ERIC ED443053: Substance Abuse Treatment and Domestic Violence. Treatment Improvement Protocol (TIP) Series 25.

167 Pages·1997·2.2 MB·English

by  ERIC

DOCUMENT RESUME
CG 030 130
ED 443 053
Cook, Paddy; Gartner, Constance Grant; Markl, Lise;
AUTHOR
Henderson, Randi; Brooks, Margaret K.; Wesson, Donald;
Dogoloff, Mary Lou; Vitzthum, Virginia; Hayes, Elizabeth
Substance Abuse Treatment and Domestic Violence. Treatment
TITLE
Improvement Protocol (TIP) Series 25.
Substance Abuse and Mental Health Services Administration
INSTITUTION
(DHHS/PHS), Rockville, MD. Center for Substance Abuse
Treatment.
REPORT NO
SMA-00-3406
PUB DATE 1997-00-00
168p.; For other documents in the TIP Series, see CG 030
NOTE
098-103 and CG 030 131-134.
CONTRACT
270-95-0013
AVAILABLE FROM National Clearinghouse for Alcohol and Drug Information,
P.O. Box 2345, Rockville, MD 20847-2345. Tel: [phone]
(Toll Free).
-- Tests/Questionnaires (160)
Non-Classroom (055)
PUB TYPE
Guides
EDRS PRICE MF01/PC07 Plus Postage.
*Battered Women; Behavior Modification; Counseling;
DESCRIPTORS
Counselor Training; Decision Making Skills; *Drug
Rehabilitation; Family Counseling; *Family Violence;
Interpersonal Relationship; *Intervention; Males; Mental
Health; *Sex Role; *Substance Abuse
ABSTRACT
The major goal of this TIP, on the best practice guidelines
to improve the treatment of substance abuse, is to provide clinicians,
educators, and paraprofessionals with the latest findings concerning domestic
violence. The information is intended to educate providers about the needs
and behaviors of batterers and survivors, and how to tailor treatment plans
accordingly. The focus is on men who abuse their female partners and women
who are battered by their male partners. It reports that up to one half of
the men who commit acts of domestic violence also have substance abuse
problems. Failure to address domestic violence issues among substance abusers
can interfere with treatment effectiveness and contribute to relapse.
Chapters include information on the survivors of domestic violence, screening
and referral of survivors and batterers for additional services, legal
issues, coordinated community linkages, and a summary of recommendations. It
states that teaching decision-making skills to both the men and women
involved in domestic violence is a key aspect of treatment. Appendixes
include: "Bibliography," "Federal Confidentiality Regulations,"
"Instruments," "Sample Personalized Safety Plan for Domestic Violence
Survivors," "Hotlines and Other Resources for Domestic Violence and Related
Issues," "Resource Panel," and "Field Reviewers." (Contains approximately 200
resources.)
(JDM)
Reproductions supplied by EDRS are the best that can be made
from the original document.
Substance Abuse and Mental Health Services Administration
U.S. DEPARTMENT.
OF HEALTH AND
HUMAN SERVICES
Public Health Service
Center for Substance Abuse Treatment
Substance Abuse and
Mental Health Services
Administration
Substance
Abuse
Treatment and
Domestic
Violence
Treatment Improvement Protocol (TIP) Series
25
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U.S. DEPARTMENT OF EDUCATION
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EDUCATIONAL RESOURCES INFORMATION
CENTER (ERIC)
I'M
This document has been reproduced as
received from the person or organization
=1
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originating it.
Minor changes have been made to
CD
improve reproduction quality.
Points of view or opinions stated in this
document do not necessarily represent
Cool)
official OERI position or policy.
AVAILABLE
BEST COPY
HOTLINES
National Domestic Violence Hotline
Suite 101-297
3616 Far West Blvd.
Austin, TX 78731-3074
(800) 799-SAFE
[phone] (TDD)
Provides crisis intervention. information about
sources of assistance, and referrals to battered
women's shelters.
Rape, Abuse, and Incest National
Network (RA INN)
[phone]
Sexual assault survivors who call will be
automatically connected to a trained counselor at
the closest center in their area.
