QuickGuide ForClinicians

BasedonTIP25 SubstanceAbuseTreatment andDomesticViolence

Contents WhyaQuickGuide? .................... 2

WhatisaTIP?......................... 3

Introduction........................... 4

ScreeningforSurvivors ................. 6

TreatmentPlanningforSurvivors ......... 9

IssuesofChildAbuse orNeglect ........ 18

ScreeningTechniquesandQuestions

forBatterers ......................... 20

TreatmentPlanningforBatterers ........ 22

ReferralandLinkages ................. 24

LegalIssues ........................ 28

Phone andInternetResources .......... 31

QuickGuide ForClinicians

BasedonTIP25 SubstanceAbuseTreatment andDomesticViolence

ThisQuickGuide isbasedalmostentirelyoninformationcontainedinTIP25,publishedin1997andbasedoninformation updatedthroughJune 1996.No additionalresearchhasbeen conductedto update thistopicsince publicationofthe original TIP.

2 SubstanceAbuse Treatmentand DomesticViolence

WHYAQUICKGUIDE?

This Quick Guide was developed to accompany Substance Abuse Treatment and Domestic Violence, Number 25 in the Treatment Improvement Protocol (TIP) Series published by the Center for Substance Abuse Treatment (CSAT), Substance Abuse and Mental Health Services Administration. This Quick Guide is based entirely on TIP 25 and is designed to meet the needs of the busy clinician for concise, easily accessed "howto" information.

The Guide isdividedinto eightsections(see Contents).These sectionswillhelpreadersquicklylocate relevantmaterial.

Clinicianscanuse the Resources onpage 31to keepupdatedwithcurrentinformationonthe mostrecentdevelopmentsinthe fieldofdomestic violence.

Formore informationonthe topicsinthisQuick Guide,readersare referredto TIP25.

3 WhatisaTIP?

WHATISATIP?

The TIP series has been in production since 1991. This series provides the substance abuse treatment and related fields with consensusbased, fieldreviewed guidelines on substance abuse treatment.

TIP25,SubstanceAbuseTreatmentandDomestic Violence:

Addressesthe concernsofabroadrange of readersincludingsubstance abuse treatment clinicians,domesticviolence programs,social workers,medicalpersonnel,programadministrators,andpolicymakers

Includesextensive research

Lists numerous resources for further information

Providesareference forsubstance abuse treatmentcliniciansworkingwithadultswho have experienceddomesticviolence

Seetheinsidebackcoverforinformationonhow to orderTIPsandotherrelatedproducts.

4 SubstanceAbuse Treatmentand DomesticViolence

INTRODUCTION

Domesticviolence isthe use ofintentionalemotional,psychological,sexual,orphysicalforce by one familymemberorintimate partnerto control another.Researchershave found thatonefourth to one halfofmenwho commitactsofdomestic violence have substance abuse problems.While domesticviolence affectsavarietyofpopulations, thisQuickGuide onlydiscussesthe treatmentof adultmale batterersandadultfemalesurvivors.

TheConnectionsBetweenSubstanceAbuse andDomesticViolence Substance abuse doesn't"cause"domesticvio

lence.

Itmayafflictbothbatterersandsurvivors.

Failure to addressdomesticviolence mayinterfere withtreatmenteffectiveness.

Asubstance abusingwomanmayfindherabusive partnerbecomesangrywhenshe seeks help,andhisviolence couldpushherto drop outoftreatment.

Some batterersare worse domesticviolence offenderswhentheyare soberso partnersof suchbatterersmaytryto subverttreatment efforts.

5 Introduction

Goals Attainingsobriety

Ensuringsurvivors'safety

CreateLinkages To effectlastingchange,people workinginboth fieldsmustrecognize the importance ofholistic treatmentandlearnto collaborate onthe client's behalf.ThisQuickGuide presentspertinentinformationonholistictreatmentofdomesticviolence situationssubstance abuse treatmentclinicians willneed.Thiswillinclude creatinglinkageswith groupspertinentto aclient'srecovery,including:

Domesticviolence programs

Healthcare communities

The criminaljustice system

Schoolsandeducationalinstitutes

Employers

Socialwelfare

ATTENTION: Due to the highcorrelationbetween the two problems,allclientswho presentforsubstance abuse treatmentshouldbe questioned aboutdomesticviolence.

