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Overview of Webinar Format

• Polling Questions• Questions for Presenters• Webinar Evaluations• FDC Blog

2

3

Questions & Discussion

Please type and send your questions through the Question and Answer box located on the bottom half on your panel/dashboard.

Welcome to the FDC Learning

Academy 2013!To date:4 Learning

Communities

23 Webinar presentations

Over 1600 total attendees

45 States

5

Planning Community

Mission and Underlying

Values

Principles of Collaborative

Practice

Screening & Assessment

Engagement & Retention

Information Sharing &

Data Systems

Early Implementation

Community

Services to Children

Trauma-Informed Services

Responses to Behavior

Critical Issues: A

PanelDiscussion

Joint / Shared

Outcomes

Enhanced Community

Engaging Defense

Attorneys

Engaging Fathers in

FDC

Marketing to Stakeholders

Budget & Sustainability

Moving Towards

System-Wide Change

Advanced Practice

Community

Use of Jail as a

Sanction

Evidence-Base

Parenting

Trauma-informed

FDC

Judicial Leadership and Ethics

Child Well-being and

Services to Children

FDC Learning Academy

FDC Models:

Parallel vs. Integrated

Effective Drug

Treatment

Sustain-ability

March 13 Responding to DV in FDC

April 10 Passing the Judicial Baton – Why Judicial Succession Planning Matters in FDC

May 8 Reaching the Tipping Point – FDCs as a National Child Welfare Reform Strategy

June 19 FDC Peer Learning Courts – Highlighting Effective FDC Practices

August 14 So Who Are You Really Serving? The Challenge of Serving Special Populations in FDCs

September 11 Raising the Bar in FDCs – A Look at FDC Guidelines

FDC Learning Academy 2013

Knowledge Sharing Community

6

This project is supported by Award No. 2009-DC-BX-K069 awarded by the Office of Juvenile Justice and Delinquency

Prevention, Office of Justice Programs

National Family Drug Court Technical Assistance and Training Program

Responding to Domestic Violence in

Family Drug Court

March 13, 2013

Theresa Lemus, MBA, BSN, LATCLarry Bennett, PhD, LCSW

Julie DeFranco. MSWJulie Borba. CATC

Today’s Presenters

Larry Bennett, PhD, LCSWChicago, Illinois

8

Theresa Lemus, MBA, BSN, LADCReno, Nevada

Julie DeFranco, MSW Julie Borba, CATASanta Barbara County, California

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• To understand the relationships between DV and substance abuse and why such understanding is important for FDC professionals

• To learn screening methods and intervention strategies for FDC teams

• To explore collaborative strategies to respond to familieswith interpersonal violence

Learning Objectives

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Polling Question Our FDC Team (Steering Committee, Operational Team) includes a representative from the DV community?

1. Agree2. Somewhat agree3. Disagree4. Not sure/Don’t know

#1

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Responding to DV in FDC –A Challenging PathTheresa Lemus, MBA, BSN, LADC

Responding to Domestic Violence in FDCs

Why is this issue important?

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• Cross-over population; co-occurrence range from 30-60%• Many FDCs screen out high risk, high need families• Unidentified DV or unsafe intervention may contribute to

poor outcomes for families• Lack of screening protocols for DV• Lack of training regarding DV• Lack of interagency partnerships with DV providers

Domestic Violence in FDC

What do we know?

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Starting Point

Bringing the Greenbook to Life: A Resource Guide for Communities

To download a copy: http://www.thegreenbook.info/documents/BJA.pdf

This is not an easy path for FDCs

Sharing Knowledge Laying a Foundation

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Polling Question Domestic violence advocacy and services are included in assessment and case plans in our FDC.

