Framework for Providing Substance Abuse Treatment to a Client Experiencing Domestic Violence

Crisis Intervention

• Enhance client’s safety by developing a safety plan. Collaborate immediately with your local domestic violence center.
• Validate and believe client’s victimization.
• Identify her options. This includes a discussion of what she has tried before, what helped and what did not. Also explore the risks associated with adopting a particular option. (Note: It is very important for staff to allow a victim to describe what happened previously as a result of using what would appear to be an appropriate option, such as calling law enforcement. She may have done this numerous times and her batterer was not arrested, leading to harsher beatings after the officer left.) Refer to Response to Violence Inventory in Chapter 3.

Intervention
For treatment to be successful, it is critical for mental health staff to collaborate with their local certified domestic violence center and to ensure that staff have domestic violence training. Treatment planning must include the following:

• Long-term safety planning.
• Treatment for physical health issues including screening for HIV and other STDs.
• Emphasis on placing responsibility for abuse upon the batterer. While staff emphasize the need for substance abusers to assume responsibility fort heir addiction rather than blame others, the key in domestic violence intervention is to get the victim to acknowledge she is only responsible for her behavior not her partner’s behavior.
• Work on improving decision-making skills.
• Ensuring emotional health.
• Stabilization of detoxification.
• Evaluation and treatment of any health concerns. Documentation of injuries. If pregnant, further assessment of physical and sexual abuse is imperative.
• Attend to immediate emotional and psychological symptoms that may impact substance abuse intervention.

Assessment

• Obtain both a substance abuse history as well as an abuse history. Use of an abuse inventory, such as the Abusive Behavior Observation Checklist (ABOC - see Chapter 3), will assist you in your assessment. Be aware that it is common for domestic violence victims to minimize the extent of their abuse, just as they minimize their substance abuse.