Domestic
Violence Addiction Treatment
Text: Substance Abuse
Treatment and Domestic Violence:
Treatment Improvement
Protocol (TIP) Series #25
By: Patricia A. Fazzone
DNSc., John K Holton PhD & Beth G. Reed PhD
Copyright © 2001 by:
Institute of Addiction Awareness
24881 Alicia Pkwy., #E-519
Laguna Hills, CA 92653
www.CEUInstitute.com
949-643-3802
A. EFFECTS OF DOMESTIC VIOLENCE
1)
Domestic
violence is the use of __________ emotional, psychological, sexual, or physical
force by one family member or intimate partner to control another.
a)
intentional
b)
unintentional
c)
episodic
d)
random
2)
Defining
and rigidly adhering to men’s and women’s traditional roles is a manifestation
of _____________.
a)
psychological
abuse
b)
emotional
abuse
c)
using
privilege
d)
a
lifestyle choice
3)
In
the United States, a woman is beaten every fifteen seconds.
a)
TRUE
b)
FALSE
4)
Research
shows what percentage of men who commit acts of domestic violence also have
substance abuse problems?
a)
85%
b)
<20%
c)
35%
- 55%
d)
25%
- 50%
5)
Research
suggest that aggression towards an inebriated victim is considered _________
than aggression toward a sober one.
a)
less
acceptable
b)
the
same as
c)
more
acceptable
d)
either
B or C
6)
The
belief that domestic violence will stop once the drinking or drug use stops is
_________.
a)
usually
borne out
b)
not
usually borne out
c)
based
on solid clinical research
d)
an
anecdotal finding under investigation
7)
Under
what circumstances is a partner’s enabling a substance abuser to drink or use
chemicals considered a safety measure?
a)
Under
no circumstances
b)
When
the batterer is less violent when sober or abstinent
c)
Before
the survivor seeks treatment
d)
When
the batterer is more violent when sober or abstinent
8)
Denial,
enabling, codependency and powerlessness _________.
a)
strike
some domestic violence workers as stigmatizing, repressive and counter to
appropriate goals for violence survivors
b)
form
the core of a shared therapeutic vocabulary between substance abuse counselors
and domestic violence counselors
c)
accurately
describe the tools used by the survivor to cope with domestic violence
d)
are
terms relevant to substance abuse recovery only
B. SURVIVORS
9)
The
chief concern for treatment providers with a client who informs them she is a
victim of domestic violence is:
a)
validating
and believing her.
b)
providing
for the immediate physical safety of her environment.
c)
identifying
her options.
d)
assuring
her that she is believed.
10) Women who were victims of
childhood sexual abuse and sexual assault are likely to have _________ when
compared to women who were not abused.
a)
a
higher incidence of substance abuse
b)
a
lower incidence of substance abuse
c)
the
same incidence of substance abuse
d)
unknown
incidence
11) Couples and family therapy
_________.
a)
is
a good treatment modality for domestic violence survivors
b)
is
more appropriate for substance abusers and their families
c)
may
be dangerous for domestic violence survivors
d)
should
be encouraged for batterer’s who have little empathy
12) Cuts and bruises from
domestic violence tend to be on the legs, back and other areas covered by
clothing.
a)
TRUE
b)
FALSE
13) One of the ongoing coping
mechanisms used by many survivors is ________.
a)
the
exaggeration of physical sensations, including physical pain.
b)
an
increase in somatic complaints
c)
a
suppression of emotions regarding the abuse
d)
the
repression of physical sensations, including physical pain
14) For a proportion of domestic
violence survivors, decision making is _______ .
a)
a
new skill that must be acquired for the first time
b)
a
lost skill that must be relearned
c)
a
preferred but unnecessary skill for recovery from substance abuse
d)
often
difficult, but important for recovery from substance abuse
15) What percent of battered
women met the criteria for PTSD in Kemp et al’s 1991 study of battered women in
a shelter?
a)
50%
b)
75%
c)
84.4%
d)
64%
16) An additional stressor for a
survivor of domestic abuse who is a parent is:
a)
the
financial responsibility of the
children.
b)
the
fact that some children are not supportive of their mother’s choices.
