Substance Misuse, Trauma and Family Violence

There is often heated debate about the links between these three factors. When a report from the Centre for Justice Innovation (UK) Substance misuse, trauma and domestic abuse perpetration: The perspective from Family Drug and Alcohol Courts (justiceinnovation.org) came across my desk, I was interested in seeing how they made sense of the issues, given this was an area that I have been very interested in.

Key findings that they argue for included:

• A need for evidence-informed, individualised practice and a shift away from a ‘one-size-fits-all’ approach to domestic abuse interventions. As they argue that given the diversity within users of violence, intervention programmes should be responsive to the range of needs and risks presented, allowing for a tailored and integrated approach.
  
  
• Substance misuse, trauma and domestic abuse are closely intertwined and interact in complex ways that warrant further exploration. We know that one outcome of trauma is using avoidance strategies, with alcohol and drug misuse being one. We also now recognise that the range of adverse childhood experiences may impact emotional development leading to cognitive and emotional problems that place people at risk of both substance misuse and domestic abuse perpetration.
  
  
• Co-occurrence of substance use, trauma and family violence is more the norm than the exception.
  
  
• Family violence interventions should be provided within a trauma-informed and motivational framework. While holding users of violence accountable is important, so is the need to build engagement through motivational interviewing techniques.
  
  
• As they note, current programmes are generally based upon cognitive behavioural principles  Current interventions operate at a cognitive and psychoeducational level which may not elicit sustainable change in underlying emotionally based problems. We have known for a long time that enhancing emotional regulation skills are one of the best ways to manage family violence risk.
  
  
• And finally, those working with users of violence should recognise their role as fathers and consider their family context. Interventions focusing specifically on fathering can harness parental motivation to change; there is evidence that fatherhood and building positive relationships with children can be powerful motivators towards desistance. They advocate a whole of family approach, which “may allow for risks and relational dynamics to become more visible, for appropriate interventions to be identified and where these risks cannot be addressed through intervention, for appropriate safeguarding and risk management plans to be put in place.”

Interestingly, this thinking is very much in line with what we consider best practices in finding ways to disrupt domestic and family violence.

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