The Relationship Between Domestic Violence and Substance Abuse Treatment Outcomes

The Relationship Between Domestic Violence and

Substance Abuse Treatment Outcomes

Chapter 1: Introduction to the Study

Introduction

Substance use has been found to play a role in clients’ compliance with treatment

and further perpetuation of violence. According to research, there is a relationship

between domestic violence and substance abuse (Amstrong et al., 2019). Substance abuse

is a factor in a large percentage of the incidents that involve intimate partner violence

(IPV) (Amstrong et al., 2019). Substance abuse can exacerbate and precipitate the risk of

perpetrating intimate partner violence (Armstrong et al., 2019). However, there is a gap in

the research about how substance abuse affects offenders’ treatment and further violence

(Peterson et al., 2018).

This study focused on exploring how substance abuse affects treatment

compliance among individuals who commit IPV. Numerous research studies address the

connection between substance abuse and violence. Research has found a strong

association between criminality and substance abuse, which is the reason why a substance

abuser is more likely to become the perpetrator (Giarrantano et al., 2020).

Substance abuse damages the body system and the abuser’s ability to think clearly.

Research indicates that women and men are the aggressors in relationships at

similar rates (Raj & Shankar, 2017). It is essential to understand the role that gender plays

in domestic violence and substance abuse. There are different motivations, severity, and

ongoing patterns of abuse. Several studies have found that substance abuse affects males

and females differently, which poses unique obstacles to treatment effectiveness

(Giarratano et al., 2020). Research shows that women with poor mental health are three

times more likely to have experienced domestic violence and substance abuse (Manuel et

al., 2017). Reviewing current research that addresses when and how these issues occur

can shed light on the association between substance abuse and domestic violence.

It is crucial to take into consideration factors that may strengthen the relationship

between substance abuse and IPV. Factors that may deserve attention are co-occurring

disorders such as substance abuse and mental illness. Several studies have found an

association between mental illness and IPV (McKee & Hilton, 2019). Treatment

programs address substances and mental illness in assessments; however, it is not the

focus of a domestic violence treatment program. Courts have found themselves having to

refer clients to multiple treatment programs to address these issues. Research has found

that when offenders are provided with multiple treatment referrals, it hurts success and

completion rates (Brunner et al., 2019). This is because they are likely to avoid the

treatments altogether by showing no commitment to the different referrals.

Previous studies have found a relationship between substance abuse and reduced

treatment for intimate partner violence (McKee & Hilton, 2019). The study addressed

whether substance abuse affects IPV treatment by reducing compliance and participation

in treatment, in other words causing increased dropout, and/or whether substance abuse

contributes directly to further incidents of IPV or both. This study sought to understand

the relationship between substance abuse and the treatment of IPV. Further issues that

hinder the treatment of individuals who commit IPV are comorbid substance abuse

disorders and mental health issues like depression, anxiety, posttraumatic stress disorder,

and bipolar disorder (McKee & Hilton, 2019). Physical aggression has been found to

increase in individuals with multiple underlying issues (McKee & Hilton, 2019).

There is a repeated failure of treatment programs to address the factors that affect

retention and changing the delivery of services (Brunner et al., 2019). Individuals abusing

substances while in court-ordered treatment programs are more likely to drop out of

Batterer Intervention Programs (Brunner et al., 2019). Substance abuse creates a context

in which risk is exacerbated (Horstman et al., 2019). Despite the high rates of IPV in

individuals who abuse substances, there is very little information on the treatment

approaches that are used with this population (Brunner et al., 2019). To obtain an

understanding of the best treatment outcome, it is essential to address the multiple factors

affecting treatment. Hence, interventions that target substance abuse in individuals who

have a history of IPV may lead to a reduction of IPV. Individuals who commit IPV are

referred to attend counseling/education programs (known as the Batterer Intervention

Program) (BIP). Most pro-arrest laws mandate arrest by law enforcement in cases of

domestic violence incidents regardless of the incident’s intensity and possibly prosecutors

cannot drop charges.

Chapter 1 is organized into several sections, which discusses the different themes

addressed. The researcher will discuss background information on the relationship

between domestic violence and substance abuse treatment programs, identify the problem

statement, the purpose of the study, and research questions and hypotheses guiding the

study. In addition, the researcher will introduce the theoretical frameworks, namely the

cycle of violence theory and social exchange theory, to inform the study. Last, the

researcher will discuss the nature of the study, definition of terms, assumptions, scope

and delimitations, limitations, and significance, and will provide a summary of the

chapter.

Background

Domestic violence, particularly IPV, is a common acute problem with negative

effects on victims and aggressors. In 2019, the World Health Organization classified IPV

as a health epidemic affecting the public globally (McKee & Hilton, 2019). While

research suggests that men and women are common perpetrators of IPV, Spencer et al.

(2021) established that the majority of the victims are usually women who report

experiencing serious forms of violence such as battering and verbal abuse. In acute IPV,

Stringer and Baker (2018) reported that there is an increased risk of victims developing

mental problems or substance use disorders.

Research suggests that domestic violence is occurring at an alarming rate globally.

As an illustration, Sullivan (2018) estimated that at least 35 percent of women in the

United States have instances of rape, physical violence, or stalking from their intimate

partners. In Canada, current data suggests that at least 25 percent of women experience

IPV in their lifetime (Sullivan, 2018). Conflicting with the above results, Telles et al.

(2020) cautioned care to be undertaken when examining the prevalence rate of IPV in the

treatment population given the increase in IPV cases. For instance, a recent systematic

review (Amstrong et al., 2019) established that nearly half of all victims in mental health

care settings have at least been directly witnessed or involved in IPV, which varies across

the globe.

Research has established a direct link between IPV and substance use. Zarling et

al. (2019) conducted a qualitative study to establish the relationship between domestic

violence and substance abuse on a sample of 213 drug addicts recruited in treatment

programs. Based on the study findings, IPV was associated with acute depression, sleep

disorders, suicidal thoughts, and PTSD, which negatively impaired the psychological

functioning of the victims. Researchers including Telles et al. (2020) also reported that

the severity of IPV on victims depends on the type of violence committed against them,

including shoving which could be linked to depression, or stalking which could be linked

to suicidal thoughts. Additional research by Manuel et al. (2017) demonstrated that

emotional abuse, which is an aspect of IPV, is connected to acute depression, low esteem

among individuals, and recurring PTSD. Thus far, the evidence reviewed suggests that

IPV is a serious problem associated with several health issues, including depression, low

self-esteem, PTSD, and suicidal thoughts that could have negative effects on the

psychological well-being of the victims.

A decrease in IPV has been linked to substance use in domestic violence treatment

programs. For example, Peterson et al. (2020) found that at least 30 percent of women in

substance abuse treatment programs have experienced IPV in their lives. According to

Manuel et al. (2017), the focus is to reduce the severity and frequency of IPV by

influencing behavior change among individuals to adopt positive behaviors.

Researchers have suggested that the link between IPV and substance abuse

treatment programs is complex. For instance, Zarling et al. (2019) found an indirect

relationship between domestic violence and substance treatment outcomes whereby the

rate of violence continued to surge despite the treatment for domestic violence. However,

Peterson et al. (2018) found that substance abuse treatment programs have a positive

effect on reducing the prevalence rate of IPV. Pérez and Ruiz (2017) found that 60

percent of men enrolled for substance abuse treatment had a 30 percent decrease in their

previous behaviors. Despite the evidence suggesting a possible direct link between IPV

and substance abuse treatment outcomes, limited research has been conducted to establish

whether substance use treatment programs directly or indirectly affect IPV rates where

one or both partners have been enrolled in treatment for substance use programs (Pérez &

Ruiz, 2017). As such, there has been a continued trend of increased IPV rates among

individuals enrolled in substance abuse treatment programs despite the assurance that

such programs will reduce victim’s exposure to domestic abuse (Peterson et al., 2020).

There is the need therefore to investigate the relationship between substance abuse and

domestic violence treatment outcomes.

Historically, policymakers have initiated policies to regulate substance use abuse.

Some of the policies have targeted the supply chain by limiting the amount of drugs

delivered to people. However, limited efforts have been focused on the relationship

between substance use and IPV when one of the partners is enrolled in substance abuse

treatment programs (Amstrong et al., 2019, Cafferky et al., 2018). To address the above

gap, I conducted a quantitative correlational study to investigate the relationship between

substance abuse and domestic violence treatment.

Problem Statement

Little is known about how domestic violence treatment outcomes relate to

substance abuse among intimate partners. Previous researchers such as Manuel et al.

(2017) have reported that intimate partners who are in treatment for substance use have

an improved containment of domestic violence. More intimate partners enrolled in

treatment for substance abuse engage in IPV than intimate partners not enrolled in

substance abuse treatment (Spencer et al., 2019). Researchers have reported that some

domestic abuse treatment programs could increase aggressiveness in individuals enrolled

in domestic abuse treatment programs, thereby increasing IPV rates due to drug abuse

incidences (McKee & Hilton, 2019). Substance abuse addicts have been found to struggle

with IPV, Telles et al. (2020) found that when someone is receiving treatment for

domestic abuse while still having substance use problems, their aggressive behavior

toward a victim increases. Intimate partner violence is a common problem for people in

substance use disorder treatment programs. Research on substance use disorder by

Spencer et al. (2019) established that the rate of IPV towards partners was about 50

percent, nearly three times the rate of IPV reported in community-based samples who do

not use substances. Similarly, a study by McKee and Hilton (2019) on substance use

treatment on a sample of 319 DV victims established that IPV relating to partners

surpassed 67 percent for men while 39 percent for women, and the rates were 70 percent

higher for men and women with close intimate partner relationships. Involvement in IPV

is a predictor of substance abuse problems, and poor domestic violence treatment

response by the offenders enrolled in treatment programs (Manuel et al., 2017).

Researchers have linked IPV with several costs, such as physical, mental, interpersonal

impairment, and occupational problems that affect individuals’ lives directly (McKee &

Hilton, 2019). Thus, it is critical to explore the relationship between domestic violence

treatment outcomes and substance abuse among intimate partners.

Despite the surge in IPV among individuals in substance use treatment programs,

there is limited understanding of the relationship that exists between domestic violence

treatment outcomes and substance abuse among intimate partners (Manuel et al., 2017).

There is evidence that substance use problems do not respond well to IPV treatment.

However, via counseling and monitoring, treatment programs across the US have

attempted to lower the number of IPV instances. The consequence is that domestic

violence treatment programs are typically recommended to a smaller number of people

who are struggling with substance use. Domestic violence treatment programs are

important in providing IPV-targeted programs that would result in reduced IPV rates

against partners.

However, past research suggests a gap in the literature regarding the link that

exists between domestic violence treatment outcomes and substance abuse, especially

when one or both partners are enrolled in domestic violence treatment programs.

Researchers such as Spencer et al. (2019) identified the need for additional research to

examine domestic violence treatment outcomes, especially IPV, and its link to substance

abuse where one of the partners is participating in substance abuse treatment. McKee and

Hilton (2019) also recommended additional research to understand the extent to which

domestic violence treatment outcomes relate to substance use and IPV rates among

intimate partners. The gaps identified above clearly suggest the need to understand the

relationship that exists between domestic violence treatment outcomes and substance

abuse among intimate partners to mitigate its costs related to health and interpersonal

relationships.

Purpose of the Study

The purpose of this quantitative correlational study is to investigate how

substance abuse among intimate partners relates to domestic violence treatment

outcomes. The study findings may fill the current gap in the literature identified by

previous researchers relating to the extent to which DV treatment outcomes influence

substance abuse among intimate partners (Pérez & Ruiz, 2017). For instance, Spencer et

al. (2019) identified a gap in the literature by noting that there is limited understanding to

explain how domestic violence outcomes influence substance abuse among the victims.

To address this gap in the literature, the researcher conducted a quantitative correlational

study to explore the extent to which domestic violence treatment outcomes influence

substance abuse among intimate partners. The independent variable for the study is

substance abuse and the dependent variable is domestic violence treatment outcomes.

Research Questions and Hypotheses

Based on the theoretical framework of the study, the following research questions

and hypotheses were used in guiding the study:

RQ1: How does substance abuse among intimate partners relate to domestic

violence treatment outcomes?

H10: Substance abuse among intimate partners is unrelated to domestic violence

treatment outcomes.

H11: Substance abuse among intimate partners is related to poorer domestic

violence treatment outcomes.

RQ2: Will women in domestic violence treatment programs who abuse substances

be at higher risk of reoffending than women who do not abuse substances?

H20. Women who abuse substances are not at higher risk of reoffending than

women who do not abuse substances.

H21. Women who abuse substances are at higher risk of reoffending than women

who do not abuse substances.

RQ3: Will men in domestic violence treatment programs who abuse substances be

at higher risk of reoffending than men who do not abuse substances?

H30. Men who abuse substances are not at higher risk of reoffending than men

who do not abuse substances.

H31. Men who abuse substances are at higher risk of reoffending than men who do

not abuse substances.

RQ4: Are women involved in domestic violence treatment programs who abuse

substances more likely not to complete treatment than women who do not abuse

substances?

H40: Women involved in domestic violence treatment programs who abuse

substances are not more likely not to complete treatment as compared to those who do not

abuse substances.

H41. Women involved in domestic violence treatment programs who abuse

substances are more likely not to complete treatment as compared to those who do not

abuse substances.

RQ5: Are men involved in domestic violence treatment programs who abuse

substances more likely not to complete treatment than men who do not abuse substances?

H50: Men involved in domestic violence treatment programs who abuse substances

are not more likely not to complete treatment as compared to those who do not abuse

substances.

H51. Men involved in domestic violence treatment programs who abuse substances

are more likely not to complete treatment as compared to those who do not abuse

substances.

Theoretical Framework

Two theoretical frameworks, namely cycle of violence theory and social exchange

theory, informed the study. Walker (1972) pioneered the cycle of violence theory. The

theory has three phases that explain how violence occurs. The three phases include

tension building, such as a person feeling angry, embarrassed, or hopeless which could

cause tension to build and lead to violence. Victims may feel frustrated and self-righteous

when the abuser becomes arrogant, controlling, or engages in drug use. Phase two is the

violent episode, which is characterized by behaviors such as protecting oneself,

submitting helplessly, or seeking help. The behavior displayed in phase two, which is the

violent episode, is when the aggressor becomes increasingly controlling and is dangerous

and violent enough to hurt the victim.

The third phase is the remorse or honeymoon stage which is used to explain the

process that the aggressor goes through after exploding into violent acts. In the

remorseful or honeymoon stage, the aggressor may feel resentful, be in denial, and feel

hopeful that the crime will not occur again. By focusing on the three phases of violence,

namely tension building, violent episode, and remorseful stage, the cycle of violence

theory was used in this study to understand the stages of IPV. In addition, the three stages

were used to understand how behavior change following violence, such as remorse could

reduce IPV.

