As a criminal justice human service practitioner, your primary obj.docx

As a criminal justice human service practitioner, your primary
objective depends on which element of the criminal justice
system you belong to. For example, judicial branch practitioners
interpret the law, law enforcement and security officers serve
and protect, and correctional, probation, and parole officers
provide care, custody, and control.
Write a 900-word report that discusses biological,
psychological, or sociological causes of a violent crime of your
choice. Address the following in your report:
· Describe your chosen violent crime.
· Discuss biological, psychological, or sociological causes of
your chosen violent crime.
· If you are working as a human services practitioner in a law
enforcement agency, discuss how you would utilize a biological,
psychological, or sociological criminological theory to manage
the offender.
· If you are working as a human services practitioner in the
judicial system, discuss how you would utilize a biological,
the offender.
· If you are working as a human services practitioner in a
correctional facility, discuss how you would utilize a biological,
the offender.
ORIGINAL ARTICLE
BI never knew which way he would swing…:^ Exploring the
Roles

of Substances in the Lives of System-Involved Intimate Partner
Violence Survivors
Jennifer E. O’Brien1
& Dania Ermentrout1 & Cynthia Fraga Rizo1 & Wen Li1 &
Rebecca J. Macy1 & Sarah Dababnah2
Published online: 8 July 2015
# Springer Science+Business Media New York 2015
Abstract This article reports findings of a mixed-methods
study exploring the role that substances play in the lives of
service-mandated female survivors of intimate partner vio-
lence (IPV). The study sample consists of 22 women who
had completed a court- and/or child protective services
(CPS)-mandated IPV parenting program. Quantitative results
reveal moderate levels of current substance use and higher
levels of past substance use. Qualitative analyses yield three
key areas of participants’ perspectives of substances and vio-
lence: (a) role of participants’ substance use, including coping
and partner influence; (b) role of partner’s substance use, in-
cluding severity and substance preferences; and (c) relation-
ship between substance use and IPV, including effects on
safety and IPV frequency and severity. We find victimization
is a function of a partner’s—rather than a victim’s—substance
use. Future programming should focus on the overlapping risk
factors between substance use and IPV.
Keywords Substance use .Mandated . Court-involved .
Child welfare system-involved . Child protective services
involvement . Treatment-mandated
Intimate partner violence (IPV) is a significant public concern
because IPV directly affects nearly 1 million women each

year, and the effects of IPV have a wide ranging ripple-
effect on others within each woman’s life (Black et al.
2011). Findings from a recent national survey estimate that
at some point in her lifetime, one out of every three women
in the United States will experience rape, physical violence, or
stalking perpetrated by a current or former intimate partner
(Black et al. 2011). In addition, IPV is associated with myriad
negative consequences for survivors, including an array of
short- and long-term physical and mental health problems
(Briere and Jordan 2004; Campbell 2002). In particular, sub-
stance use (i.e., the use of alcohol, illicit drugs, and abuse/
misuse of prescription medication) is a relevant and serious
concern for many IPV survivors. As compared with women in
the general population, women who have experienced IPVare
five times more likely to abuse substances (Logan et al. 2002).
Although research has examined substance use among broad
samples of IPV survivors, relatively little is known about the
role that substances play in the lives of a growing and partic-
ularly vulnerable group of IPV survivors labeled as system-
involved IPV survivors. This group consists of IPV survivors
who (a) become involved with child protective services (CPS)
and/or the criminal justice system, (b) are the primary care-
givers to minor children, and (c) are mandated to services by
either the courts or CPS.
Growing Trend of System-Involved IPV Survivors
An unanticipated result of the pro-arrest domestic violence
policies introduced in the late 1980s has been the increasing
numbers of female IPV survivors becoming involved with the
court system and/or CPS and mandated to services. Many of
these women are also the primary caregivers for their children
and thus have a unique set of needs that must be addressed if
the mandated services are going to be effective toward ensur-
ing the well-being of children in the household.

* Jennifer E. O’Brien
[email protected]
1 School of Social Work, University of North Carolina at
Chapel Hill,
Tate-Turner-Kuralt Building, 325 Pittsboro Street CB #3550,
Chapel
Hill, NC 27599, USA
2 School of Social Work, University of Maryland, College Park,
MD,
USA
J Fam Viol (2016) 31:61–73
DOI 10.1007/s10896-015-9747-1
http://crossmark.crossref.org/dialog/?doi=10.1007/s10896-015-
9747-1&domain=pdf
Court Involvement Since the institution of pro-arrest policies
and warrantless arrests in the 1980s, the United States has
experienced a growing trend of female IPV survivors arrested
for domestic violence offenses and thereby becoming in-
volved with the court system (Klein 2004; Rajan andMcClos-
key 2007; Swan and Snow 2006). Women comprise between
8 and 20 % of all IPV arrests, and many of those arrested for
IPV also report IPV victimization (Rajan and McCloskey
2007; Simmons et al. 2010). Women IPV survivors might be
arrested as domestic violence offenders for a number of rea-
sons, including using violence to defend themselves or their
children (Swan and Snow 2006). Further, an unintended con-
sequence of the institution of presumptive arrest policies and
mandatory arrest for domestic violence has been increased
rates of dual arrest in domestic violence cases. Both persons
involved in a domestic dispute can be arrested if the police

officers cannot determine the primary aggressor or when lo-
calities have mandatory dual-arrest statutes (Busch and Ro-
senberg 2004; Miller 2001). Thus, a female IPV survivor
could be arrested despite never perpetrating violence against
an abusive partner. Other female IPV survivors might accept
responsibility for a violent incident as a means of avoiding
retaliation from their abusive partners.
CPS Involvement Child exposure to domestic violence has
been shown to have long lasting and devastating conse-
quences for child development, including academic, behavior-
al, social, emotional, and mental health problems (Bedi and
Goddard 2007; Kitzmann et al. 2003). Moreover, children
living in households with IPV are at elevated risk for other
forms of child maltreatment, including neglect and physical
abuse (Edleson 1999). Therefore, many states have created
child welfare policies that include IPV exposure as a form of
child maltreatment (Moles 2008; U. S. Department of Health
and Human Services 2013). As more state governments add
statutes to make exposing a child to domestic violence a form
of child maltreatment and a punishable crime (US DHHS,
2013), it is likely that increasing numbers of female IPV sur-
vivors and their children will become involved with courts
and CPS.
Service Mandates IPV survivors involved with the courts
and/or CPS are often mandated to services in lieu of jail time
(Simmons et al. 2010). Furthermore, policy makers have in-
creasingly emphasized the critical need for CPS workers to
address IPV in their work with families reported for child
maltreatment; this emphasis has likely led to the large number
of CPS referrals to attend IPV-related services. Given that
these system-involved women are also IPV survivors
(Hamberger and Potente 1994), it is critical that any required
services account for experience of victimization as well as the
unique needs and characteristics of IPV survivors (Feder and