1. Agree2. Somewhat agree3. Disagree4. Not sure/Don’t know

#2

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Domestic Violence Screening, Brief Intervention, and Referral

Larry Bennett, PhD, LCSW, U. of Illinois, Chicago

Drug Courts and DV Offenders

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• DV known: referred to Drug Court to address substance abuse issues believed to trigger DV

• DV history known (but often underestimated) • DV offense history viewed < SUD history• DV Unknown: referred to Drug Court

• Half of partnered men entering substance abuse treatment have battered in the past year1 and are 11 times as likely to batter on a day in which they have been drinking 2

• Between 55 and 99 percent of women who have SA issues have been victimized at some point in their life3 and between 67 and 80 percent of women in SA treatment are DV victims 4

Substance Use and DV – There is a Link

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• Most men not drinking or drugging when they batter 1

• Most (80%) heavy drinkers don’t batter 1

• The apparent correlation between substance (ab)use and DV fits only a sub-group of people.2

• When male-dominant attitudes are controlled, relationship between SA and DV lessens, suggesting both SA and attitudes toward gender are important in preventing DV.3

But….

20

References

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1 Gondolf, E.W. (1999). Characteristics of court-mandated batterers in four cities: Diversity and dichotomies. Violence Against Women, 5, 1277-1293.

2 Fals-Stewart W. (2003). The occurrence of partner physical aggression on days of alcohol consumption: A longitudinal diary study. Journal of Consulting and Clinical Psychology, 71, 41–52.

3 Jahn Moses, D.J., Reed, B.G., Mazelis, R., & D’Ambrosio, B. (2003). Creating trauma services for women with co-occurring disorders. Substance Abuse and Mental Health Services Administration. Available at www.prainc.com/wcdvs/pdfs/CreatingTraumaServices.pdf

4 Cohen, J.B., Dickow, A., Horner, K., Zweben, J.E., Balabis, J., Vandersloot, D., Reiber, C. (2003). Abuse and violence history of men and women in treatment for methamphetamine dependence. American Journal on Addictions, 12, 377-385.; Downs, 2001.

21

Paths Between Substance Use and DV

• The dis-inhibiting effects of chemicals on cognitive processes

• The effects of co-occurring conditions• Beliefs about effect of drugs and alcohol on behavior• Motivation for power• The situation• Earlier trauma• Excuse-making • BOTTOM LINE: Cannot assume

treatment, abstinence, recovery will result in a reduction of DV

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Screening

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If I could talk to your partnerwould she/he/they say. . .

• You make them feel unsafe even in their own home?• They feel ashamed of the things you do to them?• They try not to rock the boat because they are afraid of what

you might do?• They feel programmed to react a certain way to you?• They feel like you keep them prisoner?• You make them feel like they have no control over their

life, no power?• They hide the truth from others because they are afraid not

to?• They feel owned and controlled by you?• You can scare them without laying a hand on them?• You have a look that goes straight through them me and

terrifies them? 23

Domestic Violence

Covered by the Law

(episodic, physical, serious)

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Domestic ViolenceExperienced by Victims(episodic & continuous, physical & non-physical, serious)

Domestic Violence

Covered by the Law

(episodic, physical, serious)

Johnson DV Typology• Intimate Terrorism (Control)

• Almost always men abusing women, more severe, more frequent

• Situational Couple Violence (Conflict)• Gender symmetry, non-controlling, less

severe, less frequent• Violent Resistance (Self Defense)

• Violence in response to Intimate Terrorism, usually self-defense, usually women, non-controlling

• Mutual Violent Control (very rare: “mutual combat”)• Both partners seek control with violence

27

Holtzworth-Munroe (Male) Batterer Typology

• Typical: Normal/family-only (50%)• Unstable: Dysphoric/borderline (25%)• Antisocial: Generally violent (25%)

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Normal BatterersThe Family-only/Typical Type

• 50% of batterers in court• Not likely to be substance abusers• Not likely to have mental disorders• These men are normal and indistinguishable from

men in the general population (except in income and race)

29

Unstable BatterersThe Dysphoric/Borderline Type

• Emotionally unstable• Depressed, anxious, hostile, labile, “borderline

personality”• 25-40% of court-involved batterers• Alcohol and drugs often used to regulate mood

(and/or other form of neurotransmitter manipulation such as compulsive sex, gambling, risk-taking)

30

Generally Violent BatterersThe Antisocial Type

• Emotionally stable, may lack empathy• 10-30% of court-involved batterers• More likely to seriously injure victim• May abuse drugs and alcohol to relieve boredom (or

other, like risk, sex, etc.)• May be confounded with race/ethnicity

Swan & Snow Typology of Women Using IPV

• Victims (34%)• Similar to Johnson VR type

• Aggressors (12%)• Mutual Violence/Male Coercive (32%)• Mutual Violence/Female Coercive (18%)

