A newly published pilot study has found that a peer delivered violence prevention program helped women in substance use treatment build protective skills and experience a marked drop in intimate partner violence within just three months.

The program, known as THRIVE (The Healthy Relationships and Interpersonal Violence Education program), was developed by researchers at Clemson University and Prisma Health in South Carolina. It was designed to tackle a problem that often goes unnoticed in addiction treatment settings, the extremely high rates of sexual and intimate partner violence experienced by women receiving care for substance use disorders.

Published in the Journal of Traumatic Stress, the study followed 90 women recruited from three treatment facilities in Greenville, South Carolina, between June and December 2024. Participants took part in two one hour sessions delivered by trained peer support specialists, people with lived experience of recovery who also held certification in community engagement and addiction counselling.

Why a Peer Delivered Violence Prevention Program Makes Sense

Between 60% and 90% of people in substance use treatment report a history of interpersonal violence, and women face a significantly higher risk than men of both sexual and intimate partner violence. Despite this, fewer than half of treatment facilities have adopted trauma informed care, and dedicated violence prevention services remain rare in these settings.

The researchers turned to peer support specialists to close this gap. Because facilitators shared lived experience with recovery, participants reported feeling less judged and more willing to open up. One participant explained during an exit interview that she preferred someone who had been through it herself, adding that she would otherwise feel judged by someone who could not understand what she had lived through.

This trust proved central to the success of the peer led prevention program. Facilitators were found to be 96% adherent to the protocol, and participants rated the sessions highly for satisfaction, engagement, quality, and helpfulness, each scoring above four out of five.

Encouraging Results After Three Months

The preliminary findings from this peer delivered violence prevention program are striking. At the start of the study, 73.9% of participants reported experiencing physical or psychological intimate partner violence in the previous three months. By the three month follow up, that figure had fallen to 42.0%, a statistically significant decline.

Participants also showed meaningful gains across several protective factors. Knowledge of consent increased, as did awareness of trauma related resources available to survivors. Confidence in using resistance responses during sexually aggressive situations rose from an average of 4.90 to 5.29 on a seven point scale, while intentions to engage in risky dating behaviour, such as using substances while on a date, dropped substantially.

Retention throughout the trial stayed strong for a notoriously transient population. Nearly 79% of women completed both THRIVE sessions, and more than two thirds remained engaged at the three month mark, a promising sign for the feasibility of scaling this type of program more widely.

Where the Peer Delivered Violence Prevention Program Still Needs Work

Not every outcome moved in the desired direction. Rates of sexual violence exposure did not show a significant decline, with some participants reporting slightly higher rates at follow up than at baseline. The study authors suggest this may partly reflect greater awareness and recognition of what counts as sexual violence, rather than a genuine rise in incidents. Attitudes toward rape myths and dating violence also showed little change, though the authors note that participants already held low levels of these beliefs before the program began, leaving little room for further improvement.

The researchers were candid about the limitations of a single arm pilot trial without a comparison group, noting that some improvements could reflect the broader effects of substance use treatment itself rather than the prevention program alone. They have called for future controlled trials with longer follow up periods, additional booster sessions, and a stronger focus on skills training and trauma focused help seeking.

A Model Worth Watching

Despite these open questions, the pilot trial points to a workable path for embedding violence prevention directly into substance use treatment, using staff who are already trusted by participants. Given how closely violence exposure and substance use are linked, this kind of peer support prevention program could offer a scalable way to protect vulnerable women while they work toward recovery.

The study authors say the approach is now ready for a larger, controlled trial to confirm whether these encouraging early results can be replicated across broader and more diverse populations.

Source: dbrecoveryresources