Substance Abuse and Domestic Violence: Breaking the Link

Greg Stuart“I’ve always been interested in people and relationships,” says Gregory Stuart, associate professor in the UT Knoxville Department of Psychology. “I’m particularly interested in relationship functioning and dynamics.”

Stuart studies intimate partner violence (IPV) and the effects of substance abuse on IPV. In tackling these difficult and sensitive subjects, he says he ultimately hopes to improve relationships and family functioning.

“Not all intimate partner violence is fueled by substance use,” he says. “However, there is abundant theoretical and empirical evidence linking the two.” Stuart notes that men and women can be perpetrators of violence, as well as victims, and that instances of both perpetrating violence and being victimized by it increase on “drinking days,” as opposed to “nondrinking days,” among substance abusers.

Stuart’s research on IPV and substance abuse began while he was working at Brown University, in Providence. Rhode Island has a mandatory arrest law for instances of domestic violence: when a domestic disturbance call comes in, one or both partners are arrested, and the arrest usually results in court-ordered participation in a batterer intervention program. But does it work?

“The goal of the intervention program, of course, is to reduce recidivism,” Stuart says, “but research suggests that men arrested and court-referred to the programs have about the same level of violence recidivism as men who are arrested and don’t complete the program or don’t go at all. There are serious concerns about the efficacy of batterer programs.” Stuart and colleagues recently detailed these concerns in an article published in a special issue of the Journal of the American Medical Association.

Looking for better results, Stuart launched a clinical trial in which male batterers were randomly assigned to either the standard batterer intervention program or the standard batterer intervention combined with a brief alcohol intervention focused on the participant’s motivation for using alcohol. While the research still is in progress, preliminary results suggest that participants who receive the alcohol intervention have better substance-use and partner-violence outcomes than those receiving only the standard batterer intervention.

“This is with only a one-session ninety-minute alcohol intervention,” Stuart emphasizes. “Obviously our preference would be to do a full ten to twelve sessions of substance abuse treatment, but in most cases, participants aren’t in the batterer programs willingly and they aren’t necessarily motivated to address their alcohol and drug use either.”

In 2007 he began a similar randomized clinical trial in which a brief alcohol intervention is administered to women arrested for domestic violence and ordered by the court to attend the batterer intervention program.

UT Psychological Clinic
A Half-Century of Community Service, and Counting

The UT Knoxville Department of Psychology leads the way in research and graduate education, while offering the Knoxville community quality clinical therapy at an affordable price.

Located on the Hill in the landmark Austin Peay Building, the UT Psychological Clinic provides individuals, couples, and families of the community with approximately 500 patient-contact hours per month. Therapy is billed on a sliding scale based on patients’ income and ability to pay.

Serving community clients also means serving students, since 48 doctoral students in clinical psychology currently staff the facility, gaining valuable skills and experience as clinicians.

The clinic has operated for 50 years, demonstrating all three elements of the university’s mission of research, teaching, and outreach. In its first two decades, throughout the ’50s and ’60s, the clinical training model at the UT Psychological Clinic was consistent with the Boulder Model, one that features clinical practitioners engaged in research. This paradigm persisted until the early 1990s, when professors in the clinical psychology program championed “the Tennessee Model” for clinical training. The Tennessee Model offers psychology graduate students a set of guidelines for conceptualizing practice and research as separate but complementary enterprises that inform each other to ensure maximum benefits for both the client and the advancement of psychological knowledge.

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A member of the College of Arts and Sciences’ faculty only since August 2008, Stuart hopes eventually to apply his Rhode Island–tested alcohol intervention to batterer intervention programs in Tennessee. Moreover, he wants to adapt the program so it can be used with college students.

“I can easily see tailoring the brief alcohol interventions for students, applying this research to students engaged in hazardous drinking behaviors, which can increase the risk for physically and sexually aggressive behavior. I’m a believer that one’s research should be used to improve the therapy one gives, and vice versa,” says Stuart, who appreciates being in an environment where he has the flexibility to engage in both research and therapy, as well as teaching.

“UT was the only place I applied to,” he says of his decision to relocate from Brown to Tennessee. “I had a good thing going there—there was no reason to leave Brown—but the psychology faculty here is truly extraordinary. I don’t know if people realize what an embarrassment of riches there is here.”

Besides Stuart, departmental colleagues Todd Moore, Deborah Rhatigan, Kristina Gordon, Deborah Welsh, and James McNulty also focus on aspects of intimate relationship functioning in their research. “The opportunity to collaborate with these incredible researchers and exceptional people is what brought me to UT: the opportunity to work with a remarkable faculty in a top-notch department. The rest of the clinical faculty—Paula Fite, Michael Nash, Jenny MacFie, and Derek Hopko—all do tremendous work, as well as the faculty in the experimental and counseling psychology areas.”

The University of Tennessee is a powerhouse in this kind of research,” he says. “I believe that UT is the best place in the U.S. to study intimate relationships and family violence.”

Stuart’s research has been funded by approximately $5 million in grants, on which he is the principal investigator, from the National Institute on Alcohol Abuse and Alcoholism, one of the National Institutes of Health. He is also a co-investigator or consultant on 17 additional grants. His scholarly output thus far includes 127 publications, and he serves as an ad hoc reviewer for 32 scientific journals.

In addition to his associate professorship at UT, Stuart still holds several positions back in Providence. He has an appointment as an associate professor in the Department of Psychiatry and Human Behavior at the Alpert Medical School of Brown University; he is the director of family violence research at Butler Hospital; and he serves as an adjunct faculty member at the Brown University Center for Alcohol and Addiction Studies.

—Leigh Powell