c)
older
children (especially boys) commonly ally themselves with the batterer.
d)
B
and C
17) _______________ poses the
greatest risk of relapse for battered women.
a)
Failure
to identify trigger events
b)
Revictimization
by their abusive partners
c)
The
inability to make reasoned decisions
d)
Failure
to seek psychological counseling
18) Adolescents who have
observed their fathers abusing their mothers ________.
a)
exhibit
high levels of aggression and acting out
b)
are
at decreased risk of adopting these same strategies in their interactions with
their partners
c)
are
at increased risk of adopting these same strategies in interactions with their
partners
d)
A
and C
19) Treatment providers must
adhere to the laws in their states regarding mandated reporting of child abuse
and neglect:
a)
even
if the client perceives those actions as a betrayal of trust.
b)
only
if doing so will not be perceived by the client as a betrayal of trust.
c)
whenever
a child is in immediate danger.
d)
only
if the issue of abuse and neglect will be addressed in therapy.
C. BATTERERS
20) When researchers examined
court documents, they found that ______ percent of incarcerated batterers
reported a history of drug addiction.
a)
25%
b)
50%
c)
89%
d)
67%
21) Acute intoxication by the
male is a better predictor of battering than chronic alcohol abuse.
a)
TRUE
b)
FALSE
22) Domestic violence is
correlated to:
a)
middle
income.
b)
approval
of violence against women.
c)
gender-based
stereotypes.
d)
B
and C
23) McClelland’s theory of
alcohol and power motivation suggested that ________ might be the factor that
accounts for the high correlation between substance abuse and spousal abuse.
a)
the
need for personal power
b)
societal
norms for male dominance
c)
the
need for interpersonal dominance
d)
gender-based
stereotypes
24) A problem identified by the
Consensus Panel regarding anger management group for batterers was that
___________.
a)
many
are led by clinicians with inadequate skills
b)
they
may indirectly reinforce battering behavior
c)
batterers
find them irrelevant to their situation
d)
A
and B
25) Responsible treatment of
batterers includes teaching:
a)
techniques
of regulating anger.
b)
them
to reveal their anger.
c)
them
to repress their anger.
d)
them
to redirect their anger away from others.
26) Which group of batterers did
Gondolf’s study identify as most likely to abuse alcohol?
a)
Typical
batterers (52%)
b)
Antisocial
batterers (41%)
c)
Sociopathic
batterers (7%)
d)
All
groups used alcohol in a similar manner
27) In Dutton’s program, which
type of batterer was most likely to be compliant with treatment?
a)
Psychopathic
wife assaulters
b)
Overcontrolled
assaultive males
c)
Cyclical/emotionally
volatile wife abusers
d)
All
groups were equally non-compliant
28) Substance abuse treatment
providers should not treat batterer and victim couples together without
consulting a domestic violence expert.
a)
TRUE
b)
FALSE
29) What behavior in a batterer
can serve as a barometer for a client’s progress in his substance abuse?
a)
The
degree to which he assumes responsibility for his actions.
b)
The
reduction in violent acting out against his spouse.
c)
The
regularity of his attendance at 12 step meetings.
d)
None
of the above
30) The focus of treatment for a
batterer must be on encouraging the client to:
a)
develop
enough self-awareness to recognize the beliefs and attitudes that contribute to
violent behavior.
b)
control
the emotions that contribute to his violent behavior.
c)
A
and B
d)
Neither
A nor B
31) The Consensus Panel
recommends postponing family and couples counseling until the batterer
_____________.
a)
is
removed from the home
b)
has
demonstrated a pattern of nonviolent and noncoercive behavior for a year
c)
agrees
to a non-violence contract
d)
A
and C
D. SCREENING AND REFERRAL
32) Screening for domestic
violence in substance abuse treatment is undertaken to:
a)
identify
a common cause for relapse
b)
identify
survivors
c)
identify
batterers
d)
B
and C
33) Evidence suggests that a
father who abuses his children seldom abuses his wife as well.
a)
TRUE
b)
FALSE
34) When should a client who may
be a survivor of domestic violence never be asked about battering?
a)
When
someone who might be the batterer is present.
b)
When
there is no direct evidence of battering, such as bruises.
c)
Before
trust between the counselor and the client has been established.
d)
When
criminal charges are pending against the alleged batterer.
