Contents
 

Why a Quick Guide? . . . . . . . . . . . . . . . . . . . . 2
 

What is a TIP? . . . . . . . . . . . . . . . . . . . . . . . . . 3
 

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
 

Screening for Survivors  . . . . . . . . . . . . . . . . . 6
 

Treatment Planning for Survivors  . . . . . . . . . 9
 

Issues of Child Abuse or Neglect  . . . . . . . . 18
 

Screening Techniques and Questions 

for Batterers  . . . . . . . . . . . . . . . . . . . . . . . . . 20
 

Treatment Planning for Batterers  . . . . . . . . 22
 

Referral and Linkages  . . . . . . . . . . . . . . . . . 24
 

Legal Issues  . . . . . . . . . . . . . . . . . . . . . . . . 28
 

Phone and Internet Resources  . . . . . . . . . . 31
 
   

   

Quick Guide
 For Clinicians
 

Based on TIP 25

Substance Abuse Treatment

and Domestic Violence

This Quick Guide is based almost entirely on information contained in TIP 25, published in 1997 and based on information

updated through June 1996. No additional research has been

conducted to update this topic since publication of the original

TIP.
           

       

         

           

         

         

           

                   

           

   

   

   

2 Substance Abuse Treatment and Domestic Violence

WHY A QUICK GUIDE?

This Quick Guide was developed to accompany

Substance Abuse Treatment and Domestic

Violence, Number 25 in the Treatment

Improvement Protocol (TIP) Series published by the

Center for Substance Abuse Treatment (CSAT),

Substance Abuse and Mental Health Services

Administration. This Quick Guide is based entirely

on TIP 25 and is designed to meet the needs of

the busy clinician for concise, easily accessed

"how­to" information.

The Guide is divided into eight sections (see

Contents). These sections will help readers quickly locate relevant material.

Clinicians can use the Resources on page 31 to

keep updated with current information on the

most recent developments in the field of domestic

violence.

For more information on the topics in this Quick

Guide, readers are referred to TIP 25.
               

           

         

       

   

         

   

What is a TIP? 3

WHAT IS A TIP?

The TIP series has been in production since 1991.

This series provides the substance abuse treatment and related fields with consensus­based,

field­reviewed guidelines on substance abuse

treatment.

TIP 25, Substance Abuse Treatment and Domestic

Violence:

• Addresses the concerns of a broad range of

readers including substance abuse treatment

clinicians, domestic violence programs, social

workers, medical personnel, program administrators, and policymakers

• Includes extensive research

• Lists numerous resources for further information

• Provides a reference for substance abuse treatment clinicians working with adults who have

experienced domestic violence

See the inside back cover for information on how

to order TIPs and other related products.
     

   

   

   

       

   

   

   

   

4 Substance Abuse Treatment and Domestic Violence

INTRODUCTION

Domestic violence is the use of intentional emotional, psychological, sexual, or physical force by

one family member or intimate partner to control

another. Researchers have found that one fourth

to one half of men who commit acts of domestic

violence have substance abuse problems. While

domestic violence affects a variety of populations,

this Quick Guide only discusses the treatment of

adult male batterers and adult female survivors.

The Connections Between Substance Abuse

and Domestic Violence

• Substance abuse doesn't "cause" domestic violence.

• It may afflict both batterers and survivors.

• Failure to address domestic violence may interfere with treatment effectiveness.

• A substance abusing woman may find her abusive partner becomes angry when she seeks

help, and his violence could push her to drop

out of treatment.

• Some batterers are worse domestic violence

offenders when they are sober so partners of

such batterers may try to subvert treatment

efforts.
     

     

   

     

   

   

Introduction 5

Goals

• Attaining sobriety

• Ensuring survivors' safety

Create Linkages

To effect lasting change, people working in both

fields must recognize the importance of holistic

treatment and learn to collaborate on the client's

behalf. This Quick Guide presents pertinent information on holistic treatment of domestic violence

situations substance abuse treatment clinicians

will need. This will include creating linkages with

groups pertinent to a client's recovery, including:

• Domestic violence programs

• Health care communities

• The criminal justice system

• Schools and educational institutes

• Employers

• Social welfare

ATTENTION: Due to the high correlation between

the two problems, all clients who present for substance abuse treatment should be questioned

about domestic violence.