Henning 2005; Simmons et al. 2008; Stuart et al. 2006).
As the number of system-involved IPV survivors mandated
to services increases, so does the number of community agen-
cies struggling to identify the most appropriate services to
deliver to this particularly vulnerable population of survivors.
With notable exceptions, the limited research on system-
involved IPV survivors has included few intervention research
studies (Simmons et al. 2010), yielding scant information on
the needs and characteristics of these women to guide service
delivery (Macy et al. 2013a, b).
The MOVE Program
Two community-based agencies—a domestic violence agen-
cy and a child-abuse prevention agency—found themselves
serving increasing numbers of women who were system-
involved IPV survivors, primary caregivers of children, and
mandated to services. In response, the two agencies began
collaborating to create and implement the Mothers Overcom-
ing Violence through Education and Empowerment (MOVE)
program. Given the scant research available to guide this ef-
fort, MOVE was based on the professional expertise and ex-
perience of the providers working in the two agencies and
informed by curricula developed for families experiencing
IPV (e.g., Turner et al. 2006a; Turner et al. 2006b).
MOVE is a 13-week parenting program intended for IPV
survivors either mandated to treatment for violence against
their abusive male partners or mandated by CPS to attend a
parenting program. The MOVE program consists of a
psychoeducational, therapeutic parenting group for mothers
that delivers content on IPV, parenting, and safety. Concurrent
with the mothers’ group, the program offers therapeutic sup-
port group services for their children. Details of the MOVE
program structure and content have been published elsewhere

(e.g., Macy et al. 2012; Macy et al. 2013a).
MOVE Program-Related Research Since 2007, our re-
search team has worked with the two community-based agen-
cies delivering MOVE to document the program, to examine
the program’s feasibility and acceptability among system-
involved IPV survivors and their children (Macy et al.
2013a; Ermentrout et al. 2014), and to evaluate program out-
comes (Macy et al. 2012; Macy et al. 2013b). Further, our
work with MOVE has addressed knowledge gaps by
documenting the characteristics, needs, and help-seeking be-
haviors of IPV survivors mandated to community services by
the courts and/or CPS (Macy et al. 2013a). Our prior research
with a sample of 73 service-mandated female IPV survivors
found the participants were characterized by high levels of
negative risk factors, including IPV victimization, and high
levels of depressive and posttraumatic stress symptoms; how-
ever, participants were also characterized by high levels of
positive factors, including positive parenting attitudes,
62 J Fam Viol (2016) 31:61–73
knowledge, and practices, as well as active help-seeking be-
haviors. Although this prior research also aimed to examine
participants’ experiences with substance use by using gold-
standardmeasures (i.e., Brief Michigan Alcoholism Screening
and Drug Abuse Screening Test; Pokorny et al. 1972; Skinner
1982), a majority of participants chose not to complete ques-
tions related to their alcohol and drug use. Our evaluation led
us to conclude the most likely reasons for participants’ declin-
ing to provide sensitive information included participants’
vulnerable status, their involvement in multiple systems, and
their possible fears that disclosure might have legal repercus-
sions (Macy et al. 2013a).

Nonetheless, available evidence not only supports the as-
sociation of IPV victimization and substance abuse but also
documents the prevalence of substance use among system-
involved IPV survivors (Stuart et al. 2013; Young et al.
2007). Although scant, this evidence underscores the critical
importance of developing a better understanding of the role of
substances in the lives of these women, which can help guide
service delivery and the development of best-practice proto-
cols for this group of IPV survivors.
Current Study To address this critical knowledge gap, our
research team conducted an exploratory, mixed-methods
study to investigate the substance-related experiences of
system-involved IPV survivors mandated to services. Given
the dearth of existing research, our study was guided by a
broad research question intended to help us discover all rele-
vant substance-related experiences of these survivors: What is
the role of substances in the lives of women IPV survivors
mandated to services by CPS and/or the court systems?Within
the framework of this broad question, we explored the partic-
ipants’ perspectives on their own personal use of substances
(including substance use in the family-of-origin), their part-
ners’ use of substances, and the role of substances in the se-
verity and frequency of IPV.
Method
Study Sample
This study used a sample of 22 women who (a) had
been mandated by the county court or CPS to receive
services from one of two community based agencies
delivering MOVE, (b) had completed the MOVE pro-
gram, and (c) who had participated in evaluations of the
MOVE program between June 2008 and July 2011. Ad-

ditional eligibility criteria specified that participants had
to be (a) a woman, (b) able to comprehend and verbally
communicate in English, and (c) self-identify as a sur-
vivor of IPV. Notably, the woman’s history of current or
past substance use was not a criterion for study
inclusion. We chose to include participants regardless
of their substance use status to acquire a broad under-
standing of system-involved IPV survivors’ perspectives
on and experiences of substance use. All study proce-
dures were approved by the Office of Human Research
Ethics at the research team’s university.
Prior Eligibility for MOVE Program Eligibility for inclu-
sion in our study required that the woman had completed
the MOVE program. To be eligible for the MOVE pro-
gram, participants had to be (a) a woman mandated by
the county court or CPS system to receive domestic vio-
lence or parenting services, and (b) screen positive for prior
or current IPV, with the caveat that the woman was not the
primary abuser. Program eligibility was determined through
a detailed biopsychosocial assessment conducted by a mas-
ter’s-level social worker with expertise in family violence.
This intake worker assessed each woman’s history of vio-
lence, giving special attention to histories of family
violence.
Sample Recruitment for the Present Study Potential par-
ticipants (n=91) were recruited via a letter mailed to the
safe address the woman had provided when she was
enrolled in the MOVE program. However, to protect
confidentiality and to ensure any unintended recipients
would not be able to discern that the woman was being
invited to participate in an IPV study, the recruitment
letter was a generic informational letter that provided a
telephone number to call for study specifics. Approxi-

