DRUG TREATMENT COURT goals:

1. Effective Practices for Managing Domestic Violence and AddictionDrug Treatment Conference“Evidence-Based Practice Made Practical”August 31th, 2010Presenter:Bea Coté, LCSW, LMFT

2. DRUG TREATMENT COURT goals: • To increase the personal, familial, and societal accountability of adult and juvenile offenders and defendants and respondents in juvenile petitions for abuse, neglect, or both; and • To promote effective interaction and use of resources among criminal and juvenile justice personnel, child protective services personnel, and community agencies.

3. DRUG TREATMENT COURT goals: • To reduce alcoholism and other drug dependencies among adult and juvenile offenders and defendants and among respondents in juvenile petitions for abuse, neglect, or both; • To reduce criminal and delinquent recidivism and the incidence of child abuse and neglect; • To reduce the alcohol-related and other drug-related court workload;

4. Why this is important to you: • Often, the folks you see in court are also DV clients • Making the right referral • Protecting victims • Not protecting abusers- holding them accountable

5. Some basics: Nationwide, in 50% of all domestic violence murders, the killer had used alcohol before the murder. So far this year in North Carolina, there have been at least *45 murders related to domestic violence. *Not enough evidence; unclear relationship; unsolved murder; body not discovered; murders last couple days

6. That means of course, there’s a likelihood that 22of these people were murdered by someone who was drunk. *(but probably not solely high on other substances) • 12/43 were male victims. 4 of those were men killed by women. • 4 were people attempting to defend victims. 1 was a same-sex partner. • 5/43 were children. • That leaves us with 28/43 were women: girlfriends; wives; ex-girlfriends; ex-wives.

7. Many of these folks have been involved with our systems; our services, prior to the murders. Someone had an opportunity to recognize, address, refer, protect, hold accountable, treat, incarcerate, house, support and advocate. This does not mean that we are responsible for the murders. We are responsible for making DV unacceptable in North Carolina.

8. Definitions • DV community’s domestic violence definition – a pattern of coercive, controlling or abusive behaviors toward an intimate partner/former partner. Note that only the violent behavior or threats violate laws. • NC law- defines it as a physical act of abuse or threats toward family or household members or former household members • Today, we’re talking about the first definition

9. Gender bias? • In a 1995-1996 study conducted in the 50 States and the District of Columbia, 7.6% of men were raped and/or physically assaulted by a current or former spouse, cohabiting partner, or dating partner/acquaintance at some time in their lifetime (ABA, 2000). • (based on survey sample of 16,000 participants, equally male and female) • Intimate partners committed 3% of the nonfatal violence against men (Tjaden & Theonnes, 2003). • One in 33 men have been the victim of an attempted or completed rape by an intimate partner (Theonnes & Tjaden, 2000).

10. Gender • Our DV teams at the CMC network report that over the last quarter, 98% of DV-related injuries they saw were inflicted by male partners on women. • Caution: male victims are less likely to report; less likely to seek services.

11. The Missing Statistic

13. What DV isn’t • A fight • A lovers’ quarrel • An argument • A dispute • An incident • Isolated • First time

14. 9-1-1 call: “Did you have a good time?”

15. When the victim is in Drug Court: • Up to 80% of battered women who seek safety at a shelter are drug/alcohol abusing or dependent. (She) may or may not have been that way when she met her abuser. Either way, her addiction makes her much more vulnerable. • Her D/A issues are going to be a lot more obvious to you in court and you may be tempted to address that problem first. • She may appear more out-of-control- may be a “hot mess”! • She has to be safe before she can be sober.

16. When the abuser is your client: • If you don’t know, you may unwittingly be protecting him and re-victimizing her. • He may use his addiction/alcoholism as an excuse. • He may use her addiction as an excuse. • He may “clean up” a whole lot better than she does; may present better in court. He could just be a really good obfuscator.

17. She may buy that she’s the problem and may try to convince the court of that. She may make him look good, thinking he has a better chance of convincing you that he’s okay- because she’s the problem. She may be completely dependent on him and therefore truly believe a number of things: that he’s not abusive; that he’s her rescuer; he’s a good parent, etc. She needs to believe those things.

18. Why are victims with addictions at higher risk? • Abusers who seek/build vulnerable women. Some do it for the challenge; others are needy. • What factors make her more vulnerable? • DSS involvement

21. THE RELATIONSHIP BETWEEN SUBSTANCE ABUSE AND DOMESTIC VIOLENCE

22. SUBSTANCE ABUSE Isolation of the family Causes a lot of pain Mental, Emotional, Physical, Verbal, Sexual, & Financial effects Lowers self-esteem & negatively affects sense of selfworth DOMESTIC VIOLENCE Isolation of the family Causes a lot of pain Mental, Emotional, Physical, Verbal, Sexual, & Financial effects Lowers self-esteem & negatively affects sense of selfworth Similar Characteristics Between Substance Abuse and Domestic Violence

23. Failed attempts to stop using Intergenerational cycle Genetic Deny, minimize problem Progressive Relapse Can be fatal Failed attempts to stop violence or leave Intergenerational cycle Learned behavior Deny, minimize problem Progressive Return to abusive relationship Can be fatal Similar Characteristics Between Substance Abuse and Domestic Violence cont’d

25. So, what does it look like, when alcohol anddomestic violence come together?*WARNING- Look away if you’re queasy

29. When a batterer says, “the alcohol made me do it “he’s blaming one problem: violence, on another: alcohol abuse”.

30. In characterizing substance abuse and domestic violence, practitioners have observed that the two problems are “separate but similar, and they each interact and exacerbate each other”. For, example, both problems are passed on from generation to generation: both involve denial, with substance abusers

31. and batterers blaming victims for their behavior; usually, neither problem decreases until a crisis occurs; and secrecy is often the rule, with victims of abuse (wrongly) blaming themselves for their partner’s substance abuse or violent behavior” (Engelmann, 1992, p.6).