For more detailed information, see TIP 25, 

pp. xiii–xix.
   

       

   

6 Substance Abuse Treatment and Domestic Violence

SCREENING FOR SURVIVORS

CAUTION: It is important not to ask potentially

painful questions too soon; otherwise, a client may

feel overwhelmed and reluctant to return.

Clues for the Treatment Provider

• Physical injuries around the face, neck and

throat

• Inconsistent/evasive answers when questioned

about injuries

• A history of relapse or noncompliance with substance abuse treatment

• Stress related illness and conditions

• Complications in pregnancy

The way in which a client describes her partner's

treatment of her can also be a clue to possible

domestic violence. Does he:

•,solate her?

•)orce her to sell drugs?
 

•+arm other family members or pets?
 

•7hreaten to hurt her, himself or others?
   

   

   

Screening for Survivors 7

Child abuse is also a clue. Research indicates that

a father who abuses his children often abuses his

wife as well.

ALERT: Survivors are often reluctant to disclose

the amount of violence in their lives.

Crisis Intervention 

When a woman informs staff she is a victim of

domestic violence, providers should: 

• Ensure her safety: Whether a client is entering

inpatient or outpatient treatment, the immediate physical safety of her environment must be

of chief concern. If inpatient, security measures

should be intensified; if outpatient, a safety plan

should be developed.

• Assure her she is believed: Reinforcement of

the counselor's belief of a survivor's victimization is a critical component of ongoing emotional support. Affirming the survivor's experience

helps empower her to participate in immediate

problem solving and longer term treatment

planning.

• Identify her options: Treatment providers

should ask the survivor to identify her options,

share information that would expand her
8 Substance Abuse Treatment and Domestic Violence

options, and support her in devising a safety

plan.

• Evaluate health concerns, including any need

for detoxification.

• Attend to anything that may interrupt the initiation of treatment.

For more detailed information, see TIP 25, 

pp. 9–11, pp. 38–42.
             

             

               

               

             

                 

           

   

         

   

Treatment Planning for Survivors 9

TREATMENT PLANNING 

FOR SURVIVORS

Safety From the Batterer

In the early stages of treatment, the substance

abuse counselor should help the client develop a

safety plan by referring her to a domestic violence

service provider. It is also important to address the

batterer's reaction to his partner being in treatment

and minimize the client's risk of harm in order for

her to more easily continue her treatment.

Safety Tips for Survivors and Their Families

The following pages contain tips that can be

relayed to survivors and their families to help keep

them safe from batterers.  The following six pages

are reprinted with permission from the American

Bar Association (see resources section for more

information).

In an Hmergency 

If you are at home and you are being attacked:

• Stay away from the kitchen (the abuser can find

weapons there, such as knives).

• Stay away from bathrooms, closets or small

spaces where the abuser can trap you.

• Get to a room with a door or window to escape.
   

   

   

     

   

   

   

       

10 Substance Abuse Treatment and Domestic Violence

• Get to a room with a phone to call for help; lock

the abuser outside if you can.

• Call 911 (or your local emergency number) right

away for help; get the dispatcher's name.

• Think about a neighbor or friend you can run to

for help.

• If a police officer comes, tell him/her what happened; get his/her name and badge number.

• Get medical help if you are hurt.

• Take pictures of bruises and injuries.

• Call a domestic violence program or shelter

(some are listed at the end of this document);

ask them to help you make a safety plan.

How to protect yourself at home

• Learn where to get help; memorize emergency

phone numbers.

• Keep a phone in a room you can lock from the

inside; if you can, get a cellular phone that you

keep with you at all times.

• If the abuser has moved out, change the locks

on your door; get locks on the window.

• Plan an escape route out of your home; teach it

to your children.

• Think about where you would go if you need to

escape.
   

   

     

   

     

     

   

Treatment Planning for Survivors 11

• Ask your neighbors to call the police if they see

the abuser at your house; make a signal for

them to call the police; for example, if the

phone rings twice, a shade is pulled down or a

light is on.

• Pack a bag with important things you'd need if

you have to leave quickly, put it in a safe place,

or give it to a friend or relative you trust.

• Include cash, car keys and important information such as: court papers, passport or birth

certificate, medical records and medicines,

immigration papers.

• Get an unlisted phone number.

• Block caller ID.

