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      The comparative effectiveness of Integrated treatment for Substance abuse and Partner violence (I-StoP) and substance abuse treatment alone: a randomized controlled trial

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          Abstract

          Background

          Research has shown that treatments that solely addressed intimate partner violence (IPV) perpetration were not very effective in reducing IPV, possibly due to neglecting individual differences between IPV perpetrators. A large proportion of IPV perpetrators is diagnosed with co-occurring substance use disorders and it has been demonstrated that successful treatment of alcohol dependence among alcohol dependent IPV perpetrators also led to less IPV. The current study investigated the relative effectiveness of Integrated treatment for Substance abuse and Partner violence (I-StoP) to cognitive behavioral treatment addressing substance use disorders including only one session addressing partner violence (CBT-SUD+) among patients in substance abuse treatment who repeatedly committed IPV. Substance use and IPV perpetration were primary outcome measures.

          Method

          Patients who entered substance abuse treatment were screened for IPV. Patients who disclosed at least 7 acts of physical IPV in the past year (N = 52) were randomly assigned to either I-StoP or CBT-SUD+. Patients in both conditions received 16 treatment sessions. Substance use and IPV perpetration were assessed at pretreatment, halfway treatment and posttreatment in blocks of 8 weeks. Both completers and intention-to-treat (ITT) analyses were performed.

          Results

          Patients (completers and ITT) in both conditions significantly improved regarding substance use and IPV perpetration at posttreatment compared with pretreatment. There were no differences in outcome between conditions. Completers in both conditions almost fully abstained from IPV in 8 weeks before the end of treatment.

          Conclusions

          Both I-StoP and CBT-SUD+ were effective in reducing substance use and IPV perpetration among patients in substance abuse treatment who repeatedly committed IPV and self-disclosed IPV perpetration. Since it is more cost and time-effective to implement CBT-SUD+ than I-StoP, it is suggested to treat IPV perpetrators in substance abuse treatment with CBT-SUD+.

          Trial registration

          ClinicalTrials.gov: NCT00847873

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          Most cited references56

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          Typologies of male batterers: three subtypes and the differences among them.

          Previous typologies of male batterers, including typologies developed by means of rational-deductive and empirical-inductive strategies, are reviewed. On the basis of this review, 3 descriptive dimensions (i.e., severity of marital violence, generality of the violence [toward the wife or toward others], and psychopathology/personality disorders) that consistently have been found to distinguish among subtypes of batterers are identified. These dimensions are used to propose a typology consisting of 3 subtypes of batterers (i.e., family only, dysphoric/borderline, and generally violent/antisocial). A developmental model of marital violence is then presented, and the previous literature is reviewed to examine how each batterer subtype might differ on variables of theoretical interest. Finally, some of the methodological limitations of previous typology research are reviewed, and suggestions for future work are offered.
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            Alcohol and intimate partner violence: a meta-analytic review.

            The link between alcohol use/abuse and partner violence attracted increasing research attention in the past decade. Some studies reported a null or weak association between alcohol use and intimate partner violence, whereas other studies reported a moderate or large association. Using a meta-analytic approach, the link between alcohol use/abuse and male-to-female partner violence as well as female-to-male partner violence was examined herein. The results indicate that there is a small to moderate effect size for the association between alcohol use/abuse and male-to-female partner violence and a small effect size for the association between alcohol use/abuse and female-to-male partner violence. For men only, several moderators were also examined and the magnitude of the effect sizes varied significantly as a function of the type of sample and type of alcohol measure selected. Specifically, there was a larger association of alcohol and aggression in clinical versus non-clinical samples and when measures assessed more severe alcohol problems.
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              The reliability of the Alcohol Timeline Followback when administered by telephone and by computer.

              The Alcohol Timeline Followback (TLFB) has been shown to be a psychometrically sound assessment instrument for obtaining retrospective daily estimates of alcohol consumption. These evaluations, however, have been limited to face-to-face paper-and-pencil interviews. As use of the TLFB method has increased, investigators have reported using the method to collect follow-up data by telephone. Also, as with many assessment instruments, a computerized version of the TLFB method has been developed. The psychometric characteristics of the TLFB method under these administration conditions have not been evaluated. This paper presents results from two studies showing that the Alcohol TLFB method can obtain reliable drinking data when administered over the telephone and by computer.
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                Author and article information

                Journal
                BMC Psychiatry
                BMC Psychiatry
                BMC Psychiatry
                BioMed Central
                1471-244X
                2013
                16 July 2013
                : 13
                : 189
                Affiliations
                [1 ]Department of Clinical Psychology, University of Amsterdam, Amsterdam, The Netherlands
                [2 ]Cognitive Science Center Amsterdam, University of Amsterdam, Amsterdam, The Netherlands
                [3 ]Forensic Outpatient Clinic De Waag, Amsterdam, The Netherlands
                [4 ]Jellinek Substance Abuse Treatment Centre, Arkin, Amsterdam, The Netherlands
                [5 ]King Abdulaziz University, Jeddah, Saudi Arabia
                Article
                1471-244X-13-189
                10.1186/1471-244X-13-189
                3716952
                24059784
                82f6c2d7-34f3-4f86-8873-0b3bd590ac45
                Copyright ©2013 Kraanen et al.; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 24 January 2013
                : 12 July 2013
                Categories
                Research Article

                Clinical Psychology & Psychiatry
                substance use disorders,intimate partner violence,perpetration,treatment,randomized controlled trial,comorbidity,cognitive behavior therapy

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