The second theoretical framework to guide the study is the social exchange theory

(Arthur & Clark, 2009). Social exchange theory is based on the assumption that people

can evaluate the benefits and risks of their social relationships with people (Arthur &

Clark, 2009). Individuals will seek to engage in activities that minimize social risks while

engaging in positive behaviors that promote the physical, emotional, and psychological

well-being of their close friends. Social exchange theory was used in this study to

understand behavioral intentions relating to intimate partners’ intentions to re-offend by

assessing the risks and benefits of engaging in IPV.

Nature of the Study

A quantitative research methodology has been selected for the current study.

Researchers use a quantitative study to investigate a phenomenon using numerical data or

numbers (Antwi & Hamza, 2015). In addition, Winter (2000) argued that a quantitative

study is used when the researcher intends to test a hypothesis by investigating the

relationship between study variables (Antwi & Hamza, 2015, Bloomfield & Fisher, 2019).

In this study, the researcher used a quantitative methodology because the intent is to test

research hypotheses relating to the extent to which substance abuse relates to DV

treatment outcomes. Quantitative research methodology is appropriate for investigating

the current research problem. Specifically, I investigated the relationship between

substance abuse (independent variable) and IPV treatment outcomes, including

reoffending and treatment completion (dependent variables). Therefore, a quantitative

research methodology is adequate to address the current study problem.

Alternative research methodologies were also considered but rejected for failing

to align with the study’s purpose. Researchers investigate a phenomenon using a

qualitative research methodology through participants’ views and perceptions in natural

settings (Winter, 2000). Here, researchers focus on using self-related data on participants

to explore a phenomenon (Bloomfield & Fisher, 2019). While using qualitative research

methodology to explore a phenomenon, the researcher does not test hypotheses to test the

relationship between study variables (Antwi & Hamza, 2015). The focus of this study is

to investigate the relationship between study variables using numbers, statistics, and

hypothesis testing. Therefore, a qualitative research methodology is deemed inappropriate

for investigating the current problem and was rejected.

A mixed methods approach was also considered. According to Antwi and Hamza

(2015), a mixed-method approach is used when a researcher intends to investigate a

phenomenon using qualitative and quantitative information. The primary purpose of

using a mixed-method approach is for the researcher to initiate exhaustive research on a

phenomenon using different methods that can provide an in-depth analysis of the

phenomenon being studied (Winter, 2000). However, for the present study, the researcher

does not intend to collect both qualitative and quantitative data but only collect

quantitative data (Bloomfield & Fisher, 2019). In this case, the mixed method approach

was incompatible with the study focus, and thus discarded.

A correlational research design has been selected to guide the current study. A

correlational research design is used when the purpose of the study is to establish a

relationship between variables (Curtis et al., 2016). In this study, I intend to investigate

the relationship between domestic violence treatment outcomes and substance abuse,

making a quantitative correlational research design appropriate for the study. Alternative

quantitative research designs such as quasi-experimental and cross-sectional research

designs were considered, but rejected because they did not align with the study purpose

(Curtis et al., 2015). Experimental design focuses on conducting experiments on variables

while manipulating the independent variables (Curtis et al., 2016). However, the current

study does not entail the manipulation of variables, making experimental design

inappropriate for the study.

Data were be collected through a survey instrument. The domestic violence

inventory (DVI) was used to collect data on domestic violence history. The DVI is a

multi-dimensional report survey instrument that has six subscales: truthfulness, violence,

control, alcohol, drug, and stress-coping abilities. The survey is estimated to take 60

minutes and participants respond using true or false options. To acquire a thorough

picture of the prevalence of domestic violence, the researcher also accessed secondary

data that has already been gathered by Fresno County probation departments or Domestic

violence treatment programs. The information that were gathered includes DVI

assessments as well as quarterly reports from various agencies that include demographic

data such as the number of clients in the program that are active, terminated, and

graduated. Data analysis was conducted through multiple regression supported by SPSS

software.

Definitions

Intimate partner violence. Intimate partner violence refers to a conflict between

individuals with close relationships, such as couples (Winter, 2000).

Substance abuse. Substance abuse refers to the excessive use of psychoactive

drugs, including alcohol, pain medications, and other illegal drugs (McKee & Hilton,

2019).

Assumptions

Assumptions refer to the things that the researcher considers true when

conducting a study (Bloomfield & Fisher, 2019). The researcher assumes participants was

honest with their responses. The assumption was important because truthful responses

will improve the credibility, validity, and generalizability of the study results. It is also

assumed that the selected participants have adequate time to take part in the study. The

assumption is valid because low participant participation is likely to hurt the sample size

used, which could compromise the generalizability of the study findings.

Scope and Delimitations

Scope of delimitations refers to the boundaries that the researcher uses to guide

the study (Winter, 2000). The present topic about the relationship between domestic

violence and substance abuse outcomes delimited the study. In particular, the study

focused on substance abuse and DV treatment outcomes. Literature beyond this scope

were not used. The geographical location selected delimited the study. In this case, I only

used participants from Fresno City in California in data collection. Lastly, the selected

research methodology delimited the data collection process. A quantitative correlational

study design has been selected for the current study in data collection, implying that no

other research methodology was used.

Limitations

Assumptions are the potential weaknesses in a study (Winter, 2000). The first

limitation of the study relates to the sample size used. First, the study used a small sample

size because this is an academic study. A small sample size is used because the researcher

has to complete the study within a pre-defined period. To reduce the impact of this

limitation on the study process, the researcher screened all participants.

Another limitation of the study is related to funding. This being an academic

study, there is a problem regarding its funding. Limited funding could hurt the research

process because the researcher has to finance different processes such as transportation

costs from one place to another which are vital to the outcome of the study. To mitigate

this limitation, the researcher will use personal savings and gifts from family members to

finance the research process.

The last limitation of the study relates to the researcher’s novice skills in data

collection and analysis. Notably, this is the first formal research I have conducted.

Limited skills in conducting surveys, interacting with participants, and conducting data

analysis using statistical software could limit the thoroughness of the study results.

However, to address this problem, the investigator took part in training programs on data

collection and analysis. The researcher consulted with methodological experts in the

study to ensure that key concepts are aligned with research methods.

Significance

There are several benefits relating to theory and practice that the study findings

will inform. The present study seeks to offer valuable information that researchers,

scholars, and stakeholders may use in the criminal justice system to understand better the

link between substance abuse and domestic violence treatment outcomes among intimate

partners. The study results may be impactful to the criminal justice system and the

relevant DV treatment programs.

In terms of theoretical contribution, the study was be based on two theories,

namely the cycle of violence theory and social exchange theory. According to Manuel et

al. (2017), the cycle of violence theory identifies three stages through which violence

occurs. In particular, the theory emphasizes that violence occurs through three stages

namely tension-building phase, violent episode, and remorseful and honeymoon stage.

The variables forming the theory may add to the current literature on how IPV occurs in

terms of the process and behavior change. The study findings may make a key

contribution to practice by providing scientific research with information that can

influence substance abuse among intimate partners and adherence to domestic treatment

outcomes to reduce the prevalence of IPV.

The study made several contributions to positive social change. In particular, the

researcher provided information that can address substance abuse and its link to domestic

abuse treatment outcomes. Offenders in domestic violence treatment programs may be

rehabilitated through effective treatment that reduces substance use and intimate partner

violence. A reduction in domestic violence, consequently IPV, contributed to the positive

growth of the community because people may develop healthier relationships with

reduced IPV.

Summary

Chapter 1 discussed several sections. I discussed background information on the

relationship that exists between domestic violence and substance abuse treatment

programs. I identified the problem statement, the purpose of the study, and the research

questions and hypotheses guiding the study. I also introduced theoretical frameworks,

namely the cycle of violence theory and social exchange theory, to inform the study.

Lastly, I discussed the nature of the study, the definition of terms, assumptions, scope and

delimitations, limitations, and significance. In the next chapter, Chapter 2, I will review

the literature related to the current topic.

Chapter 2: Literature Review

Introduction

Domestic violence has become an issue of public health concern among

stakeholders who consider it a threat to a partner relationship. As reported by Cafferky et

al. (2018), domestic violence among substance addicts is high and alarming. Gilchrist et

al. (2019) investigated the effectiveness of treatment programs in reducing domestic

violence among male perpetrators. Several interventions were reviewed on their

effectiveness in reducing violence among this population. The study found that the

incorporation of treatment for substance abuse and trauma seems to have better results as

compared to the programs that did not incorporate these components (Gilchrist et al.,

2019). The researchers suggested the need for additional research to address comorbid

issues such as substance abuse and trauma in treatment programs since addressing these

issues assists in the reduction of domestic violence perpetration (Gilchrist et al., 2019).

The focus of this study is to investigate the relationship between substance use and

domestic violence treatment programs. The chapter presents different sections related to

the literature review.

Literature Search Strategy

Chapter two entails a detailed review of various literature sources including

seminal work, peer-reviewed journal articles, books, professional journals, and

government publications or reports relevant to the topic. As supported by Mendez et al.

(2016), the strength of a literature review analysis is determined by the selection and

evaluation of foundational sources that consolidate a knowledge base to justify or

validate the nature of references used. Similar thoughts are echoed by Reynolds et al.

(2016) who assert that conducting a literature review should be extensive enough to

effectively underpin the supporting literature relating to the current topic of study. Given

this, the investigator implemented an elaborate literature review process that was used to

search and locate the most suitable sources needed for the review.

The researcher used the World Wide Web, the Walden University Library, and

Google Scholar to locate several databases for scholarly or peer-reviewed articles

relevant to the topic of study. The researcher then searched different databases, including

PubMed Central, Database of Abstracts of Reviews of Effects, PsycINFO, UpToDate,

PubMed, Psycharticles, ProQuest, PsychoInfo, Academic Premier, Sage, JSTOR,

ResaearchGate, EMBASE, ScienceDirect, Google Scholar, Cochrane Library, Emerald,

EBSCO, and Elsevier. The keywords or search terms used to search databases include

domestic violence intervention, recidivism, intimate partner violence, domestic violence,

substance abuse, substance abuse treatment outcomes, victim-offender mediation, and

batterer intervention program. To provide the most current and relevant information, the

investigator focused on sources that were published from 2017-2021. This ensured that

the sources used were current within 5 years.

Theoretical Framework

The study was based on two theoretical frameworks. The first framework is the

cycle of violence theory suggested by Walker (1972). The theory of cycle violence has

three phases. The first phase is the tension-building phase. In the tension-building phase,

the person feels angry, unfairly treated, embarrassed, or hopeless (Telles et al., 2020).

The partner may feel tense, frustrated, and self-righteous. In this case, one of the partners

may verbally be abusive, arrogant, controlling, and use drugs. Such demands and acts of

aggression create a conducive environment for tensions that would later result in conflicts

(Koziol-McLain et al., 2018). Phase two explains violence as a violent episode. This

episode’s common behavior includes an individual trying to protect oneself, submitting

helplessly, or seeking help (Foulds et al., 2017). The partner may feel angry, enraged, or

frustrated. The behavior exhibited in this case is dangerously violent and may hurt an

individual and the perpetrator’s controlling behavior increases (Spencer et al., 2019).

Phase three is the remorseful or honeymoon stage. After exploding and hurting a

partner, the next stage of violence includes the perpetrator being remorseful of their

practices (Curry et al., 2018). The person may feel resentful, hopeful, self-denial, and full

of excuses for the crime committed (Telles et al., 2020). Some of the individuals may

decide to withdraw from others to prevent future incidences. Behavior change may

include making promises to change, blaming others for the mysteries, or using drugs as

an excuse (Geyen & Bailey, 2021). The theory may be used in this study to understand

distinct phases of violence and how they result in IPV. The theory was also used to

understand how behavior changes after committing a crime can reduce IPV (Gilchrist et

al., 2019).

The second theory that was used in this study is the social exchange theory. Social

exchange theory is based on the premise that individuals can evaluate their social

relations’ risks and benefits (Geyen & Bailey, 2021). In this theory, individuals attempt to

minimize risks by engaging in positive behaviors. The theory helped understand

substance abuse patients’ behaviors and their intentions to commit and avoid violence

against partners after enrolling in a treatment program (Gilchrist et al., 2019). The theory

was also used to understand behavioral intentions linked to intentions to re-offend by

accessing the risks and benefits of engaging in a crime (Giarratano et al., 2020).

Literature Review Related to Key Variables and/or Concepts

Overview of Domestic Violence

Domestic violence has been defined as any form of physical, sexual, or emotional

abuse perpetrated by one individual toward another who has or has had an intimate

relationship (Koziol-McLain et al., 2018). Researchers have also described domestic

violence as a form of abuse against children or the elderly in families (Koziol-McLain et

al., 2018). In the United States, it is estimated that domestic abuse is reported frequently

among family members or close friends (Cafferky et al., 2018). Domestic violence, as

described by Gilchrist et al. (2019), includes close friends with intimate relations.

Statistics suggest that domestic abuse in the United States affects at least 10% -15% of

women and children (Koziol-McLain et al., 2018). Easton et al. (2018) reported that

domestic violence prevalence differs contextually based on the methods and metrics

adopted to define and report it. In selected groups, the prevalence of domestic violence

varies from 0.3% - 4% and 8% - 17% of the total violence reported (Chen et al., 2018).

The link between domestic violence, including females and males with a history of an

intimate relationship, has surged globally. Most of the cases include sexual harassment,

bullying, victimization, and stalking. The most frequent victims of domestic violence, as

reported by McKee and Hilton (2019), are children and women, particularly within

families where one of the parents abuses drugs.

Defining IPV

Several theories have been advanced to identify factors that contribute to IPV.

From a feminist point of view, IPV is considered an issue of control whose history is

linked to historical traditions characterized by male dominance within intimate

relationships (Godley et al., 2017). Other scholars (Easton et al., 2018; Koziol-McLain et

al., 2018) consider IPV a normal conflict resulting from daily stressors in life, which

could easily turn into conflicts if poorly addressed. Some conflicts may turn into violence

against an immediate person (Gilchrist et al., 2019). IPV comprises a wide set of

physically aggressive behaviors among partners that vary along different dimensions such

as.

