Domestic Violence 2

Serious misuse of Power!!!

• Maladaptive response to stress and anxiety
• Present in ALL segments of society

infliction of physical pain or bodily harm

any form of sexual contact or exposure without consent

infliction of mental anguish, threatening, humiliation, intimidating, isolating

failure to provide medical, dental, or psychiatric care as needed

failure to provide nurturing and stimulation needed to ensure meeting development milestones

depriving a child of an education

illegal or improper exploitation of funds or other resources for own person or withholding of support

• 1. Perpetrator
• 2. Vulnerable Person
• 3. Crisis Situation

• rooted in childhood
• general lack of self-regard
• dissatisfaction with life
• inability to assume adult roles
• witness or experience family violence
• poor parenting 
• lack knowledge and realistic expectation
• often consider their needs more important than anyone else's and expect others to meet their needs (usually their needs are not met as a child)
• Extreme jealousy
• ETOH or drugs may play a role

• Hx of violence, neglect or deprivation
• Family authoritarianism
• Low self-esteem, feel worthless, depressed
• Poor coping skills
• Social isolation
• Unrealistic expectations of child
• Hx of mental illness 
• Perception of child as evil or bad
• Drug or ETOH abuse
• Projection of blame onto the child
• Lack effective parenting skills 
• Inability to seek help from others
• Violent temper and low tolerance of frustration with poor impulse control
• Look to child to meet their needs for love, support or reassurance
• Feel little or no control over their own life

• Legal marriage or pregnancy may initiate or increase violence
• Greatest risk for violence when partner attempts to leave relationship

• Younger than 3
• Perceived as different
• Product of an unwanted pregnancy
• Premie
• Prolonged illness

• Perceived as different due to temperament, congenital abnormalities or chronic disease
• Remind parent(s) of someone not liked (ex spouse, or older sibling)
• Different from parent's fantasy of a child
• Product of unwanted pregnancy
• Interference with emotional bonding (premie birth, prolonged illness)
• Child that doesn't fit into gender norm

adequate bonding

• Emotional dependent on perpetrator 
• Female, older than 75, white, living with relative 
• Daughter is caring for elderly father who abused her as a child 
• Elderly woman cared for by husband who has abused her in the past

• Hx of mental illness 
• Recent decline in mental status
• Recent medical problems
• Financial dependence on the victim
• Shared living arrangements with victim
• Hx of ETOH or drug abuse
• Pathological family dynamics

Perp and vulnerable person in a situation that they cannot manage --> result in violence

both parties try to reduce the tension

• Perp release built up tension
• his is unstable to control degree of destruction
• he can have amnesia and may not remember what happened 
• Victim depersonalizes the incident and cant remember the beating in detail 
• both are in shock

• Kindness and loving behaviors
• Perp feels remorse and tells victim how much she is loved and needed
• Victim believes the promises and feels loved
• Lovemaking is the best of any other time
• BUT the cycle will repeat until their is treatment

• There are periods of stability but the violence increases in frequency and intensity over time 
• With each repeated incident, the victims self-esteem erodes more and more

• Battering 
• Endangerment --> leaving child home alone

• Any sexual approach or sexual act, whether explicit or implicit with child and adult
• Sexual feelings between adults and children in the family
• Sexual activity within blended families
• Friends of family --> family reactions may cause more trauma
• Pedophile --> prefer couple of year age range
• 70-80% of all sexual abuse occurs by relative of child
• 25% females and 5% of males had sexual relationship with adult family member as child

• Touch, fondling and physical exploring child's genitalia
• Masturbation against child's body
• Manual masturbation of perp by child 
• All combination oral-genital contact
• Actual or attempted anal or vaginal intercourse
• Exhibitionism or voyeurism

all forms of sexual contact or exploitation or overtures initiated by an adult who is related to the child by family ties through surrogate family ties (step-parent)

• Usually occurs in unbroken homes
• Rarely force, usually begins with molestation or fondling leading to intercourse
• Easy to gain compliance of young child by misrepresented sex as affection or with treats and bribes
• Child loyal to parent, need of affection and desire to please
• Past beliefs --> imagination of the child... TO: mom, evil co-participant.. Dad: evil father
• Good-Bad split --> neither accurate
• Sometimes a witch hunt

