Joining forces

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New partnership-led training aims to help victims of domestic abuse incidents where substances are an issue, says Cat Payne

Domestic abuse victims with substance misuse issues are among the most vulnerable, isolated and challenging to engage. They suffer from severe and frequent abuse, and receiving the right support from skilled and experienced professionals can help to make a real difference to their lives.

According to research by Quigley and Leonard in 2000, and White and Chen in 2002, substance misuse is a factor in more than half of high-risk domestic abuse cases, with alcohol likely to contribute to ‘intimate partner violence’ in a variety of ways. Levels of consumption affect the likelihood and severity of violence, and alcohol appears to be ‘particularly important in escalating conflict’.

This increased level of risk to domestic abuse victims when there is an underlying drug or alcohol problem – and current lack of services and practitioners properly equipped to support them – has led to the development of an innovative new training course for professionals. Families Plus (a division of Action on Addiction) and Co-ordinated Action Against Domestic Abuse (CAADA), two leading national charities tackling addiction and domestic abuse, have combined their expertise to develop and deliver a training course for professionals entitled Substance use and domestic violence: providing a risk-led response.

The new joint training looks in depth at key issues faced by practitioners from both sectors, and encourages learners to explore possible differences in agency approach. The substance misuse sector traditionally favours a counselling, talking therapy approach, while the domestic abuse sector supports clients with skills that are more likely to be based on risk identification and advocacy. Space is provided for learners to reflect on their practice and consider new ways of assessing and offering support to their clients, while opportunity to connect with professionals from both fields adds to the learning environment, with facilitators encouraging participants to share difficulties and best practice.

Substance use and domestic violence uses a systemic approach to help practitioners support clients. This encourages practitioners to realise that individuals cannot be understood in isolation from one another, and that to effectively engage a client all elements of their situation should be taken into consideration, and theories and techniques give professionals the skills to see their clients as interconnected and interdependent individuals who are more fully understood in the context of their ‘system’.

The course includes time to look at the relationship between the user and his or her substance misuse, and how the effects of addiction impact the non-using members of the family. The struggle faced by significant others who are non-users is often overlooked in the treatment of substance misuse and Families Plus has long used the phrase, ‘You don’t have to misuse alcohol or drugs to suffer from alcohol or drug misuse’.

Systemic thinking is particularly important when substance misuse is an issue for the victim, the perpetrator, or both. The relationship with drugs or alcohol will have a significant impact on the relationship between couples and other family members, as the dynamic can be complicated and the risk to a victim increased. Apart from the higher levels of violence reported, opportunities for control and manipulation are increased if a victim is drug or alcohol dependent. Levels of secrecy and shame can also increase, and these become powerful barriers to asking for help and support. These issues also need to be understood in the context of cultural diversity.

Substance use and domestic abuse constitute two of the three major risk factors for child abuse and neglect, as identified by the Munro review of child protection in 2011. In acknowledgement of this, the training also supports practitioners to identify the impact and risks for children who may be living in the household.

Practitioners have identified that one of the key issues they face when confronted with substance misuse and domestic abuse is ‘where do I start?’ It is often the case that drug and alcohol services will not work with clients who are victims of domestic abuse, and domestic abuse agencies, particularly refuges, feel they do not have the facilities to support substance misusing victims. The need for joined-up working has never been greater and this joint initiative will help practitioners find the best way to support clients in this situation.

The course has been accredited by the University of Bath at Level 4 and consists of four days of teaching. The training provides practical information alongside the theoretical approach and includes the most up-to-date evidence-based learning. Learners to date have reported a decrease in levels of anxiety following the course and increased confidence in supporting these vulnerable clients.

For more information or to sign up visit http://www.caada.org.uk/learning_development/CPD-Substance-Use-about-the-course.html

Cat Payne is therapeutic/tutor practitioner at Action on Addiction’s Families Plus service