• Use an answering machine; screen the calls.

• Take a good self­defense course.

How to make your children safer

• Teach them not to get in the middle of a fight,

even if they want to help.

• Teach them how to get to safety, to call 911, to

give your address and phone number to the

police.

• Teach them to call for help.

• Tell them to stay out of the kitchen.
       

         

     

       

   

   

   

       

12 Substance Abuse Treatment and Domestic Violence

• Give the principal at school or daycare center a

copy of your court order; tell them not to release

your children to anyone without talking to you

first; use a password so they can be sure it is

you on the phone; give them a photo of the

abuser.

• Make sure the children know who to tell at

school if they see the abuser.

• Make sure the school knows not to give your

address or phone number to anyone.

How to protect yourself outside the home

• Change your regular travel habits.

• Try to get rides with different people.

• Shop and bank in a different place.

• Cancel any bank accounts or credit cards you

shared; open new accounts at a different bank.

• Keep your court order and emergency numbers

with you at all times.

• Keep a cell phone and program it to 911 (or

other emergency number).

How to make yourself safer at work

• Keep a copy of your court order at work.

• Give a picture of the abuser to security and

friends at work.
   

   

     

   

         

   

     

   

     

             

Treatment Planning for Survivors 13

• Tell your supervisor—see if he or she can make

it harder for the abuser to find you.

• Don't go to lunch alone.

• Ask a security guard to walk you to your car or

to the bus.

• If the abuser calls you at work, save your voice

mail and save e­mail.

• Your employer may be able to help you find

community resources.

Using the law to help you

Protection or restraining orders

• Ask your local domestic violence program to

help you get a civil protection order and to help

you with criminal prosecution.

• Ask for help finding a lawyer.

In most places the judge can:

• Order the abuser to stay away from you and your

children.

• Order the abuser to leave your home.

• Give you temporary custody of your children and

order the abuser to pay you temporary child

support.

• Order the police to come to your home while the

abuser picks up personal belongings.
   

       

   

         

       

       

         

   

     

     

   

14 Substance Abuse Treatment and Domestic Violence

• Give you possession of the car, furniture and

other belongings.

• Order the abuser to go to a batterers' intervention program.

• Order the abuser not to call you at work.

• Order the abuser to give guns to the police.

If you are worried about any of the following,

make sure you:

• Show the judge any pictures of your injuries.

• Tell the judge that you do not feel safe if the

abuser comes to your home to pick up the children to visit with them.

• Ask the judge to order the abuser to pick up and

return the children at the police station or some

other safe place.

• Ask that any visits the abuser is permitted are

at very specific times so the police will know by

reading the court order if the abuser is there at

the wrong time.

• Tell the judge if the abuser has harmed or

threatened the children; ask that visits be

supervised; think about who could do that for

you.

• Get a certified copy of the court order.

• Keep the court order with you at all times.
   

     

   

       

       

   

   

       

       

   

   

Treatment Planning for Survivors 15

Criminal Proceedings

• Show the prosecutor your court orders.

• Show the prosecutor medical records about

your injuries or pictures if you have them.

• Tell the prosecutor the name of anyone who is

helping you (a victim advocate or lawyer).

• Tell the prosecutor about any witnesses to

injuries or abuse.

• Ask the prosecutor to notify you ahead of time if

the abuser is getting out of jail.

Be safe at the court house

• Sit as far away from the abuser as you can; you

don't have to look at or talk to the abuser; you

don't have to talk to the abuser's family or

friends if they are there.

• Bring a friend or relative to wait with you until

your case is heard.

• Tell a bailiff or sheriff that you are afraid of the

abuser and ask him/her to look out for you.

• Make sure you have your court order before you

leave.

• Ask the judge or sherif to keep the abuser there

for a while when court is over; leave quickly.

• If you think the abuser is following you when you

leave, call the police immediately.
     

   

     

   

       

           

                   

             

16 Substance Abuse Treatment and Domestic Violence

• If you have to travel to another State for work or

to get away from the abuser, take your protection order with you; it is valid everywhere.

Reprinted with permission from the American Bar

Association.

Psychosocial Issues

• A key aspect of treatment for substance abuse

is encouraging the client to assume responsibility for her addiction and dispelling the notion

she is responsible for her partner's behavior.