31

Key Correlates of IPV• Societal Level (Levinson, 1987)

• Women’s lack of access to divorce• Male economic control• Male domestic authority• Social approval of violence (per capita guns, use of

animals in sports, male military glory, legal response to rape & IPV)

• Community reinforcement: getting away with it• Individual Level (Hotaling & Sugarman, 1986)

• History of violence in the family of origin• Income/social class • Substance abuse by the perpetrator

32

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Violence in the Family of Origin, AdultDrinking, Approval of Violence AgainstWomen, and Battering

Violencein Familyof Origin

Alcohol/DrugAbuse

Approval ofViolence DV

N=723 Non-Abstinent Males(Kantor & Asdigian, 1993)

.30

.30

.17

.64n.s.

Great Lakes ATTC ARIV Model(Addiction Recovery & Intimate Violence)

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ARIV Screen Questions*

1. Have you been hit, kicked, punched, or otherwise hurt or threatened by someone in the past year?

2. Do you feel safe in your current relationship? 3. Is there a partner from a previous relationship

who is making you feel unsafe now?

36

* Feldhaus et al (1997). Accuracy of 3 brief screening questions for detecting partner violence in the emergency department. JAMA, 277,1357-1361.

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38

39

Intervening

40

Responding to DV in Drug Courts*

• Identify the behavior, and acknowledge the problem

• Have the treatment team work on a plan to hold the batterer accountable while they participate in Drug Court

• If possible, the treatment team should make a referral to a BIP, and include the BIP counselor as part of the treatment team for the duration of the BIP

* Miller, R. (2010). Domestic violence courts and collaborative responses to domestic violence. Paper presented at the Annual Conference, Missouri Association of Drug Court Professionals, Osage Beach, MO

Responding to DV in Drug Courts

• The treatment team and specifically the probation officer, can begin working with the Prosecutor and Judge to help respond to potential violence, and to make connections with the victim. Use of special conditions will help modify/change the batterer’s behavior.

• Drug Courts should remain focused on their goals, but they must acknowledge the DV-related behavior and add the additional goals of victim safety and batterer accountability to their planning.

42

Responding to DV Victims in Drug Court

• Acknowledge their victimization, and understand that it may be driving their substance abuse

• Refer them to victim service agency and invite the advocate to your team

• Be prepared to work with your client to allow for the possibility of relocation if their safety is compromised

• Have a protocol in place as a Court to work this out

43

Victims as Significant Others

• Make a referral to a DV program• Invite the victim in to meet with the team so

they know you are prepared to help them, and to help the batterer stop the abuse

• Be prepared to intercede legally, and plan the intercession with the victim. This may include no contact orders, etc. Always take the time to ask the victim what they think is the safest plan for them!

44

Resources

45

46

www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=hstat5.chapter.46712

SAMHSA Domestic Violence and Substance Abuse Treatment (TIP 25)

Manual of the Illinois Domestic Violence/Substance Abuse Interdisciplinary Task Force (2nd Edition, 185 pp.) www.dhs.state.il.us/page.aspx?item=38441

Trauma-informed Services for Women With Co-occurring Substance Use / Mental Health Disorders and Victims of Violence (SAMHSA) www.nationaltraumaconsortium.org/documents/CreatingTraumaServices.pdf

47

www.ispia.org/index.phpIowa Integrated Services Project

Protocol for Screening and Management of Co-occurring Substance Abuse and Domestic Violence, Georgia Commission on Family ViolenceGeorgia Department on Corrections (April 2008)http://www.gcfv.org/

Measuring Intimate Partner Violence Victimization and Perpetration – A Compendium of Assessment Tools (CDC, 2006)

http://www.cdc.gov/ncipc/pub-res/IPV_Compendium.pdf

Resource Manual

Getting Safe and Sober: Real Tools You Can UseA Teaching Kit For Use With Women Who Are Coping with Substance Abuse, Interpersonal Violence and Trauma (Available in English and Spanish)

This project was supported by the Office of Women’s Health Region X Grant # HHSP233200400566P and by Grant #’s 2003-MU-BX-0029, 2004-MU-AX-0029 awarded by the Office on Violence Against Women, U.S. Department of Justice. The opinions, findings, conclusions and recommendations expressed here are those of the presenters and authors and do not necessarily reflect the views of the Department of Justice, Office on Violence Against Women or the Office of Women’s Health. Principal Authors : Patricia J. Bland , M.A. CCDC CDP and Debi Edmund, M.A. L.P.C.

