scholarly journals Using the Behaviour Change Wheel to design an intervention for partner abusive men in drug and alcohol treatment

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Elizabeth Gilchrist ◽  
Amy Johnson ◽  
Mary McMurran ◽  
Danielle Stephens-Lewis ◽  
Sara Kirkpatrick ◽  
...  
Keyword(s):  
Substance Use ◽  
Behaviour Change ◽  
Partner Abuse ◽  
Mode Of Delivery ◽  
Intimate Partner Abuse ◽  
Intimate Partner ◽  
Nominal Group ◽  
Behaviour Change Techniques ◽  
Target Behaviour ◽  
Substance Use Services

Abstract Background We aimed to establish what core elements were required in a group therapy programme for men who disclose perpetrating intimate partner abuse in a substance use setting and develop, and test the feasibility of delivering an intervention in this setting. Methods We describe the theoretical development and feasibility testing of an integrated substance use and intimate partner abuse intervention (‘ADVANCE’) for delivery in substance use services. We employed a comprehensive eight-stage process to guide this development applying the ‘COM-B’ (‘capability’, ‘opportunity’, ‘motivation’ and ‘behaviour’) model for intervention design which specifies the following: (1) define the problem, (2) select the target behaviour, (3) specify the target behaviour, (4) identify what needs to change, (5) identify intervention functions, (6) identify policy categories, (7) select behaviour change techniques, and (8) design a mode of delivery. The development was informed by primary research conducted by the authors, consulting with organisation steering groups and by those with personal experiences. The identified targets for intervention and mode and method of delivery were then refined over 4 intervention development meetings, using the nominal group technique with the ADVANCE experts, then further refined following consultation with service user groups and wider expert groups via a learning alliance meetings. Results Our final intervention, the ADVANCE intervention consisted of a group intervention comprising of up to four pre-group individual interviews, followed by 12 × 2-h group sessions supported by integrated safety work for victim/survivors, and risk and safety support and integrity support for the professionals. The main targets for change were personal goal planning, self-regulation, and attitudes and beliefs supporting intimate partner abuse. The intervention was regarded as very acceptable to both staff and clients in substance use services, with group attendees reported positive behaviour changes and development of new skills. Conclusion We have demonstrated the ability to employ a structured eight-step process to develop an integrated intervention to address substance use-related intimate partner abuse that is acceptable to staff and clients in substance use services. This led to a feasibility study (ISRCTN 79435190) involving 104 men and 30 staff at three different locations across the UK was conducted to assess the feasibility and acceptability of the intervention and to refine the content and approach to delivery (BMC Public Health, 21: 980, 2021).

scholarly journals Using the Behaviour Change Wheel to Design an Intervention for Partner Abusive Men in Drug and Alcohol Treatment

2021 ◽  
Author(s):  
Elizabeth Allison Gilchrist ◽  
Amy Johnson ◽  
Mary McMurran ◽  
Danielle Stephens-Lewis ◽  
Sara Kirkpatrick ◽  
...  
Keyword(s):  
Substance Use ◽  
Behaviour Change ◽  
Partner Abuse ◽  
Mode Of Delivery ◽  
Intimate Partner Abuse ◽  
Intimate Partner ◽  
Theoretical Development ◽  
Behaviour Change Techniques ◽  
Target Behaviour ◽  
Substance Use Services

Abstract Background: We aimed to establish what core elements were required in a group therapy programme for men who disclose perpetrating intimate partner abuse in a substance use setting and develop, and test the feasibility of delivering an intervention in this setting. Methods: We describe the theoretical development and feasibility testing of an integrated substance use and intimate partner abuse intervention(“ADVANCE”) for delivery in substance use services. We employed a comprehensive eight stage process to guide this development applying the ‘COM-B’ model for intervention design which specifies: 1) define the problem, 2) select the target behaviour, 3) specify the target behaviour, 4) identify what needs to change, 5) identify intervention functions, 6) identify policy categories, 7) select behaviour change techniques, and 8) design a mode of delivery. The development was informed by primary research conducted by the authors, consulting with organisation steering groups and by those with personal experiences. A feasibility study (ISRCTN 79435190) involving 104 men, 27 female partners and 30 staff at three different locations across the UK was conducted to assess the feasibility and acceptability of the intervention and to refine the content and approach to delivery. Results: Our final intervention, the ADVANCE intervention consisted of a group intervention comprising of up to four pre-group individual interviews, followed by 12 x 2-hour group sessions supported by integrated safety work for victim/survivors, and risk and safety support and integrity support for the professionals. The main targets for change were personal goal planning, self-regulation and attitudes and beliefs supporting intimate partner abuse. The intervention was regarded as very acceptable to both staff and clients in substance use services, with group attendees reported positive behavior changes and development of new skills, that facilitators noted were ‘life-changing’ for some. Conclusion: We have demonstrated the ability to employ a structured eight-step process to develop an integrated intervention to address substance use related intimate partner abuse that is acceptable to staff and clients in substance use services.

scholarly journals Perspectives on Motivation and Change in an Intervention for Men Who Use Substances and Perpetrate Intimate Partner Abuse: Findings From a Qualitative Evaluation of the Advance Intervention

2021 ◽  
pp. 088626052199743
Author(s):  
Sandi Dheensa ◽  
Gemma Halliwell ◽  
Amy Johnson ◽  
Juliet Henderson ◽  
Beverly Love ◽  
...  
Keyword(s):  
Substance Use ◽  
Partner Abuse ◽  
Self Regulation ◽  
Qualitative Evaluation ◽  
Intimate Partner Abuse ◽  
Intimate Partner ◽  
Substance Use Treatment ◽  
Goal Theory ◽  
Framework Analysis ◽  
The Impact