Formoredetailedinformation,seeTIP25,pp.xiiixix.

6 SubstanceAbuse Treatmentand DomesticViolence

SCREENINGFORSURVIVORS

CAUTION: Itisimportantnotto askpotentially painfulquestionstoosoon;otherwise,aclientmay feeloverwhelmedandreluctantto return.

CluesfortheTreatment Provider Physicalinjuriesaroundthe face,neckand

throat

Inconsistent/evasive answerswhenquestioned aboutinjuries

Ahistoryofrelapse ornoncompliance withsubstance abuse treatment

Stressrelatedillnessandconditions

Complicationsinpregnancy

The wayinwhichaclientdescribesherpartner's treatmentofhercanalso be aclue to possible domesticviolence.Doeshe:

,solate her?

)orce herto selldrugs?

+armotherfamilymembersorpets?

7hreatento hurther,himselforothers?

7 ScreeningforSurvivors

Childabuse isalso aclue.Researchindicatesthat afatherwho abuseshischildrenoftenabuseshis wifeaswell.

ALERT: Survivorsare oftenreluctantto disclose the amountofviolence intheirlives.

CrisisInterventionWhenawomaninformsstaffshe isavictimof domesticviolence,providersshould:

Ensurehersafety: Whetheraclientisentering inpatientoroutpatienttreatment,the immediate physicalsafetyofherenvironmentmustbe ofchiefconcern.Ifinpatient,securitymeasures shouldbe intensified;ifoutpatient,asafetyplan shouldbe developed.

Assurehersheisbelieved: Reinforcementof the counselor'sbeliefofasurvivor'svictimizationisacriticalcomponentofongoingemotionalsupport.Affirmingthe survivor'sexperience helpsempowerherto participate inimmediate problemsolvingandlongertermtreatment planning.

Identifyheroptions: Treatmentproviders shouldaskthe survivorto identifyheroptions, share informationthatwouldexpandher

8 SubstanceAbuse Treatmentand DomesticViolence

options,andsupportherindevisingasafety plan.

Evaluatehealthconcerns,includinganyneed fordetoxification.

Attendtoanythingthatmayinterrupttheinitiationoftreatment.

Formoredetailedinformation,seeTIP25,pp.911,pp.3842.

9 TreatmentPlanningforSurvivors

TREATMENTPLANNINGFORSURVIVORS

SafetyFrom theBatterer In the early stages of treatment, the substance abuse counselor should help the client develop a safety plan by referring her to a domestic violence service provider. It is also important to address the batterer's reaction to his partner being in treatment and minimize the client's risk of harm in order for her to more easily continue her treatment.

SafetyTipsforSurvivorsandTheirFamilies The followingpagescontaintipsthatcanbe relayedto survivorsandtheirfamiliesto helpkeep themsafe frombatterers. The followingsixpages are reprintedwithpermissionfromthe American BarAssociation(see resourcessectionformore information).

InanHmergencyIfyou are athome andyou are beingattacked:

Stayawayfromthe kitchen(the abusercanfind weaponsthere,suchasknives).

Stayawayfrombathrooms,closetsorsmall spaceswhere the abusercantrapyou.

Getto aroomwithadoororwindowto escape.

10 SubstanceAbuse Treatmentand DomesticViolence

Getto aroomwithaphone to callforhelp;lock the abuseroutsideifyou can.

Call911(or yourlocalemergencynumber)right awayforhelp;getthe dispatcher'sname.

Thinkaboutaneighbororfriendyou canrunto forhelp.

Ifapolice officercomes,tellhim/herwhathappened;gethis/hername andbadge number.

Getmedicalhelpifyou arehurt.

Take picturesofbruisesandinjuries.

Calladomesticviolence programorshelter (some are listedatthe endofthisdocument); askthemto helpyou make asafetyplan.

Howto protectyourselfathome Learnwhere to gethelp;memorize emergency

phone numbers.

Keepaphone inaroomyou canlockfromthe inside;ifyou can,getacellularphone thatyou keepwithyou atalltimes.