• For some battered women, every aspect of their

life has been controlled by the batterer. Helping

her develop her own decisionmaking skills will

be integral to her recovery.

• Posttraumatic stress disorder, the increased

stress of abstinence, and the client's perception

of her own safety are all issues that can affect her

treatment and should be dealt with in treatment.

Later Recovery Issues

Practical concerns overwhelm many survivors of

domestic violence after they become abstinent.

Linkages with other programs and agencies

become extremely important in meeting the

client's responsibilities. Four areas that may need

special consideration during this time are:
   

   

   

   

   

     

Treatment Planning for Survivors 17

• Social functioning: Social isolation is common

among domestic violence survivors. Providers

should encourage the client to make her own

decisions about new activities and pastimes.

• Parenting: A survivor may need to learn new

skills that take into account the reality of her

status as a domestic violence survivor. Handling

frustration and anger is a crucial life skill that

must be addressed directly in treatment.

• Financial and legal concerns: Treatment

providers should explore with the client her

plans for future education and employment and

should have information on a variety of options.

• Relapse prevention: Revictimization by their

abusive partners poses the greatest risk of

relapse for battered women. Careful attention to

recurring episodes of violence is essential to

working with survivor clients to prevent or minimize the negative effects of relapse.

For more detailed information, see TIP 25, 

pp. 12–16, pp. 128–133.
     

   

     

   

   

   

   

18 Substance Abuse Treatment and Domestic Violence

ISSUES OF CHILD ABUSE OR NEGLECT

The confidentiality regulations in Title 42, Part 2 of

the Code of Federal Regulations require that a

client be given notice regarding the limitations of

confidentiality–orally and in writing–upon admission to a substance abuse program.

Screening for Child Abuse or Neglect

When family violence comes to the attention of

the treatment provider, it is essential to determine

whether children have been present or have been

involved in any way. It is not advisable for the substance abuse clinician to perform an assessment

of children for abuse or incest; this function

should be performed by personnel with special

expertise.

Reporting Suspected Neglect or Abuse and

Children's Protective Services Agencies 

• Clients must be informed that mandated

reporters, a category that includes substance

abuse treatment providers, are required to notify Children's Protective Services (CPS) if they

suspect child abuse or neglect.

• Clients can be informed of the right to report

their partner's abuse of children.
     

   

   

   

           

   

   

   

Issues of Child    Abuse or Neglect 19

• It is ultimately the mandated reporter's

responsibility to ensure CPS is contacted in

the event of suspected child abuse or neglect.

• It is important to prepare for the impact of

reporting child abuse on the children and the

family as whole.

• It is imperative for professionals working with

family members to provide information to them

about what to expect from CPS and, if at all possible, to talk with CPS caseworkers and accompany the family to any court hearings.

The Role of Treatment Providers in

Supporting the Mother

• Help her identify and coordinate various services

available to her.

• Support her efforts to participate in and take

advantage of these services.

• Listen as she voices her frustration about the

difficulties of meeting the demands of the various agencies.

For more detailed information, see TIP 25, 

pp. 17–19, pp. 44–45.
   

   

   

   

   

   

   

     

   

   

   

20 Substance Abuse Treatment and Domestic Violence

SCREENING TECHNIQUES AND 

QUESTIONS FOR BATTERERS
 

CAUTION: In asking questions about abuse, substance abuse treatment providers must be careful

not to enable batterers to place blame for batterings on the victim or alcohol and drugs.

Questions

• "Some people think that, under certain circumstances, it's OK to hit your wife (girlfriend, etc.).

Under what circumstances do you think violence

might be justified?"

• "If you were faced with overwhelming stress

(use a hypothetical situation), do you think you

could keep your cool?"

• "What do you think you'd do?"

By taking an open­ended social and family history,

the interviewer can gradually move to specific,

direct questions.

• "Have you ever been physically hurt by someone

in your family?" (If the client's partner has hurt

him or her, the reverse may be true.)

• "Have you ever hurt someone in your family?"
   

   

   

       

   

   

Screening Techniques and Questions for Batterers 21

The "No­Violence Contract"

Batterers entering treatment for substance abuse

can be required to sign a contract agreeing to

refrain from using violence. "No­violence" contracts are most effective when linkages with batterers' intervention programs are also in place,

but they can also help structure treatment by

specifying an achievable behavioral goal.

