ABUSE AND VIOLENCE FAMILY VIOLENCE Spouse or partner abuse Child abuse or maltreatment Elder abuse Marital rape

rape and sexual assault CHARACTERISTICS OF VIOLENT FAMILIES Social isolation Abuse of power and control Alcohol and other drug abuse Intergenerational transmission process - patterns of violence are perpetuated from one generation to the next through role modeling and social learning SPOUSE OR PARTNER ABUSE mistreatment or misuse of one person by another in the context of an intimate relationship Types: 1. Physical abuse - shoving and pushing to severe battering and choking 2. Emotional or psychological abuse - name-calling, belittling, screaming, yelling, destroying property, and making threats, refusing to speak to or ignoring the victim. 3. Sexual abuse- assaults during sexual relations such as biting nipples, pulling hair, slapping and hitting, as well as rape.

CHARACTERISTICS Abuser possessive becomes increasingly violent and abusive if she shows any sign of independence feelings of inadequacy low self-esteem poor problem solving poor social skills emotionally immature needy irrationally jealous Victims dependent depressed decreased self-esteem helplessness powerlessness

Treatment and Intervention Restraining order / protection order Individual psychotherapy or counseling Group therapy Support and self-help groups

SAFE Questions Stress/Safety What stress do you experience in your relationships? Do you feel safe in your relationships? Should I be concerned for your safety? Afraid/Abused Are there situations in your relationships where you have felt afraid? Has your partner ever threatened or abused you or your children? Have you ever been physically hurt or threatened by your partner? Are you in a relationship like that now? Has your partner ever forced you to engage in sexual intercourse that you did not want? People in relationships/marriages often fight; what happens when you and your partner disagree? Friends/Family Are your friends aware that you have been hurt? Do your parents or siblings know about this abuse? Do you think you could tell them, and would they be able to give you support? Emergency plan Do you have a safe place to go and the resources you (and your children) need in an emergency? If you are in danger now, would you like help in locating a shelter? Would you like to talk to a social worker/counselor/me to develop an emergency plan? DOS AND DONTS OF WORKING WITH VICTIMS OF PARTNER ABUSE Donts Dos Dont disclose client communications without the clients Do ensure and maintain the clients confidentiality. consent. Do listen, affirm, and say I am sorry you have been hurt. Dont preach, moralize, or imply that you doubt the client. Do express: Im concerned for your safety. Dont minimize the impact of violence. Do tell the victim: You have a right to be safe and respected. Dont express outrage with the perpetrator. Do say: The abuse is not your fault. Dont imply that the client is responsible for the abuse. Do recommend a support group or individual counseling. Dont recommend couples counseling. Do identify community resources and encourage the client to Dont direct the client to leave the relationship. develop a safety plan. Dont take charge and do everything for the client. Do offer to help the client contact a shelter, the police, or other resources.

CHILD ABUSE OR MALTREATMENT intentional injury of a child physical abuse or injuries, neglect or failure to prevent harm, failure to provide adequate physical or emotional care or supervision, abandonment, sexual assault or intrusion, and overt torture fathers, stepfathers, uncles, older siblings, and live-in partners of the childs mother often perpetrate abuse Types: 1.

2.

Physical abuse results from unreasonably severe corporal punishment or unjustifiable punishment burning, biting, cutting, poking, twisting limbs, or scalding with hot water old injuries Emotional or psychological abuse verbal assaults constant family discord emotional deprivation

withholding of affection, nurturing, and normal experiences that engender acceptance, love, security, and self-worth exposure to parental alcoholism, drug use, or prostitution 3. Sexual abuse sexual acts performed by an adult on a child younger than 18 years. incest, rape, and sodomy performed directly by the person or with an object; oral-genital contact; and acts of molestation exploitation Neglect malicious or ignorant withholding of physical, emotional, or educational necessities for the childs well-being most prevalent type of maltreatment refusal to seek health care or delay doing so; abandonment; inadequate supervision; reckless disregard for the childs safety; punitive, exploitive, or abusive emotional treatment; spousal abuse in the childs presence; giving the child permission to be truant; or failing to enroll child in school CHARACTERISTICS Abuser Victims minimal parenting knowledge and skills dependent lack of education depressed poverty decreased self-esteem emotionally immature helplessness needy powerlessness incapable of meeting their own needs possessive displacement victims of abuse as children

4.

