This TIP, Substance Abuse Treatment and Domestic Violence, presents treatment providers with an introduction to the field of domestic violence. It gives providers useful information on the role of substance abuse in domestic violence—both among the men who batter and the women who are battered. Useful techniques for detecting and eliciting such information are supplied, along with ways to modify treatment to ensure victims' safety and to stop the cycle of violence in both parties' lives. Legal issues, including duty to warn and confidentiality, are discussed. Finally, the Panel provides a blueprint for a more integrated system of care that would enhance treatment for both problems. This section includes practical suggestions for establishing linkages both between substance abuse treatment providers and domestic violence support workers and with legal, health care, criminal justice, and other relevant service agencies.

Contents

• What Is a TIP?
• Editorial Advisory Board
• Consensus Panel
• Foreword
• Executive Summary and Recommendations
• Chapter 1—Effects of Domestic Violence on Substance Abuse Treatment
  • Defining the Problem
  • Identifying the Connections
  • A New Way of Thinking
• Chapter 2—Survivors of Domestic Violence: An Overview
  • Entering the Treatment System
  • Treatment Planning for The Survivor Client
  • Issues for Children Of Survivors
  • Summary
  • Case Scenario: Profile Of a Survivor
• Chapter 3 -- Batterers: An Overview
  • Perspectives on Substance Abuse and The Batterer Client
  • Profiling Batterers
  • Treatment Issues for the Substance-Abusing Batterer
• Chapter 4—Screening and Referral of Survivors and Batterers in Substance Abuse Treatment Programs
  • Screening
  • Methods of Screening For Domestic Violence: Survivors
  • Screening for Domestic Violence: Batterers
  • Screening for Presence Of Child Abuse
  • Referral
  • Treatment Concerns for Survivors and Batterers
• Chapter 5—Legal Issues
  • Federal Law
  • Local Laws: Civil Protection and Restraining Orders
  • Other Legal Issues
  • Communicating With The Legal System
  • Dealing With the Police
  • Conclusion
• Chapter 6 -- Linkages: A Coordinated Community Response
  • Systemic Reform
  • Community-Based Linkages
  • Identifying Critical Linkages, Barriers, And Opportunities
  • Establishing a Linkage Relationship
  • Other Linkage Strategies
  • Examples of Effective Community-Based Linkages
  • Coordination of Care
• Appendix A -- Bibliography
• Appendix B—Federal Confidentiality Regulations
• Appendix C—Instruments
• Appendix D—Sample Personalized Safety Plan For Domestic Violence Survivors
• Appendix E—Hotlines and Other Resources For Domestic Violence and Related Issues
• Appendix F—Resource Panel
• Appendix G—Field Reviewers
• Tables and Figures

This publication is part of the Substance Abuse Prevention and Treatment Block Grant technical assistance program. This publication was written under contract number ADM 270-95-0013. Sandra Clunies, MS, ICADC, served as the CSAT Government project officer. Writers were Paddy Cook, Constance Grant Gartner, MSW, Lise Markl, Randi Henderson, Margaret K Brooks, Esq, Donald Wesson, MD, Mary Lou Dogoloff, Virginia Vitzthum, and Elizabeth Hayes. Special thanks go to Daniel Vinson, MD, MSHP, Mim J Landry, Mary Smolenski, CRNP, EdD, MaryLou Leonard, Pamela Nicholson, Annie Thornton, Jack Rhode, Cecil Gross, Niyati Pandya, and Wendy Carter for their considerable contributions to this document.

The opinions expressed herein are the views of the Consensus Panel members and do not reflect the official position of CSAT, SAMHSA, or the U.S. Department of Health and Human Services (DHHS). No official support or endorsement of CSAT, SAMHSA, or DHHS for these opinions or for particular instruments or software that may be described in this document is intended or should be inferred. The guidelines in this document should not be considered substitutes for individualized patient care and treatment decisions.