Intimate partner violence perpetration by men in substance use treatment, a mixed-methods study 2014-2015

Gilchrist, Gail and Radcliffe, Polly and Lea, Susan and Flavia Lucas D’Oliveira, Ana and dos Santos Figueiredo, Wagner and Regina Noto, Ana (2019). Intimate partner violence perpetration by men in substance use treatment, a mixed-methods study 2014-2015. [Data Collection]. Colchester, Essex: UK Data Archive. 10.5255/UKDA-SN-853021

Intimate partner violence (IPV) (physical, sexual or psychological abuse) occurs in all countries, cultures and among all ethnic groups; however, there are culture-specific characteristics that need to be considered in prevention and treatment including: cultural definitions and expectations of appropriate sex roles, belief in the inherent superiority of males and acceptability of violence in conflict resolution. Despite this, our understanding of the role that cultural beliefs play in IPV perpetration is limited.
Males in substance abuse treatment are more likely to be violent towards their female partners than non-substance abusers. Research suggests that 34-68% of men in substance abuse treatment have a history of IPV. Despite this, many perpetrator interventions do not address substance use, and therefore, reach far fewer individuals than substance abuse treatment programmes could. As a result, it has been argued that treatment for IPV should be integrated into substance abuse treatment. Currently, most substance abuse services lack the competencies to respond effectively to IPV. Few studies have examined IPV perpetration among substance abusers. None have examined cross-cultural issues.
This project examined and compared the prevalence and cultural construction of IPV perpetration by males in substance abuse treatment in London and South East England (England) and Sao Paulo (Brazil). In addition, current policies, treatment protocols and care pathways for male substance abusing perpetrators in both countries were reviewed, and key stakeholders interviewed to identify the barriers and facilitators to working with this client group. The research informed the development of an evidence and theory based cross-cultural capacity framework for working effectively with male perpetrators in substance abuse treatment. An International Learning Alliance Steering Group of expert academics, practitioners and policy makers from England, Brazil, Spain and the US was established at the initiation of the project; to strengthen and support the exchange and dissemination of information, research, best practice and policy, and to determine how alcohol and drug services can best respond to IPV perpetration. In addition, local Learning Alliance networks of service users and providers, policy makers and academics were established in both London and Sao Paulo to develop cross-sector solutions to this complex problem, building on the knowledge transferred from this project into practice, thereby improving interventions for substance abusers who perpetrate IPV.
The major potential benefit of this project is the capacity framework, developed collaboratively and inter-disciplinarily by members participating in the International Learning Alliance Steering Group and the local Learning Alliance networks in London and Sao Paulo. The framework considers how best to identify, assess and respond to intimate partner violence in substance abuse treatment and will clearly lay out the expected minimum standards for practice in working with perpetrators for the three levels of the substance abuse treatment workforce.
The mainstreaming of IPV perpetration interventions to substance abuse treatment will ensure that perpetrator interventions reach a wider number of perpetrators than the Criminal Justice or Domestic Violence programmes alone and may decrease substance use and violence and improve the family functioning as a whole. In addition, these local partnerships between the substance abuse and domestic violence sectors will foster collaborative and cross-agency working; and raise awareness of the need for integrated policy for both sectors.
Annually, IPV costs in the UK are estimated at £36.7 billion. Potential benefits of this work include the reduction of IPV perpetration by male substance abusers that should lead to a reduction in the resulting financial burden.

Data description (abstract)

Interviews with 504 men receiving community treatment for alcohol and/or drugs in London and South East England, England (n=223) and Sao Paulo, Brazil (n=281) using a questionnaire to determine the lifetime and 12-month prevalence and factors associated with ever perpetrating intimate partner violence (IPV). Emotional, physical and/or sexual IPV, controlling behaviours, adverse childhood experiences, attitudes towards gender relations and roles, current health state, substance use, depressive symptoms and anger expression were assessed. Thereafter, semi-structured interviews were conducted with 40 (20 from England and 20 from Brazil) of the men who had reported IPV perpetration in the questionnaire interview.

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