Substance Abuse Treatment and Domestic Violence

1 Substance Abuse and Mental Health Services Administration Substance Abuse and Mental Health Services Administration Center for Substance Abuse Treatment Substance Abuse Treatment and Domestic Violence Treatment Improvement Protocol (TIP) Series 25 Substance Abuse Treatment and Domestic Violence CSAT (TIP) 25 Blue Lines FPO (for spine positioning) Substance Abuse Treatment and Domestic Violence Treatment Improvement Protocol (TIP) Series 25 DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service Substance Abuse and Mental Health Services Administration Center for Substance Abuse Treatment 1 Choke Cherry Road Rockville, MD 20857 Acknowledgments This publication was prepared under contract number 270-95-0013 by the Knowledge Application Program (KAP), a Joint Venture of The CDM Group, Inc., and JBS International, Inc., for the Substance Abuse and Mental Health Services Administration (SAMHSA), Department of Health and Human Services (HHS).

2 Sandra Clunies, , ICADC, served as the Contracting Officer s Representative. Disclaimer The opinions expressed herein are the views of the consensus panel members and do not necessarily reflect the official position of SAMHSA or HHS. No official support of or endorsement by SAMHSA or HHS for these opinions or for the instruments or resources described are intended or should be inferred. The guidelines presented should not be considered substitutes for individualized client care and Treatment decisions. Public Domain Notice All material appearing in this report is in the public domain and may be reproduced or copied without permission from SAMHSA. Citation of the source is appreciated. However, this publication may not be reproduced or distributed for a fee without the specific, written authorization of the Office of Communications, SAMHSA, HHS. Electronic Access and Printed Copies This publication may be ordered for free from SAMHSA s Publications Ordering Web page at Or, please call SAMHSA at 1-877-SAMHSA-7 (1-877-726-4727) (English and Espa ol).

3 The document can be downloaded from the KAP Web site at Recommended Citation Center for Substance Abuse Treatment . Substance Abuse Treatment and Domestic Violence . Treatment Improvement Protocol (TIP) Series, No. 25. HHS Publication No. (SMA) 12-4076. Rockville, MD: Substance Abuse and Mental Health Services Administration, 1997. Originating Office Quality Improvement and Workforce Development Branch, Division of Services Improvement, Center for Substance Abuse Treatment , Substance Abuse and Mental Health Services Administration, 1 Choke Cherry Road, Rockville, MD 20857. HHS Publication No. (SMA) 12-4076 First Printed 1997 Revised 2000, 2002, 2003, 2005, 2008, and 2012 Contents What Is a TIP?.. v Editorial Advisory vii Consensus Panel .. ix xi Executive Summary and Recommendations.

4 Xiii Scope of the xiii Summary of xiv Supplemental Materials ..xviii Chapter 1 Effects of Domestic Violence on Substance Abuse Defining the Problem ..2 Identifying the A New Way of Chapter 2 Survivors of Domestic Violence : An Overview ..9 Entering the Treatment System ..9 Treatment Planning for the Survivor Client ..11 Issues for Children of Survivors ..17 Case Scenario: Profile of a Survivor ..20 Chapter 3 Batterers: An Overview ..25 Perspectives on Substance Abuse and the Ba tterer Client ..25 Profiling Treatment Issues for the Su bstance-Abusing Chapter 4 Screening and Referral of Survivors and Batterers in Substance Abuse Treatment Methods of Screening for Domestic Violence : Screening for Domestic Violence : Batterers ..42 Screening for Presence of Child iii Contents Treatment Concerns for Survivors and Chapter 5 Legal Issues.

5 51 Federal Law ..51 Local Laws: Civil Protection and Restraining Orders ..53 Other Legal Issues ..54 Communicating With the Legal Dealing With the Po lice ..60 Conclusion ..61 Chapter 6 Linkages: A Coordinated Community Systemic Reform ..64 Community-Based Linkages ..65 Identifying Critical Linkages, Barriers, and Opportunities ..68 Establishing a Linkage Relationship ..68 Other Linkage Examples of Effective Community-Based Linkages ..77 Coordination of Appendix A Appendix B Federal Confidentiality Regulations ..95 Types of Programs Covered by the Federal Confidentiality Rules Governing Communication of Information ..99 Five Other Exceptions to the General Confidentiality Other Requirements ..111 Conclusion ..111 Endnotes ..111 Appendix C Instruments ..115 Abuse Assessment Screen (English Version) ..116 Encuesta Sobre El Maltrato (Spanish Version)..117 Danger Assessment ..119 The Psychological Maltreatment of Women Inventory (PMWI).

