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Expósito-Álvarez C, Roldán-Pardo M, Gilchrist G, Lila M. Integrated Motivational Strategies for Intimate Partner Violence Perpetrators with Substance Use: A Randomized Controlled Trial. PSYCHOSOCIAL INTERVENTION 2024; 33:187-200. [PMID: 39234359 PMCID: PMC11370286 DOI: 10.5093/pi2024a13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Accepted: 07/03/2024] [Indexed: 09/06/2024]
Abstract
Objective: Intimate partner violence (IPV) perpetrators with alcohol and/or other drug use problems (ADUPs) have been identified as one of the main high-risk and highly resistant groups of perpetrators requiring special attention in intervention programs for IPV perpetrators. This randomized controlled trial (RCT) aimed to evaluate whether an individualized motivational plan adjusted to ADUPs (IMP-ADUPs) was superior to standard motivational strategies (IMP) in reducing ADUPs, and IPV and increasing treatment adherence in IPV perpetrators. Method: Data from a full sample of IPV perpetrators (n = 140) and a subsample of participants with ADUPs (n = 55) were collected at pre- and post-intervention and 12-month follow-up. Final outcomes included alcohol, cocaine, and cannabis use, self-reported IPV, risk of recidivism assessed by facilitators, and official IPV recidivism. Proximal outcomes included treatment adherence (stage of change, intervention dose, active participation, and dropout). Results: Both intent-to-treat (ITT) and per-protocol (PP) analyses were conducted. The IMP-ADUPs condition was superior to the IMP in reducing alcohol use at post-intervention in both the full sample and ADUPs subsample. The full sample of participants in the IMP-ADUPs condition were in a more advanced stage of change post-intervention and showed increased active participation during the intervention process than IMP participants. All participants were in a more advanced stage of change at post-intervention and reduced their alcohol use and their risk of recidivism at post-intervention and 12-month follow-up. Conclusions: These results underscore the need to develop individualized treatment approaches to address participants' risks and needs and promote their motivation to change.
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Affiliation(s)
- Cristina Expósito-Álvarez
- University of ValenciaFaculty of Psychology and Speech TherapyDepartment of Social PsychologySpainDepartment of Social Psychology, Faculty of Psychology and Speech Therapy, University of Valencia, Spain;
| | - Manuel Roldán-Pardo
- University of ValenciaFaculty of Psychology and Speech TherapyDepartment of Social PsychologySpainDepartment of Social Psychology, Faculty of Psychology and Speech Therapy, University of Valencia, Spain;
| | - Gail Gilchrist
- King’s College LondonNational Addiction Centre, Institute of Psychiatry, Psychology & NeuroscienceUKNational Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, UK
| | - Marisol Lila
- University of ValenciaFaculty of Psychology and Speech TherapyDepartment of Social PsychologySpainDepartment of Social Psychology, Faculty of Psychology and Speech Therapy, University of Valencia, Spain;
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Oberheim K, Barlow J, Nescott E. Implications of Exposure to Intimate Partner Violence in Childhood. Dela J Public Health 2024; 10:6-8. [PMID: 38966346 PMCID: PMC11221872 DOI: 10.32481/djph.2024.06.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/06/2024] Open
Abstract
The most recent available data show that children were present at 38% of domestic incidents reported throughout Delaware, and analysis of barriers to reporting predict this number to be much higher. Intimate partner violence (IPV) can take numerous forms, such as patterns of physical, sexual, psychological, economic, and reproductive abuse, meaning each situation manifests differently and requires individualized intervention. Children face unique short- and long-term challenges as a result of their witness status within such scenarios. Programming throughout Delaware works to support victims and mitigate the negative ramifications that IPV has on children and their families.
