Addressing Intimate Partner Violence in Substance Abuse Treatment: Impact of Outcome-targeted Services

Background and Purpose: Intimate partner abuse is a widespread phenomenon among women in substance abuse treatment. While prevalence estimates in the general population range from 13% to 30%, rates for women in substance abuse treatment are approximated to be much higher, spanning from 25% to 57%. Moreover, women who enter treatment with a history of intimate partner violence are more likely to develop mental health disorders stemming from abuse and trauma. Yet despite these statistics, little is known about the services provided to this group of women. The present study responds to this gap in the literature by evaluating the impact of outcome-targeted services to address mental health and substance use outcomes for women in substance abuse treatment with and without a history of intimate partner violence.

Methods: The study uses data from the National Treatment Improvement Evaluation Study (NTIES), a prospective, cohort study of substance abuse treatment programs and clients (Gerstein et al., 1997). The analytic sample consists of 1,123 women from 50 treatment facilities. Descriptive comparisons were made using chi-square tests for categorical variables, and analysis of variance (ANOVA) for continuous variables. Generalized linear mixed modeling was used to assess the impact of receipt of comprehensive services on post-treatment substance use and mental health status, using interaction variables to test for moderating effects of intimate partner violence.

Results: The study findings offer support for the use of outcome-targeted services in substance abuse treatment. Receipt of mental health services is associated with improvement in mental health status for both groups of women. Moreover, receipt of substance abuse counseling is associated with decreased post-treatment drug use for all women. While receipt of concrete services is also significantly associated with decreased post-treatment drug use for both groups, women with a history of partner violence derive greater benefit from these services. Moreover, receipt of family services is associated with a decrease in post-treatment substance use only for women with a history of partner violence.

Conclusions: This study highlights the positive impact of targeted services in substance abuse treatment for women with and without a history of intimate partner violence. In this analysis, women who received targeted services to address mental health and substance abuse outcomes were more successful in making improvements than women who did not. Moreover, the availability of additional supportive services to meet the complex needs of women who have experienced intimate partner violence may also be important in helping women to reduce their substance use at post-treatment. The findings suggest that receipt of concrete services to help women obtain housing and income support, and family services to enable women to strengthen their families and enhance social support networks, plays an important role in facilitating recovery.