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.
Highlights
Effective treatment options for providers who must deal with this issue are limited
Much of the debate about intimate partner violence (IPV) is focused on Intimate Terrorism, despite the fact that most partners who report and enter treatment for IPV engage in violence that more closely resembles Situational Couple Violence
Well-intentioned, it is important to recognize that doing what we have been doing in most substance abuse treatment programs is potentially placing patients and their families at risk
Summary
While some studies indicate that batterer treatment programs are moderately effective [24], the findings of a recently completed meta-analytic review reveals little or no effects for these programs [29], a conclusion that is consistent with several recently completed experimental studies [47] These findings raise important questions about the usual response to IPV by clinicians and members of the criminal justice system of mandating perpetrators to traditional domestic violence treatment. While it appears that treating alcohol use is an effective approach to reducing IPV, this is not a common strategy.
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