Quantifying Hybridity in Substance Use Treatment and Domestic Violence Intervention Programs

Background and Purpose.  There is little quantitative research describing collaboration of intimate partner violence (IPV) and alcohol and other drug (AOD) treatment agencies. This paper characterizes the current status of hybrid approaches to IPV and AOD interventions using data from a survey of 222 agencies which report providing both IPV and AOD services. This analysis aims to (1) quantify hybrid approaches to services for perpetrators of IPV, survivors of IPV, men in SU treatment, and women in SU treatment and (2) identify defining characteristics of organizations with high levels of IPV/AOD hybridity. 

Methods. Drawing from published lists, referrals, internet searches, solicitation of agencies identified in the literature, and snowball procedures, we constructed an initial sampling frame of 488 organizations, of which 338 (69.3%) responded and 222 (45.5%) completed the full online survey covering respondent information, organizational mission and goals, services provided, history and funding, location and physical layout, staff characteristics and training, coordination and community relations, and innovations in the area of services for co-occurring IPV and AOD. A 15-item pilot index of service and system hybridity was developed that quantified (1) the number of areas where the agency dually focused on AOD and IPV and (2) areas where the agency made changes to dually focus on both AOD and IPV. In addition to univariate and bivariate methods, we employed OLS regression to explore the relative contribution of key variables to IPV/AOD hybridity.

Results. A multidimensional typology categorized 29 (13.1%) agencies as AOD agencies, 94 (42.3%) as IPV agencies and 84 (37.8%) as multiservice agencies. Regardless of type, 94 agencies (43.1%) had programs for men with SU disorder, 122 (56.0%) had programs for women with SU disorder, 156 (71.6%) had programs for victims of IPV, and 114 (52.3%) had programs for perpetrators of IPV. The largest proportion of areas dually-focused on both SU and IPV were referrals (59.4% of agencies) and assessment (52.1%), with the least likely being dually-focused children’s services (27%) and outreach/case-finding (22.9%). The largest proportion of areas where the organization had changed in order to provide hybrid services were inter-agency collaboration (54.2%) and referral sources (53.1%) with the areas least likely to change being organizational structure (20.5%) and hiring (19.8%). Only four percent of organizations report making no changes. A significantly higher level of hybridity was found for multiservice (M=7.70±4.43) and AOD (M=7.03±3.52) agencies than in IPV agencies (M=5.94±4.10). Regression of the hybridity index on organizational characteristics yielded two independent predictors of IPV/AOD hybridity: the proportion of the agency clients who are women with co-occurring AOD (β=.49) and not being an AOD agency (β=.32).

Discussion and Implications.  The current study is limited by its exploratory measures and non-probability sampling, but adds to the discussion in an emergent area of research. Compared to IPV agencies, AOD agencies, especially those serving women, appear to have embraced hybrid approaches to IPV and AOD intervention. Hybrid approaches to IPV and AOD interventions are best conceptualized as a multidimensional construct ranging from service silos to fully integrated programs.