3 - (SYM 43) A Qualitative Approach to Developing a Brief Couples Intervention for Co-occurring Alcohol Use Disorder and Intimate Partner Violence

Alcohol use is globally and acutely related to intimate partner violence (IPV), with more frequent and severe IPV occurring among couples affected by alcohol use disorder (AUD). Despite evidence that IPV and AUD frequently co-occur and are heavily influenced by partners, no couple interventions exist to simultaneously reduce IPV and AUD. Thus, a dyadic approach that concurrently targets both partners’ IPV and AUD should be more effective and less costly. As a first step toward developing a maximally implementable couple treatment for AUD and mutual IPV, this study conducted key informant interviews with 15 clinicians who treat adults impacted by AUD and/or couple conflict to identify (1) perspectives on potential treatment barriers, (2) intervention needs/preferences, and (3) preliminary feasibility and appropriateness of a dyadic AUD and IPV intervention.

Clinicians participated in a 60-90 minute in-person or virtual qualitative interview. Following transcription, a sampling of 4 interviews were coded using line-by-line open and a priori structured coding. Two researchers used the constant comparative method to discuss structured and emergent codes. A codebook was then created to expedite coding of remaining interviews, making allowances for additional codes to emerge. Saturation was achieved.

Clinician-perceived barriers included individual-level barriers (e.g., stigma), couple-level barriers (e.g., scheduling), external barriers (e.g., insurance), and culture (e.g., preferences for rural areas). Clinician intervention needs/preferences included training demands, therapist and patient safety, intervention modality, treatment components (e.g., CBT, DBT), and eligibility criteria. All clinicians were in favor of a couple-level intervention for AUD and IPV, though appropriateness was limited to those experiencing mild-moderate IPV to ensure client safety. Feasibility depended on organizational resources (e.g., clinics having several clinicians).

By utilizing a qualitative approach, this study allowed participants to express themselves freely and uncover themes and patterns that may not have been captured via quantitative methods. This study will help develop hypotheses for future quantitative studies. Leveraging these practitioner needs is important when developing a couple-level IPV and AUD intervention to minimize the science-to-service gap. Results will enhance the implementability of future AUD and IPV interventions.