Exploring Male Students’ Lived Experiences of Intimate Partner Abuse from a Female Partner and Help-seeking

<p>This research investigated how male university students who have experienced abuse from a female intimate partner made sense of this abuse and their help seeking experiences. Students who indicated having experienced some form of Intimate Partner Abuse (IPA) were identified through a screening questionnaire and invited to take part in this study. In-depth interviews with seven students were analysed using interpretive phenomenological analysis. This analysis identified two themes related to the men’s experiences of IPA and help seeking. The first theme of stuck in the abusive relationship comprised four subthemes, each representing a barrier the men faced which kept them in an abusive relationship and prevented them from acting to end the abuse or from seeking help. These barriers were 1) the emotional investment the men had in the relationship, 2) living in an all-encompassing controlling environment, 3) their sense of responsibility to shoulder the burdens of the relationship, and 4) their understanding of abuse in relationships. The second theme moving on from the abuse described the process of overcoming and moving past these experiences. It comprised three subthemes: 1) how the men overcame the barriers and began moving on, 2) the slow process of supported recovery and learning, and 3) the existence of ongoing impacts related to the abuse. These findings add to the growing body of literature on IPA which has found that men can be the victims of abuse which can be serious, have lasting impacts, and for which they have difficulty seeking and receiving help. The need for policies and services which can overcome the barriers men face and that address their needs are discussed. This is the first qualitative research looking at men’s IPA victimisation with a student sample and future research is needed which looks at this phenomenon with students across countries and cultural groups and in relationships in which IPA was bidirectional.</p>

Exploring Male Students’ Lived Experiences of Intimate Partner Abuse from a Female Partner and Help-seeking

<p>This research investigated how male university students who have experienced abuse from a female intimate partner made sense of this abuse and their help seeking experiences. Students who indicated having experienced some form of Intimate Partner Abuse (IPA) were identified through a screening questionnaire and invited to take part in this study. In-depth interviews with seven students were analysed using interpretive phenomenological analysis. This analysis identified two themes related to the men’s experiences of IPA and help seeking. The first theme of stuck in the abusive relationship comprised four subthemes, each representing a barrier the men faced which kept them in an abusive relationship and prevented them from acting to end the abuse or from seeking help. These barriers were 1) the emotional investment the men had in the relationship, 2) living in an all-encompassing controlling environment, 3) their sense of responsibility to shoulder the burdens of the relationship, and 4) their understanding of abuse in relationships. The second theme moving on from the abuse described the process of overcoming and moving past these experiences. It comprised three subthemes: 1) how the men overcame the barriers and began moving on, 2) the slow process of supported recovery and learning, and 3) the existence of ongoing impacts related to the abuse. These findings add to the growing body of literature on IPA which has found that men can be the victims of abuse which can be serious, have lasting impacts, and for which they have difficulty seeking and receiving help. The need for policies and services which can overcome the barriers men face and that address their needs are discussed. This is the first qualitative research looking at men’s IPA victimisation with a student sample and future research is needed which looks at this phenomenon with students across countries and cultural groups and in relationships in which IPA was bidirectional.</p>

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

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).

Personal barriers to addressing intimate partner abuse: a qualitative meta-synthesis of healthcare practitioners’ experiences

Background Healthcare practitioners (HCPs) play a crucial role in recognising, responding to, and supporting female patients experiencing intimate partner abuse (IPA). However, research consistently identifies barriers they perceive prevent them from doing this work effectively. These barriers can be system-based (e.g. lack of time or training) or personal/individual. This review of qualitative evidence aims to synthesise the personal barriers that impact HCPs’ responses to IPA. Methods Five databases were searched in March 2020. Studies needed to utilise qualitative methods for both data collection and analysis and be published between 2010 and 2020 in order to qualify for inclusion; however, we considered any type of healthcare setting in any country. Article screening, data extraction and methodological appraisal using a modified version of the Critical Appraisal Skills Program checklist for qualitative studies were undertaken by at least two independent reviewers. Data analysis drew on Thomas and Harden’s thematic synthesis approach. Results Twenty-nine studies conducted in 20 countries informed the final review. A variety of HCPs and settings were represented. Three themes were developed that describe the personal barriers experienced by HCPs: I can’t interfere (which describes the belief that IPA is a “private matter” and HCPs’ fears of causing harm by intervening); I don’t have control (highlighting HCPs’ frustration when women do not follow their advice); and I won’t take responsibility (which illuminates beliefs that addressing IPA should be someone else’s job). Conclusion This review highlights the need for training to address personal issues in addition to structural or organisational barriers. Education and training for HCPs needs to: encourage reflection on their own values to reinforce their commitment to addressing IPA; teach HCPs to relinquish the need to control outcomes so that they can adopt an advocacy approach; and support HCPs’ trust in the critical role they can play in responding. Future research should explore effective ways to do this within the context of complex healthcare organisations.

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

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.