Childhelp USA/Forrester National
Child Abuse Hotline
(800) 4A-CHILD
With a focus on children and the prevention of
child abuse, this hotline provides crisis
counseling, referrals, and reporting guidance to
callers in crisis. Statistical and other informative
materials can be ordered through this number.
Access to information on partner violence is
limited.
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Substance
Abuse
Treatment and
Domestic
Violence
Treatment Improvement Protocol (TIP) Series
25
Patricia Anne Fazzone, R.N., D.N.Sc., M.P.H., C.S.
John Kingsley Holton, Ph.D.
Beth Glover Reed, Ph.D.
Consensus Panel Co-Chairs
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
Public Health Service
Substance Abuse and Mental Health Services Administration
Center for Substance Abuse Treatment
Rockwall II, 5600 Fishers Lane
Rockville, MD 20857
cJ
C.R.N.P., Ed.D., MaryLou Leonard, Pamela
This publication is part of the Substance
Nicholson, Annie Thornton, Jack Rhode,
Abuse Prevention and Treatment Block
Cecil Gross, Niyati Pandya, and Wendy
Grant technical assistance program. All
Carter for their considerable contributions to
material appearing in this volume except
that taken directly from copyrighted sources
this document.
is in the public domain and may be
The opinions expressed herein are the views
reproduced or copied without permission
of the Consensus Panel members and do not
from the Substance Abuse and Mental
reflect U.S. Department of Health and
Health Services Administration's
Human Services (DHHS). No official
(SAMHSA) Center for Substance Abuse
support or endorsement of CSAT,
Treatment (CSAT) or the authors. Citation
SAMHSA, or DHHS for these opinions or
of the source is appreciated.
for particular instruments or software that
may be described in this document is
This publication was written under contract
intended or should be inferred. The
number ADM 270-95-0013. Sandra
guidelines in this document should not be
Clunies, M.S., I.C.A.D.C., served as the
considered substitutes for individualized
CSAT Government project officer. Writers
patient care and treatment decisions.
were Paddy Cook, Constance Grant Gartner,
M.S.W., Lise Markl, Randi Henderson,
Margaret K. Brooks, Esq., Donald Wesson,
M.D., Mary Lou Dogoloff, Virginia
DHHS Publication No. (SMA) 00-3406
Vitzthum, and Elizabeth Hayes. Special
Printed 1997
thanks go to Daniel Vinson, M.D.,
Reprinted 2000
M.S.H.P., Mim J. Landry, Mary Smolenski,
Contents
What Is a TIP?
Editorial Advisory Board
vii
Consensus Panel
ix
Foreword
xi
Executive Summary and Recommendations
xiii
Scope of the TIP
xiii
Summary of Recommendations
xiv
Supplemental Materials
xviii
Chapter 1Effects of Domestic Violence on Substance Abuse Treatment
1
Defining the Problem
2
Identifying the Connections
3
A New Way of Thinking
7
Chapter 2Survivors of Domestic Violence: An Overview
9
Entering the Treatment System
9
Treatment Planning for the Survivor Client
11
Issues for Children of Survivors
17
Summary
19
Case Scenario: Profile of a Survivor
20
Chapter 3Batterers: An Overview
25
Perspectives on Substance Abuse and the Batterer Client
25
Profiling Batterers
26
Treatment Issues for the Substance-Abusing Batterer
32
Chapter 4Screening and Referral of Survivors and Batterers in Substance
Abuse Treatment Programs
37
Screening
37
Methods of Screening for Domestic Violence: Survivors
38
Screening for Domestic Violence: Batterers
42
Screening for Presence of Child Abuse
44
Referral
45
7
iii
Contents
Treatment Concerns for Survivors and Batterers
48
Chapter 5Legal Issues
51
Federal Law
51
Local Laws: Civil Protection and Restraining Orders
53
Other Legal Issues
54
Communicating With the Legal System
59
Dealing With the Police
60
Conclusion
61
Chapter 6Linkages: A Coordinated Community Response
63
Systemic Reform
64
Community-Based Linkages
65
Identifying Critical Linkages, Barriers, and Opportunities
68
Establishing a Linkage Relationship
68
Other Linkage Strategies
76
Examples of Effective Community-Based Linkages
77
Coordination of Care
79
Appendix ABibliography
81
Appendix BFederal Confidentiality Regulations
95
Types of Programs Covered by the Regulations
95
Federal Confidentiality Laws
96
Rules Governing Communication of Information
99
Five Other Exceptions to the General Confidentiality Rule
107
Other Requirements
111
Conclusion
111
Endnotes
111
Appendix CInstruments
115
Abuse Assessment Screen (English Version)
116
Encuesta Sobre El Maltrato (Spanish Version)
117
Danger Assessment
119
The Psychological Maltreatment of Women Inventory (PMWI)
121
The Revised Conflict Tactics Scale (CTS2) (for Couples)
123
Appendix DSample Personalized Safety Plan for Domestic Violence Survivors
127
Personalized Safety Plan
128
Telephone Numbers I Need to Know:
133
Appendix EHotlines and Other Resources for Domestic Violence and Related Issues
135
Hotlines
135
General Resources
136
Other Services
139
Appendix FResource Panel
147
Appendix GField Reviewers
149
iv
What Is
a
TIP?