Recovery Pitfalls for Batterers

12­Step programs can play a valuable role in supporting batterers' treatment and recovery when

their principles are followed. However, providers

should be alert to signs that clients are misinterpreting 12­Step philosophies to justify, excuse, or

evade responsibility for their violence. 

Ongoing Attention to Issues 

of Domestic Violence

Ongoing attention to issues of domestic violence

is particularly important with these clients

because it may take time for them to begin talking

about the violence in their lives. As they become

abstinent, additional issues can arise that are

integrally related to the violence. The full dimensions of a domestic violence problem are seldom

immediately clear and may emerge unexpectedly

at a later stage in treatment.

For more detailed information, see TIP 25, p. 48.
   

     

       

     

   

   

   

22 Substance Abuse Treatment and Domestic Violence

TREATMENT PLANNING 

FOR BATTERERS

• Gauge client's acceptance of responsibility.

• Link client's actions with tangible consequences, e.g., through a no violence contract.

• Encourage the batterer client to develop enough

self­awareness to recognize the beliefs and attitudes that are precursors to violence and to

control the emotions that contribute to violence.

• Formulate a treatment plan with strategies that

ensure safety for the partner and family

members.

• Help the batterer focus on changing the behaviors and events that have precipitated violence

or relapse.

• Watch for and stop clients from condoning violence or reinforcing each others' excuse­making.

• Raise the batterer's awareness of the impact his

violence has on his children's future behavior

(young boys often learn violent behavior from

male role models).

• Help batterers adopt nonviolent modes of

behavior through anger management and coping skills.
     

Treatment Planning for Batterers 23
 

• Reinforce the importance of modeling nonviolent behavior in their interactions with their partners as well as their children.

For more detailed information, see TIP 25, 

pp. 32–35.
 
   

   

       

   

   

   

   

         

   

             

             

24 Substance Abuse Treatment and Domestic Violence

REFERRAL AND LINKAGES

Referral

When answers to screening suggest that the client

may be a batterer or a survivor, he or she should

be immediately referred to a domestic violence

program. When referrals are not possible, ongoing

consultation with a domestic violence expert is

strongly encouraged. In some instances, clients

have been mandated into substance abuse treatment by courts. Substance abuse providers use

the leverage provided by the criminal justice system to ensure that clients who batter participate

in batterer's treatment as well.

Referring Survivors

• If the client reveals that she is in immediate

danger, the counselor needs to attend to this

before addressing other issues.

• Advise the client to take simple legal precautions and to safeguard important documents,

e.g., social security card, driver license, etc.

• Discuss possible reprisal by the batterer if the

police become involved and plan a response.

• If a survivor client expresses concern about her

children, refer her for shelter and legal advocacy.

• Resources can be identified by contacting a

local domestic violence program, a State pro­
   

   

   

   

   

   

   

Referral and Linkages 25

gram or the National 24­Hour Domestic
 

Violence Hotline, 1­800­799­SAFE. 

Referring Batterers

• When suspected batterers are identified, substance abuse treatment providers should refer

them to batterer's intervention programs as a

key part of treatment planning.

• With the client's signed consent to release information, substance abuse counselors can share

pertinent information with domestic violence

staff to ensure both problems are being

addressed.

• Family therapy or family intervention for batterers and their partners should be provided by a

domestic violence specialist or program.

Linkages

• To effectively treat substance abuse, care must

be coordinated with domestic violence programs and other agencies pertinent to a client's

recovery, e.g., the criminal justice system, the

workplace, etc.

• Substance abuse treatment providers, domestic

violence experts, and legal or other relevant

professionals should plan client treatment

collaboratively.

• Substance abuse treatment providers should

get to know what resources and institutions

exist in their communities.
   

   

     

26 Substance Abuse Treatment and Domestic Violence

1) Domestic Violence Programs

­ Hotlines,

­ Shelters,

­ Clinicians,

­ Programs,

2) Health Care Services

­ Health Administrators,

­ Primary Care Physicians,

3) The Justice System

­ The Police Department,

­ Judges,

4) Education/Schools

­ Teachers,

­ Principals,

­ School Social Workers,

5) Employers,

6) Social Welfare

­ Social Welfare Administration,

­ Social Workers,

• Cross­screening of various problems by various

agencies is a major step toward linkage.