Despite consistent evidence that substance use is a contributory risk factor for perpetration of intimate partner abuse (IPA), little evidence exists for effective interventions for male IPA perpetrators who use substances. The Advance intervention aimed to meet this need. This 16-week intervention addressed both IPA and substance use, and was for men accessing substance use treatment who had perpetrated IPA toward a female (ex-)partner within the last 12 months. Two key theories underpinned the intervention: goal theory and self-regulation theory. In this article, we aim to illustrate the views of men and substance use treatment staff on men’s motivations to change, the ways in which men and staff said that men had changed their behavior, and the aspects of the intervention that they reported were key in the process of change. Using framework analysis, we analyzed data from 12 men who took part in the intervention as well as 31 staff members from substance use treatment services. Our five overarching themes were personal goal setting and motivation; recognition of IPA and the substance using lifestyle; improved self-regulation; considering the impact on others; and learning together in a group. Men and staff valued having a program that integrated IPA and substance use and thought the program was unique and much needed. Moreover, our findings suggest that goal theory, self-regulation, and more broadly, motivational and strengths-based approaches with practice-based activities, may be beneficial for effecting change in the substance using perpetrator population. However, further research is needed to determine the effectiveness of the intervention. Overall, our findings highlight the value of using qualitative outcome measures of perpetrator programs to complement quantitative measures of impact.

scholarly journals The Challenges of Conducting Qualitative Research on “couples” in Abusive Intimate Partner Relationships Involving Substance Use

2020 ◽  
pp. 104973232097572
Author(s):  
Beverly Love ◽  
Juliet Henderson ◽  
Amy Johnson ◽  
Danielle Stephens-Lewis ◽  
David Gadd ◽  
...  
Keyword(s):  
Substance Use ◽  
Complex Dynamics ◽  
Partner Abuse ◽  
Intimate Partner Abuse ◽  
Research Process ◽  
Intimate Partner ◽  
Heterosexual Couples ◽  
Reflexive Space ◽  
Clinical Support ◽  
Intimate Partner Relationships

Undertaking qualitative dyad or couple interviews involving intimate partner abuse and substance use presents considerable ethical, safeguarding, and theoretical challenges throughout the research process from recruitment to conducting interviews and analysis. These challenges and how they were managed are outlined using the experience from a qualitative study of 14 heterosexual “couples” that explored the complex interplay between intimate partner abuse and substance use. Managing these challenges for participants, their families, and researchers included the use of safeguarding protocols and procedures to manage risk and the provision of clinical support for experienced researchers. Researchers often felt drawn into the conflicts and complex dynamics of opposing accounts from the male and females’ relationship which could be emotionally and methodologically taxing. Researchers discussing their analysis and felt experiences with each other provided a reflexive space to manage emotions and stay close to the theoretical underpinnings.

scholarly journals ADVANCE integrated group intervention to address both substance use and intimate partner abuse perpetration by men in substance use treatment: a feasibility randomised controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Gail Gilchrist ◽  
Laura Potts ◽  
Polly Radcliffe ◽  
Gemma Halliwell ◽  
Sandi Dheensa ◽  
...  
Keyword(s):  
Substance Use ◽  
Formative Evaluation ◽  
Partner Abuse ◽  
Intimate Partner Abuse ◽  
Intimate Partner ◽  
Substance Use Treatment ◽  
Definitive Trial ◽  
The Third ◽  
Randomised Controlled ◽  
Post Randomisation

Abstract Background Substance use is a risk factor for intimate partner abuse (IPA) perpetration. Delivering perpetrator interventions concurrently with substance use treatment shows promise. Methods The feasibility of conducting an efficacy and cost-effectiveness trial of the ADVANCE 16-week intervention to reduce IPA by men in substance use treatment was explored. A multicentre, parallel group individually randomised controlled feasibility trial and formative evaluation was conducted. Over three temporal cycles, 104 men who had perpetrated IPA towards a female (ex) partner in the past year were randomly allocated to receive the ADVANCE intervention + substance use treatment as usual (TAU) (n = 54) or TAU only (n = 50) and assessed 16-weeks post-randomisation. Participants’ (ex) partners were offered support and 27 provided outcome data. Thirty-one staff and 12 men who attended the intervention participated in focus groups or interviews that were analysed using the framework approach. Pre-specified criteria assessed the feasibility of progression to a definitive trial: 1) ≥ 60% of eligible male participants recruited; 2) intervention acceptable to staff and male participants; 3) ≥ 70% of participants followed-up and 4) levels of substance use and 5) IPA perpetrated by men in the intervention arm did not increase from average baseline level at 16-weeks post-randomisation. Results 70.7% (104/147) of eligible men were recruited. The formative evaluation confirmed the intervention’s acceptability. Therapeutic alliance and session satisfaction were rated highly. The overall median rate of intervention session attendance (of 14 compulsory sessions) was 28.6% (range 14.3–64.3% by the third cycle). 49.0% (51/104) of men and 63.0% (17/27) of their (ex) partners were followed-up 16-weeks post-randomisation. This increased to 100% of men and women by cycle three. At follow-up, neither substance use nor IPA perpetration had worsened for men in the intervention arm. Conclusions It was feasible to deliver the ADVANCE intervention in substance use treatment services, although it proved difficult to collect data from female (ex)partners. While some progression criteria were met, others were not, although improvements were demonstrated by the third cycle. Lessons learned will be implemented into the study design for a definitive trial of the ADVANCE intervention. Trial registration ISRCTN79435190 prospectively registered 22nd May 2018.

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