Treatment Improvement Protocols (TIPs)
of discussions; the information and
are best practice guidelines for the
recommendations on which they reach
treatment of substance abuse, provided
consensus form the foundation of the TIP. The
as a service of the Substance Abuse and Mental
members of each Consensus Panel represent
Health Service Administration's Center for
substance abuse treatment programs, hospitals,
Substance Abuse Treatment (CSAT). CSAT's
community health centers, counseling
Office of Evaluation, Scientific Analysis, and
programs, criminal justice and child welfare
Synthesis draws on the experience and
agencies, and private practitioners. A Panel
knowledge of clinical, research, and
Chair (or Co-Chairs) ensures that the guidelines
administrative experts to produce the TIPs,
mirror the results of the group's collaboration.
which are distributed to a growing number of
A large and diverse group of experts closely
facilities and individuals across the country.
reviews the draft document. Once the changes
The audience for the TIPs is expanding beyond
recommended by these field reviewers have
public and private substance abuse treatment
been incorporated, the TIP is prepared for
facilities as alcohol and other drug disorders are
publication, in print and online. The TIPs can be
increasingly recognized as a major problem.
accessed via the Internet on the National Library
The TIPs Editorial Advisory Board, a
of Medicine's home page at the URL:
distinguished group of substance abuse experts
http: / /text.nlm.nih.gov. The move to electronic
and professionals in such related fields as
media also means that the TIPs can be updated
primary care, mental health, and social services,
more easily so they continue to provide the field
works with the State Alcohol and Other Drug
with state-of-the-art information.
Abuse Directors to generate topics for the TIPs
While each TIP strives to include an evidence
based on the field's current needs for
base for the practices it recommends, CSAT
information and guidance.
recognizes that the field of substance abuse
After selecting a topic, CSAT invites staff
treatment is evolving, and research frequently
from pertinent Federal agencies and national
lags behind the innovations pioneered in the
organizations to a Resource Panel that
field. A major goal of each TIP is to convey
recommends specific areas of focus as well as
"front-line" information quickly but
resources that should be considered in
responsibly. For this reason, recommendations
developing the content for the TIP. Then
proffered in the TIP are attributed to either
recommendations are communicated to a
Panelists' clinical experience or the literature. If
Consensus Panel composed of non-Federal
there is research to support a particular
experts on the topic who have been nominated
approach, citations are provided.
by their peers. This Panel participates in a series
What Is a TIP?
blueprint for a more integrated system of care
This TIP, Substance Abuse Treatment and
that would enhance treatment for both
Domestic Violence, presents treatment providers
with an introduction to the field of domestic
problems. This section includes practical
violence. It gives providers useful information
suggestions for establishing linkages both
on the role of substance abuse in domestic
between substance abuse treatment providers
violenceboth among the men who batter and
and domestic violence support workers and
the women who are battered. Useful techniques
with legal, health care, criminal justice, and
for detecting and eliciting such information are
other relevant service agencies.
supplied, along with ways to modify treatment
Other TIPs may be ordered by contacting The
to ensure victims' safety and to stop the cycle of
National Clearinghouse for Alcohol and Drug
violence in both parties' lives. Legal issues,
Information (NCADI), [phone] or (301) 468-
including duty to warn and confidentiality, are
2600; TDD (for hearing impaired), [phone].
discussed. Finally, the Panel provides a
10
vi