Spousal / Partner Abuse > Part 2, Foreword - Substance Abuse Treatment and Domesitc Violence

Part-2: Substance Abuse and Domesitc Violence

A note of explanation:

This is the second Part of this 15 hour course.It addresses the concurrence of Substance Abuse and Male on Female Domesitc Violence.This is part of the Treatment Improvement Protocol (TIP) Series that is produced by the Substance Abuse and Mental Health Services Administration's (SAMHSA) Center for Substance Abuse Treatment (CSAT).A further explanation of the TIP is below.In addition, as a help in taking the test, the information is highlighted in a colored font with the actual questions on the bottom of each page where the content is found. The correct answer is in red.The first 20 questions are from Part 1. The last 40 questions are from Part 2.

We hope this is helpful to you in identifying the information needed for taking the test.


Treatment Improvement Protocol (TIP) Series 25

Patricia Anne Fazzone, R.N., D.N.Sc., M.P.H., C.S.

John Kingsley Holton, Ph.D.

Beth Glover Reed, Ph.D.

Consensus Panel Co-Chairs


Public Health Service

Substance Abuse and Mental Health Services Administration

Center for Substance Abuse Treatment

Rockwall II, 5600 Fishers Lane

Rockville, MD 20857

DHHS Publication No. (SMA) 973163

Printed 1997


This publication is part of the Substance Abuse Prevention and Treatment Block Grant technical assistance program. All material appearing in this volume except that taken directly from copyrighted sources is in the public domain and may be reproduced or copied without permission from the Substance Abuse and Mental Health Services Administration's (SAMHSA) Center for Substance Abuse Treatment (CSAT) or the authors. Citation of the source is appreciated.

This publication was written under contract number ADM 270-95-0013. Sandra Clunies, M.S.,

I.C.A.D.C., served as the CSAT Government project officer. Writers were Paddy Cook,

Constance Grant Gartner, M.S.W., Lise Markl, Randi Henderson, Margaret K. Brooks, Esq., Donald Wesson, M.D., Mary Lou Dogoloff, Virginia Vitzthum, and Elizabeth Hayes. Special thanks go to Daniel Vinson, M.D., M.S.H.P., Mim J. Landry, Mary Smolenski, C.R.N.P., Ed.D.,

MaryLou Leonard, Pamela Nicholson, Annie Thornton, Jack Rhode, Cecil Gross, Niyati Pandya, and Wendy Carter for their considerable contributions to this document.

The opinions expressed herein are the views of the Consensus Panel members and do not reflect

the official position of CSAT, SAMHSA, or the U.S. Department of Health and Human Services

(DHHS). No official support or endorsement of CSAT, SAMHSA, or DHHS for these opinions or for particular instruments or software that may be described in this document is intended or should be inferred. The guidelines in this document should not be considered substitutes for individualized patient care and treatment decisions.

What Is a TIP?

Treatment Improvement Protocols (TIPs) are best practice guidelines for the treatment of substance abuse, provided as a service of the Substance Abuse and Mental Health Service Administration's Center for Substance Abuse Treatment (CSAT). CSAT's Office of Evaluation,Scientific Analysis and Synthesis draws on the experience and knowledge of clinical, research,and administrative experts to produce the TIPs, which are distributed to a growing number of facilities and individuals across the country. The audience for the TIPs is expanding beyond public and private substance abuse treatment facilities as alcohol and other drug disorders are increasingly recognized as a major problem.

The TIPs Editorial Advisory Board, a distinguished group of substance abuse experts and professionals in such related fields as primary care, mental health, and social services, works with the State Alcohol and Other Drug Abuse Directors to generate topics for the TIPs based on the field's current needs for information and guidance.

After selecting a topic, CSAT invites staff from pertinent Federal agencies and national organizations to a Resource Panel that recommends specific areas of focus as well as resources that should be considered in developing the content for the TIP. Then recommendations are communicated to a Consensus Panel composed of non-Federal experts on the topic who have been nominated by their peers. This Panel participates in a series of discussions; the information and recommendations on which they reach consensus form the foundation of the TIP. The members of each Consensus Panel represent substance abuse treatment programs, hospitals, community health centers, counseling programs, criminal justice and child welfare agencies, and private practitioners. A Panel Chair (or Co-Chairs) ensures that the guidelines mirror the results of the group's collaboration.

A large and diverse group of experts closely reviews the draft document. Once the changes recommended by these field reviewers have been incorporated, the TIP is prepared for publication, in print and online. The TIPs can be accessed via the Internet on the National

Library of Medicine's HSTAT home page at the URL: http://text.nlm.nih.gov. The move to electronic media also means that the TIPs can be updated more easily so they continue to provide the field with state-of-the-art information.

While each TIP strives to include an evidence base for the practices it recommends, CSAT recognizes that the field of substance abuse treatment is 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. For this reason, recommendations proffered in the TIP are attributed to either Panelists' clinical experience or the literature. If there is research to support a particular approach, citations are provided.

This TIP, Substance Abuse Treatment and Domestic Violence, presents treatment providers with an introduction to the field of domestic violence. It gives providers useful information on the role of substance abuse in domestic violence -- both among the men who batter and the women who are battered. Useful techniques for detecting and eliciting such information are supplied, along with ways to modify treatment to ensure victims' safety and to stop the cycle of violence in both parties' lives. Legal issues, including duty to warn and confidentiality, are discussed. Finally, the Panel provides a blueprint for a more integrated system of care that would enhance treatment for both problems. This section includes practical suggestions for establishing linkages both between substance abuse treatment providers and domestic violence support workers and with legal, health care, criminal justice, and other relevant service agencies.