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Affiliation(s)
- Kelly Oberheim
- Undergraduate Research Assistant, KIDS COUNT in Delaware
| | - Janice Barlow
- Policy Scientist, Center for Community Research and Service; Director, KIDS COUNT in Delaware
| | - Erin Nescott
- Associate Policy Scientist, Center for Community Research and Service
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Gilchrist G, Dheensa S, Johnson A, Henderson J, Radcliffe P, Dwyer G, Turner R, Thomson K, Papastavrou Brooks C, Love B, Zenasni Z, Berbary C, Carter B, Parrott S, Li J, Easton C, Bergman C, Feder G, Gilchrist E. Adapting the ADVANCE group program for digitally-supported delivery to reduce intimate partner violence by men in substance use treatment: a feasibility study. Front Psychiatry 2024; 14:1253126. [PMID: 38328518 PMCID: PMC10847362 DOI: 10.3389/fpsyt.2023.1253126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 12/27/2023] [Indexed: 02/09/2024] Open
Abstract
Introduction COVID-19 restrictions created barriers to "business as usual" in healthcare but also opened the door to innovation driven by necessity. This manuscript (1) describes how ADVANCE, an in-person group perpetrator program to reduce intimate partner violence (IPV) against female (ex)partners by men in substance use treatment, was adapted for digitally-supported delivery (ADVANCE-D), and (2) explores the feasibility and acceptability of delivering ADVANCE-D to men receiving substance use treatment. Methods Firstly, the person-based approach and mHealth development framework were used to iteratively adapt ADVANCE for digitally-supported delivery including conceptualization, formative research, and pre-testing. Then, a non-randomized feasibility study was conducted to assess male participants' eligibility, recruitment, and attendance rates and uptake of support offered to their (ex)partners. Exploratory analyses on reductions in IPV perpetration (assessed using the Abusive Behavior Inventory; ABI) and victimization (using the revised ABI; ABI-R) at the end of the program were performed. Longitudinal qualitative interviews with participants, their (ex)partners, and staff provided an understanding of the program's implementation, acceptability, and outcomes. Results The adapted ADVANCE-D program includes one goal-setting session, seven online groups, 12 self-directed website sessions, and 12 coaching calls. ADVANCE-D includes enhanced risk management and support for (ex)partners. Forty-five participants who had perpetrated IPV in the past 12 months were recruited, forty of whom were offered ADVANCE-D, attending 11.4 (SD 9.1) sessions on average. Twenty-one (ex)partners were recruited, 13 of whom accepted specialist support. Reductions in some IPV perpetration and victimization outcome measures were reported by the 25 participants and 11 (ex)partners interviewed pre and post-program, respectively. Twenty-two participants, 11 (ex)partners, 12 facilitators, and 7 integrated support service workers were interviewed at least once about their experiences of participation. Overall, the program content was well-received. Some participants and facilitators believed digital sessions offered increased accessibility. Conclusion The digitally-supported delivery of ADVANCE-D was feasible and acceptable. Remote delivery has applicability post-pandemic, providing greater flexibility and access. Given the small sample size and study design, we do not know if reductions in IPV were due to ADVANCE-D, time, participant factors, or chance. More research is needed before conclusions can be made about the efficacy of ADVANCE-D.
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Affiliation(s)
- Gail Gilchrist
- National Addiction Center, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Sandi Dheensa
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Amy Johnson
- School of Health in Social Science, Department of Clinical Psychology, Center for Psychological Therapies, University of Edinburgh, Edinburgh, United Kingdom
| | - Juliet Henderson
- National Addiction Center, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Polly Radcliffe
- National Addiction Center, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Georges Dwyer
- National Addiction Center, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Richard Turner
- National Addiction Center, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Kate Thomson
- School of Health in Social Science, Department of Clinical Psychology, Center for Psychological Therapies, University of Edinburgh, Edinburgh, United Kingdom
| | - Cat Papastavrou Brooks
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Beverly Love
- National Addiction Center, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Zohra Zenasni
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Cassandra Berbary
- College of Health Sciences and Technology, Rochester Institute of Technology, Rochester, NY, United States
| | - Ben Carter
- National Addiction Center, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Steve Parrott
- Department of Health Sciences, University of York, York, United Kingdom
| | - Jinshuo Li
- Department of Health Sciences, University of York, York, United Kingdom
| | - Caroline Easton
- College of Health Sciences and Technology, Rochester Institute of Technology, Rochester, NY, United States
| | | | - Gene Feder
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Elizabeth Gilchrist
- School of Health in Social Science, Department of Clinical Psychology, Center for Psychological Therapies, University of Edinburgh, Edinburgh, United Kingdom
