Publication year
2015
Citation Title
A randomized controlled clinical trial of the Strength At Home Men's Program for partner violence in military veterans
Journal Name
The Journal of Clinical Psychiatry
Journal Volume
77
Issue Number
9
Page Numbers
1168-75
DOI
10.4088/jcp.15m10020
Summary
Evaluation of the efficacy of the Strength at Home Men's Program (SAH-M), a group intervention program designed to end intimate partner violence (IPV), was conducted. One hundred and thirty-five male Veterans and Service members and 111 female partners participated in a randomized controlled clinical trial. Overall, participants exhibited a reduction in physical and psychological IPV use.
Key Findings
Participants in the SAH-M program, relative to those who were in the non-treatment group, reduced behaviors that involved controlling their partner through isolation and monitoring.
SAH-M program reductions in physical and psychological IPV were maintained at the 3-month follow-up.
Participants in the SAH-M program exhibited significant reductions in both denigration and hostility IPV compared to the non-treatment group.
Implications for Program Leaders
Continue providing IPV training opportunities for professionals working with Service members and their partners
Promote, across military branches, the benefits of intervention approaches for IPV offenders
Provide support groups for IPV offenders and their partners
Implications for Policy Makers
Continue support for more understanding on the relationship between IPV and Service members that have been in a combat related mission
Increase collaboration between military branches and local community organizations to enhance programs for Service member IPV offenders
Encourage awareness campaign on military bases regarding the importance of addressing IPV
Methods
Participants were recruited over a period of three years and from two major metropolitan areas in the Northeast by clinician-referrals, self-referrals, and court-referrals.
Groups of 4-5 IPV offenders were assigned randomly to receive either SAH-M immediately or an enhanced treatment as usual (ETAU).
The SAH-M is a 12-week group therapy program that works with individuals social information processing deficits.
Statistical analysis was used to investigate the effect of treatment on changes in IPV over time.
Participants
Participants had to be over 18, a male Veteran or Service member, and one self, collateral, or court-report of at least one act of male-to-female physical IPV, and no current substance or dependence abuse.
The mean length of intimate relationships was 87 months and 67% of the sample had children.
Over 65% of the men reported exposure to military combat, with over half having had a posttraumatic stress disorder diagnosis.
Limitations
The study was limited to heterosexual male Veteran or Service members who engaged in IPV as such limits the generalizability to other types of relationships.
Out of the 67 participants that were allocated to the SAH-M program only 49 participated in the post-treatment assessment, and 45 in the 3-month follow up, such a drop-out can affect the outcomes of the study.
The mean number of sessions attended in the 12-week program was 7.3 with 71.6% attending 6 or more sessions and 55.2% attending 9 or more sessions, which can potentially limit the benefits of the program.
Avenues for Future Research
Explore in-depth the relationship between IPV, military combat, and military culture
Examine how treatment program outcomes for male and female IPV offenders may differ
Address possible factors that may contribute to the recidivism of participants and IPV behaviors
Focus
Multiple Branches
Target Population
Population Focus
Military Branch
Military Component
Abstract
Objective: We evaluated the efficacy of the Strength at Home Men’s Program (SAH-M), a trauma-informed group intervention based on a social information processing model to end intimate partner violence (IPV) use in a sample of veterans/service members and their partners. To date, no randomized controlled trial has supported the efficacy of an IPV intervention in this population. Method: Participants included 135 male veterans/service members and 111 female partners. Recruitment was conducted from February 2010 through August 2013, and participation occurred within 2 Department of Veterans Affairs hospitals. Male participants completed an initial assessment that included diagnostic interviews and measures of physical and psychological IPV using the Revised Conflict Tactics Scales and were randomly assigned to an enhanced treatment as usual (ETAU) condition or SAH-M. Those randomized to SAH-M were enrolled in this 12-week group immediately after baseline. Those randomized to ETAU received clinical referrals and resources for mental health treatment and IPV services. All male participants were reassessed 3 and 6 months after baseline. Female partners completed phone assessments at the same intervals that were focused both on IPV and on the provision of safety information and clinical referrals. Results: Primary analyses using hierarchical linear modeling indicated significant time-by-condition effects such that SAH-M participants compared with ETAU participants evidenced greater reductions in physical and psychological IPV use (? = ?0.135 [SE = 0.061], P = .029; ? = ?0.304 [SE = 0.135], P = .026; respectively). Additional analyses of a measure that disaggregated forms of psychological IPV showed that SAH-M, relative to ETAU, reduced controlling behaviors involving isolation and monitoring of the partner (? = ?0.072 [SE = 0.027], P = .010). Conclusions: Results provide support for the efficacy of SAH-M in reducing and ending IPV in male veterans and service members.
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