35) The client who has been
sexually assaulted by her partner may _________.
a)
exaggerate
the experience if it is an infrequent occurrence
b)
fail
to recognize the experience if she was sexually abused as a child
c)
normalize
the experience particularly if it has been a repeated one
d)
all
of the above
36) What concept(s) is it
important to convey to a survivor when framing screening questions about
domestic violence?
a)
Substance
abuse is no excuse
b)
There
is no justification for battering
c)
The
counselor is non-judgmental about the role of the survivor in the cycle of
abuse
d)
A
and B
37) In some cases of domestic
violence, denial is _________.
a)
an
adaptive survival technique developed as a direct response to unsuccessful
attempts to obtain help
b)
a
maladaptive coping skill that keeps the survivor in the dependent victim role
c)
a
survivor’s way of maintaining control over the substance abusing batterer
d)
B
and C
38) Avoiding the implication
that substance abuse is the “cause” of violence is:
a)
more
important in screening batterers than in screening survivors.
b)
less
important in screening batterers than in screening survivors
c)
as
important in screening batterers than in screening survivors.
d)
unimportant
in the screening process for domestic violence.
39) Inquiries into possible
child abuse should not occur until _________.
a)
the
counselor suspects the children are in physical danger
b)
the
client has been notified that the counselor is a mandated reporter of suspected
child abuse or neglect
c)
the
children are safe from the abuser
d)
the
counselor receives an independent report of child endangerment
40) If a treatment provider
suspects that the child of a client has been a victim of violence, he or she
must ________:
a)
contact
CPS or home health services immediately
b)
interview
the child to determine if there is abuse in the home
c)
refer
the child to a health care provider immediately
d)
act
only if the child appears to have been harmed
41) In order to ensure that both
problems are addressed, substance abuse counselors can share information with
domestic violence staff _____.
a)
at
any time during the course of treatment
b)
if
the client has signed a written release for exchange of information
c)
whenever
a substance abuse treatment provider suspects violence is interfering with the
client’s recovery
d)
when
both treatment providers believe it is in the interests of the client’s
treatment program to do so.
42) No-violence contracts can
help structure treatment by specifying an achievable behavioral goal for the
batterer.
a)
TRUE
b)
FALSE
43) Survivors benefit in
participating in ________.
a)
mixed
gender groups that use confrontational techniques
b)
mixed
gender groups that do not use confrontational techniques
c)
same
sex groups that use confrontational techniques
d)
same
sex groups that do not use confrontational techniques
E. LEGAL ISSUES
44) The Violence Against Women
Act ____.
a)
made
domestic violence a criminal offense
b)
made
domestic violence a civil rights violation
c)
is
part of the Violent Crime Control and law Enforcement Act
d)
B
and C
45) Many abused women are afraid
to seek child support because they fear that doing so:
a)
will
interfere with their receiving child welfare benefits.
b)
will
result in the batterer receiving visitation rights, which would force
disclosure of their new location.
c)
will
force them into a welfare to work program.
d)
will
result in their being responsible for debt the batterer incurred in their
absence.
46) The most common and easily
obtainable mechanism of relief for victims of domestic violence is _________.
a)
a
civil protection order
b)
a
criminal restraining order
c)
a
civil injunction
d)
A
and C
47) Treatment providers must not
let ________ prevent them from routinely inquiring about domestic violence in
the course of providing appropriate care to clients.
a)
confidentiality
restrictions
b)
developing
a therapeutic alliance
c)
establishing
trust with a client
d)
B
and C
48) Federal confidentiality laws
regulations:
a)
permit
substance abuse treatment programs to comply with State mandatory child abuse
reporting laws.
b)
do
not permit substance abuse treatment programs to comply with State child abuse
reporting laws.
c)
give
substance abuse treatment programs the option of complying with State child
abuse reporting laws.
d)
allow
substance abuse programs to exceed permit substance abuse treatment programs to
exceed the requirements of State child abuse reporting laws.
