198196 Substance abuse and intimate partner violence: Behavioral couples therapy for gay and lesbian couples

Tuesday, November 10, 2009

Keith Klostermann, PhD , School of Nursing, University of Rochester, Rochester, NY
Monique Clinton-Sherrod, PhD , Risk Behavior and Family Research Program, RTI International, Cullowhee, NC
William Fals-Stewart, PhD , School of Nursing, University of Rochester, Rochester, NY
Intimate partner violence (IPV) is a highly prevalent problem among heterosexual couples in which a partner abuses alcohol or other drugs. Most surveys reveal that annual rates of partner physical aggression in clinical samples of married or cohabiting substance-abusing patients are 3-4 times higher (i.e., 45-60%) than observed in national surveys (i.e., 15%). Behavioral Couples Therapy (BCT) for substance abuse significantly reduces IPV among these dyads compared to other interventions. Far less is known about rates of IPV among gay and lesbian couples in which a partner has a substance use disorder and there are no data exploring how BCT may affect rates of IPV.

In this study, gay couples (N = 52) and lesbian couples (N = 48) in which one partner had a substance use disorder were recruited. Partners were randomly assigned to BCT or 12-step facilitation treatment (in which the nonsubstance-abusing partner did not participate). At baseline, annual prevalence rates of IPV among gay couples (63%) and lesbian couples (50%) were comparable to those observed among substance-abusing heterosexual couples. There were no differences in prevalence rates of IPV among couples in the two conditions at baseline. During a 12-month posttreatment follow-up, IPV prevalence rates among gay couples (15%) and lesbian couples (8%) who received BCT were lower (i.e., ps < .05) than prevalence rates for gay couples (46%) and lesbian couples (38%) in individual treatment. These findings are similar to those for heterosexual couples and suggest BCT may be an appropriate form of treatment for these couples.

Learning Objectives:
Identify prevalence rates of intimate partner violence among gay and lesbian substance-abusing couples. Compare the differences in treatment outcomes (i.e., substance use, and violence) between treatment-as-usual (i.e., 12-step facilitation) and a couples-based treatment (i.e, Behavioral Couples Therapy [BCT]) for gay and lesbian couples.

Keywords: Substance Abuse, Family Violence

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Serve as Principle Investigator (PI) on the following federal grant: “Examining the Effects of Behavioral Couples Therapy on Intimate Partner Violence” Serves as Co-Investigator (Co-I) on the following recent federal grants: “Brief Couples Therapy in Drug Abuse Treatment,” NIDA “BCT for Drug Abuse: A Group Therapy Approach,” NIDA “Parent Skills Training in Couples Therapy,” NIDA “Cognitive Rehabilitation of Substance Abuse,” NIDA Participant, National Institute of Health Summer Institute on the Design and Conduct of Randomized Clinical Trials Involving Behavioral Interventions, 2008 Klostermann, K., Kelley, M. K., Mignone, T., & Pusateri, L. (2008). Substance abuse and Partner Violence: The case for integrated treatment. Aggression and Violent Behavior. In press. Klostermann, K., Mignone, T., & Chen, R. (2008). Subtypes of alcohol and intimate partner violence: A latent class analysis. Violence and Victims. In press. Mignone, T., Klostermann, K., & Chen, R. (2008). The relationship between relapse to alcohol and relapse to violence. Journal of Family Violence. In press. Fals-Stewart, W., Klostermann, K., & Clinton-Sherrod, M. Substance abuse and intimate partner violence. In D. O’Leary and E. Wooden (Eds.), Understanding Psychological and Physical Aggression in Couples. Mahwah, NJ, US: Lawrence Erlbaum Associates. In press. Klostermann, K., & Fals-Stewart, W. (2006). Intimate partner violence and alcohol use: Exploring the role of drinking in partner violence and its implications for intervention. Aggression and Violent Behavior: A Review Journal, 11, 587-597. Kennedy, C., Klostermann, K., Gorman, C., & Fals-Stewart, W. (2005). Treating substance abuse and intimate partner violence: Implications for addiction professionals. Counselor Magazine, 6(1), 28-34. Klostermann, K. (2006). Substance abuse and intimate partner violence: Treatment considerations. Substance Abuse Treatment, Prevention, and Policy, 1, 1-24.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: LGBT substance use related issues
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