Encyclopedia of Psychology and Law

See alsoDanger Assessment Instrument (DA); Intimate

Partner Violence; Spousal Assault Risk Assessment

(SARA); Substance Use Disorders

Further Readings

Klostermann, K. C., & Fals-Stewart, W. (2006). Intimate

partner violence and alcohol use: Exploring the role of

drinking in partner violence and its implications for

intervention. Aggression and Violent Behavior, 11,

587–597.

Stith, S. M., & Smith, D. B., Penna, C. E., Ward, D. B., &

Tritt, D. (2004). Intimate partner physical abuse

perpetration and victimization risk factors: A meta-analytic

review. Aggression and Violent Behavior, 10,65–98.

SUBSTANCEABUSETREATMENT

A number of different methods are used to treat sub-

stance abuse. The most common method often used by

treatment facilities is 12-step counseling, although little

is known about its effectiveness. Treatment modalities

include inpatient, day treatment, and outpatient care,

usually followed by aftercare. Twelve Step Facilitation

Therapy has been scientifically validated but is rarely

adopted for use in 12-step treatment facilities.

Motivational interviewing has been determined to be

an effective means to motivate clients to seek therapy

and change substance use and can be particularly effec-

tive with unmotivated clients. Numerous cognitive-

behavioral therapies have been effective as interventions

in substance use disorders. Relapse prevention therapy

is the most widely used cognitive-behavioral approach.

Twelve-step counseling, cognitive-behavioral therapy,

therapeutic communities, and even Vipassanamedita-

tion have been used in jails and prisons to intervene in

substance use disorders and recidivism.

Substance Abuse Treatment

and the Criminal Justice System

Evidence exists that quality substance abuse treatment

can lead to lower recidivism and relapse rates among

substance users in the criminal justice system. In addi-

tion, court-ordered treatment has been found to be

extremely cost-effective when compared with incarcer-

ation as an alternative. Many jurisdictions now have

drug courts that generally offer treatment as an alterna-

tive to imprisonment, but the type of treatment available

to participants varies widely across the country. Traffic

courts often include mandated treatment courses for

DUI offenders, but the evidence that these programs

change drinking and driving behavior is inconsistent,

perhaps because the content of these courses vary

widely across jurisdictions. Treatment outcomes are

often used by mental health courts, probation officers,

and parole boards as evidence to determine the success

of rehabilitation efforts.

Typical Care at Treatment Facilities

The prevailing model of treatment in the United States

uses 12-step counseling (often referred to as the

Minnesota Model). Although many of these programs

have abstinence as a requirement for entry into the

facility and as a goal for treatment, researchers find that

many clients do not remain abstinent but will reduce

their substance use. Although most treatment centers

use a similar model, the quality and content of the 12-

step counseling across treatment facilities is not consis-

tent. In addition, the 12-step counseling provided by

many treatment centers has not been tested under con-

trolled conditions to determine if it is in fact effective.

Addiction counselors are certified by state boards.

The process often requires documentation of counselor

education in Minnesota Model principles and an exam-

ination of counseling skills by peers. Although some

addiction counselors have undergraduate and graduate

degrees, many states do not require these credentials for

a counselor to be certified. Addiction counselors often

have personal experiences in 12-step recovery.

TTrreeaattmmeenntt MMooddaalliittiieess

Treatment modalities vary. Treatment can be con-

ducted in inpatient or outpatient settings. In the past,

most treatment was provided in 28-day inpatient stays,

until research showed that outpatient care is just as

effective as inpatient care for most clients. Since those

findings, the insurance industry has pushed the treat-

ment toward a predominantly outpatient model. People

with substance use disorders and co-occurring severe

mental disorders (such a debilitating depression or psy-

choses) may benefit more from the structured environ-

ment of an inpatient stay. Day treatment also is available

in some communities to provide structured treatment

and care during business hours (clients return home dur-

ing the evening). Many treatment facilities provide med-

ical care, family programs, and sometimes nutrition and

fitness programs. Counseling format varies between

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