mately 1 week following receipt of the letter, a research
team member made a second recruitment contact at-
tempt using the participant-designated safe phone num-
ber. Telephone contact with potential participants
followed a carefully worded recruitment script. Recruit-
ment attempts ceased after two letters and four phone
calls received no response.
Women who responded to the recruitment letters or
phone calls were assessed for study eligibility by a
member of the research team, using a brief 11-item
screening tool. The women were given the option of
completing the screening over the phone or by meeting
with a member of the research team at one of the two
participating community agencies. Most of the women
completed the screening items over the telephone before
scheduling an individual intake interview; however, a
few of the women preferred to complete the screening
tool in person. In these cases, the women completed the
screening tool face-to-face with a member of the re-
search team in private spaces provided by the two com-
munity agencies. If the woman was found eligible for
inclusion, the research team member would then pro-
ceed with the in-depth interview.
J Fam Viol (2016) 31:61–73 63
Of the 91 women who were initially mailed recruitment
letters, only 29 (31.9 %) responded to the study invitation.
All but one of the 29 women were eligible for study inclusion,
and 22 (78.9 %) agreed to participate.
Data Collection Procedures

Qualitative and quantitative data were collected from the 22
CPS and/or court-involved IPV survivors through individual
interviews conducted by a member of the research team. In-
terviews were held during regular business hours in private
spaces within the community agency where MOVE was de-
livered (i.e., a location familiar to participants). Participants
selected the day and time for their interview. To ease the bur-
den of participation, participants were provided with research
supports such as snacks, subsidized transportation, and on-site
child care. Women who agreed to participate also received a
$25 gift card in appreciation of their time. Clinical staff mem-
bers from the community agencies were aware of the nature of
the interview sessions and were available if safety concerns
arose or if the participants needed to arrange for counseling to
address topics broached during the interviews. Immediately
preceding the interview, the research team member obtained
the participant’s oral informed consent to perform the inter-
view and to digitally record the interview.
The in-depth individual interviews were conducted using a
semi-structured interview guide consisting of open-ended
questions and follow-up probes; the guide was developed by
the research team and informed by the extant literature (Patton
2002). Standardized questions allowed for a wide range of
responses and encouraged respondents to generate novel
themes whereas the follow-up probes encouraged depth of
responses (Patton 2002). The questions explored the follow-
ing topics: (a) the woman’s motivation for her substance use
(past and/or current); (b) the influence of the intimate partner
on the woman’s substance use; (c) current or former intimate
partners’ substance use; (d) the impact of intimate partner’s
substance use on the woman and her children; and (e) the
impact of substance use by either partner on experiences of
relationship violence.
Digital files of interviews were transcribed and reviewed

for accuracy by members of the research team. Digital files
were stored on a password protected computer within a pass-
word protected file. Following transcription, all digital files
were deleted. Methods to enhance the rigor of the research
included obtaining expert feedback on the semi-structured in-
terview guide and implementing data triangulation by using
more than one method to collect similar data (i.e., question-
naire and interviews; Padgett 2008).
Assessments and Measures To complement the qualitative
interview data, participants were asked to complete a back-
ground information survey and two standardizedmeasures. To
ensure all participants could participate equally without regard
to literacy, disability or education status, participants could
choose to complete the measures as self-report questionnaires
or through oral interviews.
Participant Background Information Questionnaire We
developed a 59-item questionnaire to collect general demo-
graphic data and detailed information on the participant’s (a)
substance use, (b) family composition, (c) relationship status,
(d) experiences with violence perpetration, (e) experiences
with violence victimization, (f) legal involvement, and (g)
treatment program referrals. Although the survey was largely
comprised of close-ended, multiple-choice questions, open-
ended responses were included to provide the opportunity
for clarification. The self-report surveys were completed
anonymously and no identifying information was collected.
Alcohol Use Participants’ use of alcohol was assessed using
the Alcohol Use Disorders Identification Test (AUDIT) devel-
oped by theWorld Health Organization (Saunders et al. 1993).
The AUDIT is a 10-item, self-report screening test for at-risk
drinking that is widely used with various populations and in a
range of settings (Babor et al. 2001). The AUDIT assesses

hazardous drinking, dependence symptoms, and harmful al-
cohol use. Possible scores range from 0 to 40 points. The
cutoff value of 8 points is typically used, although research
with female populations have used lower cutoff scores (Allen
et al. 1997; Babor et al. 2001; Berner et al. 2007). For exam-
ple, Bradley et al. (2003) reported a cutoff score of 3 yielded
satisfactory sensitivities (0.70) and specificities (0.86) for the
estimation of at-risk drinking in female respondents. There-
fore, the current study identified participants with AUDIT
scores of 3 or greater as exhibiting at-risk drinking.
The validity and reliability of AUDIT have been
established through results from numerous studies across pop-
ulations, settings, and countries. The AUDIT has demonstrat-
ed high internal consistency reliability ranging from 0.75 to
0.97, high test-retest reliability (r=0.86), cross-cultural valid-
ity, and applicability for both male and female respondents
(Allen et al. 1997; Babor et al. 2001; Reinert and Allen
2007). Findings have also suggested that AUDIT scores cor-
relate well with results obtained from other screening tests
(e.g., MAST, CAGE; Allen et al. 1997; Babor et al. 2001).
The internal consistency reliability of AUDIT in this current
study was .87.
Drug Use Participant’s drug use was assessed using the Drug
Use Disorders Identification Test (DUDIT; Stuart et al. 2003).
The DUDIT is an 11-item self-report screening test that as-
sesses drug use, drug abuse, and adverse consequences related
to drug use (Stuart et al. 2003). The DUDITwas developed as
a companion for AUDIT with parallel items, and has been
used to determine harmful drug use and drug dependency in
64 J Fam Viol (2016) 31:61–73