Treatment and Intervention KEY: recognize when the childs behavior is outside what is normally expected for his or her age and developmental stage ensure the childs safety and well-being psychiatric evaluation play therapy family therapy psychiatric or substance abuse treatment for parents short-term or long-term foster care services report suspected child abuse with accurate and thorough documentation of assessment data WARNING SIGNS OF ABUSED/NEGLECTED CHILDREN Serious injury, such as fractures, burns, or lacerations with no reported history of trauma Delay in seeking treatment for a significant injury Child or parent gives a history inconsistent with severity of injury Inconsistencies or changes in the childs history during the evaluation by either the child or the adult Unusual injuries for the childs age and level of development High incidence of urinary tract infections; bruised, red, or swollen genitalia; tears or bruising of rectum or vagina Evidence of old injuries not reported that parent/caregiver cannot explain adequately

ELDER ABUSE maltreatment of older adults by family members or caretakers physical and sexual abuse, psychological abuse, neglect, self-neglect, financial exploitation, and denial of adequate medical treatment 75 years or older; 60% to 65% are women the elder has multiple, chronic mental and physical health problems and dependent on others for food, medical care, and various activities of daily living CHARACTERISTICS Abuser Victims history of family violence dependent alcohol problems depressed drug problems decreased self-esteem helplessness powerlessness Treatment and Intervention relieving the caregivers stress and providing additional resources removal of the elder POSSIBLE INDICATORS OF ELDER ABUSE Physical Abuse Indicators Frequent, unexplained injuries accompanied by a habit of seeking medical assistance from various locations Reluctance to seek medical treatment for injuries, or denial of their existence Disorientation or grogginess indicating misuse of medications Fear or edginess in the presence of family member or caregiver Psychological or Emotional Abuse Indicators Helplessness Hesitance to talk openly Anger or agitation Withdrawal or depression Financial Abuse Indicators Unusual or inappropriate activity in bank accounts Signatures on checks that differ from the elders Recent changes in will or power of attorney when elder is not capable of making those decisions Missing valuable belongings that are not just misplaced Lack of television, clothes, or personal items that are easily affordable Unusual concern by the caregiver over the expense of the elders treatment when it is not the caregivers money being spent Neglect Indicators Dirt, fecal or urine smell, or other health hazards in the elders living environment Rashes, sores, or lice on the elder Elder has an untreated medical condition or is malnourished or dehydrated not related to a known illness Inadequate clothing Indicators of Self-neglect Inability to manage personal finances, such as hoarding, squandering, or giving away money while not paying

bills Inability to manage activities of daily living such as personal care, shopping, housework Wandering, refusing needed medical attention, isolation, substance use Failure to keep needed medical appointments Confusion, memory loss, unresponsiveness Lack of toilet facilities, living quarters infested with animals or vermin Warning Indicators from Caregiver Elder is not given opportunity to speak for self, to have visitors, or to see anyone without the presence of the caregiver Attitudes of indifference or anger toward the elder Blaming the elder for his or her illness or limitations Defensiveness Conflicting accounts of elders abilities, problems, and so forth Previous history of abuse or problems with alcohol or drugs RAPE AND SEXUAL ASSAULT crime of violence and humiliation of the victim expressed through sexual means Rape - perpetration of an act of sexual intercourse with a female against her will and without her consent, whether her will is overcome by force, fear of force, drugs, or intoxicants - the woman is incapable of exercising rational judgment because of mental deficiency or when she is below the age of consent - occur between strangers, acquaintances, married persons, and persons of the same sex - highly underreported crime (shame and guilt, fear of further injury and belief that there is no recourse in the legal system) - 15 months to 82 years; highest incidence: 16 to 24 years of age Male rape - significantly underreported crime - occur between gay partners or strangers CHARACTERISTICS Abuser Victims Sexual sadists who are aroused by Fear the pain of their victims Helplessness Exploitive predators who shock and disbelief impulsively use their victims as guilt objects for gratification humiliation and embarrassment Inadequate men who believe that avoid the place or circumstances no woman would voluntarily have of the rape sexual relations with them and are give up previously pleasurable obsessed with fantasies about sex activities Men for whom rape is a displaced experience depression expression of anger and rage sexual dysfunction, insomnia impaired memory

COMMON MYTHS ABOUT RAPEMON MYTHS ABOUT RAPE When a woman submits to rape, she really wants it to happen. Women who dress provocatively are asking for trouble. Some women like rough sex but later call it rape. Once a man is aroused by a woman, he cannot stop his actions. Walking alone at night is an invitation for rape. Rape cannot happen between persons who are married. Rape is exciting for some women. Rape only occurs between heterosexual couples. If a woman has an orgasm, it cant be rape.

Treatment and Intervention Assessment: physical examination should occur before the woman has showered, brushed her teeth, douched, changed her clothes, or had anything to drink. immediate support and help express fear and rage provide emotional support give as much control back to the victim as possible sign consent prophylactic treatment for STDs (Chlamydia or gonorrhea) encourage to engage in safe-sex practices prophylaxis to prevent pregnancy rape crisis centers womens advocacy groups and other local resources supportive therapy individual therapy group therapy

WARNING SIGNS OF RELATIONSHIP VIOLENCE Emotionally abuses you Tells you with whom you may be friends or how you should dress, or tries to control other elements of your life Talks negatively about women in general Gets jealous for no reason Drinks heavily, uses drugs, or tries to get you drunk Acts in an intimidating way by invading your personal space Cannot handle sexual or emotional frustration without becoming angry Does not view you as an equal: sees himself as smarter or socially superior Guards his masculinity by acting tough Is angry or threatening to the point that you have changed your life or yourself so you wont anger him Goes through extreme highs and lows Berates you for not getting drunk or high, or not wanting to have sex with him. Is physically aggressive, grabbing ad holding you, or pushing and shoving