1. The type or severity of aggression (push or injury).

2. Frequency of the aggressive behavior.

3. Emotional or physical impact of the aggression.

Based on this perspective, Godley et al. (2017) pioneered a conceptual model of

IPV premised on control within relationships. Specifically, Chen et al. (2018) identified

and described three forms of IPV. The first component of IPV is intimate terrorism

characterized by outright male-to-female aggression. The aggression is physical, which

includes punching, pushing, or threatening a partner with a weapon. In such instances,

female-to-male violence is limited and only occurs in self-defense. Intimate terrorism is

usually accompanied by the increased likelihood over time of physical injury or fear

toward their male partners. Koziol-McLain et al. (2018) reported that intimate aggression

is considered terrorism because it involves dominance and control by one partner over the

other. The dominance may be displayed through different forms such as violence and

other practices that achieve total control over an individual (Easton et al., 2018). The

second form of IPV is violent resistance (Gilchrist et al., 2019). This type of IPV is

characterized by violence occurring due to a partner’s violent or controlling behaviors

(Cafferky et al., 2018). In this category, the individual resisting aggression is violent yet

not controlling.

The last category of IPV is known as couple violence. As described by

KoziolMcLain et al. (2018), situational couple violence includes two-way partner

aggression that is primarily moderate. The conflict may occur as a response to a conflict

escalation. Important to emphasize is that situational couple violence does not involve

control or fear among partners (Cafferky et al., 2018). Despite the nature of IPV, it is

important to emphasize that each type of violence relates to power, control, and

intimidation among victims, particularly those abusing drugs (Godley et al., 2017).

A considerable part of the current literature has focused primarily on intimate

terrorism, disregarding that most of the IPV reported includes situational couple violence.

According to Gilchrist et al. (2019), this is a common experience of a violent couple in

which one of the partners enrols in a substance abuse treatment program. Håkansson and

Jesionowska (2018) reported that over 95% of these couples’ repeated episodes of partner

aggression that are like the description of couple violence instead of patriarchal terrorism.

Patriarchal terrorism refers to violence exclusively initiated by men as a way of gaining

and maintaining absolute control over their female partners (Håkansson &

Jesionowska, 2018).

Prevalence of IPV

Depending on the definition adopted for violence, including the contextual setting,

statistics suggest that physical aggressions between partners significantly vary from one

country to another (Horstman et al., 2019). Statistics released by the Justice Department

indicate that at least 1,500 incidences of homicide or manslaughter between intimate

partners occur annually (Horstman et al., 2019). Most of these incidences, at least 1200,

involve women being victimized (Horstman et al., 2019). Additionally, 250,000

emergency department visits are reported in the United States annually involving victims

of IPV (Horstman et al., 2019). Håkansson and Jesionowska (2018) also reported that at

least 15000 female victims of IPV are documented yearly. Findings from metaanalysis

studies suggest that at least one out of every eight male partners engage in physically

aggressive behaviors such as pushing or slapping their intimate partners (Amstrong et al.,

2019; Karakurt et al., 2019). Results also suggest that women are likely to perpetrate

aggressive behaviors in intimate relationships at an equal or slightly higher rate than their

male counterparts (Peitzmeier et al., 2020). Cafferky et al. (2018), assert cautioned that

the negative consequences of male-to-female aggression in IPV are more severe than

female-to-male aggression.

It is important to note that there are inconsistencies in study results on factors

influencing IPV prevalence between males and females. Most of the inconsistencies have

been linked to the varying definitions of IPV (Godley et al., 2017). Quantitative measures

have differed from qualitative metrics that are used for defining and reporting IPV.

Regardless of the inconsistencies in the IPV definition, it is important to underscore that

IPV is a global health concern and that partners engaged in substance abuse behaviors are

disproportionately affected. (Geyen & Bailey, 2021).

Substance Abuse and Intimate Partner Violence

Intimate partner violence is one of the major public health concerns globally.

Substance abuse has been established to co-occur in 40% - 60% of IPV incidences

reported worldwide. Researchers (Habigzang et al., 2018) have suggested that IPV is

linked to substance abuse whereby one person who is abusing substances could become

violent and threaten the other person’s safety. In response to the increase in domestic

violence, studies have suggested different interventions to target substance use in men

with a history of IPV, especially regarding the use of alcohol (McKee & Hilton, 2019).

Research conducted by Geyen and Bailey (2021) established that 20% of males who

engaged in IPV were abusing drugs even after being enrolled in treatment programs.

Wichaidit and Assanangkornchai (2020) also reported that IPV is linked to alcohol use

even if the aggressor is enrolled in a treatment program. The implication is that IPV is

related to substance use.

Although historically conceived as a private issue, IPV has recently been

considered a widespread public health concern. As such, Cafferky et al. (2018)

maintained that IPV requires the immediate attention of both the treatment community

and the criminal justice system. A study conducted by Geyen and Bailey (2021)

suggested that most couples have reported a surge in aggression from their partners who

are abusing drugs even if they are enrolled in substance treatment programs.

Similar findings are reported by Geyen and Bailey (2021) who found that

instances of aggression, such as slapping or pushing partners, have risen from 15% to

20% yearly, including husband-to-wife violence from 2016 to 2020. The statistics above

suggest that IPV has increased due to drug abuse and the failure of treatment programs to

result in positive outcomes. Individuals abusing drugs are five times more likely to

engage in IPV than their counterparts who do not abuse drugs or have completed

substance use treatment programs successfully and have reformed (Easton et al., 2018).

Faced with the increase in IPV among individuals and family-involved assessments in

substance abuse treatment, Zarling et al. (2019) argued that stakeholders are baffled by

the challenge of managing such a complex situation.

There is evidence that IPV gets worse and happens more frequently when alcohol

is consumed (Sontate et al.., 2021). Relevant alcohol effects include a deterioration in

cognitive and physical mechanisms that reduce self-control, which lowers one’s ability to

settle conflicts amicably (Sontate et al., 2021). A partner’s heavy drinking might also

exacerbate existing household tensions like adultery, childcare challenges, and financial

difficulties. Additionally, beliefs held by people and society that alcohol creates

animosity may lead to more aggression.

Abuse of alcohol or other drugs has a convoluted relationship to IPV. One

common misconception concerning domestic abuse is that it is primarily brought on by

drugs and alcohol. In actuality, some substance abusers use their addiction to substances

as justification for acting violently. Drink enables the abuser to explain away his abusive

actions by blaming them on the alcohol. The user’s capacity to receive, comprehend, and

process information is impacted by alcohol. Although this mental distortion does not

result in violence, it may raise the possibility that the user would misinterpret his

partner’s or another’s actions (Chalfin et al., 2021). A significant amount of alcohol, or

any amount for alcoholics, may improve the user’s sense of dominance over others,

according to some research. Conflict over alcohol consumption (or attempts to stop it) or

the act of obtaining and consuming substances, especially illegal narcotics, can lead to

violence. According to other studies, a battered woman may use drugs with her abuser to

try to control the violence and improve her safety, and many times the victim is made to

use other drugs with the perpetrator (Sontate et al., 2021).

Unfortunately, effective treatment plans available for individuals dealing with

IPV and substance abuse are much limited (Pérez & Ruiz, 2017). To date, one of the

widely used techniques is for providers to refer IPV cases to law enforcement officers or

rehabilitation centers (Håkansson & Jesionowska, 2018). Nonetheless, there are

fundamental challenges with this approach. First, most of the batterers’ programs will

only accept legally mandated persons to participate in IPV treatment (Cafferky et al.,

2018). This means that the majority of IPV patients are not allowed to participate in IPV

treatment programs. This study focuses on exploring the risk factors of IPV among

individuals attending substance use programs.

Treatment Options for IPV among Substance-Abusing Patients

Researchers have differed about the most effective treatment programs that

patients can use to address IPV. Researchers have suggested a different mechanism that

can be used to solve IPV among substance-abusing patients. Regardless of the

inconsistencies in the definition of IPV discussed, below are some of the ways of treating

substance abuse problems.

Treatment – As – Usual (TAU)

Based on the increased prevalence of IPV in men seeking substance abuse

treatment, it is reasonable to deduce that substance abuse treatment techniques could

provide an important opportunity for addressing IPV. Nonetheless, studies have

suggested that referrals to domestic violence intervention programs are rare (McKee &

Hilton, 2019). For instance, Geyen and Bailey (2021) argued that persons enrolling in

alcoholism treatment programs are typically unassessed for IPV. The findings suggest

that referring and assessing for IPV in individuals in substance abuse treatment is an

important intervention that can support effective treatment programs. Wichaidit and

Assanangkornchai (2020) studied IPV among 301 alcoholic men who were enrolling in

an outpatient substance abuse treatment program. The focus of the research was to

evaluate these individuals for IPV because IPV was not part of the treatment. Before the

treatment, 56% of patients with alcohol problems perpetrated violence against their

female partners compared to 14% in a group with no alcohol abuse (Wichaidit &

Assanangkornchai, 2020). Following the completion of the study, the researchers found a

25% rate of IPV in all patients treated but only 15% in recovering alcoholics and at least

32% in relapsed patients (Wichaidit & Assanangkornchai, 2020).

Although there is a gap in the literature relating to female alcoholics, current

results are like those reported for male counterparts. Håkansson and Jesionowska (2018)

studied the impact of intensive alcoholism outpatient treatment programs on female IPV

perpetration. The study results suggested that there was a decrease in the prevalence and

frequency of IPV after the alcoholism treatment (Gilchrist et al., 2019). Study results also

indicated that females who experienced relapse during the first year of post-treatment

follow-ups had higher chances of perpetrating IPV than females who did not experience

relapse (Zarling et al., 2019).

Interesting results are reported by Geyen and Bailey (2021) who argued that IPV

might not predict a decrease in standard alcoholism treatment, especially in patients who

do not have relapse incidences in the post-treatment period. The results support the

assumption that patients with alcohol problems should receive substance abuse treatment

as a significant component of the IPV intervention. Nonetheless, researchers have

identified several flaws in this approach to managing IPV because it focuses primarily on

alcohol abstinence as the means to violence reduction. Other factors such as conflict

resolution skills may also influence IPV and the overall effectiveness of this approach.

Referral To Domestic Violence Intervention Programs

As previously discussed, it can be argued that a reasonable approach would be for

stakeholders to train substance abuse treatment programs to have the capacity to evaluate

the incoming patients for the likelihood of IPV and refer such patients to domestic

violence intervention programs. A review of the current literature suggests that domestic

violence intervention programs play a key role in reducing IPV among patients with

substance use disorders (Geyen & Bailey, 2021). Similar findings were reported by

Håkansson and Jesionowska (2018) who argued that domestic violence intervention

programs effectively reduce IPV. Other treatment options for IPV include cognitive

therapy and behavioral therapy.

Relationship between Substance Abuse Treatment Programs and Increased

Violence

Drug abuse has a detrimental impact on individuals’ judgment and behavior. In a

study conducted by Curry et al. (2018), the researchers described the relationship

between drug abuse and domestic violence, as “cause-effect”. Given this study, it was

established that the link between alcoholism and substance addiction treatment programs

and violence affects many thresholds, such as posing a public consequence, domestic

violence, and impairing an individual’s psychological functioning. In a comparable study,

Peacock et al. (2017) established that about 75% of the study participants (substance

abusers) who took part in drug addiction treatment reported having committed various

acts of violence such as physical assault, mugging, and using weapons to attack innocent

people. This study’s findings further showed that the rate of violence among men seeking

drug addiction treatment was higher than that of women. All genders reported engaging

in violent acts because of the influence of their substance abuse. Taken together, the

literature presented above demonstrates the impact that alcoholism or other substance

abuse has on an individual’s judgment and behavior and, in turn, leads them to commit

various acts of violence.

As expressed by Anderberg and Dahlberg (2018), the risk for violent behavior

increases with intoxication. Substance abuse treatments are offered to alcohol and drug

abusers to help mitigate their negative behavior, such as indulgence in violent activities.

Anderberg and Dahlberg argued that individuals who are not used to suppressing their

emotions of anger while sober are most likely to exhibit violent behavior due to their

overindulgence in substance abuse. In a comparable study, Widom (2017) recommended

that such individuals need to be provided with better intervention strategies to help them

control themselves. In Widom’s view, people who exhibit violent behavior after engaging

in substance abuse need to be helped to overcome this by being offered substance abuse

treatment programs that seek to address their anger when they are not sober. As expressed

in the reviewed literature, it can be deduced that IPV programs that aim to address the

substance use of those people who indulge in drug abuse can significantly help to reduce

the violent behaviors they exhibit.

People who fail to manage their anger are more likely to engage in substance

abuse than those prone to taking control of their anger when sober. According to a study

by Witkiewitz and Tucker (2020), people who reported hiding their anger were less likely

to commit a violent offense after a drinking spree. The 11% increase in extreme

substance abusers reflected people who had an impairment in addressing their angry

emotions while sober (Witkiewitz & Tucker, 2020). Such people, given a comparable

study by Sommer et al. (2017), are connected to a surge in the chance of engaging in

violent behavior. The possibility of a person being violent during or after drinking is

attributed to how satisfactorily individuals who engage in substance abuse can deal with

their anger while sober. Taken together, it is imperative to note that drinking alcohol and

consuming other substances can compel risky behavior, lower inhibitions, and rob people

of their self-control, thus causing them to act antisocially after intoxication, especially

due to rage.

Previous researchers suggest that IPV treatment programs that fail to address

addicts’ antisocial behavior are likely to result in increased violence and suicide

intentions among the victims. For instance, Easton et al. (2018) reported that those

individuals who seek substance abuse treatment have problems controlling their violent

acts or managing suicidal thoughts. Study findings further clarified that individuals who

struggle to control anger are vulnerable to act on violence and relapses, which could

affect those who are around them (Easton et al., 2018). Treatment programs that fail to

address anger may not be successful in providing the required, leading to increased

violent acts among partners of the affected victims (Spencer et al., 2021). If drug use

problems are inadequately treated, the victims may be vulnerable to homicides. In a

different study, Witkiewitz and Tucker (2020) reported that self-directed violence is

linked to substance addiction, calling for the need for effective treatment interventions to

support the victims in addressing drug addiction problems by offering mental and

emotional support to the victims.

Substance abuse treatment programs that result in unhealthy coping mechanisms

have a high probability of increasing drug abuse-related domestic violence against

intimate partners. Of immense importance to underscore that domestic violence related to

drug abuse among partners is underreported compared to other cases of homicides. The

implications are that the victims may be hesitant to seek medical support for injuries

sustained, causing further pain in fear of retaliation from their abusive partners (Curry et

al., 2019). Koziol-McLain et al. (2018) also found that partners who experienced

domestic violence attributed did not seek professional treatment because of shame, fear of

being arrested, or did not want to reveal their drug and substance abuse practices. Failure

to seek medical treatment for drug abuse-related problems has rendered drug abuse

victims susceptible to mental health problems. According to a study by Lila et al. (2020),

about 56% of partners who experienced domestic violence linked to drug abuse were

diagnosed with mental health disorders such as suicidal thoughts. The literature reviewed

thus far suggests the need for proper treatment for both victims and perpetrators of

domestic violence.