populations of IPV victims and perpetrators (Stuart et al.
2003). The DUDIT explores a respondent’s use of substances
in the following categories: marijuana, cocaine, hallucino-
gens, stimulants, tranquilizers, opiates, and other substances
(i.e., inhalants, steroids, diet pills). Scores range from 0 to 56
points, and a cutoff value of 8 points corresponds to sensitivity
and specificity values of 0.90 and 0.85, respectively, for iden-
tifying drug-related problems (Voluse et al. 2012). Berman
and colleagues have recommended the use of a cutoff value
of 2 points for identifying drug-related problems in women.
Therefore, participants in the current study with DUDIT
scores of 2 or greater were identified as having drug-related
problems. The DUDIT has an internal consistency reliability
ranging from 0.80 to 0.94 (Berman et al. 2003; Stuart et al.
2003; Voluse et al. 2012). The internal consistency reliability
in the current study was not computed due to low response
rate.
Data Analysis
Transcriptions of the interview data were imported into ATLA
S.ti (version 5.0; Muhr and Friese 2004). An initial list of
codes was developed using an open-coding approach with
two representative transcripts. The preliminary coding scheme
was informed by the research question, the semi-structured
interview guide, and the existing literature on the construct
and populations of interest (Padgett 2008; Patton 2002). Fol-
lowing this coding plan, three research team members thor-
oughly reviewed each interview transcript independently to
create a detailed codebook. One team member then deter-
mined several levels of themes within and across each inter-
view by applying systematic review strategies as well as neg-
ative case analysis (Anastas 2004; Padgett 2008). During the
transcription review process, the analysts implemented con-
stant comparison procedures by comparing and contrasting
themes generated from each analysis with existing themes

(Glaser and Strauss 1967). Successive reviews refined the
definitions of existing codes, which prompted hierarchical
sorting of codes as well as code additions and deletions.
Survey data were aggregated and used to describe the par-
ticipant population (e.g., means and standard deviations). Par-
ticipant responses to both the DUDIT and AUDIT scales were
examined both as frequencies and summative scales.
Results
Sample Characteristics
All sample demographic characteristics are reported inTable 1.
Participants ranged in age from 21 to 52 years (M=32.5; SD=
7.5). Nearly half (45.5 %) of participants self-identified as
African American/Black, 40.9 % as White, and the remaining
13.6 % self-identified as more than one racial/ethnic group.
The majority of participants (86.4 %) indicated they had com-
pleted college or obtained a technical school degree, and all
participants had received a high school degree or its equiva-
lent. More than three-quarters of participants (77.3 %) were
employed full- or part-time. The remaining 22.7 % of partic-
ipants were not employed because of disability, school atten-
dance, or work as a full-time parent. Most participants carried
some form of health insurance (77.3 %), but, notably, close to
a quarter of participants (22.7 %) self-paid for health care
services. Participants listed their sources of income as employ-
ment paycheck, child support payments, alimony, student
loans, government assistance (e.g., Supplement Security In-
come, Food Stamps, unemployment benefits, Work First) and
money from family and friends. Most participants had multi-
ple sources of income. Almost half (45.5%) of the participants
had a current intimate partner, with the length of these rela-
tionships ranging from 3 months to 12 years [M=3.5 years

(42.5 months); SD=47.5]. Notably, four of the women
(18.2 %) remained in the same intimate partner relationship
as when they first entered the MOVE program.
Lifetime use of alcohol or other drugs ranged in this sample
from 50 % of participants who reported past use of drugs in
the other category (e.g., inhalants, diet pills, steroids) to 100%
of participants who reported past use of alcohol. The majority
of participants (86.4 %) reported abuse of prescription medi-
cation at some point in their lives. Rates of current use of
substances were substantially lower and varied from 4.5 %
(use of another’s prescription medication) to 81.8 % (use of
alcohol).
Quantitative Findings
Table 2 reports the number and percentages of respon-
dents identified as having symptoms of substance use as
assessed by the AUDIT and DUDIT. More than a third
(40.9 %) of the participants met AUDIT criteria for
hazardous drinking. Almost one-third (27.3 %) of par-
ticipants reported at-risk drinking (i.e., having three or
more drinks on a typical day) and 18.2 % of partici-
pants reported binge drinking (i.e., consuming more
than six drinks on one occasion) with less than monthly
frequency. In addition, 18.2 % of participants reported
(a) needing an Beye opener^ (i.e., a drink first thing in
the morning to cope with withdrawal symptoms), and
(b) feeling guilt or remorse after drinking. Further,
4.5 % of participants reported less than monthly occur-
rences of failing to fulfill daily obligations due to drink-
ing. Current drug-related problems were reported by
9.1 % of participants (i.e., based on their DUDIT
scores). Notably, three participants (13.6 %) chose not
to respond to any DUDIT questions.

J Fam Viol (2016) 31:61–73 65
Qualitative Findings
Three overarching themes emerged from the individual inter-
views: (a) the women’s self-use of substances; (b) the partners’
substance use; and (c) the women’s perceptions of the relation-
ship between substance use and IPV. As opposed to reporting
the exact number of participants endorsing a particular theme,
the terms Bmany,^ Bmost,^ and Bfew^ are used to denote vary-
ing degrees of participant endorsement on a particular theme/
sentiment. Specifically, the term Bmany^ denotes that over
three
quarters (>75 %) of participants endorsed that particular theme
or sentiment, and the term Bmost^ is used to denote that over
half (>50%) of participants endorsed the theme or sentiment. In
contrast, the term Bsome^ indicates that less than half (<50 %)
of participants endorsed the theme or sentiment, and the term
Bfew^ is used to denote that less than one quarter (>25 %) of
participants endorsed the theme or sentiment.
Theme 1: Self-Use
The theme of self-use was characterized by the women’s rea-
sons for current and historical patterns of substance use. Sub-
themes included substance use as a coping strategy, substance
use because of the partner’s influence, and the consequences
of substance use or reasons to not misuse substances. Reasons
for substance use varied by participant as well as over time in
the participant’s life course.
Coping StrategyMany participants stated that they had used
substances to avoid the negative feelings associated with the

stress of her intimate relationship. For some, substances
helped the women to cope with and escape from relationship
conflict. For example, one participant described her use of
alcohol to cope with interpersonal conflict:
He just kept on calling and harassing and accusingme of
all kinds of stuff and, you know, it would be to the point
where, you know, I, I would have-, I would go and get a
beer out after that so I could calm down.
Another participant reported using greater dosages of pre-
scription medication than prescribed to relieve her anxiety
associated with her relationship distress:
I have it (Xanax), have it in my purse, um, because there’s
been days at work where the conflict between me and my
ex got so bad that I’ve been in tears, so I’ve, I take a
quarter or I take a half of a pill to calm myself down…I
think that it’s every 2 or 3 months it got [so] bad that I
would have to take two [pills].
Many other participants found a way of avoiding potential
conflict was to engage in substance use with their abusive
partners (e.g., BI just never really felt comfortable to drink or
do anything around him, but sometimes it was just…easier not
to fight about it^). Although most participants discussed their
use of substances as a means to cope with IPV, a few women
stated that they had used substances to relieve stress generally.
These participants explained that when they were feeling
Table 1 Sample characteristics (N=22)
Characteristics % n
Race