Ifthe abuserhasmovedout,change the locks onyourdoor;getlocksonthe window.

Plananescape route outofyourhome;teachit to yourchildren.

Thinkaboutwhere you wouldgo ifyou needto escape.

TreatmentPlanningforSurvivors 11

Askyourneighborstocallthe police iftheysee the abuseratyourhouse;make asignalfor themto callthe police;forexample,ifthe phoneringstwice,ashade ispulleddownora lightison.

Packabagwithimportantthingsyou'dneedif you have toleave quickly,putitinasafe place, orgive itto afriendorrelative youtrust.

Include cash,carkeysandimportantinformationsuchas:courtpapers,passportorbirth certificate,medicalrecordsandmedicines, immigrationpapers.

Getanunlistedphone number.

BlockcallerID.

Use anansweringmachine;screenthe calls.

Take agoodselfdefense course.

Howto makeyourchildrensafer Teachthemnotto getinthe middle ofafight,

eveniftheywantto help.

Teachthemhowto getto safety,to call911,to give youraddressandphone numberto the police.

Teachthemto callforhelp.

Tellthemto stayoutofthe kitchen.

12 SubstanceAbuse Treatmentand DomesticViolence

Give the principalatschoolor daycare centera copyofyourcourtorder;tellthemnotto release yourchildrentoanyonewithouttalkingto you first;use apassword so theycanbe sure itis you onthe phone;give themaphoto ofthe abuser.

Make surethe childrenknowwho to tellat schooliftheysee the abuser.

Make surethe schoolknowsnotto giveyour addressorphone numberto anyone.

Howto protectyourselfoutsidethehome Change yourregulartravelhabits.

Tryto getrideswithdifferentpeople.

Shopandbankinadifferentplace.

Cancelanybankaccountsorcreditcardsyou shared;opennewaccountsatadifferentbank.

Keepyourcourtorderandemergencynumbers withyou atalltimes.

Keepacellphone andprogramitto 911(or otheremergencynumber).

Howto makeyourselfsaferatwork Keepacopyofyourcourtorderatwork.

Give apicture ofthe abuserto securityand friendsatwork.

TreatmentPlanningforSurvivors 13

Tellyoursupervisorseeifhe orshe canmake itharderfortheabusertofindyou.

Don'tgo to lunchalone.

Askasecurityguardto walkyou to yourcaror to the bus.

Ifthe abusercallsyou atwork,save yourvoice mailandsave email.

Youremployer maybe able to helpyou find communityresources.

Usingthelawtohelpyou

Protectionorrestrainingorders Askyourlocaldomesticviolence programto

helpyou getacivilprotectionorderandto help you withcriminalprosecution.

Askforhelpfindingalawyer.

Inmostplacesthejudgecan: Orderthe abuserto stayawayfromyou andyour

children.

Orderthe abuserto leave yourhome.

Give you temporarycustodyofyourchildrenand orderthe abuserto payyou temporarychild support.

Orderthe police to come to yourhome while the abuserpicksuppersonalbelongings.

14 SubstanceAbuse Treatmentand DomesticViolence

Give you possessionofthe car,furniture and otherbelongings.

Orderthe abuserto go to abatterers'interventionprogram.

Orderthe abusernotto callyou atwork.

Orderthe abuserto give gunsto the police.

Ifyou areworriedaboutanyofthefollowing, makesureyou: Showthe judgeanypicturesofyourinjuries.

Tellthe judge thatyou do notfeelsafe ifthe abusercomesto yourhome to pickupthe childrento visitwiththem.

Askthe judge to orderthe abuserto pickupand returnthe childrenatthe police stationorsome othersafe place.

Askthatanyvisitsthe abuserispermittedare atveryspecifictimesso the police willknowby readingthe courtorderifthe abuseristhere at the wrongtime.

Tellthe judge ifthe abuserhasharmedor threatenedthe children;askthatvisitsbe supervised;thinkaboutwho coulddo thatfor you.

Getacertifiedcopyofthe courtorder.

Keepthe courtorderwithyou atalltimes.

TreatmentPlanningforSurvivors 15

CriminalProceedings Showthe prosecutoryourcourtorders.

Showthe prosecutormedicalrecordsabout yourinjuriesor picturesifyou have them.