49) Under Federal law, a law
enforcement agency may use information about a person’s substance abuse
treatment to _______.
a)
prosecute
the batterer for a separate crime
b)
make
recommendations to the court in pending civil
matters, such as child custody and visitation cases
c)
revoke
his or her participation in treatment in lieu of criminal justice processing
d)
A
and C
50) When does a substance abuse
treatment provider have the “duty to warn”?
a)
When
the law requires them to do so.
b)
When
there is a serious threat of violence towards a particular person.
c)
When
a client gives permission to do so.
d)
When
there is a serious threat towards an identified group of people.
51) A substance abuse program
can report a client’s stated suicidal intent to medical personnel if
___________________.
a)
the
client gives permission
b)
the
client is not identified as a substance abuser
c)
the
threat poses an immediate danger to the health of any individual and requires
immediate medical intervention
d)
A,
B or C
52) Federal confidentiality laws
permit a program to reveal information about a client’s status as a substance
abuser __________.
a)
only
if the client gives written consent
b)
if
the client threatens an assault or perpetrates an assault on the premises of
the program
c)
if
the client is in the program as a condition of release from prison or jail
d)
A
and B
53) If a counselor knows that a
client is a fugitive from justice, a refusal to assist or give officers
information is a criminal offense in some States.
a)
TRUE
b)
FALSE
F. COMMUNITY RESPONSE
54) A search warrant does not
authorize the program to permit the police to enter the premises:
a)
TRUE
b)
FALSE
55) When treating substance
abusers who are also involved in domestic violence, managing the coordination
of services should be handled by:
a)
the
legal system in charge of the criminal aspects of the case.
b)
the
batterer’s substance abuse counselor.
c)
substance
abuse treatment providers, domestic violence expe.rts, and legal and other
relevant professionals should plan treatment collaboratively
d)
the
survivor’s domestic violence counselor.
56) When establishing a
collaborative relationship between a substance abuse treatment program and a
domestic violence program, an important first step for both programs is to
________.
a)
clarify
terminology used by each program
b)
ask
for feedback to ensure that all parties are interpreting information in the
same way
c)
A
and B
d)
clarify
the limitations imposed on each by State and Federal laws
57) One reason that domestic
violence has not been incorporated into the concepts of managed care is that
_______.
a)
domestic
violence is a social and legal problem
b)
some
advocates have rejected the use of a medical model to define the problem
c)
insurance
companies often reject claims as “self induced harm”
d)
case
management can interfere with the domestic violence programs structure
58) What psychological risk
markers has research identified for becoming a victim of adult domestic
violence?
a)
High
dependency needs
b)
Antisocial
traits
c)
Poor
anger management skills
d)
none
of the above
G. CONFIDENTIALITY
59) What does United States
Code, Title 42, and Title 42, Part 2, of the Code of Federal Regulations guarantee?
a)
The
strict confidentiality of information about all persons receiving substance
abuse prevention and treatment services.
b)
Access
to substance abuse treatment regardless of ability to pay.
c)
The
limited confidentiality of information about persons receiving substance abuse
treatment in Federally funded substance abuse programs.
d)
The
separation of substance abuse and mental health treatment programs.
60) Information that is
protected by Federal confidentiality regulations may always be disclosed
______________.
a)
after
the client has signed a proper consent form
b)
after
a client has given verbal consent or the counselor to do so
c)
if
the court orders it
d)
to
further a criminal investigation
61) Which of the following items
is required on a valid release of information consent form?
a)
the
name of the client
b)
the
purpose of the disclosure
c)
a
statement that the client may revoke the consent at any time
d)
all
of the above
62) Under what circumstances
must a substance abuse program obtain the parent’s signature to make a
disclosure to anyone else about a minor in treatment?
a)
Every
time information is to be disclosed.
b)
Only
if state law requires parental permission before a minor may be treated for
substance abuse.
c)
If
the minor’s parents so stipulate in writing.
d)
a,
b and c
63) Any disclosure made with
written client consent must be accompanied by a written statement that the
information disclosed is protected by Federal law and that the recipient may
not make any further disclosure unless permitted by the regulations.
a)
TRUE
b)
FALSE
64) Client-identifying
information __________.
a)
includes
name, age, race and other personal identifiers
b)
is
information that identifies someone as a substance abuser
c)
does
not include requests for verification of information from a relative
d)
a
and c
65) When may a program
communicate with a third party payer who may be responsible for funding the
client’s treatment?
a)
After
they have obtained a client’s written consent to do so.
b)
After
the client has agreed to treatment.
c)
a
and b
d)
At
any time after services have been delivered.
