The ADVANCE team’s latest publication led by Professor Gail Gilchrist is now available.
Background: Substance use is a risk factor for intimate partner abuse (IPA) perpetration. Delivering perpetrator interventions concurrently with substance use treatment shows promise.
Methods: The feasibility of conducting an efficacy and cost-effectiveness trial of the ADVANCE 16-week intervention to reduce IPA by men in substance use treatment was explored. A multicentre, parallel group individually randomised controlled feasibility trial and formative evaluation was conducted. Over three temporal cycles, 104 men who had perpetrated IPA towards a female (ex) partner in the past year were randomly allocated to receive the ADVANCE intervention + substance use treatment as usual (TAU) (n = 54) or TAU only (n = 50) and assessed 16-weeks post-randomisation. Participants’ (ex) partners were offered support and 27 provided outcome data. Thirty-one staff and 12 men who attended the intervention participated in focus groups or interviews that were analysed using the framework approach. Pre-specified criteria assessed the feasibility of progression to a definitive trial: 1) ≥ 60% of eligible male participants recruited; 2) intervention acceptable to staff and male participants; 3) ≥ 70% of participants followed-up and 4) levels of substance use and 5) IPA perpetrated by men in the intervention arm did not increase from average baseline level at 16-weeks post-randomisation.
Results: 70.7% (104/147) of eligible men were recruited. The formative evaluation confirmed the intervention’s acceptability. Therapeutic alliance and session satisfaction were rated highly. The overall median rate of intervention session attendance (of 14 compulsory sessions) was 28.6% (range 14.3–64.3% by the third cycle). 49.0% (51/104) of men and 63.0% (17/27) of their (ex) partners were followed-up 16-weeks post-randomisation. This increased to 100% of men and women by cycle three. At follow-up, neither substance use nor IPA perpetration had worsened for men in the intervention arm.
You can access the paper for free here.
The Nuffield Foundation has published a new evidence review, Protecting young children at risk of abuse and neglect. The review draws on data and research from the last two decades to explore changing patterns of abuse and neglect in early childhood, with a focus on the child welfare and family justice systems in England and Wales.
As the review shows, The Nuffield Foundation are seeing early signs that abuse and neglect may be increasing as a result of the additional pressures caused by the pandemic. Children’s services are already under pressure as a result of increasing rates of child protection interventions over the last decade, particularly for children living in the poorest areas. In the same period, funding for preventative services to support families has decreased, and many young children who are at risk of abuse or neglect are unknown to services and therefore not receiving the help they need.
The review highlights connections and tensions in the evidence, as well as gaps and uncertainties. It concludes that the ongoing debate about whether the state is intervening too little or too much is not only impossible to answer given the inadequate data available, but is the wrong question to be posing. Instead, attention needs to be given to whether public services are intervening in the right way to prevent harm and promote positive outcomes for young children.
The review calls for re-evaluation of the current system, with a focus on how public services and agencies can adopt a holistic and collaborative approach to support young children at risk of abuse and neglect, prevent harm, and promote positive outcomes. The time is right for such a re-evaluation, given the independent review of children’s social care currently underway.
Protecting young children at risk of abuse and neglect is the second evidence review in our Changing face of early childhood series, which seeks to generate an informed debate on early childhood based on what the collective evidence tells us. The series synthesises and critically appraises a large and complex body of evidence, much of it funded by the Nuffield Foundation, bringing together perspectives from different disciplines and vantage points.