Domestic Violence and Drug Treatment
Research shows overlap between domestic violence and substance use disorders. According to one study, 40 – 80% of women in drug treatment programs have suffered intimate partner violence. [1] And women’s use of substances increases vulnerability to domestic violence.
Screening
Substance abuse treatment programs should routinely screen all clients for domestic violence involvement. Men and women alike should be screened for both victimization and battering behavior.
All screening questions should be preceded by framing questions such as:
- Because violence is so common in many people’s lives, we’ve begun to ask all our clients about it.
- I’m concerned that your (physical) symptoms may have been causeed by someone hurting you.
- I don’t know if this is a problem for you, but many of the clients we see are dealing with abusive relationships. Some are too afraid or uncomfortable to bring it up themselves, so we’ve started asking about it routinely.
- Some of the lesbian women/gay men we see here are hurt by their partners. Does your partner ever try to hurt you?[2]
Several brief screening tests are available and can be modified for use in substance abuse treatment settings such as, such as:
- American College of Obstetrics and Gynecology (2009)
- HITS: Hurt, Insult, Threaten, Scream (K. Sherin, 2003)
If there is a positive screen for domestic violence, it is important to ask the adult caregiver if there are children and how they may have been involved with or affected by the violence. With appropriate consent waivers, treatment providers may want to discuss these impacts further with any involved child welfare professional in order to ensure preventive services be made available.
Any assessment of domestic violence should also include a lethality risk to determine the immediate safety needs of the victim and children and the future risk of death or significant injury or harm due to the violence
While screening is most likely to occur during an intake or psychosocial assessment, information often doesn’t emerge until later, as trust builds between counselor and client. For this reason, it is important to periodically return to the possibility of domestic violence to ensure that these issues are incorporated into any treatment plan.
[1] Illinois Department of Human Services
[2] Clinical Guidelines on Routine Screening, Family Violence Prevention Fund.