32. Intoxication appears to increase the likelihood that a batterer may misinterpret or distort a partner’s remarks, demeanor, or actions by “blunting whatever cognitive regulators the abuser possesses” (Stosny, 1995, p. 36)

33. Alcohol, drugs, and violence • Alcohol is the substance most frequently implicated in homicide and in other violent events as well. • Evidence of an individual level association between alcohol and violence is widespread. - The consumption of alcohol increases the aggressiveness of the response to cues.

34. Alcohol, drugs, and violence • Alcoholic women are more likely to report a history of childhood physical and emotional abuse than are non-alcoholic women. • Women in recovery are likely to have a history of violent trauma and are at high risk of being diagnosed with PTSD.

35. Relationship Between Alcohol Abuse and Woman Abuse cont’d • If alcohol worked exclusively as a disinhibiting agent, there would be no domestic violence when sober. Although there is less violence when sober, substance and alcohol abusers are more likely to engage in domestic violence than are non-abusers.

37. The Victim • Substance abuse by one parent increases the likelihood that the substance-abusing parent will be unable to protect children if the other parent is violent. • Substance -abusing women often report that their abusive partners become angry or threatened when they seek help. • The man’s violence or threats of violence may push the woman to drop out of treatment.

38. The Perpetrator • Some batterers are less violent and “easier to handle” when they are drunk or high. • If a batterer is more violent when sober or abstinent, his partner may encourage drinking or taking drugs. • Victims can blame themselves for their partner’s substance abuse: “I made them do it” is an enabling ideology. • Surviving isn’t “enabling”.

39. Substance abuse and domestic violencecont’d • Alcohol and drugs do not cause family violence- they merely make abusers less likely to control their violent tendencies. • Abusers who blame their violence on drinking or drugs are not taking responsibility for their violence. • Abusers with substance abuse problems must address both issues. Treatment of one will not treat the other. • Violent abusers who abuse substances are more likely to inflict serious injury and to commit sexual violence.

40. Relationship between alcohol and violence cont’d • … (For) men incarcerated for a violent offense… chronic alcohol patterns had little predictive value, but that acute episodes of drinking immediately before the offense were significant. • Significantly higher MAST (Michigan alcoholism screening test) scores for the abusive men

41. Possible Reasons That Alcohol/Substance Abuse Can Facilitate Woman Abuse

42. … as an excuse • Time-out from responsibility and a means to disavow the resulting behavior. • Batterers use substances first as a vehicle, then as an excuse, for being controlling and violent.

43. … as a cognitive disrupter • Drugs or alcohol may reduce the user’s ability to perceive, integrate, and process information. • This increases the risk of violence. • Substance-induced cognitive distortion is one factor that increases the risk the user will interpret his partner’s behavior as arbitrary, aggressive, abandoning, or overwhelming. • Substances may make batterers be more likely than non-batterers to misinterpret the actions of their partners.

44. … as a power motive • Both substance abuse and woman abuse may share common origins in a need to achieve personal power and control. • While small quantities of a substance tend to increase a social user’s sense of altruistic power, larger quantities for social users - or any amount for an abuser- increases the user’s sense of personal power and domination over others. • This power-using relationship is more characteristic of men than women.

45. … as a situational variable • Situational variables: • Violence can occur as part of the situations associated with obtaining and using substances. (Lifestyle of an addict) • A battered woman may use substances as a means of attempting to manage the batter’s violence and a means of increasing her own safety.

46. Barriers to treatment for our clients: • Threats of physical harm, withholding of financial support, or abuse directed toward children can lead survivors to resort to using substances (or relapsing) to buffer their distress. • A victim’s becoming clean or sober can threaten the batterer’s sense of control, increasing the likelihood of an instance of domestic violence. (Upping the ante)

47. Language can be a barrier... • Domestic violence programs may speak of empowerment, moving forward, building a new life. • Substance abuse treatment may speak of denial, enabling, codependency, and powerlessness. • Some domestic violence workers are not well educated in the field of substance abuse and have inaccurate understanding of the nature of treatment. They may seem overly protective of their clients, to the point of being non-cooperative. Assure them that you have the same goals- foremost, safety for the victim.

48. Different goals... • For treatment programs, abstinence is the goal. • For domestic violence programs, safety is the goal. • It is not a matter of choosing one goal over the other- both are important. It is a matter of timing the interventions to yield the greatest benefit.

49. Screening potential victims: • See DVAC Screening Guide • Never talk to the couple together • Don’t reveal what the victim says without written his/her permission

50. Has your partner ever attempted to control, intimidate, or scare you? If • client answers yes, ask the following questions: • Have you ever been stalked by a partner or ex-partner? (following you or keeping track of your activities, causing you to feel intimidated or concerned for your safety) How long did it go on?