For more information contact:Alaska Network on Domestic Violence and Sexual Assault(907) 586-3650

www.andvsa.org

48

Larry Bennett, PhD, LCSWGreat Lakes Addiction

Technology Transfer CenterUniversity of Illinois Chicago

lwbenn@uic.edu

Contact Information

49

50

FDC Example: Santa Barbara County FTDC, California

Julie DeFranco, MSW, Santa Barbara County CWS

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Santa Barbara County

• Population: 423,895 (2010)• Land Size: 2,740 sq. miles • Population density:

155 persons/sq. mile

FTDC focuses on Northern Santa Barbara County -Santa Maria and Lompoc, which together represent approximately 84% of all new child welfare cases with parental substance abuse involvement in Santa Barbara County.

52

Santa Barbara County FTDCProgram Goals

• Provide safety, early identification, rapid access, and engagement in services for parents with AOD issues

• Provide families with comprehensive, culturally competent, gender responsive and trauma-sensitive services

• Reduce parental substance abuse and subsequent positive toxicology births, and/or exposure to parental AOD

• Strengthen parents’ confidence and competence• Improve physical, developmental, and mental health of

child participants• Decrease time to FR or PP; reduce time in out of home

care

53

Santa Barbara County FTDCBackground/History

• FDTC was developed in 2009• No initial additional funding• FTDC is one of seven problem-solving Courts

in Santa Barbara County• Participated in SAMHSA funded grant

programs, including Children Affected by Methamphetamine (CAM)

54

Trauma-Sensitive & Trauma FocusedSystem of Care

• Significant portion of target population suffers from PTSD or has history of trauma

• System of care includes trauma-sensitive substance abuse treatment provided by Good Samaritan and trauma informed treatment by CALM (Child Abuse Listening Mediation)

• All providers are required to attend a workshop on Seeking Safety to understand the relationship between trauma to mental health and substance use disorders

• Trauma sensitive + gender sensitive• Helping Women Recover – Stephanie Covington• Helping Men Recover – Dan Griffin and Stephanie

Covington

Parent Characteristics

Drug of Choice21%

36%

43%

Alcohol

Methamphetamine

Polysubstance

EthnicityEuropean American 36%Hispanic/Latina 64%

Age Group20-24 7%25-34 50%35-44 36%14-16 7%

Mean: 32 years old55

EthnicityEuropean American 47%Hispanic/Latina 18%Mixed/Multiracial 35%

GenderFemale 37%Male 63%

Age Group0-5 62%6-10 7%11-13 15%14-16 15%

Mean: 7 years old

Child Characteristics

56

Domestic Violence in Santa Barbara County

• Per the DA, in 2012 there were 4000 new victims of crimes reports in SB County

• Of those, 35% were DV related• Clear pervasive presence of DV in SB in crime and

child safety issues• Estimate that at least a quarter of FDTC cases have

an element of DV• Often DV emerges in CWS cases as a hidden factor;

highlights need for improved assessments to ensure accurate interventions addressing underlying traumas

57

FTDC Screening Protocol • Screenings/Tools include:

• SDM (Structured Decision Making: Safety, Risk, and Family Needs Assessment)

• Safety Planning• CLETS (Criminal History Inquiries/Calls for Service to

Home)• Client/CH interviews/Social Hx:Jurisdiction/Disposition• CSS (Children Services Screenings)• ASI (Addiction Severity Index)• NCFAS-G+R: North Carolina Family Assessment Scale

for General Services and Reunification• TSCC (Trauma Symptom Checklist for Children)• TSCYC (Trauma Symptom Checklist for Young

Children)• TSI (Trauma Symptom Index)

58

FDTC Client ResponsesAddiction Severity Index (ASI)

0

10

20

30

40

50

60

70

Conflicts with Partner

Experienced Emotional Abuse

Experienced Physical Abuse

Experienced Sexual Abuse

Perc

ent

Past 30 Days Lifetime59

FDTC Client ResponsesAddiction Severity Index (ASI)

