The Impact of Comprehensive Services for Women with a History of Intimate Partner Violence in Substance Abuse Treatment

Background: An alarmingly high proportion of women who enter substance abuse treatment have experienced violence at the hands of an intimate partner. While estimates of the prevalence of intimate partner violence in the general population range from 13% to 30%, prevalence rates for women in substance abuse treatment are approximated to be much higher, spanning from 25% to 57%. Yet despite these statistics, little is known about the services provided to this group of women, and the impact of these services on post-treatment outcomes. In an attempt to address this gap in the literature, the present study will assess the differential impact of targeted services on post-treatment substance use for women with and without a history of intimate partner violence in substance abuse treatment.

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 determine whether a history of intimate partner violence moderates the impact of receipt of comprehensive services on post-treatment substance use. Missing values were specified for these comparisons.

Results: Study findings indicate that women with a history of intimate partner violence differ from other women in their pathways to recovery. While receipt of concrete services, such as housing and assistance obtaining benefits, is significantly associated with decreased post-treatment drug use for all women, women with a history of intimate 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 intimate partner violence. Yet despite the importance of concrete and family services, women with a history of intimate partner violence were no more likely to receive them than other women.

Conclusions: These findings suggest that services that focus on connecting women with concrete resources, and strengthening their families and support networks are particularly important in facilitating treatment success for women with a history of intimate partner violence. These findings are congruent with literature on intimate partner abuse and trauma among women in substance abuse treatment, which stress the importance of enabling women to achieve safety and foster greater stability for their families. While prior research suggests that comprehensive services in substance abuse treatment are important for all clients, these services may be crucial for women who have been victimized by intimate partner abuse.