Systemic perspectives on Intimate Partner Violence treatment

This paper reviews changes in the research literature on Intimate Partner Violence (IPV) since our earlier review (Stith, Rosen, & McCollum, 2003). A rationale for systemic treatment of IPV has emerged from research that has continued to document the limited effectiveness of single gender treatment approaches for offenders and that has identified sub-types of abusive relationships, including Situational Couple Violence, that often includes the reciprocal use of violence. Consistent findings from the available outcome research have demonstrated that for carefully screened couples who choose to stay together, systemic interventions decrease incidences of IPV and decrease the risk factors for IPV with no increase in risk. Implications for research and treatment are offered

Behavioral Couple Therapy: Partner-Involved Treatment for Substance-Abusing Women

Among the various psychosocial interventions presently available to treat alcohol and drug abuse, it could be argued that partner-involved treatments are the most broadly efficacious. There is not only substantial empirical support for the use of couple-based treatments in terms of improvements in primary targeted outcomes, such as substance use and relationship adjustment, but also in other areas that are of clear public health significance, including intimate partner violence (IPV), children\u27s adjustment, and cost-benefit ratio and cost-effectiveness. During the last few decades, programmatic research on the application of partner-involved therapies for substance abuse has been among the most active and fruitful. Although marital and family therapies for substance abuse have been used with a wide variety of patient populations, the purpose of this chapter is to focus on the application of partner-involved interventions with women who abuse substances and are in intimate relationships. More specifically, we (1) provide a conceptual rationale as to why couple therapy for female patients with substance abuse problems may be particularly appealing, compared to more traditional individual-based approaches; (2) describe theoretical and practical considerations involved when implementing couple therapy with these patients; (3) examine available evidence for the efficacy of couple therapy with female patients who abuse alcohol and drug; and (4) discuss future directions with respect to partner-involved therapies with these patients

Work and Family Variables as Related to Paternal Engagement, Responsibility, and Accessibility in Dual-Earner Couples with Young Children

Fathers and mothers (N = 75 dual-earner couples) of preschool-aged children completed questionnaires that examined work and family variables as related to paternal involvement in three areas: engagement (i.e., directly interacting with the child), responsibility (i.e., scheduling activities and being accountable for the child\u27s well-being), and accessibility (i.e., being available to the child but not in direct interaction). Fathers\u27 reports of responsibility and accessibility were significantly predicted by structural variables and beliefs; however, fathers\u27 reports of engagement were not predicted by work and family variables. Mothers\u27 reports of work and family variables did not predict their reports of father involvement. These findings suggest that for fathers of young children, parental involvement appears mainly self-determined

Estimating statistical power for open-enrollment group treatment trials

Modeling turnover in group membership has been identified as a key barrier contributing to a disconnect between the manner in which behavioral treatment is conducted (open enrollment groups) and the designs of substance abuse treatment trials (closed enrollment groups, individual therapy). Latent class pattern mixture models (LCPMM) are an emerging tool for modeling data from open enrollment groups with membership turnover in recently proposed treatment trials. The current article illustrates an approach to conducting power analyses for open enrollment designs based on Monte Carlo simulation of LCPMM models using parameters derived from published data from an RCT comparing Seeking Safety to a Community Care condition for women presenting with comorbid PTSD and substance use disorders. The example addresses discrepancies between the analysis framework assumed in power analyses of many recently-proposed open enrollment trials and the proposed use of LCPMM for data analysis

Alcoholism and Intimate Partner Violence: Effects on Children’s Psychosocial Adjustment

It is widely recognized that alcoholism and relationship violence often have serious consequences for adults; however, children living with alcoholic parents are susceptible to the deleterious familial environments these caregivers frequently create. Given the prevalence of IPV among patients entering substance abuse treatment, coupled with the negative familial consequences associated with these types of behavior, this review explores what have been, to this point, two divergent lines of research: (a) the effects of parental alcoholism on children, and (b) the effects of children’s exposure to intimate partner violence. In this article, the interrelationship between alcoholism and IPV is examined, with an emphasis on the developmental impact of these behaviors (individually and together) on children living in the home and offers recommendations for future research directions

What should be done with antisocial personality disorder in the new edition of the diagnostic and statistical manual of mental disorders (DSM-V)?

Antisocial personality disorder, psychopathy, dissocial personality disorder and sociopathy are constructs that have generally been used to predict recidivism and dangerousness, alongside being used to exclude patients from treatment services. However, 'antisocial personality disorder' has recently begun to emerge as a treatment diagnosis, a development reflected within cognitive behaviour therapy and mentalisation-based psychotherapy. Many of the behaviour characteristics of antisocial personality disorder are, at the same time, being targeted by interventions at criminal justice settings. A significantly higher proportion of published articles focusing on antisocial personality concern treatment when compared to articles on psychopathy. Currently, the proposal for antisocial personality disorder for the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, suggests a major change in the criteria for this disorder. While the present definition focuses mainly on observable behaviours, the proposed revision stresses interpersonal and emotional aspects of the disorder drawing on the concept of psychopathy. The present commentary suggests that developments leading to improvement in the diagnosis of this type of disorder should, rather than focusing exclusively on elements such as dangerousness and risk assessment, point us to ways in which patients can be treated for their problems

Validity of self-reported criminal justice system involvement in substance abusing women at five-year follow-up

<p>Abstract</p> <p>Background</p> <p>Few studies have compared self-reported criminal behaviour with high-quality databases of criminal offences and judicial sanctions. Self-reported problems from drug abusers are generally believed to be valid. We assessed the validity of self-reported theft, drug offences and prison sentences from a five-year follow-up of female substance abusers who were originally treated in a compulsory care unit in Lund, run by the Swedish Board of Institutional Care.</p> <p>Methods</p> <p>Data from a total of 106 of a consecutive sample of 132 women inter-viewed in a five-year follow-up. All were thoroughly assessed for somatic complaints, psychiatric and psychological problems, background factors with standardized instruments. Data over the five years were linked to official records of judicial sanctions, retrieved from The National Council for Crime Prevention, Stockholm, Sweden. Register data have a full cover for the whole cohort. The current data base contain full data back to 1975 up to 2004.</p> <p>Results</p> <p>Agreement was assessed for each year, as well as for the total period. Statistical control was performed for other types of crimes and prison. Although statistically significant, agreement was modest, and in contrast to previous studies, patients under-reported violence charges.</p> <p>Conclusion</p> <p>The findings suggest that self-reports of criminal behaviour from women can be used with some caution, and that the validity of self-report may vary between types of criminal justice system involvement.</p

Substance abuse and intimate partner violence: treatment considerations

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