African American
/ Black
54.5 12
White 45.5 10
Education
Completed high
school/GED
100 22
Completed college
/technical school
degree/graduate
school
40.9 9
Employment
Full-time employment 68.2 15
Unemployed 22.7 5
Health insurance
No health insurance
/self-pay
22.7 5
Private insurance 45.5 10

Children
% of mothers living
with their children
86 19
Relationship status
In a relationship 45.5 10
In same relationship
that brought them
to [Masked] program
18.2 4
Current or former partner data
Partner required to attend
any treatment program
36.4 8
Table 2 Participant’s self-reported substance use (N=22)
Substance use variables % n
Past use of other drugs 50 11
Current use of other drugs 18.2 4
DUDIT score >2 (drug-related problems) 9.1 2
DUDIT score mean M (mode) 0.39 (0)

Past use of alcohol 100 22
Current use of alcohol 81.8 18
AUDIT score >3 (at-risk drinking) 40.9 9
AUDIT score M (mode) 2.91 (2)
DUDIT drug use disorders identification test, AUDIT alcohol
use disor-
ders identification test
66 J Fam Viol (2016) 31:61–73
Bstressed or uptight about something,^ substances helped
them to Bloosen up^ and Btake the edge off.^
Partner Influence Most participants also reported their part-
ner’s substance-use behaviors influenced their own use of al-
cohol and drugs. Some participants discussed using sub-
stances with their partner as a means of connection and noted
mutual enjoyment. One participant described this type of
relationship-based substance use:
If it [marijuana] was there and we did it together, and we
had a good time- and just kinda kept doing it. Whereas
before I was with him…it’s not that I hadn’t smoked, but
it wasn’t a big hobby for me- and then when I was with
him it was like, yeah, we-, I smoked pretty often.
By contrast, many other participants described substance
use with their partner as a means of gaining their partner’s
acceptance, rather than their own enjoyment. For example,
one participant noted that her former partner enjoyed smoking

marijuana and Bhe would want me to do it with him…we
would just pass it around, everyone was doing it…one of
those things where we don’t want anyone not getting high…
peer pressure sort of stuff.^ Equally important, some partici-
pants reported that their abusive partners used substances for
coercion and manipulation. One woman reflected that her
partner would Bget me drunk so he could do some things I
didn’t really want to do.^
Consequences of Substance Use In addition to reasons
prompting their substance use, many participants also de-
scribed reasons they currently chose to avoid using or
misusing substances. Many women attributed their choice to
refrain from substance use to their past abusive relationships.
The comment of one participant echoed the voices of many
participants:
I’mnot gonna be put in a positionwhere someone is going
to harm me again- I’m not going to do it…I just won’t
allow myself to lose control with substances because I’m
not going to put myself in that kind of situation again.
In addition to their past abusive relationships, some partic-
ipants had been raised in families in which they were exposed
to substance misuse. These women had a unique perspective
on the familial turmoil that can be caused by substance mis-
use. In the words of one woman, BI grew up with my dad, you
know, on drugs and alcohol, and it don’t do nothin’ but tear a
family apart. And I didn’t use because I wanted to try and keep
my family together.^ Universally, participants saw their deci-
sions to avoid substance misuse as a part of a larger effort to
engage in better self-care, including Bexercising all the time,^
and Beating right.^
Theme 2: Partner Use

Study findings also determined an overarching theme describ-
ing different facets of substance use by intimate partners. Sub-
themes included the partner’s substance use preferences and
severity of use, as well as participant’s preferences for their
partner’s substance use.
Partner Substance Use Preferences and Severity Substance
use in former relationships varied widely regarding substance
preferences and severity. All participants were familiar with the
substances abused by their partners, listing marijuana, cocaine,
prescription drugs (not prescribed to them), liquor, and beer as
substances of choice. Few participants discussed partners who
never drank or used drugs, partners who enjoyed Bthe occasion-
al beer,^ and a few others discussed partners who demonstrated
consistent daily drug and/or alcohol use. One participant de-
scribed the severity of a former partner’s use of multiple sub-
stances, saying, B[He would] always have other people’s pre-
scriptions and stuff that he’d take…He always drank until he
got drunk and couldn’t remember.^ Another participant was
unsure of the severity of her partner’s use because he chose to
use out of the house and did not use substances daily. This
participant stated, BI don’t know how often [he used sub-
stances]. I didn’t see him on pay days, twice out of the month.^
Participant Preferences for Partner’s Substance Use Be-
cause different substances tended to calm or relax abusive
partners, many of the women reported that they preferred
and would encourage their partner to use the substances that
elicited fewer negative consequences. For example, one par-
ticipant reported she preferred her partner to use prescription
medication rather than alcohol because when he used prescrip-
tion drugs, Bhe really stayed to himself.^ A different partici-
pant noted that when her partner was Bhigh or drinking, he
was the nicest person. But when he’s not, he’s….not nice at
all. I would havewished that he would have drank a little more
often.^ Another participant indicated certain drugs had a sop-

orific effect on her partner, stating, Bcocaine and marijuana for
some reason mellowed him out.^ Overwhelmingly, most par-
ticipants reported that when their partners were unable to ob-
tain their drug of choice, the frustration and physical conse-
quences of the lack of access to the substance combined to
intensify their relationship conflict. The comments of one par-
ticipant were typical of the experiences described by many:
BWhen he was drinking, he was fine. When he was high, he
was fine. It’s just when he’s not high or drinking, I guess he
gets agitated, and that’s when all the commotion starts.^
Theme 3: The Relationship Between Substance Use and IPV
The third theme, the relationship between substance use and
violence, not only highlights the intersection of substance use
J Fam Viol (2016) 31:61–73 67
with violence but also demonstrates the effects of substance
use on personal safety. Specifically, many participants noted
changes in the frequency and severity of IPV related to the
perpetrator’s use of substances. In addition, we identified re-
lated subthemes, including substance use as a precursor to
violence, violence as a precursor to partner’s substance use,
and the unpredictability of the partner’s behavior when using
substances.
Substance Use as a Precursor to ViolenceMany participants
reported that a partner’s substance use often preceded the onset
of an episode of violence. Most women reported the effects of
substance use on violence varied depending on both their own
and their partner’s moods. One participant noted the importance
of her partner’s mood on his behavior after ingesting alcohol:
BHe would drink anywhere from a 6-pack to a 12-pack a day.

