Drug dependent women with partner violence treatment issues
Download
1 / 22

- PowerPoint PPT Presentation


  • 339 Views
  • Uploaded on

Drug-dependent women with partner violence: Treatment Issues. Brenda A. Miller Senior Scientist Prevention Research Center/PIRE Berkeley, CA. Conceptualizing Violence & Victimization. Physical assaults Sexual assaults Psychological terror and abuse Attacks on self-esteem & self worth.

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about '' - jacob


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
Drug dependent women with partner violence treatment issues

Drug-dependent women with partner violence: Treatment Issues

Brenda A. Miller

Senior Scientist

Prevention Research Center/PIRE

Berkeley, CA.

Miller, B.A., APA, May 1-6, 2004


Conceptualizing violence victimization
Conceptualizing Violence & Victimization

  • Physical assaults

  • Sexual assaults

  • Psychological terror and abuse

  • Attacks on self-esteem & self worth

Miller, B.A., APA, May 1-6, 2004


Severe partner violence psychological abuse straus gelles 1990
Severe partner violence/psychological abuse Straus & Gelles, 1990

  • Kicked, bitten, or hit with fist

  • Hit with object

  • Beat up

  • Burned or scalded

  • Choked, strangled, or smothered

  • Threatened with knife or gun

  • Used knife or gun

  • Threatened life with automobile

  • Threatened life in some other manner

Miller, B.A., APA, May 1-6, 2004


Psychological control aggression pence paymar 1993
Psychological control & aggression Pence & Paymar, 1993

Power/control wheel:

  • Intimidation (glaring or staring)

  • Emotional abuse (not sexually desirable)

  • Isolation (controlling access to friends/family)

  • Minimizing, denying or blaming (blame woman)

  • Using children (if leave, children stay)

  • Exert male “privilege” (man’s night out)

  • Economic abuse (control money)

  • Use coercion/threats (harm children/pets)

Miller, B.A., APA, May 1-6, 2004


Prevalence of pv among women drug users
Prevalence of PV among women drug users

  • General population studies

  • Community samples of drug users

  • Medical patients

  • In- or outpatients for AOD treatment

Miller, B.A., APA, May 1-6, 2004


Women s lifetime victimization and their drug use national victim center 1992
Women’s Lifetime Victimization and Their Drug Use(National Victim Center, 1992)

Miller, B.A., APA, May 1-6, 2004


Female male drug problems by male partner violence cunradi et al 2000
Female & Male Drug Problems by Male Partner ViolenceCunradi, et al., 2000

Miller, B.A., APA, May 1-6, 2004


Emergency departments pv and aod n 143 el bassell et al 2003
Emergency Departments: PV and AODN=143El-Bassell, et al., 2003

  • Women physically abused by partner violence in past year (18%)

  • Significantly higher indicators of drug problems among abused women (DAST)

  • Significantly higher indicators of alcohol problems among abused women (AUDIT)

  • Alcohol and drug interactions

Miller, B.A., APA, May 1-6, 2004


Inpatient detoxification treatment n 101 hien and scheier 1996
Inpatient detoxification treatmentN=101Hien and Scheier, 1996

Miller, B.A., APA, May 1-6, 2004


Prevalence of severe partner violence aod outpatients n 315
Prevalence of Severe Partner Violence AOD OutpatientsN=315

Miller, B.A., APA, May 1-6, 2004


Theoretical explanations for victimization aod connections
Theoretical Explanations for Victimization – AOD Connections

Victimization preceding AOD:

  • Victimization produces changes in self-perceptions and self-esteem

  • Self-Medication following victimization e.g., for PTSD symptoms

  • Changes in peer-group associations following victimization

Miller, B.A., APA, May 1-6, 2004


Theoretical explanations for aod victimization connections
Theoretical Explanations for AOD-Victimization Connections Connections

  • Heavy AOD use reduces ability to provide self-protection/psychopharmacologic drug effects

  • Heavy AOD use reduces cognitive capabilities including recognizing risks

  • Involvement in AOD lifestyle places individual in settings where criminal activity takes place

Miller, B.A., APA, May 1-6, 2004


Comorbid psychological health disorders associated with partner violence
Comorbid psychological & health disorders associated with partner violence

  • Many points in the system where individuals appear with psychological/physical health problems

  • Opportunities for screening

  • Funnels into appropriate treatment

  • Handicapped by fragmented system

Miller, B.A., APA, May 1-6, 2004


Mental health symptoms associated with physical abuse n 182 gil revas et al 1997
Mental health symptoms associated with physical abuse partner violenceN=182 (Gil-Revas et al., 1997)

Rank order of symptoms significantly correlated to physical abuse for women

  • PTSD (r=.31)

  • Contemplated suicide (r=.24)

  • Anxiety (r=.18)

  • Depressive symptoms (r=.15)

  • Attempted suicide (ever, r=.16, last year r=.10)

Miller, B.A., APA, May 1-6, 2004


Links between partner violence and health status
Links between partner violence and health status partner violence

  • Lower perceived health status

  • Lower health care quality

  • Chronic headaches

  • Chronic pain, chronic pelvic pain

  • Gastrointestinal disorders

  • Somatic problems

  • Poorer health outcomes

  • Risk for STDs including HIV

Miller, B.A., APA, May 1-6, 2004


Drug treatment outcomes for women with partner violence histories
Drug Treatment outcomes for women with partner violence histories

  • Neither physical nor sexual abuse were related to return to drug use during or after treatment (6 month follow-ups) (Gil-Revas, 1997)

  • Specific psychological disturbances associated with treatment participation are not the same ones associated with histories of violence (Gil Revas, 1997)

  • Another study by Hien & Scheier also suggests that outcomes are not predicted by histories of violence

Miller, B.A., APA, May 1-6, 2004


Sensitivity in treating women with partner violence histories
Sensitivity in treating women with partner violence histories

  • Groups with men and women may not be safest environment

  • Asking means it is ok to tell

  • Respecting women’s right to participate in making decisions about her life

  • Assuring that a safety plan is in place

Miller, B.A., APA, May 1-6, 2004


Barriers to identifying family violence in aod settings
Barriers to Identifying Family Violence in AOD Settings histories

  • Beliefs about importance of family violence to AOD problems

  • Concerns about expertise in delivering family violence counseling

  • Treatment protocol concerns

Miller, B.A., APA, May 1-6, 2004


Barriers to identifying aod problems in family violence settings
Barriers to Identifying AOD Problems in Family Violence Settings

  • Safety is the predominant concern

  • If perpetrator has the problem--concern that he (and she) will view the AOD as the “cause” of the violence

  • If victim has the problem--concern that she (or he) will view the violence as justified

Miller, B.A., APA, May 1-6, 2004


Barriers in both aod family violence settings
Barriers in Both AOD & Family Violence Settings Settings

  • Lack of training & education

  • Lack of resources

  • Specialization of services

  • Crisis mentality

Miller, B.A., APA, May 1-6, 2004


Important system strategies
Important System Strategies Settings

  • Addressing violence protection as part of AOD treatment services for women

  • Linking AOD treatment services to agencies that provide services for family violence

  • Addressing a safer community approach to violence and to drugs

Miller, B.A., APA, May 1-6, 2004


Conclusion
Conclusion Settings

Community and System responses needed to reduce violence that women experience in their lives—the responsibility does not reside solely in treating women who are victims but addressing the larger community/environmental context

Miller, B.A., APA, May 1-6, 2004


ad