66) If a client does not want
the insurance carrier to be notified and is unable to pay for treatment:
a)
the
program may refer the client to a publicly funded program.
b)
the
program may bill the insurance company anyway.
c)
the
program must continue to treat the client regardless of payment.
d)
b
and c
67) Referrals by a member of the
substance abuse treatment team to another agency for services for a client are
exempt from Federal confidentiality laws.
a)
TRUE
b)
FALSE
68) Federal regulations
regarding confidentiality define a “medical emergency” as:
a)
a
condition resulting from an accident or illness which requires the attention of
a physician or surgeon.
b)
any
condition which requires more than basic first aid to maintain or restore an
individual’s health or well-being.
c)
any
condition that is serious and requires urgent medical attention.
d)
a
condition which poses an immediate threat to the health of any individual and
which requires immediate intervention.
69) If someone telephones a
client at a program:
a)
staff
may not reveal that the client is at the program unless the program has a
written consent form signed by the client to make a disclosure to that
particular caller.
b)
staff
may reveal that the person is at the program if the individual gives verbal
permission for them to do so.
c)
staff
may reveal that the person is at the program if the individual has signed a
general consent to release information over the telephone.
d)
b
or c
70) A criminal justice system
consent __________.
a)
may
be revoked by the client before its expiration date
b)
may
not be revoked before its expiration date or event
c)
falls
under Federal confidentiality laws
d)
b
and c
71) Any information received by
one of the eligible criminal justice agencies from a treatment program may be
used ______________.
a)
by
that justice agency in connection with its official duties with respect to all
criminal proceedings in which the client is involved
b)
by
that justice agency in connection with its official duties with respect to all
drug-related criminal proceedings in which the client is involved
c)
by
that justice agency only in connection with its official duties with respect to
that particular criminal proceeding
d)
by
that justice agency only in connection with its official duties at its
discretion with the courts
72)
Under
Federal regulations a program may reveal client-identifying information in a
way that does not reveal the client’s status as a drug or alcohol abuse client.
a)
TRUE
b)
FALSE
73)
A
subpoena, search warrant, or arrest warrant signed by a judge _________.
a)
is
not sufficient standing alone to require or even permit a program to disclose
information
b)
is
sufficient standing alone to require or even permit a program to disclose
information
c)
is
the same as an authorizing order if it is signed by a Federal judge
d)
b
and c
74)
A
Qualified Service Organization:
a)
can
reveal information a substance abuse program cannot under the Federal
confidentiality
laws.
b)
should
only be used when an agency or official outside the program is providing a
service to the program itself.
c) may be used between programs providing
alcohol and drug abuse services.
75)
a and c
75)
Under
Federal regulations clients have a right to see their clinical records:
a)
at
the discretion of the program.
b)
whenever
they wish.
c)
for
good cause as determined by the client
d)
when
the program permits the client to view or obtain copies of their records.
DESCRIPTION:
This advanced course provides guidelines for substance abuse treatment providers in the public sector and in community programs. Based on clinical research and interviews with expert service providers, this course contains a summary of information available regarding the effects of domestic violence on the treatment of substance abuse, statistics describing domestic violence in this country as it pertains to substance abuse, and practical methods for developing an effective community-based treatment protocol to address the relevant issues. Also included are Federal confidentiality regulations.
OBJECTIVES:
After completing this course, the participant will
be able to:
1)
define
domestic abuse.
2)
identify
the signs and symptoms of abuse in a recovering batterer or survivor.
3)
list
the characteristics of a batterer or victim.
4)
explain
the links between substance abuse and domestic violence.
5)
recognize
effective interventions for domestic violence.
6)
prepare
a plan for coordinated community-based care for survivors of domestic violence.
7) state the basic requirements and limitations of Federal confidentiality regulations.