Individuals who engage in substance abuse are vulnerable to depression, anxiety,

and other psychosocial disorders. For instance, depression, aggression, and anxiety have

been reported as considerable contributors to increased violence (Spencer et al., 2021).

Substance abuse interventions that do not address mental disorders in drug addicts are

ineffective in providing healing to them, thereby increasing violence linked to drug

abuse. Depressed individuals are likely to engage in antisocial behavior, such as domestic

violence against intimate partners. Treatment measures adopted to help such drug addicts

must address issues related to depression, anxiety, and aggressive behaviors (Pérez &

Ruiz, 2017). Thus far, the articles reviewed show that effective therapeutic techniques

that address depression, anxiety, and aggression among drug addicts can reduce instances

of domestic violence among partners (Cafferky et al., 2018). Besides, it is also significant

to underscore that ineffective DV treatment programs that fail to address the depression,

anxiety, and aggression in substance abuse addicts could lead to a surge in intimate

partner violence.

DV program’s failure to address substance abuse could lead to increased intimate

partner violence. Peacock et al. (2017) expressed that about 61% of Americans aged 18

and older indulge in substance abuse, including the use of alcohol. The study suggested

that 43% of victims consume more than five drinks a day. In 2017, during this study’s

period, 1% of the general population participated in intimate partner violence. Peacock et

al. noted that the increased domestic violence rate in the United States has been attributed

to drug abuse. Anderberg and Dahlberg (2018) also reported that exposure to drug abuse

without timely treatment increases the likelihood of intimate partner violence occurring.

Widom (2017) recommended DV treatment programs for Americans who are vulnerable

to drug abuse practices as a strategy for reducing intimate partner violence. Taken

together, the articles reviewed suggest that delayed treatment programs following

exposure to drug abuse practices among partners could increase intimate partner violence.

Individuals using drugs such as heroin and cocaine have a high chance of

committing intimate partner violence when they fail to secure enough money to purchase

the drugs. As presented by Widom (2017), narcotics, alcohol, psychomotor stimulants,

and hallucinogens differ from each other and their relatedness to various kinds of crimes.

Therefore, people who use narcotics need intervention to abstain from criminal offenses

that they do to raise extra cash for drug purchases. DV Treatment programs that focus on

how individuals can avoid addiction are reported to be effective in managing criminal

acts and instances of intimate partner violence among theme (Geyen & Bailey, 2021).

The literature reviewed justifies that ineffectual DV treatment programs do not address

the facts presented above, leading to a surge in criminal cases emanating from

individual’s overindulgence in substance abuse.

Substance abuse and crime have been interlinked for a long time. The two

concepts have had a causal relationship, leading to a person involved in one vice to, at

some point, get involved in the other vice as well. According to Koziol-McLain et al.

(2018), inmates who have just been released from prison, especially those who have a

history of drug use, have a very high chance of reporting relapses and becoming more

violent against their partner (Easton et al., 2018). Relapse is likely to be reported in the

first few months after being released from prison. Zarling et al. (2019) also affirmed that

at least half of the American inmate population experiences relapse, which increases the

chances of being arrested and committing intimate partner violence. Upon being released

from prison, most of the inmates find it challenging to integrate back into society. In

particular, the prison environment, which is characterized by violence, is different from

the outside environment. In such instances, the ex-inmates may find themselves

committing crimes or engaging in aggressive behaviors that are categorized as intimate

partner violence (Easton et al., 2018). For inmates who are introduced to drug abuse

while in prison, they may be forced to engage in crime to fund their drug habits, which is

a classic sample of reoffending (Pérez & Ruiz, 2017). Similarly, inmates who were

arrested for substance abuse are likely to be rearrested for the same offense a few months

after being released from prison.

From a different perspective, inmates who have just been released from prison

have faced challenges that could cause intimate partner violence or reoffending. The main

challenges include getting employment, getting along with their friends, access to

healthcare, and education (Geyen & Bailey, 2021). Koziol-McLain et al. (2018) reported

that ex-inmates face unwarranted stigma and suspicion from society, making it

challenging for them to get the required social support to aid their reintegration process.

In the absence of such support, they are likely to contemplate committing crimes leading

to intimate partner violence. Faced with limited social support from society, the former

inmates get involved in substance abuse and other criminal activities to fund their life

needs. While under the influence of drugs, some of the inmates engage in criminal

activities, such as vandalism or intimate partner violence as a form of revenge against the

society that has ignored their need for social support (Cafferky et al., 2018).

Similarly, inmates who are trying to reintegrate into society experience stress.

The stress can result from poor relationships with close family members and friends after

being incarcerated (Geyen & Bailey, 2021). Likewise, other social factors that may cause

stress to former inmates include an increased financial burden to finance their lives

(Giarratano et al., 2020) and challenges in finding employment (Cafferky et al., 2018).

The above challenges are bound to make the first few months of their reintegration into

society difficult and unstable (Easton et al., 2018). Stress resulting from the lack of social

support and employment opportunities may cause former inmates to engage in substance

abuse as a way of forgetting about their problem of finding money illegally to support

their daily needs (Brunner et al., 2019).

Inmates coming from prison report different mental problems because of the

hostile environment they live in during their prison time. According to Koziol-McLain et

al. (2018), mental health problems among inmates may be caused by living conditions in

prison or some traumatic events that befell the inmates after being incarcerated.

According to Giarratano et al. (2020), the inmates’ mental health issues may be worsened

by the difficulties encountered in prison, which hurt their subsequent reintegration into

society. Mental health could also be linked to the effects of an individual withdrawing

from drug abuse and the continued conflict to overcome negative thoughts related to drug

abuse (Gilchrist et al., 2019). Mental health issues manifest in violent acts, such as

intimate partner violence or other criminal activities (Zarling et al., 2019). Substance

abuse also contributes to the escalation of violent acts among people suffering from

related mental health issues that are known (Easton et al., 2018).

Drug abuse and crime have always coexisted with each other. According to

Horstman et al. (2019), at least thirty-eight percent of inmates on parole had a substance

use disorder in the year 2012. It would be prudent to note that substance abuse on its own

is a crime, punishable by law, and for which people have been incarcerated. Over half of

the parolees and two-thirds of the offenders recidivate within the first three years

following their release from prison (Isobe et al., 2020). The addictive nature of drugs

being abused has been a significant reason for a higher likelihood of former drug

offenders engaging in substance abuse even after being released from prison.

Criminal cognition refers to how people justify their criminal behavior, exhibit

distorted thinking, and neutralize the negative consequences resulting from crime (Easton

et al., 2018). Substance abuse is one of the most significant causes of criminal cognitions.

Inmates who have just been released from prison exhibit behaviors that are consistent

with criminal cognitions to justify their participation in illegal activities (Geyen & Bailey,

2021). Substance abuse has been known to create anarchy among former inmates in that

the inmates develop a mental mindset that criminal life is highly rewarding (Isobe et al.,

2020). Likewise, the inmates’ challenges as they try to fit into society cause them to take

part in substance abuse. As a result, the inmates get forced towards substance abuse,

which interferes with their mental state and increases the likelihood of the former inmates

reoffending and finding their way back to prison.

Research suggests that not all repeated crimes are caused by the criminal

cognitions of the offenders. Individuals with severe substance use disorders are likely to

engage in reoffending (Zarling et al., 2019). Addiction related to particular substances has

become one of the greatest driving forces causing reoffending among former inmates

(Cafferky et al., 2018). Crimes associated with addiction include possession of illegal

substances or engaging in other crimes such as domestic violence and theft or robbery

with violence to acquire resources to fund one’s addictive habits (Brunner et al., 2019).

Suppose one does not have a strong dependence on substances. In that case, there is a

limited likelihood of being caught up in substance-related offenses such as possession

and robbery to acquire resources to fund drug habits (Isobe et al., 2020). It is, therefore,

quite clear that substance abuse increases the likelihood of an inmate reoffending.

Recidivism as a vice also depends on the nature of substances being used by

former inmates. According to Horstman et al. (2019), the chances of reoffending among

substance-involved individuals were at least three or four times higher than individuals

not abusing drugs. The drugs involved also played an essential part, as indicated by the

fact that the chances of reoffending were at least six times higher for those who use crack

cocaine than those who did not (Isobe et al., 2020). Similarly, recidivism had three times

greater chances of happening to those who use heroin, two and a half times greater for

those who use powder cocaine, and about one and a half times greater for offenders who

use marijuana than inmates who did not use any of the substances as mentioned above

(Isobe et al., 2020).

Substance abuse can be said to be one of the most significant contributors to the

likelihood of recidivism among former IPV inmates (Koziol-McLain et al., 2018).

Substance abuse is associated with a myriad of social ills, together with detrimental

effects on the mental and physical health of the people who abuse them. Societal failures

such as stigma towards former inmates and hesitation in accepting them back into society

is also a significant driving force that pushes the former inmates towards substance abuse

(Cafferky et al., 2018), increasing the likelihood of the inmates re-offending.

Summary of Literature on the Relationship between Domestic Violence and

Substance Abuse

Study results by Giarratano et al. (2020) suggested that behaviors related to

aggression among females are linked to substance use. Research has shown that most

partners engaging in substance use practices are likely to commit more crimes than men

(Håkansson & Jesionowska, 2018). Crime and substance abuse are linked. A systematic

review conducted by Horstman et al. (2019) in the prison population established that

alcohol abuse is 18% - 30% in males and 10% - 24% in females. Important to emphasize

from the study findings is that Zarling et al. (2019) reported that substance use was linked

to violent crimes (Horstman et al., 2019).

Violent crimes such as assault, homicide, and other IPV forms are related to

substance use. According to Sullivan (2018), substance abuse increases the likelihood of

an individual engaging in domestic violence. Comparable findings were reported by

Geyen and Bailey (2021) who argued that domestic violence is a widespread problem

linked to the excessive use of drugs among patients. A comparative study to assess the

relationship between substance and IPV established that most domestic violence-involved

partners were linked to substance use (Isobe et al., 2020). Domestic violence is higher, so

it is important to emphasize that substance use is related to the increased risk of IPV

(McHugh et al., 2018). Gray and Squeglia (2018) reported that the increase in IPV among

substance use patients was linked to mental disability that affected their ability to

evaluate the offending risks and benefits. Reoffending cases have widely been reported in

patients with substance use problems. Stringer and Baker (2018) reported that IPV cases

among prisoners were higher even though many were recruited to different programs.

Taken together, it can be concluded that the intentions to re-offend depend on the

substance use behaviors among individuals.

Risk Factors for Domestic Violence and Its Influence on Substance Used Treatment

Program

Age

Study findings have suggested a positive link between substance use and IPV.

Researchers such as Manuel et al. (2017) have argued that age influences treatment,

whereby young individuals tend to withdraw from substance use treatment programs that

are meant to reduce their IPV vulnerabilities. According to Peterson et al. (2018), age is a

consistent factor in IPV, particularly among adults. Giarratano et al. (2020) also found

that age was linked to IPV.

Young individuals enrolled in substance use treatment programs are more likely

to engage in domestic violence than their aged counterparts. In a similar study consisting

of 200 substance abuse patients, Sullivan (2018) established a direct link between

domestic violence among individuals abusing drugs and their likelihood of engaging in

domestic violence again. Lilley-Walker also reported comparable findings et al. (2018)

whose study findings on factors that influence recidivism among alcoholic individuals

linked age to domestic violence. Based on their study, researchers established that young

people were three times more likely to engage in domestic violence while on substance

use treatment programs than the aged.

In a different study to investigate the effects of age on substance use program

adherence and recidivism among offenders, Hill et al. (2021) found that adults aged 55

years and above show compliance to different treatment programs compared to youths.

The researchers also reported that adults were three less likely to engage in repeated

domestic violence against their partners than youths (Mancera et al., 2018). Taken

together, the study findings suggest that age is an important predictor of domestic abuse

and adherence to substance use treatment programs (Isobe et al., 2020). Additionally, it

can also be concluded that age determines the willingness of an individual to be

remorseful of their past domestic violence and prevent future violence than youth who

would blame situations for their domestic violence and continue engaging in IPV even

after enrolling in substance use programs (Wilsnack et al., 2018). In summary, it can be

concluded that age plays an essential role in determining substance use treatment

program adherence response among individuals. Researchers have also found a direct

link between adherence to substance use treatment programs and domestic violence, as

discussed below.

Gender

The current literature overall suggests that people are likely to perpetrate IPV on

an equal margin (Ahmadabadi et al., 2017). Conflicting results from systematic reviews

conducted by Giarratano et al. (2020) indicated that domestic violence and willingness to

adhere to treatment programs differ across genders. Findings reported by Bernardi and

Steyn (2019) on the differences in domestic violence perpetrated based on gender

established that women were more likely to commit domestic violence than their male

counterparts. Additional findings by Brunner et al. (2019) established that gender played

a key role in determining domestic violence prevalence. According to the study, it was

established that males and women had an equal chance of perpetrating violence against

each other (Easton et al., 2018).

Equally, Armstrong et al. (2019) found that people had an equal chance of

engaging in domestic violence, especially if they abused drugs. Similarly, study findings

by Gilchrist et al. (2019) established that people were 30% more likely to engage in

domestic violence, which was harmful to each other. Based on the above results, it can be

concluded that gender played a key role in determining the prevalence rate of domestic

violence. According to a study by Ahmadabadi et al. (2017), it was established that

people had an equal chance of perpetrating domestic violence, particularly if one of the

partners abusing drugs.

The findings above are consistent with those of Giarratano et al. (2020) who

found that female IPV perpetration was higher than in men. The results suggested that

men were more aggressive in using physical forces to dominate their female partners.

This led to an increased IPV number among couples where one partner is enrolled in

substance use programs. Findings by Easton et al. (2018) suggested that the rate of

domestic violence among substance use abusers was higher in males than in females

because women were less hostile compared to their male counterparts. The findings also

suggested that men were more violent when perpetrating domestic abuse than females

(Brunner et al., 2019).

The reviewed above articles present mixed results on the prevalence of domestic

abuses among genders. Researchers have reported the domestic abuse rate to be higher

among men abusing drugs based on the context. Other researchers have reported a direct

link between gender and domestic violence when both couples are using drugs (Bernardi

& Steyn, 2019; Isobe et al., 2020). In instances where both couples abuse drugs, study

results have suggested that domestic violence prevalence is equal as each partner is likely

to engage in domestic violence against his or her partner.