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Closson K, Zulu B, Jesson J, Dietrich JJ, Pakhomova T, Basham CA, Beksinska M, Kaida A. Examining gender and sexual orientation differences in physical intimate partner violence experienced and perpetrated by youth living in eThekwini district South Africa during the COVID-19 pandemic. BMC Public Health 2023; 23:2300. [PMID: 37990170 PMCID: PMC10664660 DOI: 10.1186/s12889-023-17199-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 11/09/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Young women and Lesbian, Gay, Bisexual, Trans, Non-binary/no gender, or Questioning (LGBTQ+) youth in South Africa face some of the highest global levels of intimate partner violence (IPV). Given limited evidence in the wake of the COVID-19 pandemic, which has fuelled IPV globally, we aimed to describe and compare experiences and perpetration of IPV of youth aged 16-24 by sexual orientation and gender identity (SOGI). METHODS During the study period (December 2021-May 2022), youth aged 16-24 from eThekwini district, South Africa completed an online survey to understand multilevel impacts of the pandemic on youth. Participants were asked about experiences and perpetration of physical IPV since the start of the COVID-19 pandemic (March 2020). Descriptive statistics and adjusted logistic regressions compared the likelihood of experiencing and/or perpetrating physical IPV between cisgender and transgender inclusive heterosexual men; heterosexual women; gay, bisexual, or questioning men [GBQM]; lesbian, gay, bisexual, or questioning women [LGBQW]; or gender/sexual non-conforming youth [non-conforming]. RESULTS Of 1,588 youth (mean age = 21.7 [SD = 2.3]; 71.7% Black) with non-missing SOGI and physical IPV data, 238 (15.0%) were LGBTQ+ (40.3% LGBQW and 36.1% non-conforming). Overall, 14.6% of respondents experienced physical IPV and 9.8% perpetrated physical IPV since the start of the pandemic, which differed by SOGI (12.3% of heterosexual men, 13.9% of heterosexual women, 22.0% of GBQM, 18.2% of LGBQW, and 25.0% of non-conforming youth experienced and 10.3% of heterosexual men; 7.7% of heterosexual women; 10.0% of GBQM; 18.2% of LGBQW; and 16.7% of non-conforming youth perpetrated). In adjusted models, compared to heterosexual women, non-conforming youth had increased odds of experiencing (adjusted odds ratio [aOR] = 2.36; 95%CI, 1.26-4.39) physical IPV and compared to heterosexual men, non-conforming youth had greater odds of perpetrating physical IPV (aOR = 2.19; 95%CI, 1.07-4.48) during the pandemic. CONCLUSION Over one in six youth in our study experienced and one in ten perpetrated physical IPV since the onset of the COVID-19 pandemic, with gender and sexual non-conforming youth experiencing and perpetrating IPV at significantly greater rates than cisgender/heterosexual peers. Our findings highlight the need for gender transformative efforts that move beyond the gender binary to support healthy relationships and IPV prevention for LGBTQ + youth in South Africa and globally.
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Affiliation(s)
- Kalysha Closson
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
- Center on Gender Equity and Health, School of Medicine, University of California, San Diego, California, USA
| | - Bongiwe Zulu
- Maternal Adolescent and Child Health Research Unit (MRU), Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Julie Jesson
- Center for Epidemiology and Research in POpulation Health (CERPOP), Université de Toulouse, Toulouse, France
| | - Janan J Dietrich
- Perinatal HIV Research Unit (PHRU), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
| | - Tatiana Pakhomova
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - C Andrew Basham
- Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital/Harvard Medical School, Boston, MA, USA
| | - Mags Beksinska
- Maternal Adolescent and Child Health Research Unit (MRU), Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Angela Kaida
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada.
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Micklitz HM, Nagel Z, Jahn S, Oertelt-Prigione S, Andersson G, Sander LB. Digital self-help for people experiencing intimate partner violence: a qualitative study on user experiences and needs including people with lived experiences and services providers. BMC Public Health 2023; 23:1471. [PMID: 37533005 PMCID: PMC10394820 DOI: 10.1186/s12889-023-16357-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 07/20/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND Intimate partner violence (IPV) is a prevalent public health issue associated with multiple physical and mental health consequences for survivors. Digital interventions can provide low-threshold support to those experiencing IPV, but existing digital interventions have limited efficacy in improving the safety and mental health of IPV survivors. Digitally adapting an integrative intervention with advocacy-based and psychological content holds promise for increasing the efficacy of digital interventions in the context of IPV. METHODS This study examines the needs, acceptability and usability of an integrative digital intervention for people affected by IPV. We used the think-aloud method and semi-structured interviews with a sample of six people with lived experiences of IPV and six service providers. We analyzed the data using thematic analysis. RESULTS We identified the increasing general acceptance of digital support tools and the limited capacity of the current support system as societal context factors influencing the acceptance of and needs regarding digital interventions in the context of IPV. An integrative digital self-help intervention offers several opportunities to complement the current support system and to meet the needs of people affected by IPV, including the reduction of social isolation, a space for self-reflection and coping strategies to alleviate the situation. However, potentially ongoing violence, varying stages of awareness and psychological capacities, and as well as the diversity of IPV survivors make it challenging to develop a digital intervention suitable for the target group. We received feedback on the content of the intervention and identified design features required for intervention usability. CONCLUSION An integrative digital self-help approach, with appropriate security measures and trauma-informed design, has the potential to provide well-accepted, comprehensive and continuous psychosocial support to people experiencing IPV. A multi-modular intervention that covers different topics and can be personalized to individual user needs could address the diversity of the target population. Providing guidance for the digital intervention is critical to spontaneously address individual needs. Further research is needed to evaluate the efficacy of an integrative digital self-help intervention and to explore its feasibility it in different settings and populations.