The longer, the later into the night he got, the more, depending
on what his mood was beforehand, the more alcohol affected
(increased the violence during) the evening.^ Some participants
focused on specific behaviors that emerged when a partner was
intoxicated, stating that the use of substances resulted in their
partner becoming emotionally, physically, and financially abu-
sive. In one particularly poignant comment, a woman stated,
BWhen hewas drinking, hewould yell. Hewould put me down.
Sometimes he would hit me or push me. He was just…he was
just violent…the next day he never would remember it.^Many
women noted the regularity with which their partners engaged
in substance use before perpetrating violence made them feel
that they needed to be in Bdefense mode^ as soon as they
realized the partner had been using. The comment of one wom-
an was typical of many participants’ stories:
After he had been using, I never felt safe…when I could,
I would call a friend to be there until he went to sleep…
He used to just fight (when he would drink). BYou hear
me talking to you?^ Pulling on my arm, slapping me.
A few women reflected that their use of substances, rather
than their partner’s use, contributed to the perpetration of vi-
olence. One woman stated her substance use was motivated
by spite (BI knew it would be something that would piss him
off^), and she used alcohol when she was angry at her partner
and wanted to provoke a fight. Another woman reflected that
when she and her partner were both under the influence of
alcohol, their drinking would incite mutual violence: BAs soon
as we both had a few, that’s when it’d really start.^ Universal-
ly, participants acknowledged the impact substance use had on
subsequent IPV perpetration.
Violence as a Precursor to Partner’s Substance Use Partic-
ipants also reported substance use often occurred after vio-
lence perpetration. As previously noted, many of the women

reported using substances to relieve their stress stemming
from the abusive relationship. Similarly, many of the partici-
pants reported their partner was often more apt to use sub-
stances following the perpetration of violence. In a statement
reflective of many, one women said, BI think he would be
more likely to go out and drink or smoke or whatever [after
an argument], because we had that argument…it was a lot of
stress.^ In these cases, substance use was often associated
with Bmellowing out,^ or Bcooling off^ after an intense fight
or argument during which violence occurred.
Although most participants reported that a partner’s use of
substances led to changes in the frequency or severity of phys-
ical violence, sexual violence, and verbal abuse, a few partic-
ipants denied that the partner’s substance use had an impact on
the violence in their relationship. However, these few partici-
pants noted other instigators of relationship violence such as
the abusive partner’s response to the stress of parenthood,
childhood trauma, military affiliation, poor anger manage-
ment, and lack of emotional maturity. One participant linked
her former partner’s violent behavior to his depression, stat-
ing, BIt’s like his depression just had him angry. So he didn’t
know how to cope and he just expressed himself through
anger and then the violence.^
Unpredictability of Partner when Using Many participants
reported substance use made their partner’s mood states and
behaviors extremely unpredictable. For example, one woman
described her partner as having a dual personality when he
was under the influence of substances:
In the beginning [when my former partner would drink],
he would get more bold, and there was a rape incident.
There were other issues where he would become violent
and pin me down, or just go into a fit. And then, at other

times, it would be fun and happy, and the night would
end with [consensual] sex. So, you just kind of never
knew what was going to happen.
Another participant noted that her partner’s mood would
change drastically depending on the particular substance he
was using:
I guess he thought it was more debonair if he was drink-
ing wine. So he would behave one way. And if it was
liquor, he would get a different…I mean, it was strange I
guess that I noticed these things. He usually just had a
bad attitude if there was beer around. If it was wine, he
felt like hewas that connoisseur, all high andmighty and
hoity-toity. I never knew what way he would swing, if it
would be really fun or if it would be really bad.
Regardless of their partner’s ultimate mood, the study
participants universally acknowledged substance use had
profound effects on their partner’s behaviors. One
68 J Fam Viol (2016) 31:61–73
woman’s comment summarized those of many in describ-
ing the effects of substance use on behaviors as Balways
very intense.^
Discussion
This study presents exploratory quantitative and qualitative
findings about the role of substances in the lives of system-
involved IPV survivors. Given the increased number of wom-
en arrested for IPV (Klein 2004; Rajan and McCloskey 2007)
and the number of families involved in CPS that are affected

by substance-use disorders (Stuart et al. 2013; Young et al.
2007), this research makes a significant and timely contribu-
tion to the existing but limited knowledge base. Findings from
the current study provide a context for understanding the role
of substances in the lives of this group of IPV survivors and
their families as well as point to directions for intervention
development.
Quantitative Findings
Quantitative results from this study offer critical information
regarding survivors’ past and current substance-use behaviors.
Evaluation using a standardized assessment measure showed
more than a third of the study sample (N=22) met criteria for
hazardous drinking. Despite high levels of reported past use
(50 %; n=11), few participants indicated any level of current
drug use. Although a few participants (n=3; 13.6 %) did not
respond to questions about drug use, the majority (n=16;
72.3 %) reported they were not currently using any drugs.
Given the participants’ recent—and sometimes ongoing—in-
volvement with CPS and the courts, we speculate that partic-
ipants might have been reluctant to disclose their substance
use because they were worried about potential repercussions.
Accordingly, participants might have felt more comfortable
disclosing past use of substances. In addition, participants
might have felt a greater stigma attached to current use, there-
by reducing the likelihood of disclosure to individuals consid-
ered as authority figures, including university-affiliated re-
search teams.
We also speculate participants’ life circumstances made it
more likely that those who had reported past drug use were not
using substances at the time of data collection. These circum-
stances include (a) the participants’ life changes reflecting the
benefits of the IPV and parenting programming they had re-
ceived, (b) the participants’ response to increased scrutiny by