Additional findings have reported significant differences in the adherence rates to

treatment programs that are meant to treat IPV among individuals abusing drugs. For

instance, Brunner et al. (2019) reported a high likelihood that females would adhere to

different treatment programs than their male counterparts. Given the above findings,

females were three times more likely to adhere to substance use treatment programs

meant to help them reduce domestic abuse than men. Comparable findings were reported

by Giarratano et al. (2020) who conducted a study to investigate adherence to treatment

programs among substance use abusers. In their research, 215 substance use abusers were

recruited to take part. Based on the findings, it was established that 90% of women

participated fully in a treatment program that sought to address IPV.

Different from Mancera et al. (2018), Sullivan (2018) established that men were

50% less likely to finish their treatment sessions than women. The noncompletion of

substance use treatment programs among men significantly increased the risk of engaging

again in domestic violence (Easton et al., 2018). In summary, the study findings suggest

that there is a direct relationship between treatment adherence and domestic violence

across the genders (Telles et al., 2020). The findings indicated that a person’s likelihood

to engage again in domestic violence depends on their ability to complete substance

abuse treatment programs (Armstrong et al., 2019). Additionally, individuals who were

less likely to complete their treatment program had higher chances of minimizing their

risk of engaging in domestic violence (Armstrong et al., 2019).

Socioeconomic Factors

Socioeconomic status is a significant predictor of domestic violence. According to

Giarratano et al. (2020), economically sound individuals have a lower probability of

engaging in domestic violence. A study conducted by Wilsnack et al. (2018) established

that employed individuals were three times less likely to engage in domestic violence

because they could afford essential bills. On the contrary, a report by Raj and Shankar

(2017) established that unemployed individuals found themselves motivated to engage in

substance abuse, domestic violence, and non-compliance to treatment programs.

McKee and Hilton (2019) found that substance abusers had a low probability of

engaging in treatment programs because they found it difficult to pay for their basic

needs such as house rent or buy food. The frustration attached to lack of employment, as

reported by Armstrong et al. (2019) could lead to most of them engaging in domestic

violence, substance abuse, and no adherence to treatment programs. Bernardi and Steyn

(2019) found that 90% of individuals enrolled in IPV treatment programs were more

likely to engage in domestic violence against their partners as a way of shielding their

incapability to provide for their families. Bernardi and Steyn’s (2019) findings were

supported by Mancera et al. (2018) who also found that a lack of financial support for

drug addicts accused of IPV increased their likelihood of engaging in domestic violence

again after abusing drugs.

Lilley-Walker supported comparable thoughts et al. (2018) who established that

unemployed drug addicts were 70% more likely to report recidivism compared to their

counterparts who could attain support from friends, family members, or colleagues.

Easton et al. (2018) also reported that financial incentives are a major factor influencing

the likelihood of substance abusers committing crimes. A study conducted by McKee and

Hilton (2019) established that most individuals who offended their partners while on

treatment linked it to a lack of financial support. A study conducted by Gilchrist et al.

(2019), on predictors of substance use and domestic violence found that 90% of

individuals who withdrew from substance use treatment programs linked it to a lack of

economic resources to finance their life needs as they continued accessing treatment

programs. Cafferky et al. (2018) reported an increase in substance abuse incidences

among individuals enrolled in substance use treatment programs linked to the

socioeconomic aspect.

Additional studies have reported inconsistent findings on the relationship between

socioeconomic status, substance abuse, and domestic violence. For instance, a study by

Gilchrist et al. (2019) found that an individual’s socioeconomic status, such as education

and income level, was indirectly linked to domestic violence and adherence to treatment

to substance abuse programs. Findings by Telles et al. (2020) suggested that individuals’

likelihood to engage in domestic violence again after enrolling in substance use treatment

programs was independent of their socio-economic status. According to their results,

Geyen and Bailey (2021) found that reoffending among offenders registered for

substance treatment programs was dependent on individual factors such as personal

behavior.

Researchers such as Raj and Shankar (2017) also found that individual behaviors,

such as remorse after engaging in domestic violence and enrolling in substance use

programs, were dependent on their attitudes on the extent to which they were remorseful.

Such personal factors insignificantly correlate with an individual’s willingness to

recommit to domestic violence (McKee & Hilton, 2019). Taken together, the study above

findings suggest that there is a direct link between socioeconomic status and substance

use treatment programs.

Researchers have established a direct link between substance use, domestic

violence, and adherence to substance treatment programs. According to Mancera et al.

(2018), socioeconomic status influences human life and functioning, such as physical and

mental health. Low socioeconomic status and its primary correlates, including low

educational achievements, poverty, and poor health, affect an individual functioning

(Spencer et al., 2019). The implication is that low socioeconomic status may affect an

individual’s ability to cognitively function well and access the risk of committing crimes,

thereby showing a high probability of achieving domestic violence. Study results by

Curry et al. (2018) have shown that the prevalence of domestic correlates with low

economic status and has an indirect relationship with education. According to the

researchers, socioeconomic status affects an individual’s mental stability to concentrate

on substance use programs (Wilsnack et al., 2018), making it particularly important for

them to have an income source that would support their livelihood (Raj & Shankar,

2017).

Summary and Conclusions

The focus of this study is to investigate the relationship between domestic

violence and substance abuse treatment programs. According to Easton et al. (2018),

substance use has become an important aspect of domestic violence. The analysis

conducted suggests that at least 90% of all domestic violence is associated with substance

abuse. These findings are consistent with Telles et al. (2020), who reported a statistically

significant relationship between substance use and intimate partner violence.

Although studies have previously linked domestic violence to substance use, the

current literature search did not reveal research examining the relationship between

domestic violence and substance use treatment outcomes. Spencer et al. (2019) identified

a literature gap relating to the relationship between domestic violence and substance

abuse treatment outcomes. McKee and Hilton (2019) also suggested the need for further

research to investigate the relationship between domestic violence and substance abuse

treatment. Mancera et al. (2018) also suggested the need for further research to

understand the impact of substance use treatment programs on domestic violence for a

better understanding of how it influences recidivism among offenders.

Chapter 3: Research Method

Introduction

The purpose of this quantitative study is to explore the relationship between

domestic violence treatment outcomes and substance abuse of adult male and female

offenders. The study sought to fill a gap in understanding the risk factors that can lead to

reoffending in domestic violence. Due to a lack of adequate information, organizations

have had challenges in dealing with domestic violence and substance abuse issues. The

current research project is unique because it explores the impact that substance abuse has

on intimate partner violence (IPV). It explores the role that substance abuse has in

dropout and noncompliance in court-ordered Batterer Intervention Program (BIP)

treatment and the effect of substance abuse on IPV’s continued incidents.

Substance abuse has been recognized as a very significant issue when treating

individuals who commit intimate partner violence. Substance abuse is found to

exacerbate and precipitate the risk of perpetrating intimate partner violence (Armstrong et

al., 2019). However, there is a gap in the research about how substance abuse impacts

offenders’ treatment and further violence (Kraanen et al., 2014). Data were collected

from Fresno County Probation to address the following research questions:

RQ1: How does substance abuse among intimate partners relate to domestic

violence treatment outcomes?

H10: Substance abuse among intimate partners is unrelated to domestic violence

treatment outcomes.

H11: Substance abuse among intimate partners is related to poorer domestic

violence treatment outcomes.

RQ2: Will women in domestic violence treatment programs who abuse substances

be at higher risk of reoffending than women who do not abuse substances?

H20. Women who abuse substances are not at higher risk of reoffending than

women who do not abuse substances.

H21. Women who abuse substances are at higher risk of reoffending than women

who do not abuse substances.

RQ3: Will men in domestic violence treatment programs who abuse substances be

at higher risk of reoffending than men who do not abuse substances?

H30. Men who abuse substances are not at higher risk of reoffending than men

who do not abuse substances.

H31. Men who abuse substances are at higher risk of reoffending than men who do

not abuse substances.

RQ4: Are women involved in domestic violence treatment programs who abuse

substances more likely not to complete treatment than women who do not abuse

substances?

H40: Women involved in domestic violence treatment programs who abuse

substances are not more likely not to complete treatment as compared to those who do not

abuse substances.

H41. Women involved in domestic violence treatment programs who abuse

substances are more likely not to complete treatment as compared to those who do not

abuse substances.

RQ5: Are men involved in domestic violence treatment programs who abuse

substances more likely not to complete treatment than men who do not abuse substances?

H50: Men involved in domestic violence treatment programs who abuse substances

are not more likely not to complete treatment as compared to those who do not abuse

substances.

H51. Men involved in domestic violence treatment programs who abuse substances

are more likely not to complete treatment as compared to those who do not abuse

substances. Chapter 3 contains an overview of the methodology used for this study. This

overview will include the study design, population, sampling method, sample size,

instrumentation, and data analysis methods. Ethical considerations and study limitations

are also described.

Research Design and Rationale

This research used a quantitative approach. Quantitative research provides an

understanding of the relationship between the variables. This quantitative method

involved a comparative non-experimental design that is consistent with the crosssectional

survey method (Edmonds & Kennedy, 2016). A quantitative method is appropriate for

the current research project since the main aim of the study is to measure variables which

in turn explain the issue being studied.

Additionally, the researcher employed a non-experimental quantitative study with

a correlational design to determine if there are relationships between domestic violence

treatment outcomes and substance abuse of adult male and female offenders. A

nonexperimental quantitative methodology with a correlational design is most appropriate

for specific reasons. First, the study includes numerical data that are analyzed to test

hypotheses (McCusker & Gunaydin, 2015). Second, the choice of a nonexperimental

quantitative method with a correlational design ensures research objectivity as the

researcher is separated from the research participants (McCusker & Gunaydin, 2015).

Third, there is no manipulation of independent variables; thus, this study is a

nonexperimental quantitative method with a correlational design (McCusker &

Gunaydin, 2015). Additionally, a nonexperimental quantitative method with a

correlational design is the correct design for the current study because the objective is to

identify and evaluate the relationship between the dependent variables (re-offense and

completing treatment program) and the independent variables (substance abuse).

A quantitative research methodology uses numerical data that allows for statistical

analyses, helps reduce biases, and is based on an objectivity paradigm (Bowers, 2017).

Quantitative research measures include statistical, mathematical, or numerical analyses of

data collected through questionnaires and surveys or by the manipulation of pre-existing

statistical data using computational techniques. A qualitative approach is not appropriate

because the study does not focus on exploring a phenomenon or establishing a theory,

model, or definition (Allwood, 2012). Due to the nature of the research questions posed,

binary logistic regression is the best fit for data analysis for this study. Binary logistic

regression analysis is used to predict a dichotomous dependent variable, re-offense

(yes/no) and treatment completion (yes/no), in this case, based on an independent

variable, substance abuse -yes/no (Mertler & Vannata, 2013). Additionally, binary

logistic regression analysis also determines the overall fit and the relative contribution of

each of the predictors to the total variance explained (Mertler & Vannatta, 2013). In

binary logistic regression, covariates may be added to the model to control for the effects

they may have. Possible covariates that may be considered are age, gender, and

employment status.

Methodology

Population

The population of this study includes domestic violence offenders in treatment in

Fresno County. Adult arrests for domestic violence account for about 60% of all adult

arrests for interpersonal violence in the United States according to the FBI’s National

Incident-Based Reporting System can be used to make the calculation (NIBRS).

Sampling and Sampling Procedures

The researcher utilized a convenience sampling approach to select several

participants for the study. According to Etikan et al. (2016), convenience sampling entails

the recruitment of participants based on the ease with which they can be accessed. As

such, convenience sampling is typically done based on proximity, especially when there

are significant cost and time implications that can only be eased with convenience

sampling. In the current study, convenience sampling allowed the investigator to

randomly select participants until the required sample size is attained. This sampling

strategy was selected because other probabilistic methods such as simple random,

stratified, and cluster sampling are not only costly but also inappropriate.

Before selecting the convenience sampling approach, the researcher considered

several probabilistic sampling techniques particularly designed for quantitative studies.

First, the researcher considered the random sampling approach, which involves initially

obtaining a list of all the members of the target population and blindly selecting a sample

from the list. Generally, simple random sampling allows a researcher to gather the

greatest number of participants, which is necessary when attempting to gain as many

participants as required in quantitative research (Etikan et al., 2016). This sampling

technique means that a researcher makes use of various population-contact methods,

rather than honing the search for a sample toward a specific means (such as emails) that

are often more appropriate for other sampling techniques (such as purposive or snowball

sampling)

Despite its lucrative benefits, particularly of low bias and reduced sampling error,

the random sampling technique was deemed inappropriate for the current study since the

researcher could not obtain a list of all adult offenders of domestic violence in the United

States. Additionally, even if the researcher could have obtained such a list, the list would

probably have been too lengthy thus requiring a significant amount of computational time

and resources currently not at the researcher’s disposal. The population included in the

current study includes only those adult offenders (18 years of age or older) of domestic

violence provided by Domestic Violence Treatment program (Family and Behavior

Intervention Services Inc.) located in Fresno County.

A priori power analysis was conducted using G*Power to determine the required

minimum sample size for the study. Four factors were considered in the power analysis:

significance level, effect size, the power of the test, and statistical technique. The

significance level, also known as Type I error, refers to the chance of rejecting a null

hypothesis given that it is true (Haas, 2012). Most quantitative studies make use of a 95%

confidence level because it adequately provides enough statistical evidence of a test

(Creswell & Poth, 2017). The effect size refers to the estimated measurement of the

relationship between the variables being considered (Cohen, 1988). Cohen (1988)

categorizes effect size into small, medium, and large. Berger, Bayarri, and Pericchi

(2013) purported that a medium effect size is better as it strikes a balance between being

too strict (small) and too lenient (large). The power of a test refers to the probability of

correctly rejecting a null hypothesis (Sullivan & Feinn, 2012). In most quantitative

studies, 80% power is usually used (Sullivan, & Feinn, 2012).

The statistical test to be used for this study is binary logistic regression. The

calculation of a minimum sample size for logistic regression requires previous knowledge

such as the expected odds ratio (effect size), the proportion of observations in either

group of the dependent variable, and the distribution of each independent variable (Faul

et al., 2009: Berman & Silvers, 2016). If these are not known, it is best to use an estimate

to determine the appropriate sample size. Using G*Power, the minimum sample size was

computed by utilizing a medium effect size of OR = 2.47, based on the categorization of

effect sizes by Chinn (2000) who categorized odds ratio into small (OR = 1.44), medium

(OR = 2.47), and large (OR = 4.25). To conduct binary logistic regression to detect a

medium effect size of OR = 2.47, at the 5% level of significance, with 80% power, a

minimum sample size of at least 72 is required. The G*Power output is depicted in Figure

Figure 1

G*Power Output for Minimum Sample Required for Binary Logistic Regression

Procedures for Recruitment, Participation, and Data Collection

Research data was collected from different sources. These included Quarterly

reports from Fresno County Probation, DVI – Domestic Violence Inventory responses

from the participants, and statistics from the domestic violence database on multiple

domestic violence charges. Permission from the Domestic Violence Treatment Program

(Family and Behavior Intervention Services Inc.) was obtained to gain access to the

study data. Additionally, consent was obtained from study participants to use their

responses to the DVI.

