Considering Partner Violence in the Addiction Treatment Setting

Polaris Health Directions and the Southern California Permanente Medical Group are working together to improve detection of intimate partner violence (IPV) among patients in treatment for addiction.

Part of an ongoing project in the spirit of outcomes-informed care, the project ultimately seeks to demonstrate the plausibility of addressing IPV and addiction concurrently. Doing so may improve the rate of completing substance abuse treatment, lower the likelihood of relapse, and ultimately lead to lower health care costs.

The first phase of the project, described in the fall issue of Advances in Addiction & Recovery, centered on embedding questions about past and present abuse into a substance abuse treatment support system, Polestar Addiction.

Corresponding changes were made to the system’s clinical reports, including adding diagnostic codes to improve the chances that a clinician would follow up on the detected abuse. Additionally, counselors were provided training on initiating conversation with patients if current abuse was identified:

Clinicians were instructed to validate and affirm the abuse with phrases such as: (1) “You are not alone. Help is available;” (2) “You do not deserve to be treated this way. It’s not your fault;” and (3) “I am concerned about your safety, and how this may be affecting your health.” They were given in-person training on how to obtain additional information, document it, and to make referrals to community IPV agencies.

These efforts had an immediate impact. In 2008, before the questions were added, six patients were coded for abuse in to Kaiser’s electronic health record system. Just two years later, more than 500 patients were coded for abuse.

The next phases of this project will explore the effect on medical outcomes of improved detection and management of IPV and its physical and emotional manifestations. New family violence measures, including scales for PTSD and Abuse Adjustment, are being added to SATSS, and a pilot study will be launched to assess the impact of IPV on substance abuse treatment engagement and long-term outcomes.

Read the full article here.