflammatory Bowel Disease Epidemiology and Health Outcomes in Sexual and Gender Minority Individuals

Objective This study explored differences in attitudes about sexual violence, knowledge of intimate partner violence (IPV) prevention resources, and participation in IPV prevention activities among young men based on their fraternity membership and house status (ie, official house versus unofficial house versus no house). Participants: 1,457 undergraduate men completed surveys in the 2017–2018 academic year. Fraternity members indicated whether their fraternity had an official, unofficial, or no house. Methods: The survey included measures of attitudes towards sexual violence, knowledge of IPV resources, and participation in IPV prevention activities. Results: Fraternity members with unofficial houses were more accepting of sexual violence than nonmembers, whereas fraternity members with official houses were exposed to more IPV prevention messages than nonmembers. Conclusions: Results highlight the importance of considering fraternity house status as a risk factor for sexual violence. Unofficial houses that are not regulated by the university may be particularly problematic for IPV.

Rates of intimate partner violence (IPV) and HIV in South Africa are among the highest globally. IPV is associated with a range of adverse mental health and HIV outcomes. The Common Elements Treatment Approach (CETA) is a transdiagnostic, evidence-based intervention delivered by lay providers. To compare the effectiveness of CETA to active attention control in reducing IPV, depression, Post-Traumatic Stress Disorder (PTSD), and substance use among women at risk of poor HIV outcomes who have experienced IPV. Women living with HIV with an unsuppressed viral load or at risk for poor adherence and experienced past 12-month IPV were recruited from Johannesburg-area clinics and randomised 1:1 to CETA or control (SMS HIV appointment reminders plus safety checks and planning). The primary trial outcome was HIV retention and viral suppression, reported elsewhere. This paper reports secondary outcomes, evaluated at three and 12 months: IPV, depression, PTSD, and substance use. Participants were enrolled between November 11, 2021 to July 19, 2023 and randomised to CETA (N=202) or control (N=197). In the intent to treat analysis, the Cohen's d treatment effect for depression at three months was 0.24 (difference in mean change -3.1; 95% CI: -6.1, 0.1) and 0.48 at 12 months (-6.2; 95% CI: -9.5, -2.8). The PTSD treatment effect was 0.39 at three (-0.3; 95% CI: -0.5, -0.1) and 0.47 at 12 months (-0.3; 95% CI: -0.5, -0.2). Effect sizes were larger in a subgroup of participants with the top 50% of baseline symptom scores (depression: d=0.50, d=0.74; PTSD: d=0.58, d=0.94, at three and 12 months, respectively). There were no statistically significant differences in change for substance use or IPV. At baseline, only 12% of participants had past 3-month substance use and 32% had past 3-month or ongoing experiences of IPV, which made these outcomes challenging to evaluate. CETA was effective for reducing depression and PTSD including among high severity participants and at an extended follow-up. Future studies with increased power for substance use and IPV outcomes are warranted. CETA is a recommended treatment for depression and PTSD among this population. Clinicaltrials.gov NCT04242992 , registered January 27, 2020. What is already known about this topic?: Intimate partner violence (IPV) and related mental health problems are common in South Africa and can lead to poor HIV outcomes, such as low retention in care and viral non-suppression. There is a lack of evidence-based mental healthcare options for women living with HIV who have experienced IPV.What this study adds: Among women living with HIV and past-year IPV experiences, we found that Common Elements Treatment Approach (CETA) was an effective treatment for depression and PTSD compared to a control condition.How this study might affect research, practice, or policy: CETA is recommended to treat common mental health problems among women with HIV and experiences of IPV.

Women in substance use treatment are disproportionately affected by violence. Both a history of violence and substance use place women at risk for cumulative exposure to violence and adverse outcomes, including mental and physical health problems. Interventions are urgently needed to reduce these health disparities by preventing initial and repeated exposure to sexual and intimate partner violence among women with substance use disorders (SUDs). The Healthy Relationships and Interpersonal Violence Education (THRIVE) program adapts evidence-based strategies for this population and is informed by the information, motivation, behavioral skills theoretical model. Topics include the intersection of substance use and violence, consent, risk detection, protective behavioral strategies, and help seeking. THRIVE uses a novel approach by delivering the program via peer support specialists (PSSs), trained advocates in recovery from SUDs who can help overcome barriers to care, including stigma and accessibility. The first objective is to determine program acceptability and feasibility. The second objective is to determine the preliminary effectiveness of THRIVE, including its effect on violence-related knowledge and attitudes, protective behaviors, exposure to sexual and intimate partner violence, substance use, and mental health. The study entailed a single-arm trial of THRIVE with 71 women in behavioral and medication-assisted substance use treatment, recruited from 3 outpatient and residential treatment sites. Interview data assessing intervention acceptability and feasibility were collected from participants and PSSs. Participants completed assessments at 4 time points over 3 months (baseline, after the intervention, and 1- and 3-month follow-ups). Self-report questionnaires assessed (1) violence prevention knowledge, attitudes, and behaviors; (2) exposure to sexual and intimate partner violence; and (3) substance use and mental health. To determine acceptability and feasibility, both quantitative and qualitative data were collected on feasibility (recruitment and retention), adherence, and acceptability (engagement, perceived usefulness, barriers and facilitators to participation and adoption, and working alliance with PSSs). Of the 92 women recruited and enrolled, 71 (77%) completed the intervention, 58 (63%) completed the 1-month follow-up, and 44 (48%) completed the 3-month follow-up between June 2024 and March 2025. The mean age of enrolled participants was 35 (SD 9.87) years, and the majority were White (n=79, 86%), followed by Black (n=4, 4%) and other racial and ethnic identities (n=7, 8%). THRIVE will address critical gaps in the field by (1) expanding violence prevention strategies to SUD treatment settings, (2) integrating sexual and intimate partner violence prevention, (3) incorporating a focus on illicit substance use, and (4) engaging PSSs to overcome barriers to care. The long-term objective of this project is to develop an accessible, scalable, and efficacious prevention program that reduces the incidence of exposure to sexual and intimate partner violence, substance use, and violence-related mental health disorders for women in substance use treatment. ClinicalTrials.gov NCT06608979; https://clinicaltrials.gov/study/NCT06608979. DERR1-10.2196/68673.