Other TIPs may be ordered by contacting The National Clearinghouse for Alcohol and Drug

Information (NCADI), (800) 729-6686 or (301) 468-2600; TDD (for hearing impaired), (800)


Editorial Advisory Board

Karen Allen, Ph.D., R.N., C.A.R.N.

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. Brown, M.D., M.P.H.

Associate Professor

Department of Family Medicine

University of Wisconsin School of Medicine

Madison, Wisconsin

Dorynne Czechowicz, M.D.

Associate Director

Medical/Professional Affairs

Treatment Research Branch

Division of Clinical and Services Research

National Institute on Drug Abuse

Rockville, Maryland

Linda S. Foley, M.A.

Former Director

Project for Addiction Counselor Training

National Association of State Alcohol and Drug Directors

Washington, D.C.

Wayde A. Glover, M.I.S., N.C.A.C. II


Commonwealth Addictions Consultants and Trainers

Richmond, Virginia

Pedro J. Greer, M.D.

Assistant Dean for Homeless Education

University of Miami School of Medicine

Miami, Florida

Thomas W. Hester, M.D.

Former State Director

Substance Abuse Services

Division of Mental Health, Mental Retardation and Substance Abuse

Georgia Department of Human Resources

Atlanta, Georgia

Gil Hill


Office of Substance Abuse

American Psychological Association

Washington, D.C.

Douglas B. Kamerow, M.D., M.P.H.


Office of the Forum for Quality and Effectiveness in Health Care

Agency for Health Care Policy and Research

Rockville, Maryland

Stephen W. Long


Office of Policy Analysis

National Institute on Alcohol Abuse and Alcoholism

Rockville, Maryland

Richard A. Rawson, Ph.D.

Executive Director

Matrix Center

Los Angeles, California

Ellen A. Renz, Ph.D.

Former Vice President of Clinical Systems

MEDCO Behavioral Care Corporation

Kamuela, Hawaii

Richard K. Ries, M.D.

Director and Associate Professor

Outpatient Mental Health Services and Dual Disorder Programs

Harborview Medical Center

Seattle, Washington

Sidney H. Schnoll, M.D., Ph.D.


Division of Substance Abuse Medicine

Medical College of Virginia

Richmond, Virginia

Consensus Panel


Patricia Anne Fazzone, R.N., D.N.Sc., M.P.H., C.S.

Assistant Professor

School of Nursing

Kansas University Medical Center

Kansas City, Kansas

John Kingsley Holton, Ph.D.

Site Director

Maternal and Child Health

School of Public Health

Harvard University

Chicago, Illinois

Beth Glover Reed, Ph.D.

Associate Professor

School of Social Work and Program in Women's Studies

University of Michigan

Ann Arbor, Michigan

Workgroup Leaders

Larry Bennett, Ph.D.

Assistant Professor

Jane Addams College of Social Work

University of Illinois at Chicago

Chicago, Illinois

Vivian Brown, Ph.D.

President and Chief Executive Officer


Culver City, California

Candace M. Shelton, M.S., C.A.D.A.C.

Clinical Director

Guiding Star Lodge

Indian Rehabilitation, Inc.

Phoenix, Arizona

Kimberly Smith Cofield, M.Ed.

Executive Director

Casa Myrna Vasquez, Inc.

Boston, Massachusetts

Carey Tradewell, M.S., C.A.D.C. III

President and Chief Executive Officer

Milwaukee Women's Center, Inc.

Milwaukee, Wisconsin

Oliver J. Williams, Ph.D.

Associate Professor

Graduate School of Social Work

University of Minnesota

Minneapolis, Minnesota


Roland Byrd, C.C.D.C., M.A.


Montana Chemical Dependency Center

Montana State Department of Public Health and Human Services

Butte, Montana

Lonnie Hazlewood, M.S.H.P.

Managing Partner

Austin Stress Clinic, Ltd.

Austin, Texas

Judy Howard, M.D.

Professor of Pediatrics

Developmental Studies Program

Department of Pediatrics

School of Medicine

University of California at Los Angeles

Los Angeles, California

Kate Malliarakis, C.N.P., M.S.M., N.C.A.D.C. II

American College of Nurse Practitioners

Arlington, Virginia

Jan Mickish, Ph.D.

Executive Director

Colorado Domestic Violence Coalition

Denver, Colorado

Brenda Miller, Ph.D.

Deputy Director

Research Institute on Addictions

Buffalo, New York

Beth E. Richie, Ph.D.

Associate Professor

Program in Public Health

Hunter College

City University of New York

New York, New York

Eric D. Wish, Ph.D.


Center for Substance Abuse Research

University of Maryland at College Park

College Park, Maryland

Diane Zainhofsky

Executive Director

Abused Adult Resource Center

Bismarck, North Dakota


The Treatment Improvement Protocol (TIP) series fulfills SAMHSA/CSAT's mission to improve treatment of substance use disorders by providing best practices guidance to clinicians, program administrators, and payers. TIPs are the result of careful consideration of all relevant clinical and health services research findings, demonstration experience, and implementation requirements. A panel of non-Federal clinical researchers, clinicians, program administrators, and patient advocates debates and discusses their particular area of expertise until they reach a consensus on best practices. This panel's work is then reviewed and critiqued by field reviewers.

The talent, dedication, and hard work that TIPs panelists and reviewers bring to this highly participatory process have bridged the gap between the promise of research and the needs of practicing clinicians and administrators. We are grateful to all who have joined with us to contribute to advances in the substance abuse treatment field.

Nelba Chavez, Ph.D.


Substance Abuse and Mental Health Services Administration

David J. Mactas


Center for Substance Abuse Treatment

Substance Abuse and Mental Health Services Administration

Spousal / Partner Abuse > Part 2, Foreword - Substance Abuse Treatment and Domesitc Violence
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