• Classic incest family or multi-problem incest family
• Incest is a relationship based on sexual abuse 
• Occurs because of combined individual and family processes
• Step-fathers indistinguishable
• Fathers fear heterosexual failure 
• Decrease inhibitions-- ETOH, rationalization, stress
• Usually careful seducers & give rewards
• Confusion as some parts may be pleasant 
• Siblings may dislike special treatment
• Loyalty and power --> issues w/ fear offamily disintegration

• insomnia 
• anxiety
• fearful dreams 
• general withdrawal 
• school failure
• truancy
• running away
• drugs
• prostitution

• PTSD
• developmental triggers
• chronic depression

• marital estrangement frequently with sexual problems
• daughter parentified
• father unaware of unable to meet his own needs (looks outside of self for satisfaction)
• shows poor judgement, impulsive or heightened sense of entitlement

aggression... not passion or sex

• Date
• Marital
• Statutory

• can occur at any age
• highest risk 16-24 years old and single
• occurs inown neighborhood
• stranger rape--> victim chosen for no reason but being at the wrong place at the wrong time
• Location significant (parking lot or home)

• Occurs immediately after the assault
• May last for a few weeks
• Lifestyle disorganized 
• Somatic symptoms are common
• Reaction to crisis includes disruptions in cognitive, affective, and behavioral functions

• Reactions likely to be experienced include-->
•        intrusive thoughts 
•        increased motor activity 
•        increased emotional liability
•        fears and phobias

fear, anger, anxiety, crying, sobbing, restlessness, tension

feelings are masked or hidden by a calm composed affect

additional symptoms, depression, ETOH, suicide

tells no one, anxiety is suppressed and may arise years later

if their lifestyle is close to what was present before the rape

kills the spirit and ability to succeed later in life, to feel deeply and to make emotional contact with others (occurs whenever physical violence occurs)

Physical, development, or educational

benign or hostile

• Be aware of personal beliefs and feelings about rape
• Prepare to give empathetic and effective care
• Examine personal feelings about abortion

• Anger
• Embarrassment
• Confusion
• Fear
• Anguish
• Helplessness
• Discouragement
• Blame the Victim mentality

• Verbal 
•      Tell me about what happened to you
•      Who takes care of you? (for children and dependent elders) 
•      What happens if you do something wrong?
•      How do you and your partner resolve disagreements?
•      What do you do for fun?
•      Who helps you with your child/parent?
•      What time do you have for yourself?

• What arrangements do you make when you have to leave your child alone?
• How do you discipline your child?
• When your infant cries for a long time, how do you get him/her to stop?
• What about your child's behavior bothers you the most?

• conduct in private
• be direct, honest, and professional
• use language the client understands
• ask client to clarify words not understood
• be understanding and attentive 
• assesses safety and reduce danger
• inform if you must referral to protective services

• Do not judge or accuse 
• Do not use the words "abuse" or "violence" 
• Do not display horror, anger, shock, or disapproval 
• Do not force a child or anyone else to remove clothing

• If explanation does not match in injury, or if client minimizes the seriousness of the injury, violence may be suspected
• Ask directly in a non-threatening manner
• Observe nonverbal response and verbal 
• Evaluate --> level of anxiety and coping responses, family coping, support systems, suicide and homicidal potential, drug and ETOH use
• Maintain accurate records
• Follow protocol for sexual assault (in event goes to trial)
• Be curious about injuries to pregnant women 
• Recurrent visits for injuries attributed to being "accident prone" 
• Bruises at various stages of healing and with strange shapes (fingers, belt)

• Legal responsibility and mandated to report cases of child and elder abuse
• Each state has specific guidelines for reporting

Measures taken to prevent the occurrence of family violence

Early intervention in abusive situations to minimize their disabling or long-term effects.

• Facilitating healing and rehab process
• Providing support
• Assisting survivors of violence to achieve their optimum  level of well-being

• A plan for fast escape if domestic violence situation occurs. 
• Identified sign of escalation of violence and designated this as the time to leave
• Include in plan a destination and a way to get there. 
• Hotline, shelter, etc
• hide money, keys, car keys
• code word with family
• remove weapons
• important docs

• Counseling
• Case Management
• Milieu therapy
• self-care activities
• health teaching
• psychotherapy-individual, family, couple, group