Tellthe prosecutorthe name ofanyone whois helpingyou (avictimadvocate orlawyer).

Tellthe prosecutoraboutanywitnessesto injuriesorabuse.

Asktheprosecutorto notifyyou aheadoftime if the abuserisgettingoutofjail.

Besafeatthecourthouse Sitasfarawayfromthe abuserasyou can;you

don'thave to lookatortalkto the abuser;you don'thave to talkto the abuser'sfamilyor friendsiftheyare there.

Bringafriendorrelative to waitwithyou until yourcase isheard.

Tellabailifforsheriffthatyou are afraidofthe abuserandaskhim/herto lookoutforyou.

Make sure you have yourcourtorderbefore you leave.

Askthe judge orsherifto keepthe abuserthere forawhile whencourtisover;leave quickly.

Ifyou thinkthe abuserisfollowingyou whenyou leave,callthe police immediately.

16 SubstanceAbuse Treatmentand DomesticViolence

Ifyou have totravelto anotherState forworkor to getawayfromthe abuser,take your protectionorderwithyou;itisvalideverywhere.

ReprintedwithpermissionfromtheAmericanBar Association.

PsychosocialIssues Akeyaspectoftreatmentforsubstance abuse

isencouragingthe clientto assume responsibilityforheraddictionand dispellingthe notion she isresponsible forherpartner'sbehavior.

Forsome batteredwomen,everyaspectoftheir life hasbeencontrolledbythe batterer.Helping herdevelopherowndecisionmakingskillswill be integralto herrecovery.

Posttraumatic stress disorder, the increased stress of abstinence, and the client's perception of her own safety are all issues that can affect her treatment and should be dealt with in treatment.

LaterRecoveryIssues Practicalconcernsoverwhelmmanysurvivorsof domesticviolence aftertheybecome abstinent. Linkageswithotherprogramsandagencies become extremelyimportantinmeetingthe client'sresponsibilities.Fourareasthatmayneed specialconsiderationduringthistime are:

TreatmentPlanningforSurvivors 17

Socialfunctioning: Socialisolationiscommon amongdomesticviolence survivors.Providers shouldencourage the clienttomake herown decisionsaboutnewactivitiesandpastimes.

Parenting: Asurvivormayneed to learnnew skillsthattake into accounttherealityofher statusasadomesticviolence survivor.Handling frustrationandangerisacruciallifeskillthat mustbe addressed directlyintreatment.

Financialandlegalconcerns: Treatment providersshouldexplore withthe clienther plansforfuture educationandemploymentand shouldhave informationonavarietyofoptions.

Relapseprevention: Revictimizationbytheir abusive partnersposesthe greatestriskof relapse forbatteredwomen.Carefulattentionto recurringepisodesofviolence isessentialto workingwithsurvivorclientsto preventorminimize the negative effectsofrelapse.

Formoredetailedinformation,seeTIP25,pp.1216,pp.128133.

18 SubstanceAbuse Treatmentand DomesticViolence

ISSUESOFCHILDABUSEORNEGLECT

The confidentialityregulationsinTitle 42,Part2of the Code ofFederalRegulationsrequirethata clientbe givennotice regardingthe limitationsof confidentialityorallyand inwritinguponadmissionto asubstance abuse program.

ScreeningforChildAbuseorNeglect Whenfamilyviolence comesto the attentionof the treatmentprovider,itisessentialto determine whetherchildrenhave beenpresentorhave been involvedinanyway.Itisnotadvisable forthe substance abuse clinicianto performanassessment ofchildrenforabuse orincest;thisfunction shouldbe performedbypersonnelwithspecial expertise.

ReportingSuspectedNeglectorAbuseand Children'sProtectiveServicesAgencies Clientsmustbe informedthatmandated

reporters,acategorythatincludessubstance abuse treatmentproviders,are requiredto notifyChildren'sProtective Services(CPS)ifthey suspectchildabuse orneglect.

Clientscanbe informedofthe rightto report theirpartner'sabuse ofchildren.

IssuesofChild Abuse orNeglect 19

Itisultimatelythemandated reporter's responsibilitytoensureCPS iscontacted in theeventofsuspectedchild abuseorneglect.