• Because of its influence on the client, integrating the criminal justice system's efforts should

be one of the first steps in forming linkages.
   

   

   

   

       

Referral and Linkages 27

Due to the increasing call for cost containment,

collaborative endeavors are critical to the future

of many programs.

Collaborative Care Services

When creating linkages, remember that collaborative services should be:

• Client centered.

• Holistic.

• Flexible.

• Collaborative.

• Coordinated.

• Accountable.

Case Management

In the case management approach, a specially

trained single practitioner or case management

team is responsible for coordinating linkages to

the wide variety of services needed by many if not

most clients in substance abuse treatment.

For more detailed information, see TIP 25, 

pp. 63–80.
   

     

     

     

28 Substance Abuse Treatment and Domestic Violence

LEGAL ISSUES 

CAUTION: Neither this Quick Guide nor TIP 25

should be considered a substitute for competent

legal advice from a qualified attorney.

The Violence Against Women Act

The Violence Against Women Act (VAWA) strengthens many of the laws regarding violence motivated by gender, outlines Federal as well as State

enforcement provisions and penalties, and makes

crimes against women and children a civil rights

violation. Under VAWA:

• Past sexual behavior or alleged sexual predisposition of the victim is no longer admissible evidence in civil or criminal proceedings involving

sexual misconduct.

• New Federal criminal penalties apply to anyone

who crosses a State line in order to commit

domestic violence or to violate a civil protection

order.

• States are required to enforce civil protection

orders issued by other states.
     

     

     

   

   

   

   

Legal Issues 29

• Victims must have the opportunity to testify

regarding the potential danger of the pretrial

release of a defendant.

Disclosure and Consent

• Typically, State laws regulate the disclosure of

patient information related to domestic violence.

• These laws differ from Federal laws that govern

consent to disclose substance abuse­related

information.

When it comes to reporting crimes that are discussed in treatment to a third party (e.g., the

police or a lawyer), the counselor must ask three

questions: (1) Does State law require the program

to make a report? (2) Does State law permit the

program to make a report? (3) How can a report

be made without violating the Federal law and

regulations governing confidentiality or patients'

records?

Legal Resources

• State Department of Health

• Single State Authority for Substance Abuse

and/or Domestic Violence

• State Attorney General

• Local bar associations
   

30 Substance Abuse Treatment and Domestic Violence

• Agency board members who are attorneys

• Local advocacy groups for people experiencing

domestic violence

• Local law schools

For more detailed information, see TIP 25, 

pp. 51–61, pp. 95–109.
           

Phone and Internet Resources 31

SELECTED PHONE AND INTERNET

RESOURCES

Hotlines

National Domestic Violence Hotline

(800) 799­SAFE

(800) 799­3224

Rape, Abuse, and Incest National Network (RAINN)

(800) 656­4673

http://www.rainn.org

Child Help USA/National Child Abuse Hotline

(800) 4A­CHILD

http://www.childhelp.org

General Resources

National Coalition Against Domestic Violence

(303) 839­1852

http://www.ncadv.org

National Victim Center (NVC)/Infolink 

(800) FYI­CALL

https://www.victimsofcrime.org/

American College of Obstetricians and

Gynecologists (ACOG)

(202) 638­5577

http://www.acog.org
   

32 Substance Abuse Treatment and Domestic Violence

Other Services

Center for the Prevention of Sexual and Domestic

Violence

(206) 634­1903

http://www.ncdsv.org/

Domestic Violence Project/Face to Face

(800) 842­4546

Domestic Violence Training Project

(800) 865­3699

Family Violence and Sexual Assault Institute

(903) 534­5100

American Bar Association Commission on

Domestic Violence

http://www.abanet.org/domviol/home.html

Other Treatment Improvement

Protocols (TIPs) that are relevant to

this Quick Guide:

TIP 27, Comprehensive Case Management for

Substance Abuse Treatment

SMA 15­4215

TIP 35, Enhancing Motivation for Change in

Substance Abuse Treatment

SMA 13­4212

TIP 36, Substance Abuse Treatment for Persons

With Child Abuse and Neglect Issues

SMA 12­3293

See the inside back cover for ordering information

for all TIPs and related products.

HHS Publication No. (SMA) 15­3583

Printed 2001

Reprinted 2010

Revised 2015