The DVI is a multidimensional self-report test that assesses adults with a domestic

violence history. The DVI scales measure six areas: Truthfulness, Violence, Control,

Alcohol, Drug, and Stress Coping Abilities. Administration of the test takes about 30

minutes and is computer-scored. There are 155 true and false and multiple-choice

questions. The DVI is a reliable instrument (Lindeman & Rhanuma, 2011). The

computer-generated scores are available for this study, to ensure the privacy of the

sample identifying information were blacked out. The scores that were used for this study

are the domestic violence scale and alcohol and drug scales. Other information such as

the gender of the participants was used.

Instrumentation and Operationalization of Constructs

As mentioned in the previous section, secondary data provided by the Domestic

Violence Treatment Program includes scores from the Domestic Violence Inventory

(DVI). The DVI is a multidimensional self-report questionnaire that evaluates adults who

have perpetrated domestic violence. The variables measured in the DVI include

Truthfulness, Violence, Control, Alcohol, Drug, and Stress Coping Abilities. However,

this study focused on the independent variable of substance abuse (yes or no) and the

dependent variables of re-offending (yes or no) and completion of treatment (yes or no).

These variables are all measured at the nominal level of measurement and are

dichotomous. Gender was assessed at the nominal level of measurement as either male or

female. Employment status was assessed and measured at the nominal level as either

employed or unemployed. Lastly, age was measured at the interval level of measurement.

The reliability has been tested by the creators of the instrument (DeVon et al.,

2007). Test reliability refers to a scale’s consistency of measurement. Cronbach’s Alpha,

a measure of reliability, was used to measure the internal consistency of each scale. A

generally accepted rule is that α of 0.6-0.7 indicates an acceptable level of reliability and

0.8 or greater is a very good level. Nunnally (1978) recommends a minimum level of .7.

Reliability ranged from .70 - .80 indicating acceptable reliability (Murphy &

Davidshofer, 2001). In testing, the term validity refers to the extent to which a test

measures what it was designed to measure. The DVI exhibited acceptable construct

validity, as individuals known to have more severe problems or symptoms received

higher scale scores than individuals known to have fewer problems or symptoms (DeVon

et al., 2007).

Operationalization

This study utilized the independent variables of substance abuse, measured at the

nominal level of measurement and coded as 0 for no and 1 for yes; Gender, assessed at

the nominal level of measurement as either 0 = male or 1 = female; Employment status

assessed and measured at the nominal level as either 1 = employed or 0 = unemployed

and age was measured at the interval level of measurement. There are two dependent

variables including re-offending (1 = yes or 0 = no) and completion of treatment (1= yes

or 0 = no). These variables are all measured at the nominal level of measurement and are

dichotomous. Table 1 below summarizes the statistical tests, variables, and hypotheses

tested in the data analysis.

Table 1

Hypothesis Summary, Statistical Tests, and Scales of Measurement

Null Hypothesis Statistical Test Independent

Variables/Scale of

Measurement

Dependent

Variable/Scale of

Measurement

H10: Men who abuse

substances are not at higher

risk of reoffending than

men who don’t abuse

substances.

Binary logistic

regression

Substance

abuse/nominal

Age/interval

Employment status

(nominal)

Re-offending

(nominal

dichotomous)

H20: Women who abuse

substances are not at higher

risk of reoffending than

women who don’t abuse

substances.

Binary logistic

regression

Substance

abuse/nominal

Age/interval

Employment status

(nominal)

Re-offending

(nominal

dichotomous)

H30: Men involved in

domestic violence

treatment programs who

abuse substances are not at

higher risk of not

completing treatment as

compared to those who do

not abuse substances.

Binary logistic

regression

Substance

abuse/nominal

Age/interval

Employment status

(nominal)

Treatment

completion

(nominal

dichotomous)

Table 1 (continued)

Null Hypothesis Statistical Test Independent

Variables/Scale of

Measurement

Dependent

Variable/Scale of

Measurement

H40: Women involved in

domestic violence

treatment programs who

abuse substances are not at

higher risk of not

Binary logistic

regression

Substance

abuse/nominal

Age/interval

Employment

status/nominal

Treatment

completion/

nominal

dichotomous

completing treatment as

compared to those who do

not abuse substances.

Data Analysis Plan

Analysis of the resulting quantitative data was conducted using the statistical

software suite Statistical Package for the Social Sciences (SPSS) version 23. The data

were cleaned by examining the dataset for missing data (Field, 2013). If a value is

missing, the entire case was removed from the analysis (listwise deletion). In listwise

deletion, a case is dropped from an analysis because it has a missing value in at least one

of the specified variables. The analysis is only run on cases that have a complete set of

data.

Descriptive statistics of the data for the predictor and dependent variables were

reported. Frequency and percentages summary were obtained for categorical variables

while the measure of central tendencies of means and standard deviations and minimum

and maximum values were conducted for continuous demographic variables, such as age.

To address the research questions, binary logistic regression was conducted to test

the following four models:

(1) For males: logit(Re-offending) = β0 + β1Substance Abuse+ β2Age +

β3Employment Status

(2) For females: logit(Re-offending) = β0 + β1Substance Abuse+ β2Age +

β3Employment Status

(3) For males: logit(Treatment Completion) = β0 + β1Substance Abuse+ β2Age +

β3Employment Status

(4) For females: logit(Treatment Completion) = β0 + β1Substance Abuse+ β2Age +

β3Employment Status

However, before conducting binary logistic regression, some assumptions must be

met. These include linearity between the continuous independent variables and the logit

transformation of the dependent variable, the absence of multicollinearity, and the

absence of significant outliers (Field, 2013). Linearity was tested using the Box-Tidwell

procedure (Field, 2013). To perform the Box-Tidwell procedure, all continuous

independent variables (age) are first transformed into their natural logs. Second,

interaction terms for each of the continuous independent variables and their respective

natural log-transformed variables are created. Third, binomial logistic regression is

carried out with the dependent variables and independent variables as well as the

interaction term. If the interaction term is not significant (p > .05), there is no violation of

the assumption. Multicollinearity was tested by calculating variance inflation factors

(VIF) and any VIF over 9 was considered evidence of multicollinearity (Field, 2013).

Standardized residuals will be calculated to test for outliers. Any residual over 2.0 was

considered an outlier (Field, 2013). Once the assumptions are tested, to explore the

research questions, the independent variables of substance abuse, age, and employment

status were entered into SPSS. The dependent variables of re-offending and treatment

completion was then be entered. Significance was assessed at the 5% level, thus any

pvalue less than or equal to 0.05 was deemed significant.

Threats to Validity

Heale and Twycross (2015) defined validity as the degree to which the constructs

of a study are measured in a quantitative study. The researcher assumes that the study

maintains research validity because the survey adequately measures the constructs of the

DVI. The DVI exhibits acceptable construct validity, as individuals known to have more

severe problems or symptoms received higher scale scores than individuals known to

have fewer problems or symptoms (DeVon et al., 2007). Additionally, the current

research project used a convenience sampling technique in selecting the research

participants. This sampling technique is known for its inability to generalize the research

findings to the population as a whole, thus producing a threat to external validity.

Ethical Procedures

Ethical considerations are an integral part of all research. The Belmont Report

(U.S. Department of Health and Human Services, 1979) describes the ethical

considerations researchers must address. Researchers must protect vulnerable participants

and adhere to respect for persons, autonomy, justice, and beneficence. The study

employed convenience nonprobability sampling and the data collected did not include

any personally identifying information. The data collected did not include any names, IP

addresses, or emails of the participants. The data was downloaded to a secure,

passwordprotected personal computer.

The researcher adhered to respect for persons by ensuring that no personally

identifiable information is collected. If the results did contain any such data, it was

stripped by the researcher before data analysis. The researcher conformed to autonomy by

ensuring that individuals voluntarily participate in the study without being coerced. The

researcher ensured that no vulnerable participants will be included in the study by

specifying the minimum age of 18 as inclusion criteria. Beneficence was achieved as the

researcher helped safeguard the welfare of participants by obtaining IRB approvals for

the study. The IRB reviewed the study to determine that there is minimal risk to

participants.

Summary

The purpose of this quantitative study is to explore the relationship between

domestic violence treatment outcomes and substance abuse of adult male and female

offenders. Secondary data were utilized from the Domestic violence treatment program

and Fresno County Probation Department to address the following research questions and

corresponding null and alternative hypotheses:

RQ1: How does substance abuse among intimate partners relate to domestic

violence treatment outcomes?

H10: Substance abuse among intimate partners is unrelated to domestic violence

treatment outcomes.

H11: Substance abuse among intimate partners is related to poorer domestic

violence treatment outcomes.

RQ2: Will women in domestic violence treatment programs who abuse substances

be at higher risk of reoffending than women who do not abuse substances?

H20. Women who abuse substances are not at higher risk of reoffending than

women who do not abuse substances.

H21. Women who abuse substances are at higher risk of reoffending than women

who do not abuse substances.

RQ3: Will men in domestic violence treatment programs who abuse substances be

at higher risk of reoffending than men who do not abuse substances?

H30. Men who abuse substances are not at higher risk of reoffending than men

who do not abuse substances.

H31. Men who abuse substances are at higher risk of reoffending than men who do

not abuse substances.

RQ4: Are women involved in domestic violence treatment programs who abuse

substances more likely not to complete treatment than women who do not abuse

substances?

H40: Women involved in domestic violence treatment programs who abuse

substances are not more likely not to complete treatment as compared to those who do not

abuse substances.

H41. Women involved in domestic violence treatment programs who abuse

substances are more likely not to complete treatment as compared to those who do not

abuse substances.

RQ5: Are men involved in domestic violence treatment programs who abuse

substances more likely not to complete treatment than men who do not abuse substances?

H50: Men involved in domestic violence treatment programs who abuse substances are not

more likely not to complete treatment as compared to those who do not abuse substances.

This chapter provided a comprehensive description of the quantitative

correlational research design used for this study. The results and findings from the data

analysis will be presented in Chapter 4, along with the tables and graphics providing the

descriptive results and inferences regarding the underlying connection between the study

variables. Following, the interpretations of the findings are provided in Chapter 5, along

with the study’s limitations, recommendations for future studies, and implications for

positive social change.

Chapter 4: Data Analysis and Results

Introduction

The purpose of this quantitative correlational study was to investigate how

substance abuse among intimate partners relates to domestic violence treatment

outcomes. The research questions that guided this study were:

•RQ1: How does substance abuse among intimate partners relate to domestic

violence treatment outcomes?

•RQ2: Will women in domestic violence treatment programs who abuse substances

be at higher risk of reoffending than women who do not abuse substances?

•RQ3: Will men in domestic violence treatment programs who abuse substances be

at higher risk of reoffending than men who do not abuse substances?

•RQ4: Are women involved in domestic violence treatment programs who abuse

substances more likely not to complete treatment than women who do not abuse

substances?

•RQ5: Are men involved in domestic violence treatment programs who abuse

substances more likely not to complete treatment than men who do not abuse

substances?

The following is a discussion of the study’s population and sample as well as a

demographic description of the sample. Demographic descriptions included frequencies

and percentages for categorical (nominal) variables and mean and standard deviations

measured at the interval level of measurement. Also presented are the testing of

parametric assumptions for the statistical analysis and the results of statistical testing.

This chapter concludes with a discussion of the results of this project.

Descriptive Findings

Demographics

Research data were collected from Quarterly reports from Fresno County

Probation, DVI – Domestic Violence Inventory responses from the participants, and

statistics from the domestic violence database on multiple domestic violence charges.

Permission from the Domestic Violence Treatment Program (Family and Behavior

Intervention Program Inc.) was sought to gain access to the study data. Additionally,

consent was sought from study participants to use their responses. After data collection,

there were a total of N = 76 participants which included 23 (30.3%) females and 53

(69.7%) males. Ages ranged from 21 to 64 years (M = 35.38, SD = 8.72). Most

participants were Hispanic, 40 (52.6%). This was followed by Caucasian, 12 (15.8%);

some other race, 8 (10.5%); Black, 7 (9.2%); Native American, 4 (5.3%); and Asian, 2

(2.6%). Regarding marital status, most were single, 40 (52.6%). Regarding the highest

education level, most participants had a high school education, 23 (30.3%). Tables 2

through 6 provide this information.

Table 2

Gender

Frequency Percent

Female 23 30.3

Male 53 69.7

Total 76 100.0

Table 3

Age

Minimum Maximum M SD

Age 21.0 64.0 35.382 8.7162

Table 4

Race

Frequency Percent

Asian 2 2.6

Black 7 9.2

Caucasian 12 15.8

Hispanic 40 52.6

N/A 3 3.9

Native American 4 5.3

Other 8 10.5

Total 76 100.0

Table 5

Marital Status

Frequency Percent

Divorced 6 7.9

Married 19 25.0

N/A 6 7.9

Separated 4 5.3

Single 40 52.6

Widowed 1 1.3

Total 76 100.0

Table 6

Education Level

Frequency Percent

8th grade or less 4 5.3

College Graduate 3 3.9

General education diploma 8 10.5

High School 23 30.3

N/A 6 7.9

Some College 10 13.2

Some high School 21 27.6

Technical/Vocational school 1 1.3

Total 76 100.0

Study Variables

The independent variables of this study included age, current substance abuse,

and employment status. The two dependent variables included re-offender and treatment

completion. Regarding current substance abuse, 54 (71.1%) stated no use and 18 (23.7%)

stated they currently use substances. Most participants were employed, 47 (61.8%) and

27 (35.5%) were unemployed. Among the participants, 52 (68.4%) did not re-offend, and

24 (31.6%) did re-offend. Lastly, 57 (75.0%) participants did not complete the treatment

program and 19 (25.0%) did complete the program.