6 121 The Revised Conflict Tactics Scale (CTS2) (for Couples) .. 123 Appendix D Sample Personalized Safety Plan for Domestic Violence Personalized Safety Telephone Numbers I Need to Know:..133 Appendix E Hotlines and Other Resources for Domestic Violence and Related General Resources ..136 Other Services ..139 Appendix F Resource Panel ..147 Appendix G Field Reviewers ..149 iv What Is a TIP? Treatment Improvement Protocols (TIPs) are developed by the Center for Substance Abuse Treatment (CSAT), part of the Substance Abuse and Mental Health Services Administration (SAMHSA) within the Department of Health and Human Services (HHS). Each TIP involves the development of topic-specific best-practice guidelines for the prevention and Treatment of Substance use and mental disorders. TIPs draw on the experience and knowledge of clinical, research, and administrative experts of various forms of Treatment and prevention.

7 TIPs are distributed to facilities and individuals across the country. Published TIPs can be accessed via the Internet at Although each consensus-based TIP strives to include an evidence base for the practices it recommends, SAMHSA recognizes that behavioral health is continually evolving, and research frequently lags behind the innovations pioneered in the field. A major goal of each TIP is to convey "front-line" information quickly but responsibly. If research supports a particular approach, citations are provided. v Editorial Advisory Board Karen Allen, , , President of the National Nurses Society on Addictions Associate Professor Department of Psychiatry, Community Health, and Adult Primary Care University of Maryland School of Nursing Baltimore, Maryland Richard L.

8 Brown, , Assistant Professor Department of Family Medicine University of Wisconsin School of Medicine Madison, Wisconsin Dorynne Czechowicz, Associate Director Medical/Professional Affairs Treatment Research Branch Division of Clinical and Services Research National Institute on Drug Abuse Rockville, Maryland Linda S. Foley, Former Director Project for Addiction Counselor Training National Association of State Alcohol and Drug Directors Washington, Wayde A. Glover, , II Director commonwealth Addictions Consultants and Trainers Richmond, Virginia Pedro J. Greer, Assistant Dean for Homeless Education University of Miami School of Medicine Miami, Florida Thomas W. Hester, Former State Director Substance Abuse Services Division of Mental Health, Mental Retardation and Substance Abuse Georgia Department of Human Resources Atlanta, Georgia Gil Hill Director Office of Substance Abuse American Psychological Association Washington, Douglas B.

9 Kamerow, , Director Office of the Forum for Quality and Effectiveness in Health Care Agency for Health Care Policy and Research Rockville, Maryland Stephen W. Long Director Office of Policy Analysis National Institute on Alcohol Abuse and Alcoholism Rockville, Maryland Richard A. Rawson, Executive Director Matrix Center Los Angeles, California vii Editorial Advisory Board Ellen A. Renz, Former Vice President of Clinical Systems MEDCO Behavioral Care Corporation Kamuela, Hawaii Richard K. Ries, Director and Associate Professor Outpatient Mental Health Services and Dual Disorder Programs Harborview Medical Center Seattle, Washington Sidney H. Schnoll, , Chairman Division of Substance Abuse Medicine Medical College of Virginia Richmond, Virginia viii Consensus Panel Co-Chairs Patricia Anne Fazzone, , , , Assistant Professor School of Nursing Kansas University Medical Center Kansas City, Kansas John Kingsley Holton, Site Director Maternal and Child Health School of Public Health Harvard University Chicago, Illinois Beth Glover Reed, Associate Professor School of Social Work and Program in Women s Studies University of Michigan Ann Arbor, Michigan Workgroup Leaders Larry Bennett, Assistant Professor Jane Addams College of Social Work University of Illinois at Chicago Chicago, Illinois Vivian Brown, President and Chief Executive Officer PROTOTYPES Culver City.

10 California Candace M. Shelton, , Clinical Director Guiding Star Lodge Indian Rehabilitation, Inc. Phoenix, Arizona Kimberly Smith-Cofield, Executive Director Casa Myrna Vasquez, Inc. Boston, Massachusetts Carey Tradewell, , III President and Chief Executive Officer Milwaukee Women s Center, Inc. Milwaukee, Wisconsin Oliver J. Williams, Associate Professor Graduate School of Social Work University of Minnesota Minneapolis, Minnesota Panelists Roland Byrd, , Counselor Montana Chemical Dependency Center Montana State Department of Public Health and Human Services Butte, Montana Lonnie Hazlewood, Managing Partner Austin Stress Clinic, Ltd. Austin, Texas ix Consensus Panel Judy Howard, Professor of Pediatrics Developmental Studies Program Department of Pediatrics School of Medicine University of California at Los Angeles Los Angeles, California Kate Malliarakis, , , II American College of Nurse Practitioners Arlington, Virginia Jan Mickish, Executive Director Colorado Domestic Violence Coalition Denver, Colorado Brenda Miller, Deputy Director Research Institute on Addictions Buffalo, New York Beth E.