CPS and/or the court system, (c) the participants’ efforts to-
ward ending relationships with violent partners, and (d) the
participants’ desire to parent their children well and without
the influence of substances.
Qualitative Findings
Although quantitative data offer important information about
prevalence, the qualitative findings offer important informa-
tion to contextualize the role of substances and substance use
in the lives and homes of IPV survivors. Three overarching
themes emerged from the individual interviews: participant
substance use (i.e., self-use), her partner’s use, and participant
perceptions of the relationship between substance use and
IPV.
The study participants noted varying degrees of substance
use and exposure to substance use over their lifetimes and
over the course of their relationships. Many of the women
reported a change in their substance use patterns since leaving
the abusive relationship. Substance use was frequently
discussed as a means of coping with the abusive relationship.
This finding is consistent with previous studies that have
found that rates of substance use are much higher among
IPV survivors, and substance use is often identified as a meth-
od of coping (Logan et al. 2002).
A history of substance use in the family-of-origin was a
common characteristic among participants whose intimate
partners used substances or had a substance-use disorder. This
relationship is consistent with the tenets of both social learning
theory and the theory of intergenerational transmission. These
theories hold that individuals who have witnessed substance-
use behaviors in their family-of-origin not only have a in-
creased tendency to engage in similar behaviors themselves
but also have an elevated likelihood of seeking out intimate

partners with these same behaviors (Corvo and Carpenter
2000). Moreover, many of the study participants possessed a
profound self-awareness of the role substance use had played
in their entire lives; for these women, abstinence became an
important and purposeful lifestyle choice.
Participants’ discussions on the risk associated with sub-
stance use generally indicated the partner’s pattern of sub-
stance use tended to be more hazardous than the woman’s.
The women who reported Bconsistent^ substance use by a
partner were also more familiar with the severity of their part-
ner’s use. We speculate these women developed this familiar-
ity because frequent use or daily use is more difficult to hide
than occasional use. The women’s reports of frequent/severe
levels of substance use by a partner were consistent with re-
search on batterers, which has indicated high prevalence rates
of substance use among batterers (Moore and Stuart 2004).
These discussions around women’s self-use and their part-
ner’s use highlight the presence of substances in the family
home, posing potentially important ramifications for their
children. Regardless of whether the women were focusing
on self-use or a partner’s substance use, the women rarely
mentioned the intersection of substances in the home with
parenting and child development. The failure to discuss these
important issues might be related to the participants’ denial of
J Fam Viol (2016) 31:61–73 69
use, severity of use, or perceived effects (Logan et al. 2002).
However, these findings have important implications for pro-
gramming targeted to this population; specifically, these find-
ings indicate the importance of including content on the im-
pact of children’s exposure to IPVand substance use on child

well-being. Research has suggested children are often aware
when adults in the home are using substances, and might be
confused when these issues are never discussed (Gorin 2004).
Without appropriate communication, these issues create a bar-
rier to effective parenting (Gorin 2004; Young et al. 2007).
The final qualitative theme was related to the relationship
between substance use and violence. Contrary to previous
studies, participants suggested that IPV might have more to
do with a partner’s substance use rather than the survivor’s
substance use (Logan et al. 2002; Moore and Stuart 2004;
Thompson and Kingree 2006). For some participants, sub-
stance use was a precursor to abuse whereas for other partic-
ipants substance use had unpredictable consequences and was
inconsistently associated with abuse. Such unpredictability
can make it difficult to develop an effective safety plan. These
findings support previous research that has described the rela-
tionship between substance use and IPVas complex, dynamic,
and varied, with little evidence to clarify the directionality and
risk processes between the two problems (Testa 2004). Equal-
ly important, although some participants reported they felt
their partners’ substance use made the partner less violent,
others reported substance use increased their partner’s violent
behaviors.
Implications for Practice and Research
Practice Implications The wide variation in participants’ ex-
periences of substance use highlights the extreme variability
of the relationship between IPVand substance use. Indeed, the
relationship can be different in every case, and therefore, con-
textualization is an important factor in treatment planning and
intervention implementation. Intervention scientists should
aim to tailor programs for this population to facilitate survivor
self-awareness by focusing on the influence of the partner’s
substance abuse, and the survivor’s lifetime substance use

(including survivor’s childhood exposure to substance use).
In addition, programs should teach IPV survivors about the
effects of substance use on parenting, family safety, and rela-
tionship violence.
Notably, these data were collected following women’s
completion of the MOVE program. Other research on the
MOVE program shows significant reductions in IPV by the
time of program completion (Macy et al. 2013b). However,
the current findings suggest high-risk alcohol use was a prob-
lem for some of the women even after completing an IPV
treatment program. Accordingly, these findings underscore
the importance of not only addressing the physical and mental
health consequences of alcohol use in IPV treatment programs
but also helping IPV survivors to find successful behavioral
strategies (e.g., adaptive coping strategies) to mitigate their
use of alcohol.
In particular, programs should emphasize ways in which
survivors can effectively cope with IPVand substance use by
their partners and within their family-of-origin. Such coping
methods might include reflective activities about ways sub-
stance use — especially misuse and abuse — can be harmful
to both the woman and her family. Indeed, the connections
among substance use, violence, safety, and parenting might
come as a surprise for some women. Moreover, these findings
suggest IPV programming should include instruction on cop-
ing skills to address survivors’ use of substances to cope with
difficult emotions such as anger, stress, and isolation. Last,
these findings suggest IPV programs should screen all partic-
ipants for substance use, and when applicable, provide refer-
rals for treatment of substance-use disorders (Macy and
Goodbourn 2012).
Research Implications As noted earlier in this paper, little

evidence is currently available relevant to the types of pro-
gramming and interventions that are most helpful for court-
and/or CPS-involved IPV survivors. Thus, additional research
is needed that explores IPV programming for system-involved
and service-mandated survivors. In particular, findings from
the current study suggest integrating substance-use material
into IPV programming fills a critical need for survivors. Al-
though previous research has indicated substantial rates of
substance use among court- or CPS-involved IPV survivors
(Logan et al. 2002; Stuart et al. 2004; Thompson and Kingree
2006), few IPV programs have addressed survivors’ substance
abuse directly or included a substance-use component (Macy
and Goodbourn 2012). Thus, we propose that programs for
service-mandated IPV survivors address substance use and
abuse following the above recommendations, and that such
programs be rigorously evaluated to build the evidence-base
in this area. However, in making this proposal, we acknowl-
edge that researchers face a substantial considerable challenge
in determining accurate substance-use rates among this popu-
lation. As previously discussed, IPV survivors’ hesitancy to
disclose their substance use information is likely given their
involvement in multiple official systems (e.g., court, CPS).
Thus, the availability of accurate and reliable methods of data
collection is critically important to the accurate assessment of
individual survivor’s needs. Given the dearth of such tools, we
recommend researchers should explore ways to obtain valid,
reliable substance use and abuse reports from system-involved
IPV survivors. Such measurement strategies will likely re-
quire creativity and innovation. However, until novel mea-
sures andmeasurement strategies have been developed for this
population, researchers will face serious limitations in their
ability to gather valid data. As researchers work to address
these measurement issues, the qualitative findings of this
70 J Fam Viol (2016) 31:61–73