0

5

10

15

20

25

30

35

40

45

50

Not at all Slightly Moderatly Considerably Extremely

Perc

ent

Bothered or Troubled by Family Problems

How Important is Treatment for Family Problems60

Referral Protocol

Referral for screening occurs at the time of Detention Hearing• Member of target population• Santa Barbara County resident• Must enter treatment prior to Dispositional Hearing• No pending charges that could result in long- term

incarceration• Not suffering from serious mental illness• Not known to engage in serious DV • Not known to have perpetrated serious PA/SA/EA abuse

of child • Not using methadone • CWS is not recommending bypass under WIC 361.5

61

Participation Protocol

• Engaged in treatment prior to Disposition Hearing• Able to attend frequent Court hearings• Participate in Team Decision Meetings (Families with RO

are held separately) • FDTC works collaboratively with many partners

including: – Juvenile Court Team– SB County Alcohol Drug and Mental Health Services– Good Samaritan– CALM (Child Abuse Listening Mediation)– Law Enforcement / Probation / SBRNET (Santa

Barbara Regional Narcotic Enforcement Team)– Victim Witness/Rape Crisis/SART (Sexual Abuse

Response Team)– Public Health– University of California - Santa Barbara

62

Identified Strengths• Early intervention and continuum of care • Strong community collaborative partnerships• Frequent Court appearances/Court staffing• Emphasis on trauma-informed care:

– ASI– NCFAS-G+R– Seeking Safety– Helping Men Recover Groups

• Upcoming Implementation of SOP (Safety Organized Practice)

63

CWS Lessons Learned and Goals Moving Forward

• Unseen components of DV in FDTC• Negative impact on treatment/FR outcomes• Timelines for case plan and assessments• Intentional focus on staffing subsequent

disclosures of DV to inform treatment/case plan development

• Increased engagement of VW and other community partners at Team Decision Meetings

• Continued emphasis on engaging fathers

64

Seeking Safety

Julie Borba, CATC, Turning Point

“Although the world is full of

suffering, it is full also of

the overcoming of it”

Helen Keller20th-century

American writer

Good Samaritan Services

• Good Samaritan Services as the primary provider of case management and drug treatment services for FTDC clients

• Serving community since 1989; long-time provider to CWS

• Santa Maria and Lompoc• Continuum of care – emergency

shelter, detox, outpatient, residential• Seeking Safety provided since 2005

Seeking Safety

• Evidence-based, manualized group therapy

• Present-focused • Cognitive-behavioral approach• Achieve “safety” from danger associated

with PTSD & substance abuse• Addresses trauma and substance abuse

issues concurrently; teach safe coping skills that apply to both

• Designed for flexible use

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Seeking Safety Group Structure• Check-in

-Since last session, how are you feeling?-What good coping have you done?-Any substance use or other unsafe

behavior?-Did you complete your commitment?-Any community resource update?

• Quotation• Session Content (handouts)• Check-out

– Name one thing you got out of today’s session and any problems you had with the session.

– What is your new commitment?– What community resource will you call?

Safety: The Most Urgent Clinical Need

• First stage of recovery from PTSD and substance addiction is safety

• Safety is the first step in helping a victim of DV change their circumstances

• The “Safety” group is helpful with DV clients- What is safety to you?- Message of safety + community support + self-care- Development & Utilization Safe Coping Skills:

- Compassion- Listen to yourself with respect and care

- Create a buffer- Put something between you and danger (e.g. time, distance)

- Reach for community resources- Lean on them! They can be a source of great support!

Support ServicesSupport Offered• Nurturing Parenting; additional

parenting services• Mental health services, therapy• Matrix – relapse prevention group• Onsite childcare• Case management• Residential treatment• Financial services• DV community programsSupport Gaps

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Seeking Safety

For more information, visit - www.seekingsafety.org

Najavits, L. (2002). Seeking Safety: A Treatment Manual for PTSD and Substance Abuse. The Guilford Press: New York, NY.