Table 7

Current Substance Use

Percent

No 54 71.1

Yes 18 23.7

No response 4 5.3

Total 76 100.0

Table 8

Frequency

Employment Status

Frequency Percent

Not employed 27 35.5

employed 47 61.8

No response 2 2.6

Total 76 100.0

Table 9

Re-Offender

Frequency Percent

No 52 68.4

Yes 24 31.6

Total 76 100.0

Table 10

Completed Treatment

Program

Frequency Percent

No 57 75.0

Yes 19 25.0

Total 76 100.0

Data Analysis Procedures

To address the research questions, binary logistic regressions were conducted to

test the following models:

•Overall model: logit(Re-offending) = β0 + β1Substance Abuse+ β2Age +

β3Employment Status

Stratified by Sex:

•For males: logit(Re-offending) = β0 + β1Substance Abuse+ β2Age +

β3Employment Status

•For females: logit(Re-offending) = β0 + β1Substance Abuse+ β2Age +

β3Employment Status

•For males: logit(Treatment Completion) = β0 + β1Substance Abuse+ β2Age +

β3Employment Status

•For females: logit(Treatment Completion) = β0 + β1Substance Abuse+ β2Age +

β3Employment Status

However, before conducting binary logistic regression, some assumptions must be

met. These included linearity between the continuous independent variables and the logit

transformation of the dependent variable, the absence of multicollinearity, and the

absence of significant outliers (Field, 2018). Linearity was tested using the Box-Tidwell

procedure (Field, 2018). This was accomplished by computing the natural log of age and

entering the interaction term age*LnAge into the regression model. The interaction was

not significant (p > .05) indicating no violation of the linearity assumption (Field, 2018).

Multicollinearity was tested by calculating variance inflation factors (VIF) and any VIF

over 10 was considered evidence of multicollinearity (Field, 2018). There were no VIFs

that exceeded this threshold, thus no issues with multicollinearity. Lastly, standardized

residuals were calculated to test for outliers. There were no standardized residuals over

3.0, thus no issues with outliers (Field, 2018). Once the assumptions were tested, to

explore the research questions, the independent variables of age, substance abuse, and

employment status were entered into SPSS. The dependent variables re-offending and

treatment completion were entered. The regression models were run five times to assess

the relationships between the variables stratified by gender as well as collectively.

Significance was assessed at the 5% level, and any p-value less than or equal to 0.05 was

deemed significant.

Results

This first research question was addressed:

RQ1: How does substance abuse among intimate partners relate to domestic

violence treatment outcomes?

Regarding re-offense, the model was not significant, χ2(3) = 2.845, p = .416. Age, current

substance abuse, and employment status were not significant predictors of re-offense (p >

.05). Table 11 provides this information.

Table 11

Binary Logistic Model of Age, Current Substance Abuse, and Employment Status

Predicting Re-Offence

B S.E. Wald df p OR 95% C.I.for OR

Lower Upper

Age .007 .031 .050 1 .823 1.007 .948 1.070

Current substance use .935 .590 2.512 1 .113 2.548 .801 8.103

Employment status .390 .571 .467 1 .494 1.477 .482 4.527

Constant -1.610 1.186 1.842 1 .175 .200

However, regarding the completion of the program, the model was significant, χ2(3) =

12.429, p = .006. Specifically, employment status was significant (B = 1.765, OR =

5.853, p = .033). People who are employed are 5.853 times as likely to complete the

program as those who are not employed. Table 12 provides this information.

Table 12

Binary Logistic Model of Age, Current Substance Abuse, and Employment Status

Predicting Completion of Treatment Program

B S.E. Wald df p OR 95% C.I.for OR

Lower Upper

Age .034 .036 .914 1 .339 1.035 .965 1.110

Current substance use -2.020 1.110 3.312 1 .069 .133 .015 1.168

Employment status 1.765 .828 4.550 1 .033 5.843 1.154 29.589

Constant -3.340 1.539 4.710 1 .030 .035

The relationship between age, current substance abuse, employment status, and re-

offense was assessed separately for females and males to address RQ 2 and RQ 3. The

second research addressed was:

RQ2: Will women in domestic violence treatment programs who abuse substances

be at higher risk of reoffending than women who do not abuse substances?

The model was not significant, χ2(3) = 1.391, p = .708. None of the predictors were

significant (p > .05). These results are provided in Table 13.

Table 13

Binary Logistic Model of Age, Current Substance Abuse, and Employment Status

Predicting Re-Offence (Women)

B S.E. Wald df p OR 95% C.I.for OR

Current substance use .510 1.481 .119 1 .731 1.666

Lower

.091

Upper

30.366

Age -.051 .095 .289 1 .591 .950 .788 1.145

Employment status 1.232 1.090 1.278 1 .258 3.430 .405 29.046

Constant .171 2.868 .004 1 .952 1.187

The third research question addressed was:

RQ3: Will men in domestic violence treatment programs who abuse substances be

at higher risk of reoffending than men who do not abuse substances?

The model was not significant, χ2(3) = 4.220, p = .239. Although none of the predictors

were significant (p > .05), current substance abuse was marginally significant (B = 1.347,

OR = 3.847, p = .054), indicating that participants were a current substance abuse are

3.847 times likely to re-offend compared with no current substance abuse. These results

are provided in Table 14.

Table 14

Binary Logistic Model of Age, Current Substance Abuse, and Employment Status

Predicting Re-Offence (Men)

B S.E. Wald df p OR 95% C.I.for EXP(B)

Lower Upper

Current substance use 1.347 .701 3.699 1 .054 3.847 .975 15.184

Age .022 .035 .394 1 .530 1.022 .955 1.094

Employment status .098 .717 .018 1 .892 1.102 .270 4.496

Constant -2.344 1.505 2.425 1 .119 .096

The relationship between age, current substance abuse, employment status, and

treatment program completion was assessed separately for females and males to address

RQ4 and RQ5. The fourth research addressed was:

RQ4: Are women involved in domestic violence treatment programs who abuse

substances more likely not to complete treatment than women who do not abuse

substances?

The model was not significant, χ2(3) = 1.850, p = .604. Age, current substance

abuse, and employment status were not significant predictors of treatment program

completion (p > .05). Table 15 provides this information.

Table 15

Binary Logistic Model of Age, Current Substance Abuse, and Employment Status

Predicting Completion of Treatment Program (Female)

B S.E. Wald df p OR 95% C.I.for EXP(B)

Lower Upper

Current substance use -19.255 22929.608 .000 1 .999 .000 .000 .

Age -.072 .118 .364 1 .546 .931 .738 1.174

Employment status .916 1.380 .441 1 .507 2.499 .167 37.359

Constant .240 3.488 .005 1 .945 1.271

The fifth research question addressed was:

RQ5: Are men involved in domestic violence treatment programs who abuse

substances more likely not to complete treatment than men who do not abuse substances?

The model was significant, χ2(3) = 13.675, p = .003. Current substance abuse was

marginally significant (B = -2.279, OR = 0.102, p = .054), indicating that participants

with current substance abuse are less likely to complete treatment compared with no

current substance abuse. Additionally, those participants who are employed are 13,571

times more likely to complete the treatment program compared to those who are not

employed (B = 2.608, OR = 13.571, p = .030). Table 16 provides this information.

Table 16

Binary Logistic Model of Age, Current Substance Abuse, and Employment Status

Predicting Completion of Treatment Program (Male)

B S.E. Wald df p OR 95% C.I.for OR

Lower Upper

Current substance use -2.279 1.185 3.701 1 .054 .102 .010 1.044

Age .050 .042 1.402 1 .236 1.051 .968 1.142

Employment status 2.608 1.202 4.708 1 .030 13.571 1.287 143.097

Constant -4.358 2.139 4.150 1 .042 .013

Summary

The purpose of this quantitative correlational study was to investigate how

substance abuse among intimate partners relates to domestic violence treatment

outcomes. The research questions that guided this study were:

•RQ1: How does substance abuse among intimate partners relate to domestic

violence treatment outcomes?

•RQ2: Will women in domestic violence treatment programs who abuse substances

be at higher risk of reoffending than women who do not abuse substances?

•RQ3: Will men in domestic violence treatment programs who abuse substances be

at higher risk of reoffending than men who do not abuse substances?

•RQ4: Are women involved in domestic violence treatment programs who abuse

substances more likely not to complete treatment than women who do not abuse

substances?

•RQ5: Are men involved in domestic violence treatment programs who abuse

substances more likely not to complete treatment than men who do not abuse

substances?

Regarding the first research question, age, current substance abuse, and

employment status were not significant predictors of re-offense However, regarding

completion of the program, employment status was significant (B = 1.765, OR = 5.853, p

= .033). People who are employed are 5.853 times as likely to complete the program as

those who are not employed. Regarding the second research question, women in domestic

violence treatment programs who abused substances were not at higher risk of

reoffending than women who did not abuse substances. Regarding men (RQ3), current

substance abuse was marginally significant (B = 1.347, OR = 3.847, p = .054), indicating

that participants who had current substance abuse are 3.847 times more likely to reoffend

compared with no current substance abuse. Regarding treatment completion for women

(RQ4), age, current substance abuse, and employment status were not significant

predictors of treatment program completion. Regarding treatment completion for men

(RQ 5), participants with current substance abuse are less likely to complete treatment

compared with no current substance abuse. Additionally, those participants who are

employed are 13.571 times more likely to complete the treatment program compared to

those who are not employed (B = 2.608, OR = 13.571, p = .030).

What follows in Chapter 5 is a discussion of how the results of this study are

interpreted in the context of the theoretical framework. Any limitations of the results of

the study will be provided. Additionally, recommendations for future research will be

discussed.

Chapter 5: Summary, Conclusions, and Recommendations

Introduction

Chapter 5 presents a discussion of the results of this study, their implications, and

how they are interpreted in the context of the theoretical framework. Limitations of the

study are discussed. Further, implications for social change, recommendations for

practice, and future research are discussed.

The problem addressed in this research is that little is known about how domestic

violence treatment outcomes are related to substance abuse among intimate partners. The

study aimed to fill the current gap in the literature relating to the extent to which DV

treatment outcomes influence or are influenced by substance abuse among intimate

partners (Pérez & Ruiz, 2017). To fill the gap in research, the study sought to investigate

how substance abuse among intimate partners relates to domestic violence treatment

outcomes, including reoffending and treatment completion. There was the need,

therefore, to explore the relationship between substance abuse and domestic violence

treatment outcomes. This study seeks to offer valuable information to researchers,

scholars, and stakeholders who may use it in the criminal justice system to understand

better the link between substance abuse and domestic violence treatment outcomes

among intimate partners. Further, this information may impact the criminal justice system

and the relevant DV treatment programs.

In this study, the researcher used quantitative methodology because the intent was

to test research hypotheses relating to the extent to which substance abuse among

individuals in DV treatment relates to DV treatment outcomes. The resulting quantitative

data was analyzed using the statistical software suite Statistical Package for the Social

Sciences (SPSS) version 23. Descriptive statistics of the data for the predictor and

dependent variables were reported. Frequency and percentage summaries were obtained

for categorical variables, while the scale measure was conducted for continuous

demographic variables, such as average age .

Results of the current research demonstrated that age, substance abuse, and

employment status did not significantly predict re-offense. However, employment status

was a significant predictor of completion of the treatment programs such that employed

people are more likely to complete the programs than unemployed people.

Surprisingly, in this study, women in domestic violence treatment programs who

abused substances were less likely to re-offend than those who did not engage in

substance abuse. The difference could have been influenced by the underlying trauma the

women have as well as the availability of social support networks that can support

women in overcoming re-offending behaviors. Other than having social support

networks and underlying impacting intention to re-offend, motivation to change may also

influence re-offense among women in violence treatment programs. Men who abused

substances were more likely to re-offend than men without current substance abuse. Age,

current substance abuse, and employment status were not significant predictors of

treatment completion for women. Men with current substance abuse were less likely to

complete treatment programs than those without current substance abuse. The study

indicates that employed individuals are more likely to complete treatment programs than

those who are unemployed.

Interpretation of the Findings

The interpretation of findings was discussed based on each research question as

described below.

RQ1: How does substance abuse among intimate partners relate to domestic

violence treatment outcomes?

Although current substance abuse, age, and employment status were not

significant predictors of re-offence, results further demonstrated that employment status

was a significant predictor of the completion of the treatment program. The findings

imply that employed people are more likely to complete domestic violence treatment

programs than those who are not employed. Past research indicates that age influences

the willingness of an individual to be remorseful of their past domestic violence and

refrain from future violence, such that older offenders are more likely to be remorseful

than youth who would be more likely to blame situations for their domestic violence and

continue engaging in IPV even after enrolling in substance use programs (Wilsnack et al.,

2018). It suggests that age plays an essential role in determining substance use treatment

program adherence response among individuals.

Unlike current study findings that current substance abuse, age, and employment

status were not significant predictors of re-offense, previous research indicates a direct

link between age, substance abuse, and re-offense (Sullivan, 2018). Sullivan (2018)

established a direct relationship between domestic violence among individuals abusing

drugs and their likelihood of engaging in domestic violence again. Lilley-Walker et al.

(2018) also revealed that young people were three times more likely to engage in

domestic violence while on substance use treatment programs compared to older people.

The previous research findings by Lilley-Walker et al. (2018) and Sullivan (2018)

contradict the current study findings that substance abuse and age had no significant link

with re-offending in domestic violence. The discrepancy in findings could be because of

the different sample sizes, as the current study used a small sample size which may limit

the generalizability of findings.

On the other hand, the current study findings agree with other past studies stating

that people with employment complete violence treatment programs at a higher rate

compared to those without employment. Consistent with this finding, previous empirical

studies indicate that employed individuals were three times less likely to engage in

domestic violence because they could afford to pay essential bills. Similar to the current

study findings, a report by Raj and Shankar (2017) established that unemployed

individuals were motivated to engage in substance abuse, domestic violence, and

noncompliance with treatment programs. Unemployed individuals engage in such

behaviors due to stress and economic strain, loss of identity and self-esteem as well as a

sense of hopelessness and lack of future orientation (Raj and Shankar (2017) McKee and

Hilton (2019) found that substance abusers had a low probability of engaging in treatment

programs because they found it difficult to pay for their basic needs, such as house rent or

buying food, leading to substance abuse and limited adherence to treatment programs.

Agreeing with current study findings, previous literature highlights that the frustration

attached to lack of employment could lead to offenders engaging in domestic violence,

substance abuse, and nonadherence to treatment programs (Armstrong et al., 2019). The

findings contributed to previous research by indicating that employment significantly

predicts adherence to domestic violence treatment programs.

RQ2: Will women in domestic violence treatment programs who abuse

substances be at higher risk of re-offending than women who do not abuse substances?

The findings indicated that women who abused substances were less at risk of

reoffending compared to women without substance abuse. These results imply that

women who engage in substance abuse were not as likely to re-offend as the women who

do not engage in substance abuse. However, in their research, McKee and Hilton (2019)

found that IPV among women with substance abuse was higher than those without

substance abuse who are less likely to re-offend. Involvement in IPV predicts substance

abuse problems among women and poor domestic violence treatment response by the

offenders enrolled in treatment programs (Manuel et al., 2017). The current study

findings are discrepant from what previous research has found. This may be due to the

small sample of women in this research or to other unknown factors. Further research

could help to clarify the role current substance abuse plays in DV re-offending among

females.

