ADVANCE-D: Advancing theory and treatment approaches for men convicted of intimate partner violence who misuse substances

The ADVANCE-D programme aims to develop a new way of addressing substance use and IPV by integrating the specialisms of substance use treatment services and perpetrator programmes. Given this, the ADVANCE and ADVANCE-D Programmes will be delivered in substance use treatment, probation, criminal justice social work and domestic abuse services.  Through this research, we will assess whether ADVANCE-D is superior in reducing IPV perpetration compared to usual criminal justice offender management (CJOM) for men who misuse substances subject to probation/supervision in the past 4-, 12-, and 24-months post-baseline.

Around 1 in 3 women experience IPV, defined as any behaviour by an (ex)- intimate partner causing physical, sexual or psychological harm, including aggression, sexual coercion, psychological abuse, financial abuse and controlling behaviours resulting in poor mental, physical and sexual health. Having a male partner who misuses alcohol and/or drugs (substances) increases the risk of experiencing IPV and of domestic homicide. Delivering effective targeted behaviour change interventions to male IPV perpetrators who misuse substances will reduce the harm to their female (ex)-partners. However, the Domestic Abuse Commissioner for England and Wales has recently highlighted the lack of access to perpetrator programmes, with less than 1% of perpetrators receiving specialist behaviour change interventions.

Healthcare costs are 42% higher for IPV survivors, persisting for years after IPV stops. IPV costs the lives of almost 2 UK women a week. Social and economic costs of IPV are around £66bn a year in the UK. In the UK, perpetrator programmes reduce IPV by 30-65%, an investment return of £14 for every £1 spent. Therefore, providing targeted perpetrator programmes to court-mandated offenders who misuse substances and are ineligible for existing perpetrator programmes will result in reduced costs to society, health and social care and improved well-being of men, their (ex)-partners and children. If (cost) effective, ADVANCE-D would reduce recidivism and future imprisonment and could be implemented across the UK and wider. 

ADVANCE is a 14-week programme that can be delivered as a group-based in-person programme or for digitally-supported delivery (ADVANCE-D) by two trained staff from substance use treatment services, probation services, social work services or domestic abuse services (facilitators). ADVANCE was originally developed and tested for men in substance misuse treatment and has been offered to 94 men (54 in the treatment arm of an RCT and 40 in a feasibility study). We found it was feasible for trained substance misuse treatment staff to deliver and acceptable to men on the programme. Men offered the ADVANCE group intervention, compared to usual substance misuse treatment only, reported promising clinical outcomes and positive behaviour change, including reductions in IPV.  

We are currently undertaking a UK wide multicentre cluster randomised controlled trial (cRCT) with nested process evaluation assessing IPV perpetration in 32 Probation Delivery Unit (PDU)/ Criminal Justice Social Work teams (CJSW) randomised to ADVANCE-D compared to usual criminal justice offender management (CJOM) (1:1), combined with nested process evaluation.  

Most studies have investigated physical IPV as the primary outcome and included short-term follow-ups. Evaluations with longer term outcomes and comparisons with existing probation programmes are lacking. To address these shortcomings, also identified by NIHR, we will use a rigorous study design to evaluate the short, medium, and long-term outcomes of ADVANCE-D in probation with men who misuse substances but who are unsuitable for existing probation-based perpetrator interventions. Linkage with routinely collected data will ensure longer term follow-up at 24 months.

Funded by: NIHR Public Health Programme [NIHR154546] (1 November 2023-31 October 2027.)

In partnership with: Engaging People on Probation Group, Safelives, Against Violence and Abuse, Welsh Women’s Aid