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Articles   |    
Differences Between U.S. Substance Abuse Treatment Facilities That Do and Do Not Offer Domestic Violence Services
Amy Cohn, Ph.D.; Lisa M. Najavits, Ph.D.
Psychiatric Services 2014; doi: 10.1176/appi.ps.201300005
View Author and Article Information

When this study was conducted, Dr. Cohn was with the Department of Mental Health Law and Policy, University of South Florida, Tampa. She is now with the Schroeder Institute for Tobacco Research and Policy Studies, American Legacy Foundation, Washington, D.C. (e-mail: acohn@legacyforhealth.org). Dr. Najavits is with the U.S. Department of Veterans Affairs Boston Healthcare System and the Department of Psychiatry, Boston University School of Medicine.

Copyright © 2014 by the American Psychiatric Association

Abstract

Objective  Victimization by and perpetration of domestic violence are associated with co-occurring mental and substance use disorders.

Methods  This study used data from the National Survey of Substance Abuse Treatment Services to examine differences in organizational factors, treatment approaches offered, and client-level factors among 13,342 substance abuse treatment facilities by whether or not they offered domestic violence services.

Results  Only 36% of the facilities offered domestic violence services. Those that offered such services were more likely than those that did not to treat clients with co-occurring disorders. Principal-components analysis reduced eight treatment approaches to two factors: psychosocial services and traditional substance abuse services. Regression models indicated that the frequency with which psychosocial services were offered depended on the percentage of clients with co-occurring disorders who were being treated in the facility and whether or not that facility offered domestic violence services. Specifically, facilities that did not offer domestic violence services and that had a high percentage of clients with co-occurring disorders were more likely to offer psychosocial services than facilities that offered domestic violence services. A larger proportion of facilities offering domestic violence services offered traditional substance abuse treatment services, compared with facilities not offering domestic violence services, but this relationship was not contingent on the percentage of clients with co-occurring disorders at each facility.

Conclusions  Improved efforts should be made to tailor treatments to accommodate the links between domestic violence, mental disorders, and substance abuse.

Abstract Teaser
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Table 1Characteristics of 13,342 U.S. substance abuse treatment facilities, by whether or not they offered domestic violence services
Table Footer Note

a Percentages may not sum to 100 because of rounding or missing data.

Table Footer Note

*p<.01, **p<.001

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Table 2Eight treatment approaches offered by 13,342 U.S. substance abuse treatment facilities, by whether or not they also offered domestic violence services
Table Footer Note

a For low or no use, response options were “never,” “rarely,” and “sometimes.” For high or frequent use, response options were “always” or “often.”

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Table 3Factor loadings for frequency of offering eight treatment approaches
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Table 4Final regression models of predictors of offering psychosocial and traditional substance abuse services among 13,342 U.S. substance abuse treatment facilitiesa
Table Footer Note

a Models adjusted for covariates.

Table Footer Note

b Value not listed because it was not significant (p>.05).

Table Footer Note

c Co-occurring substance use and mental disorders. Domestic violence services and percentage with co-occurring disorders represent z-transformed variables; does not offer domestic violence services is the reference group.

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