RQ3: Will men in domestic violence treatment programs who abuse substances

be at higher risk of re-offending than men who do not abuse substances?

While no predictors were significant in predicting re-offence among men who

abuse substances, men with current substance abuse were more likely to re-offend than

those without. The results suggest that current substance abuse among men is likely to

contribute to re-offenses compared to men who do not have current substance abuse.

Similar to the current study results, past research highlighted that IPV is directly linked to

substance abuse, whereby men who abuse substances could become violent and threaten

the other person's safety again (Habigzang et al., 2018). To respond to an increase in

domestic violence among men, as current study findings indicate, other studies have

suggested different interventions to target substance use in men with a history of IPV

(McKee & Hilton, 2019). In support of current study findings, Geyen and Bailey (2021)

established that most males who engaged in IPV abused drugs even after enrolling in

treatment programs. Wichaidit and Assanangkornchai (2020) also reported that IPV is

linked to alcohol use even if the aggressor is enrolled in a treatment program, indicating

that IPV is related to substance use among re-offending men. The study results add to the

previous research by establishing that men in this study with current substance abuse were

likelier to re-offend than men without current substance abuse.

RQ4: Are women involved in domestic violence treatment programs who abuse

substances more likely not to complete treatment than women who do not abuse

substances?

Research findings indicated that employment status, age, and current substance

abuse were not significant predictors of treatment program completion among women.

The findings imply that age, substance abuse, and employment status of women did not

predict their completion of treatment programs. Contrary to the current study results,

other studies indicate a significant association between violence treatment programs and

age, employment, and current substance abuse. Bernardi and Steyn (2019) found that

most individuals, especially women enrolled in IPV treatment programs, were more

likely to engage in domestic violence against their partners to shield their incapability to

provide for their families because of lack of employment. The current study results are in

contrast to Mancera et al.’s (2018) findings, which found that lack of financial resources

for drug addicts accused of IPV increased their likelihood of engaging in domestic

violence again and non-compliance with treatment. Giarratano et al. (2020) also stated

that other social factors that may cause stress to individuals include financial burden,

which may increase their engagement in domestic violence.

The current research found that employment did not significantly impact

adherence to domestic violence treatment programs. On the one hand, previous literature

indicates that women who receive limited social support may feel socially alienated or

socially disenfranchised and this may lead them to become involved in substance abuse

(Cafferky et al., 2018). These findings add to the previous literature by revealing that

women's age, substance abuse, and employment status did not predict domestic violence

treatment program completion.

RQ5: Are men involved in domestic violence treatment programs who abuse

substances more likely not to complete treatment than men who do not abuse substances?

The results demonstrated that current substance abuse was a significant predictor of not

completing violence treatment programs among men. As per the findings, men with

current substance abuse are less likely to complete treatment compared to those with no

current substance abuse. Further, the findings revealed that employed people are more

likely to complete domestic violence treatment programs than those who are not

employed. The result implies that employment and substance abuse predict the

completion of domestic violence treatment programs such that those who engage in

substance abuse are less likely to complete treatment programs than those who do not.

The findings are consistent with Telles et al. (2020), who established a link between

substance use, domestic violence, and adherence to substance treatment programs

Previous studies indicated that a person's likelihood to engage again in domestic violence

depends on their ability to complete substance abuse treatment programs (Armstrong et

al., 2019). In this regard, the noncompletion of substance use treatment programs among

men significantly increased the risk of engaging again in domestic violence (Easton et al.,

2018).

In addition, the current study indicates that men with employment are more likely

to complete treatment programs than those unemployed. However, the findings failed to

indicate whether employment has an impact on women completing treatment programs.

This may be because of the small sample size used in this research or other factors such

as fewer women are employed because they are taking care of children or other family

members, so they have family responsibilities instead of employment. The results support

Mancera et al.’s (2018) findings indicating that socioeconomic status, such as

employment income, influences human life and functioning, including physical and

mental health, and lack of employment contributes to non-adherence to domestic violence

treatment programs. Curry et al. (2018) demonstrated that the prevalence of domestic

violence correlates with low economic status, including unemployment, which can lead to

a lack of adherence to treatment programs. As a result, unemployed and substanceabusing

individuals are more likely to disengage from substance abuse and domestic violence

treatment programs than those employed and with higher socioeconomic status (Wilsnack

et al., 2018). People in domestic violence treatment programs need employment because

it is particularly important for them to have an income source to support their needs (Raj

& Shankar, 2017).

In contrast to the current study findings, Geyen and Bailey (2021) found that

reoffending among offenders registered for substance treatment programs depended on

individual factors such as personal behaviors and substance abuse had no impact on their

engagement in domestic violence treatment programs. Others, such as Peacock et al.

(2017), also indicate a direct link between adherence to substance use and domestic

violence treatment programs and employment status among men who abuse substances.

Limitations of the Study

The study is limited by scope because the study was conducted in one

geographical setting. Using one location will limit the generalizability of the study

findings to other geographical locations and populations. This study was also limited by

research design. A quantitative correlational study design was used in the current study in

data collection, and no other research methodology was used. Limiting research to only

statistical data eliminated further information that may have been received from

participants through in-depth interviews.

Quantitative studies are more effective, and the findings are more reliable when a

large sample size is adopted (Winter, 2000). However, this study was limited by the

sample size. A small sample size was used because the researcher had to complete the

study within a pre-defined period. Such time restrictions negatively affected the study

outcomes because most predictors were not found to predict treatment completion and

reoffense, particularly among women in violence treatment programs.

The study was limited to archival data. With archival data, one can only use the

data that is already collected and cannot ask other questions that one might wish to ask if

it were up to them to seek clarity of the information provided in the archival data.

Another limitation of the study was related to funding. Being an academic study,

there was an issue with its funding. Limited funding negatively impacted the research

process because the researcher had to finance different processes, such as transportation

costs from one place to another, which were vital to the study's results. To mitigate this

limitation, the researcher used personal savings and gifts from family members to finance

the research process.

The last limitation of the study related to the researcher’s novice data collection

and analysis skills. Notably, this was the first formal research the researcher ever

conducted. As a result, limited skills in conducting surveys, interacting with participants,

and conducting data analysis using statistical software limited the thoroughness of the

study results. However, to address this problem, the researcher took part in data

collection and analysis training programs.

Recommendations

Several recommendations were discussed, including recommendations for further

research and recommendations for practice.

Recommendations for Future Research

The geographical setting limited the study. The population of this study included

domestic violence offenders in treatment in Fresno County. Based on this limitation, the

researcher recommends that more studies be conducted in different settings to enhance

the generalizability of the study outcomes. Additional study locations and settings could

improve the reliability and generalization of the findings to different locations and

populations.

This study was limited to a quantitative correlational design used in the current

study in data collection. Limiting research to only statistical data eliminated further

information that may have been received from participants through interviews. As a

result, there is a need for further research to use qualitative research design to collect

views and perceptions of participants about the lived experience of substance abusers in

domestic violence treatment programs. Qualitative research exploring participants' lived

experiences in DV treatment might yield ideas that could lead to improvement in DV

programs. Also, it would be particularly valuable to study because female offenders in

domestic violence treatment programs do not appear to respond like males. Females in

this study were not more likely to engage in repeated domestic violence if they continued

to abuse substances, nor were they more likely to complete treatment if employed, and

we do not understand why this is.

Quantitative studies require large data samples for the effectiveness and reliability

of study findings (Winter, 2000). However, this study was limited by the small sample

size because the researcher had access to a particular domestic violence program and

needed to complete the study within a pre-defined period. More research using a larger

sample and multiple locations could improve the reliability and generalizability of the

findings.

Further research should be conducted to explore the relationship between

substance abuse and women in domestic violence treatment programs. The results of this

study found some unexpected gender differences. Women who abused substances had a

lower rate of re-offending than those who were not current substance abusers, while men

who abused substances had a higher rate of re-offending than those who did not. Also,

men who did not abuse substances had a higher rate of treatment completion than men

who did abuse substances, while there was not a significant difference among women. All

the variables of age, substance abuse, and employment should be investigated to

determine how they impact women and men in domestic violence treatment programs

using a larger sample size. There may be some differences in how men and women use

and respond to treatment which would be useful for treatment providers to better

understand so programs could be developed with these issues in mind.

Recommendations for Practice

It is recommended establishing and implementing community mentorship

programs to support people developing healthier relationships with reduced IPV. These

programs would create awareness among couples and families of the importance of

peaceful and healthier relationships. Cafferky et al. (2018) stated that IPV needs the

consideration of both the treatment community and the criminal justice system. This can

also be affected by creating awareness about healthier relationships. Healthier

relationships may be void of substance abuse and domestic violence among partners in

the community. Peacock et al. (2017) established that both genders, men, and women

engage in violent acts because of the influence of their substance abuse, thus healthier

relationships are void of such acts.

I would also recommend creating and implementing domestic violence treatment

programs that address both substance abuse and domestic violence. There are offenders

who may be rehabilitated through effective treatment that reduces substance use and

domestic violence among families in the community. Community partners such as local

authorities should mentor families about disengaging from substance abuse. Peterson et

al. (2018) found that substance abuse treatment programs may positively reduce the IPV

prevalence rate in the community.

Researchers and scholars are also recommended to use the study findings as a

point of reference to determine further the strategies to reduce domestic violence in

couples and families. It would be useful to focus on whether males and females are

affected differently by victimization or perpetration of domestic violence and the

relationship substance abuse has to this. Future research might focus on the relationship

between substance violence and family violence and how treatment can be designed to

most effectively address both problems.

Implications

The study’s implications were described as implications for positive social change

and theoretical implications, as discussed below.

Implications for Positive Social Change

The research findings provide several contributions to positive social change. In

particular, the findings provide critical insight to address substance abuse and its

association with domestic abuse treatment results. The study findings offer valuable

information that researchers, scholars, and stakeholders can use in the criminal justice

system to understand better the link between substance abuse and domestic violence

treatment outcomes among intimate partners. The study results may also impact the

criminal justice system and the relevant DV treatment programs that would understand

the effect of substance abuse and employment on domestic violence.

Intimate partners can also use these findings to understand the need to abstain

from substance abuse for strong, healthier relationships devoid of domestic violence. The

results may also help intimate partners with domestic violence problems to comprehend

the importance of engaging and completing violence treatment programs. Domestic

violence treatment programs are significant in providing IPV-targeted programs that

reduce IPV rates against intimate partners (Spencer et al., 2019).

The government may use the study findings to establish and adopt rehabilitation

centers for treating domestic violence victims and perpetrators. Victims and offenders in

domestic violence treatment programs may be rehabilitated through effective treatment

that reduces substance use and intimate partner violence. Reducing domestic violence and

IPV may lead to positive growth in the community because people are more likely to

develop positive, healthier relationships with reduced IPV among intimate violence.

Theoretical Implications

Regarding theoretical contribution, the study adopted two theories: the cycle of

violence theory and social exchange theory. According to Manuel et al. (2017), the cycle

of violence theory identifies three stages of violence. The theory emphasizes that violence

occurs through three stages, namely the tension-building phase, violent episode, and

remorseful and honeymoon stage. The study findings provide a key contribution to

practice by providing greater insight into what can impact substance abuse among

intimate partners and adherence to domestic treatment outcomes to reduce the prevalence

of IPV. The findings indicated that engaging in substance abuse contributes to the lack of

DV treatment participation and that employment affects treatment program completion.

The implication is that study findings are consistent with the cycle of violence theory by

revealing how engaging in substance abuse impacts treatment program completion as the

theory emphasizes that the occurrence of violence happens through three stages including

the tension-building phase contributing to substance abuse violent episode leading to

domestic violence, and remorseful and honeymoon stage enhanced by the completion of

treatment.

The study also adopted the social exchange theory, based on the premise that

individuals can evaluate their social relations' risks and benefits (Geyen & Bailey, 2021).

In this theory, individuals minimize risks by engaging in positive behaviors. The theory

helps understand substance abuse patients' behaviors and intentions to commit and avoid

violence against partners after enrolling in a treatment program (Gilchrist et al., 2019). As

a result, study findings support this theory by indicating that negative behaviors, such as

substance abuse, result in domestic violence, while positive behaviors, such as engaging

in and completing violent treatment programs, contribute to reduced IPV rates.

Transportation and money can be a complicated factor in domestic violence

treatment because victims of domestic violence face challenges in accessing treatment

services. The limited movement can prevent domestic violence survivors especially those

in rural areas with sparse populations, and transportation networks, from accessing

medication, guiding and counselling sessions as well as seeking shelter away from the

perpetrator. This contributes to increased violence against the victim by the abuser.

Further, domestic violence increases financial dependence due to economic abuse of the

victims which limits them from accessing safe shelter and affords the cost of

transportation to the treatment center and safe housing as they may lack money to incur

the related costs. The challenges indicate the need for financial support to the victims to

provide solutions including help in their movement to seek treatment and shelter to make

sure that the domestic violence survivors can access the requisite resources to enhance

their recovery. The lack of money among the victims can limit their access to counselling

sessions due to the inability to incur transportation costs, while a sparse transportation

network prevents the survivors from accessing treatment and counselling centers, making

transportation and money, a complicated factor.

Conclusion

This study aimed to fill the research gap about how DV treatment and substance

abuse among domestic violence offenders are related. The current research examined

how substance abuse among intimate partners relates to domestic violence treatment

outcomes. This study sought to offer valuable information to researchers, scholars, and

stakeholders who may use it in the criminal justice system to understand better the link

between substance abuse and domestic violence treatment outcomes among intimate

partners. The research may provide valuable information for the criminal justice system

and the relevant DV treatment programs to use to develop more effective strategies to

reduce DV in the community. Employment status influences the completion of treatment

programs such that employed people are more likely to complete the programs than those

who are unemployed.

The study suggests that women in domestic violence treatment are less influenced

by substance abuse in their completion of treatment programs. However, men are more

affected by substance abuse in completing treatment programs, such that men who

currently abuse substances are less likely to complete treatment. The study provides

valuable insight into how employment significantly impacts treatment program

completion because employed individuals are more likely to complete treatment

programs than those unemployed. The results provide significant information to the

stakeholders in the criminal justice systems and rehabilitation organizations to understand

the impact of substance abuse and employment status on the offenders and victims of

DV. Further research can extend these findings by determining the most effective

strategies to reduce substance abuse and IPV in the communities.

The Relationship Between Domestic Violence and Substance Abuse Treatment Outcomes

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