“You can be abusive in tons of different ways and some of my behaviour was abusive... I would be very defensive or aggressive in the way that I said stuff and you don’t need that really.” – ADVANCE Participant
New research led by the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London, in collaboration with researchers from the Universities of Edinburgh, Bristol, Manchester and York, has explored the mechanisms behind Intimate Partner Abuse (IPA)
The report, commissioned by the National Institute for Health Research (NIHR), is the culmination of a six year research programme (ADVANCE) designed to improve the understanding of the risk factors behind IPA perpetration by men who are receiving treatment for substance use.
Being treated for substance misuse is a high-risk factor for IPA perpetration, with around 6 in 10 men currently receiving help saying that they had ever been abusive to a female partner.
In interviews with the study’s participants and their (ex)partners, abusive behaviour was found to be closely linked to substance misuse, either when they were intoxicated, when they were in withdrawal, craving substance use, or the act of acquiring said substance. The acquisition of substances also generated financial pressures which intensified the conflict.
ADVANCE is a 16-week integrated intervention that simultaneously seeks to address IPA perpetration and substance use.
The intervention can be delivered as a group-based in-person intervention or as a digital intervention and has been offered to 94 men across the UK. Of the 25 participants that were interviewed at the end of the ADVANCE digital intervention, 68% reported a reduction in their abusive behaviours, while 46% reported an increase in the number of drug-free days that they had had in the last month.
“Substance misuse and intimate partner abuse are a destructive mix that affect both perpetrator and survivor. Our study has shown the value in targeting the specific motivations of those men who are abusive to their partners, including substance use, poor emotional regulation, and poor stress-coping. The intervention is designed to promote personal responsibility as the key to facilitating meaningful change."– Professor Gail Gilchrist, the research programme’s chief investigator from King’s National Addiction Centre
“In the interviews we conducted with participants following the intervention, it was clear that the majority had found the support provided by ADVANCE beneficial. Most importantly, these findings were corroborated by many of the participants’ female partners.”
Nicola Jacobs, Domestic Abuse Commissioner said, “The better we understand domestic abuse the easier it is to tackle the behaviour of perpetrators. I therefore very much welcome this research which was led by the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at Kings College London.
“I am really pleased to see that the ADVANCE 16-week integrated intervention is simultaneously seeking to tackle intimate partner perpetration and substance use.”
While the initial study of the in-person group intervention took place in substance use treatment services in 2018/19, researchers were forced to adapt the delivery of the programme following the onset of the COVID19 pandemic. The intervention was delivered online, via a series of 6 fortnightly video groups and 12 weekly self-directed website sessions with a digital coach to recap and practise skills learned in the video groups. Website sessions were followed by a one-to-one video/phone coaching session with a facilitator.
This online approach was broadly favoured by participants, who noted that taking part online meant that it was easier and less anxiety inducing than having to travel to a treatment centre. Others said however that they found the online sessions to be less engaging than a face-to-face session.
One of the trial participants, John*, said, “the facilitator was a great support. They reinforced a lot of the messages that we were doing in the groups, and it was real-time support with what was going on in my life, which I think is invaluable.”
The researchers now hope to conduct a longer-term follow-up to explore whether these initial findings are maintained.
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