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Affiliation(s)
- Hannah M Micklitz
- Medical Psychology and Medical Sociology, Faculty of Medicine, University of Freiburg, Hebelstraße 29, 79104, Freiburg, Germany.
| | - Zoë Nagel
- Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Freiburg, Germany
| | - Stella Jahn
- Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Freiburg, Germany
| | - Sabine Oertelt-Prigione
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, the Netherlands
- Department of Sex- and Gender-Sensitive Medicine, Medical Faculty OWL, University of Bielefeld, Bielefeld, Germany
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Lasse B Sander
- Medical Psychology and Medical Sociology, Faculty of Medicine, University of Freiburg, Hebelstraße 29, 79104, Freiburg, Germany
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Expósito-Álvarez C, Santirso FA, Gilchrist G, Gracia E, Lila M. Participants in Court-mandated Intervention Programs for Intimate Partner Violence Perpetrators with Substance Use Problems: A Systematic Review of Specific Risk Factors. INTERVENCION PSICOSOCIAL 2023; 32:89-108. [PMID: 37383646 PMCID: PMC10294470 DOI: 10.5093/pi2023a7] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 03/30/2023] [Indexed: 06/30/2023]
Abstract
Men with alcohol and/or other drug use problems (ADUPs) court-mandated to attend intervention programs for intimate partner violence (IPV) perpetrators have been identified as a high-risk, highly resistant group of IPV perpetrators, as they present lower treatment adherence and higher dropout and recidivism rates. Previous research suggests that IPV perpetrators with ADUPs may require tailored interventions to address their specific risk factors. The present systematic review was conducted using PRISMA guidelines to identify the specific risk factors in men with and without ADUPs on entry to court-mandated perpetrator programs. The following databases were searched from inception to November 2021: Web of Science, PsycINFO, and Scopus. There was a screening of 3,995 records, and 29 quantitative studies were included in the review. Risk factors present in males court-mandated to perpetrator programs were grouped into four categories: sociodemographic risk factors, personality disorders and psychological adjustment, social-relational risk factors, and risk factors related to attitudes towards women. Results indicated that the main risk factors in IPV perpetrators with ADUPs, compared to those without, were higher clinical symptomatology (e.g., anger and impulsivity), personality disorders, poorer executive functions, having experienced more stressful life events, higher exposure to childhood trauma, lower intimate social support, and higher responsibility attributed to the offenders' personal context. These results contribute to a deeper understanding of the complex phenomenon of IPV and ADUPs, and could help to inform key targets for perpetrator programs that may improve the well-being of their (ex)partners and increase the effectiveness of intervention programs for IPV perpetrators.
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Affiliation(s)
- Cristina Expósito-Álvarez
- University of ValenciaDepartment of Social PsychologyValenciaSpainDepartment of Social Psychology, University of Valencia, Spain
| | - Faraj A. Santirso
- University of ValenciaDepartment of Social PsychologyValenciaSpainDepartment of Social Psychology, University of Valencia, Spain
| | - Gail Gilchrist
- National Addiction CentreInstitute of Psychiatry, Psychology and NeuroscienceKing’s College LondonLondonUKNational Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK
| | - Enrique Gracia
- University of ValenciaDepartment of Social PsychologyValenciaSpainDepartment of Social Psychology, University of Valencia, Spain
| | - Marisol Lila
- University of ValenciaDepartment of Social PsychologyValenciaSpainDepartment of Social Psychology, University of Valencia, Spain
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Lila M, Gilchrist G. Treatment Resistant Perpetrators of Intimate Partner Violence: Research Advances. INTERVENCION PSICOSOCIAL 2023; 32:55-58. [PMID: 37383643 PMCID: PMC10294455 DOI: 10.5093/pi2023a10] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Affiliation(s)
- Marisol Lila
- University of ValenciaDepartment of Social PsychologyValenciaSpainDepartment of Social Psychology, University of Valencia, Spain;
| | - Gail Gilchrist
- National Addiction CentreInstitute of Psychiatry, Psychology and NeuroscienceKing’s College LondonLondonUKNational Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK
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