Like the last column, I’ve supplied a group of interesting but unrelated research to practice reports.

Item # 1: Violence and Alcohol
Violence and its connection to alcohol is nothing new. However, recent research has uncovered some new angles on this well studied subject. For example, Castano et al. (2005) surveyed couples between 1995 and 2000 on incidence and recurrence of male-to-female partner violence (MFPV) and female-to-male violence partner violence (FMPV), and their respective relationships to drinking and alcohol abuse. All the couples surveyed were aged 18 years or older and were interviewed twice. The research team found that the volume of drinking (once other variables were controlled) was the only indicator associated with intimate partner violence. Male-to-female violence among men who drank five or more drinks per occasion each month was three times higher than abstainers or those who drink less than five drinks per occasion. The same trend held for female-to-male violence.

Having noted that, another survey conducted by Moore and Stuart (2004) found that more than one-half of the batterers reported illicit drug or alcohol use in the past year, and more than one-third of the partners reported having used one or more illicit substances in the past year. Compared to non-users, substance users scored significantly higher on all measures of intimate partner abuse after alcohol or substance use. Taken together, it appears that at least two studies are indicating that drinking more than five drinks per occasion, and/or using illicit drugs results in increased intimate partner violence.

Using this research in your practice
In terms of applying this research in practice, the implication could be directed at prevention, assessment, and treatment. In the prevention sphere, creative ways may be developed to warn potential victims of the violence they could potentially face if heavy drinking and illicit drug use became the norm in their relationship. The information also could alert the drinker or potential illicit drug user of what he or she could become should heavy drinking and illicit drug use become the rule.

As for assessment, most counselors are aware of the connections between violence and illicit drug use and heavy drinking, as indicated in previous studies. However, just in case you began to drift away from this link, let this research be a reminder that violence is ever prevalent, yet not exclusive, in such relationships. So, in terms of assessment, you need to include in your intake, a few questions that address violence. If you get a red flag from the intake, you probably need to pass the information on to a primary counselor for further investigation.

In terms of treatment, this research reminds counselors that it is necessary to address the issue of violence with their clients. If not addressed, the implications for unresolved feelings concerning past violence could jeopardize outcomes. Specifically, a past violence history needs to have partners involved with the overall counseling treatment process. Consider specialized groups or individual sessions within your program to address this important issue.

Doing the research
For those of you who wish to try your hand at doing some related violence and alcohol/drug research there are a few simple but interesting studies. For example, survey a sample of clients in your program to assess possible correlations between violence (MFPV or FMPV) and the five or more drinks per occasion variable. The point of this survey would be to assess if your population has a similar relationship between five drinks and violence, or if the number of drinks and violence is higher or lower. If higher or lower, what could be the variables that influence such outcomes?

In addition, a survey like this might be more interesting if a local middle or high school would allow you to conduct it among their students. You could add the element of illicit substance use to these questions. The results could well be applied to a creative prevention program within that school. Don’t forget to include the usual demographics (age, gender, ethnicity, etc) in these surveys.

Item # 2: What Factors Lead to Drug Treatment Admission?
A small study completed a few years ago, took note of certain factors that would lead people to seek treatment. Hser, et al (1998) surveyed 276 drug abusers and found variables that contributed to admission, as well as some that did not. In terms of age, gender, race/ethnicity, education, drug use, and years of use the study found no difference between those who came to treatment versus those who didn’t. However, there were some factors that predicted who would attend treatment.Legal pressure ranked high on this list.

Other factors that were predictive of treatment admission include lower levels of psychological distress; lower levels of family or social problems; and successful completion of a previous treatment program. Factors that tended to undermine admission to treatment include more severe overall problems (drug related and others), in addition to family problems.

Using this research in your practice
The application of research to practice from this survey could involve relevance toward the assessment and treatment end of addiction counseling. In your initial intake, you could easily highlight certain questions to note any factors a client gave for or against admission. If during an intake a client indicates successful completion of a previous program, you could inquire what factors led to that success. With such information, you could adapt your treatment to at least replicate the initial success.

If the intake noted strong legal pressure, that information could forewarn a primary counselor to make adjustments in the initial client contact. The adjustments could take into account the potential anger or reactance (the perception of unfair restriction on one’s actions by other people or organizations) to offset these potentially disruptive client factors. The same sort of adjustment could be made if in your intake you noted higher levels of psychological distress, and higher levels of family or social problems. In both cases, you could adjust treatment to engage these issues early and avoid later complications.

Doing the research
This study lends itself to some easy research possibilities. For instance, you could survey a sample of your own intakes (make the number greater than 50). From this sample, ask each individual why he or she came to treatment. You can either ask each intake directly of ask the question from a pre-established form. Make the form only one page and list a few key reasons for coming to treatment using the list of reasons noted in the research above. Then, simply count the various reasons. Finally, compare the results with the study above. You might find similarities, and you might find interesting differences. At any rate, such information can prove valuable.

As always, I am interested in the outcomes of your research efforts.

Mike Taleff is an instructor at the University of Hawai’i at Manoa and West Oahu campuses, and an instructor at National University (Hawaii branch). He can be contacted at MichaelTaleff @aol.com.

References
Castano, R., McGrath, C., Ramisetty-Mikler, S. & Field, C.A. (2005). Drinking, alcohol problems and the five-year recurrence and incidence of male to female and female to male partner violence. Alcoholism: Clinical and Experimental Research, 29, 1, 98-106.
Hser, Y.I., Maglione, M., Polinsky, M.L. & Anglin, M.D. (1998). Predicting drug treatment entry among treatment-seeking individuals. Journal of Substance Abuse, 15, 3, 213-220.
Moore, T.M. & Stuart G.l. (2004). Illicit substance use and intimate partner violence among men in batterers intervention Psychology of Addictive Behaviors, 18, 4, 385-389.

This article is published in Counselor,The Magazine for Addiction Professionals, August 2005, v.6, n.4, pp.63-65.

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