Itisimportantto prepare forthe impactof reportingchildabuse onthe childrenandthe familyaswhole.

Itisimperative forprofessionalsworkingwith familymembersto provide informationto them aboutwhatto expectfromCPSand,ifatallpossible,totalkwithCPScaseworkersandaccompanythe familyto anycourthearings.

TheRoleofTreatmentProvidersin SupportingtheMother Help her identify and coordinate various services

available to her.

Supporthereffortsto participate inandtake advantage ofthese services.

Listenasshe voicesherfrustrationaboutthe difficultiesofmeetingthe demandsofthe variousagencies.

Formoredetailedinformation,seeTIP25,pp.1719,pp.4445.

20 SubstanceAbuse Treatmentand DomesticViolence

SCREENINGTECHNIQUESAND

QUESTIONSFORBATTERERS

CAUTION: Inaskingquestionsaboutabuse,substance abuse treatmentprovidersmustbe careful notto enablebattererstoplace blame forbatteringsonthevictimoralcoholanddrugs.

Questions "Some people thinkthat,undercertaincircum

stances,it'sOKto hityourwife (girlfriend,etc.). Underwhatcircumstancesdo you thinkviolence mightbe justified?"

"Ifyou were facedwithoverwhelmingstress (use ahypotheticalsituation),do you thinkyou couldkeepyourcool?"

"Whatdo you thinkyou'ddo?"

Bytakinganopenendedsocialandfamilyhistory, the interviewercangraduallymove to specific, directquestions.

"Have you everbeenphysicallyhurtbysomeone inyourfamily?"(Ifthe client'spartnerhashurt himorher,the reverse maybe true.)

"Have you everhurtsomeone inyourfamily?"

ScreeningTechniquesand QuestionsforBatterers 21

The"NoViolenceContract" Batterersenteringtreatmentforsubstance abuse canbe requiredto signacontractagreeingto refrainfromusingviolence."Noviolence"contractsare mosteffective whenlinkageswithbatterers'interventionprogramsare alsoinplace, buttheycanalso helpstructure treatmentby specifyinganachievable behavioralgoal.

RecoveryPitfallsforBatterers 12Stepprogramscanplayavaluable role insupportingbatterers'treatmentandrecoverywhen theirprinciplesare followed.However,providers shouldbe alertto signsthatclientsare misinterpreting12Stepphilosophiesto justify,excuse,or evade responsibilityfortheirviolence.

OngoingAttentiontoIssuesofDomesticViolence Ongoingattentionto issuesofdomesticviolence isparticularlyimportantwiththese clients because itmaytake time forthemto begintalking aboutthe violence intheirlives.Astheybecome abstinent,additionalissuescanarise thatare integrallyrelatedto the violence.The fulldimensionsofadomesticviolence problemare seldom immediatelyclearandmayemerge unexpectedly atalaterstage intreatment.

Formoredetailedinformation,seeTIP25,p.48.

22 SubstanceAbuse Treatmentand DomesticViolence

TREATMENTPLANNINGFORBATTERERS

Gauge client'sacceptance ofresponsibility.

Linkclient'sactionswithtangible consequences,e.g.,throughano violence contract.

Encourage the batterer clienttodevelopenough selfawarenessto recognize the beliefsand attitudesthatare precursorsto violence and to controltheemotionsthatcontribute to violence.

Formulate atreatmentplanwithstrategiesthat ensure safetyforthe partnerandfamily members.

Helpthe battererfocusonchangingthe behaviorsandeventsthathave precipitatedviolence orrelapse.

Watchforandstopclientsfromcondoningviolence orreinforcingeachothers'excusemaking.

Raise the batterer'sawarenessofthe impacthis violence hasonhischildren'sfuture behavior (youngboysoftenlearnviolentbehaviorfrom male role models).

Helpbatterersadoptnonviolentmodesof behaviorthroughangermanagementandcopingskills.

TreatmentPlanningforBatterers 23

Reinforce the importance ofmodelingnonviolentbehaviorintheir interactionswiththeir partnersaswellastheirchildren.

Formoredetailedinformation,seeTIP25,

pp.3235.