research underscore that substance use and abuse among this
sample of IPV survivors was heterogeneous, dynamic, and
changing over time. Moreover, for some women in this study,
their partner’s substance use shaped the women’s use of sub-
stances. Therefore, the accurate measurement of substance use
among male partners may add a compelling perspective to
these women’s stories and further explain their experiences.
These rich qualitative findings suggest that measuring,
researching, and addressing substance use and abuse among
CPS- and court-involved IPV survivors will require diverse
and multifaceted strategies.
Limitations
Readers are urged to consider our study’s findings in light of
its limitations. First, our findings reflect participants’ perspec-
tives, and may be different from the perspectives of their part-
ners, CPS workers, and/or the court. Despite our efforts to
ensure confidentiality and describe our protocols to partici-
pants, some participants might have feared disclosure would
bring negative repercussions, and therefore, might not have
been fully honest about their or their partner’s substance use or
extent of violence in their relationships. Discussing substance
use by either themselves or their partners might have caused
some participants to feel discomfort, and some may have
feared judgment. We addressed this limitation by seeking
feedback from a social worker with expertise in substance
use and IPV regarding the qualitative interview questions
about substance use. In addition, all participants had some
familiarity with the research team from prior research involve-
ment. We hoped participants’ positive experiences with earlier
research participation would ease their anxieties regarding
judgment, but it is possible that familiarity with the research
team could actually heighten fear of judgment. Further, we

tried to ease participants’ worries about disclosure by repeat-
ing several times that all data would be aggregated to prevent
individual identification.
Quantitative limitations include missing data because
some participants declined to respond to the standardized
drug use measure. Although all participants appeared to
feel comfortable describing their past use of drugs other
than alcohol, it appeared fewer felt as comfortable
discussing their current drug use. In addition, the low
cut-off score used for the AUDIT was chosen to indicate
Bat-risk^ drinking behaviors in this specific population
(i.e., service-mandated female survivors of intimate partner
violence), and was not meant to imply any clinical diag-
noses regarding alcohol use disorder. Thus, scores higher
than the suggested study cut-off do not necessarily repre-
sent alcohol dependency or alcoholism, but rather
concerning, at-risk drinking behaviors. Further, the stan-
dardized measures for alcohol and drug use (i.e., AUDIT
or DUDIT) did not gather crucial information about the
partner’s use or the general context of substance use with-
in the intimate relationship and the household. As this
missing information is critical to establishing an under-
standing of the whole picture of substance use in the lives
of IPV survivors, we addressed this limitation by includ-
ing the qualitative research component.
Last, although a near 79 % participation rate among the
women our research team was able to reach is notable given
the complex circumstances of participants’ lives (e.g., CPS
and/or court-involvement, mandated to services, IPV), many
women who might have been eligible for the study did not
respond to our initial recruitment efforts. These non-
responders might differ systematically from those who
responded and participated in this study.

Despite these limitations, this study takes an important step
toward better understanding the role of substances in the lives
of system-involved IPV survivors. This research is critically
important given the urgent need to develop effective services
tailored to the complex needs of the growing population of
system-involved IPV survivors mandated to services.
Acknowledgments This research was supported by a Jane H.
Pfouts
grant from The University of North Carolina at Chapel Hill
School of
Social Work. The Duke Endowment also supported this
research. We
acknowledge the staff of InterAct and SAFEchild for their help
with this
research, as well as all of the families that participated. We
acknowledge
Diane Wyant for her feedback and edits of a previous version of
this
manuscript.
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“I...AbstractGrowing Trend of System-Involved IPV
SurvivorsThe MOVE ProgramMethodStudy SampleData
Collection ProceduresData AnalysisResultsSample
CharacteristicsQuantitative FindingsQualitative FindingsTheme
1: Self-UseTheme 2: Partner UseTheme 3: The Relationship
Between Substance Use and IPVDiscussionQuantitative
FindingsQualitative FindingsImplications for Practice and
ResearchLimitationsReferences
Assignment: Quantitative Research Study Critique
As you may recall, evidence-based practice relies on best
available evidence, which is drawn from current research

studies. But, just because a research study is published, it
doesn’t mean it is without flaw. Social workers must make
value determinations every time they interact with research they
may apply to practice.
Imagine that you are a practicing social worker and encounter a
question, issue, or challenge on which you need to learn more.
You search in the social work literature and find a quantitative
study on the topic. As you read it, you ask critical questions,
closely analyze how the study was framed and conducted,
monitor efforts toward validity, and ultimately decide whether
to integrate the information in practice.
For this Assignment, you replicate this process of critical
evaluation by critiquing a quantitative research study.
To Prepare:
· Review the Learning Resources on critical reading and
critique/evaluation.
· Select one of the quantitative research articles your Instructor
has provided.
· Read the research article with a critical eye, taking notes and
considering how the study was conducted.
· Download the Critique Template in the Learning Resources for
use in this Assignment.
By Day 7
Submit a 3-page critique of the peer-reviewed research study
you have chosen from those provided by your Instructor.
In your Assignment, be sure to identify and evaluate the
following, as described in the template:
· Title and Authors
· Literature Review
· Strategy of Research (Descriptive, Exploratory, Explanatory)
· Methodological Approach and Design
· Threats to Internal Validity
· Application to Practice
· Based on your critique of this study, is this social work
intervention or knowledge safe to integrate into your practice?

Why or why not?
Use the Learning Resources to support your critique. Make sure
to include appropriate APA citations and a reference list.
Links Provided:
https://www.youtube.com/watch?v=KN45RKksppc
https://cdn-
media.waldenu.edu/2dett4d/Walden/CAEX/6400/M3/module3/in
dex.html
https://waldenacademicskills.wordpress.com/2020/02/24/critical
-reading-for-evaluation/

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