Using the Behaviour Change Wheel to Design an Intervention for Partner Abusive Men in Drug and Alcohol Treatment

Abstract Background: We aimed to establish what core elements were required in a group therapy programme for men who disclose perpetrating intimate partner abuse in a substance use setting and develop, and test the feasibility of delivering an intervention in this setting. Methods: We describe the theoretical development and feasibility testing of an integrated substance use and intimate partner abuse intervention(“ADVANCE”) for delivery in substance use services. We employed a comprehensive eight stage process to guide this development applying the ‘COM-B’ model for intervention design which specifies: 1) define the problem, 2) select the target behaviour, 3) specify the target behaviour, 4) identify what needs to change, 5) identify intervention functions, 6) identify policy categories, 7) select behaviour change techniques, and 8) design a mode of delivery. The development was informed by primary research conducted by the authors, consulting with organisation steering groups and by those with personal experiences. A feasibility study (ISRCTN 79435190) involving 104 men, 27 female partners and 30 staff at three different locations across the UK was conducted to assess the feasibility and acceptability of the intervention and to refine the content and approach to delivery. Results: Our final intervention, the ADVANCE intervention consisted of a group intervention comprising of up to four pre-group individual interviews, followed by 12 x 2-hour group sessions supported by integrated safety work for victim/survivors, and risk and safety support and integrity support for the professionals. The main targets for change were personal goal planning, self-regulation and attitudes and beliefs supporting intimate partner abuse. The intervention was regarded as very acceptable to both staff and clients in substance use services, with group attendees reported positive behavior changes and development of new skills, that facilitators noted were ‘life-changing’ for some. Conclusion: We have demonstrated the ability to employ a structured eight-step process to develop an integrated intervention to address substance use related intimate partner abuse that is acceptable to staff and clients in substance use services.