24 SubstanceAbuse Treatmentand DomesticViolence

REFERRALANDLINKAGES

Referral Whenanswersto screeningsuggestthatthe client maybe abattererorasurvivor,he orshe should be immediatelyreferred to adomesticviolence program.Whenreferralsare notpossible,ongoing consultationwithadomesticviolence expertis stronglyencouraged.Insome instances,clients have beenmandated into substance abuse treatmentbycourts.Substance abuse providersuse the leverage providedbythe criminaljustice systemto ensure thatclientswho batterparticipate inbatterer'streatmentaswell.

ReferringSurvivors Ifthe clientrevealsthatshe isinimmediate

danger,the counselorneedsto attendto this before addressingotherissues.

Advise the clientto take simple legalprecautionsandto safeguardimportantdocuments, e.g.,socialsecuritycard,driverlicense,etc.

Discusspossible reprisalbythe battererifthe police become involvedandplanaresponse.

If a survivor client expresses concern about her children, refer her for shelter and legal advocacy.

Resourcescanbe identifiedbycontactinga localdomesticviolence program,aState pro

ReferralandLinkages 25

gramortheNational24HourDomestic Violence Hotline,1800799SAFE.

ReferringBatterers Whensuspectedbatterersare identified,sub

stance abuse treatmentprovidersshouldrefer themto batterer'sinterventionprogramsasa keypartoftreatmentplanning.

Withthe client'ssignedconsentto release information,substance abuse counselorscanshare pertinentinformationwithdomesticviolence staffto ensure bothproblemsare being addressed.

Familytherapyorfamilyinterventionforbatterersandtheirpartnersshouldbe providedbya domesticviolence specialistorprogram.

Linkages To effectivelytreatsubstance abuse,care must

be coordinatedwithdomesticviolence programsandotheragenciespertinentto aclient's recovery,e.g.,the criminaljustice system,the workplace,etc.

Substance abuse treatmentproviders,domestic violence experts,andlegalorotherrelevant professionalsshouldplanclienttreatment collaboratively.

Substance abuse treatmentprovidersshould getto knowwhatresourcesandinstitutions existintheircommunities.

2) HealthCare Services

26 SubstanceAbuse Treatmentand DomesticViolence

1) DomesticViolence Programs Hotlines, Shelters, Clinicians, Programs,

HealthAdministrators, PrimaryCarePhysicians,

3) The Justice System The PoliceDepartment, Judges,

4) Education/Schools Teachers, Principals, SchoolSocialWorkers,

5) Employers,

6) SocialWelfare SocialWelfare Administration, SocialWorkers,

Crossscreeningofvariousproblemsbyvarious agenciesisamajorsteptowardlinkage.

Because ofitsinfluence onthe client,integratingthe criminaljustice system'seffortsshould be one ofthe firststepsinforminglinkages.

ReferralandLinkages 27

Due to theincreasingcallforcostcontainment, collaborative endeavorsare criticalto the future ofmanyprograms.

CollaborativeCareServices Whencreatinglinkages,rememberthatcollaborative servicesshouldbe:

Clientcentered.

Holistic.

Flexible.

Collaborative.

Coordinated.

Accountable.

CaseManagement Inthe case managementapproach,aspecially trainedsingle practitionerorcase management teamisresponsible forcoordinatinglinkagesto the wide varietyofservicesneededbymanyifnot mostclientsinsubstance abuse treatment.

Formoredetailedinformation,seeTIP25,pp.6380.

28 SubstanceAbuse Treatmentand DomesticViolence

LEGALISSUES

CAUTION: NeitherthisQuickGuide norTIP25 shouldbe consideredasubstitute forcompetent legaladvice fromaqualifiedattorney.

TheViolenceAgainst WomenAct The ViolenceAgainstWomenAct(VAWA)strengthensmanyofthelawsregardingviolence motivatedbygender,outlinesFederalaswellasState enforcementprovisionsandpenalties,andmakes crimesagainstwomenandchildrenacivilrights violation.UnderVAWA:

Pastsexualbehaviororallegedsexualpredispositionofthe victimisno longeradmissible evidence incivilorcriminalproceedingsinvolving sexualmisconduct.