71

Contact Information Julie DeFranco, MSW

Social Service Supervisor IICourt Services/FDTC

Child Welfare Services2125 Centerpointe Parkway

Santa Maria, CA 93455(805) 346-7170

j.defranco@sbcsocialserve.org

Julie Borba, CATCDrug and Alcohol Counselor

Good Samaritan Services /Turning Point Outpatient Drug Facility

805-736-0357 x 211jborbagssi@gmail.com

73

Questions & Discussion

Please type and send your questions through the Question and Answer box located on the bottom half on your panel/dashboard.

74

Next Steps and ResourcesTheresa Lemus, MBA, BSN, LADC

75

How is Responding to DV a Collaborative

Practice Issue?

A Structure for Collaboration:@ System and Case Level

Oversight/Advisory

Committee

Director Level

Quarterly

Program Funder:Ensure long-term

sustainability

Steering Committee

Management Level

Monthly or Bi-Weekly

Policy-Maker: Remove barriers

to ensure program success

FDC Treatment Team

Front-line Staff

Weekly

Staff Cases: Ensure client

success

FDC STRUCTURE

Meets

Membership

Primary Function

Systems Level Case Level

Responding To DV@ Systems Level

Oversight/Advisory

Committee

Steering Committee

77

• Given the large cross-over population, is your FDC giving proportional attention?

• Major national DV initiatives – are connected with the DV stakeholders? Building connections? Invited or included in meetings?

• Information sharing policies?

Responding To DV@ Case Level

• Screen for DV• Refer and/or provide trauma-informed

services• Gain knowledge about DV

• Monitor progress in CWS case plan• Provide In-depth assessment of

client and family needs

• Develop partnerships with DV services

• Referral process, including “warm handoff”, monitor barriers to access

Treatment & Recovery

Child Welfare

Relationships and

Community78

Additional Checklist Items

• Are you partnering with community based DV programs available to serve FDC clients?

• Can you co-locate DV advocates in FDCs for case consultation and supportive services?

• Have you developed cross-system protocols and partnerships to ensure coordinated services and responses to families?

• Cross train DV and FDC staff and partners?

80

National DV Initiatives

Office on Violence Against Women –US Department of Justicehttp://www.ovw.usdoj.gov/

National Center on DV, Mental Health, and Traumahttp://www.nationalcenterdvtraumamh.org/about/

81

DV Funding

• Federal Violence Against Women Act (DOJ)• Child Abuse Prevention and Treatment (CAPTA: HHS)• Family Violence Prevention and Services Act (FVPSA: HHS) • Court Improvement Program (HHS)• Joint DOJ/HHS funded Greenbook sites• State CW operating funds

Cross-System Resources

Cross System Dialogue: An Effective Strategy to Promote Communication Between the Domestic Violence Community, Child Welfare System, and the Courts (NCJFCJ, 2008)http://www.thegreenbook.info/documents/crosssystemdialogue.pdf

For more tools and resources, visit:The Greenbook Initiativehttp://www.thegreenbook.info/read.htm

83FOR MORE INFORMATION OR TO SCHEDULE A SITE VISIT :Email: PeerLearningCourts@cffutures.org

Baltimore City Circuit Court, Juvenile Division

MarylandJudge: Robert B. Kershaw

Chatham County Juvenile Court,Family Dependency Treatment Court

GeorgiaJudge: Patricia P. Stone

Hillsdale County Family Drug Court

MichiganJudge: Michelle Bianchi

Jackson County Family Drug Court16th Judicial District

MissouriCommissioner: Molly Merrigan

Pima County Juvenile CourtArizona

Judge: Susan Kettlewell

Visit the FDC Learning

Academy Blog

www.familydrugcourts.blogspot.com

• Webinar updates• Presenter info• Learning resources• Post a follow-up question

Links to Resources

84

Ask our presenters

Webinar registration

85

Register Now!Passing the Judicial Baton -

Why Succession Planning Matters in FDC

https://www1.gotomeeting.com/register/850795632

Wed., April 10th - 10am-12pm PT

85

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86

Contact Information

Theresa Lemus, MBA, BSN, LADCProgram Associate

Children and Family Futurestlemus@cffutures.org

RESOURCESPlease visit:

http://www.cffutures.org/projects/ family-drug-courts

GENERAL INQUIRESfdc@cffutures.org

VISIT www.cffutures.org

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