Addressing Both Intimate Partner Violence and Alcohol/Other Drugs: Hybrid Innovations in Contested Spaces

Approaches for addressing Intimate partner violence (IPV) and Alcohol/Other Drugs (AOD) have evolved differently, in assumptions about causes, how best to intervene, and funding and regulatory mechanisms. Although IPV and AOD are frequently intertwined, studies identify many barriers to addressing both together, but great need. An example of trench to bench, practice-based knowledge development, this study addresses the following questions.  What have organizations and practitioners that address both IPV and AOD learned about a) strategies for different environments and populations, and b) how to navigate barriers and competing paradigms?

Methods:  Case study and comparative case study methods were employed within grounded theory frameworks. Organizations [N=35] were identified in 20 states and Canada by expert and funder referrals, internet and literature searches, multiple list-serves, and snowball techniques. Most completed an 88 item screening survey. All attend to both IPV and AOD, with 12 located primarily in the IPV field, 9 primarily in the AOD field, and 9 defined as multiservice or with a another primary emphasis. Five more are primarily woman-centered and bridge both fields: two specialize in IPV and AOD. Case studies integrated information from multiple sources: websites, program reports, tax information, the screening survey, one or more intensive interviews with a knowledgeable informant, and in some cases, a site visit. Multiple comparative databases were analyzed (field and organizational characteristics (2), transactions with environments (4), participant focused activities (5), and ethical/other dilemmas. Analyses included investigator, theoretical, data, and procedural triangulation, with axial and deep coding of emerging themes and patterns.

Results:  Some organizations achieved hybrid approaches through collaborations with one or more organizations in the other field, or among units in multiservice organizations (e.g., referrals, staff exchanges, case conferences). Other organizations in either the IPV or AOD fields expanded their internal approaches to incorporate elements more common in the other field (e.g., a specialized unit to for AOD in an IPV organization or a batterers’ intervention program in an AOD organization). Some organizations with high levels of hybridity included both collaboration and expansion strategies. Other very hybrid organizations developed overarching philosophies that allowed them to bridge fields (e.g., trauma, readiness to change, harm reduction). Types of staff employed, their training and supervision were key elements in hybridity strategies (e.g., hiring someone with substantial knowledge/credentials from the other field), or were highly influenced by their overall organizational hybridity strategies (e.g., everyone cross-trained in very hybrid organizations).

Discussion: Results from this purposive sample allow us to characterize the innovative ways programs are implementing hybridity, but cannot be generalized to other types of organizations. Additional methodological issues include locating and screening different types of organizations engaged in hybrid work, identifying and operationalizing types and levels of hybridity, and characterizing important aspects of their environments. Very hybrid organizations used many strategies to implement hybridity. These were influenced by their primary missions, staff who understood both fields, whether they worked with survivors or perpetrators or both, and available community resources. How power and gender were understood and navigated differed substantially across approaches.