NewFederalcriminalpenaltiesapplyto anyone who crossesaState line inorderto commit domesticviolence orto violate acivilprotection order.

Statesare requiredto enforce civilprotection ordersissuedbyotherstates.

LegalIssues 29

Victimsmusthave theopportunityto testify regardingthe potentialdangerofthe pretrial release ofadefendant.

DisclosureandConsent Typically,State lawsregulate the disclosure of

patientinformationrelatedto domesticviolence.

These lawsdifferfromFederallawsthatgovern consentto disclose substance abuserelated information.

Whenitcomesto reportingcrimesthatare discussedintreatmentto athirdparty(e.g.,the police oralawyer),the counselormustaskthree questions:(1)DoesState lawrequire the program to make areport?(2)DoesState lawpermitthe programto make areport?(3)Howcanareport be made withoutviolatingthe Federallawand regulationsgoverningconfidentialityorpatients' records?

LegalResources State DepartmentofHealth

Single State AuthorityforSubstance Abuse and/orDomesticViolence

State AttorneyGeneral

Localbarassociations

30 SubstanceAbuse Treatmentand DomesticViolence

Agencyboard memberswho are attorneys

Localadvocacygroupsforpeople experiencing domesticviolence

Locallawschools

Formoredetailedinformation,seeTIP25,pp.5161,pp.95109.

Phone andInternetResources 31

SELECTEDPHONE ANDINTERNET RESOURCES

Hotlines NationalDomesticViolence Hotline

(800)799SAFE (800)7993224

Rape, Abuse, and Incest National Network (RAINN) (800)6564673 http://www.rainn.org

ChildHelpUSA/NationalChildAbuse Hotline (800)4ACHILD http://www.childhelp.org

GeneralResources NationalCoalitionAgainstDomesticViolence

(303)8391852 http://www.ncadv.org

NationalVictimCenter(NVC)/Infolink(800)FYICALL https://www.victimsofcrime.org/

AmericanCollege ofObstetriciansand Gynecologists(ACOG)

(202)6385577 http://www.acog.org

http://www.acog.orghttp:https://www.victimsofcrime.orghttp://www.ncadv.orghttp://www.childhelp.orghttp://www.rainn.org

32 SubstanceAbuse Treatmentand DomesticViolence

OtherServices Centerforthe PreventionofSexualandDomestic Violence

(206)6341903 http://www.ncdsv.org/

DomesticViolence Project/Face to Face (800)8424546

DomesticViolence TrainingProject (800)8653699

FamilyViolence andSexualAssaultInstitute (903)5345100

AmericanBarAssociationCommissionon DomesticViolence http://www.abanet.org/domviol/home.html

http://www.abanet.org/domviol/home.htmlhttp://www.ncdsv.org

OrderingInformation TIP25 SubstanceAbuseTreatment

andDomesticViolence

TIP25RelatedProducts

KAP KeysforClinicians basedonTIP 25

Do notreproduce ordistribute thispublicationfor afee withoutspecific,writtenauthorizationfromthe OfficeofCommunications, Substance Abuse and MentalHealthServicesAdministration,U.S. DepartmentofHealthandHumanServices.

TwoWaystoObtainFREE CopiesofAllTIPsProducts

1. CallSAMHSA:1877SAMHSA7 (18777264727)(EnglishandEspaol)

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OtherTreatmentImprovement Protocols(TIPs)thatarerelevantto thisQuickGuide:

TIP27,ComprehensiveCaseManagementfor SubstanceAbuseTreatment SMA154215

TIP35,EnhancingMotivationforChangein SubstanceAbuseTreatment SMA134212

TIP36,SubstanceAbuseTreatmentforPersons WithChildAbuseandNeglectIssues SMA123293

Seetheinsidebackcoverfororderinginformation forallTIPsandrelatedproducts.

HHSPublicationNo.(SMA)153583 Printed2001

Reprinted2010 Revised2015

Table of ContentsWhy a Quick Guide?What is a TIP?IntroductionScreening for SurvivorsTreatment Planning for SurvivorsIssues of Child Abuse or NeglectScreening Techniques and Questionsfor BatterersTreatment Planning for BatterersReferral and LinkagesLegal IssuesPhone and Internet Resources