Domestic Violence 2

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  1. Abuse is...
    Serious misuse of Power!!!

    • Maladaptive response to stress and anxiety
    • Present in ALL segments of society
  2. Types of Maltreatment

    Physical Violence
    infliction of physical pain or bodily harm
  3. Types of Maltreatment 

    Sexual Violence
    any form of sexual contact or exposure without consent
  4. Types of Maltreatment 

    Emotional Violence
    infliction of mental anguish, threatening, humiliation, intimidating, isolating
  5. Types of Maltreatment

    Physical Neglect
    failure to provide medical, dental, or psychiatric care as needed
  6. Types of Maltreatment

    Development Neglect
    failure to provide nurturing and stimulation needed to ensure meeting development milestones
  7. Types of Maltreatment

    Education Neglect
    depriving a child of an education
  8. Types of maltreatment

    Economic Maltreatment
    illegal or improper exploitation of funds or other resources for own person or withholding of support
  9. Actual violence requires:
    • 1. Perpetrator
    • 2. Vulnerable Person
    • 3. Crisis Situation
  10. Basic of the Perpetrator
    • 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
  11. Characteristics of Violent Parents
    • 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
  12. Characteristics of Vunerable person: Partner
    • Legal marriage or pregnancy may initiate or increase violence
    • Greatest risk for violence when partner attempts to leave relationship
  13. Characteristics of Vunerable person: Child
    • Younger than 3
    • Perceived as different
    • Product of an unwanted pregnancy
    • Premie
    • Prolonged illness
  14. Vulnerable Person --> Child is most likely abused if
    • 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
  15. What is the best prevention for child abuse
    adequate bonding
  16. Characteristics of Vulnerable 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
  17. Characteristics of Elder Abuse
    • 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
  18. What is a crisis situation?
    Perp and vulnerable person in a situation that they cannot manage --> result in violence
  19. Cycle of Violence 

    Tension building
    both parties try to reduce the tension
  20. Cycle of Violence 

    Acute battering
    • 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
  21. Cycle of Violence 

    Honeymoon stage
    • 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
  22. Escalation/De-escalation
    • 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
  23. Physical Violence examples...
    • Battering 
    • Endangerment --> leaving child home alone
  24. What is sexual violence in children?
    • 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
  25. What are the different forms of sexual abuse of children?
    • 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
  26. Incest
    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)
  27. Sexual Violence 

    • 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
  28. Incest basics cont
    • 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
  29. What are some symptoms of incest?
    • insomnia 
    • anxiety
    • fearful dreams 
    • general withdrawal 
    • school failure
    • truancy
    • running away
    • drugs
    • prostitution
  30. What are some later problems associated with incest?
    • PTSD
    • developmental triggers
    • chronic depression
  31. What is the summary of incest?
    • 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
  32. Rape is an act of
    aggression... not passion or sex
  33. What are the types of rape?
    • Date
    • Marital
    • Statutory
  34. What are the basics of rape?
    • 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)
  35. Rape Trauma Syndrome 

    Acute Phase
    • 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
  36. Rape Trauma Syndrome

    Long-Term Reorganization Phase
    • Reactions likely to be experienced include-->
    •        intrusive thoughts 
    •        increased motor activity 
    •        increased emotional liability
    •        fears and phobias
  37. Rape Victim Responses

    Express Response
    fear, anger, anxiety, crying, sobbing, restlessness, tension
  38. Rape Victim Responses

    Controlled response
    feelings are masked or hidden by a calm composed affect
  39. Rape Victim Responses

    Compounded Rape
    additional symptoms, depression, ETOH, suicide
  40. Rape Victim Responses

    Silent Rape
    tells no one, anxiety is suppressed and may arise years later
  41. What gives rape survivors the best chance for recovery?
    if their lifestyle is close to what was present before the rape
  42. Emotional Violence
    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)
  43. Neglect
    Physical, development, or educational
  44. Economical Maltreatment
    benign or hostile
  45. What is part of the self-assessment of the nurse regarding rape?
    • Be aware of personal beliefs and feelings about rape
    • Prepare to give empathetic and effective care
    • Examine personal feelings about abortion
  46. What are some common responses for a self essessment by a nurse regarding rape?
    • Anger
    • Embarrassment
    • Confusion
    • Fear
    • Anguish
    • Helplessness
    • Discouragement
    • Blame the Victim mentality
  47. What are the interview guidelines for interviewing a victim?
    • 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?
  48. What are some open ended question for parents?
    • 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?
  49. DO's (abuse victims, interview)
    • 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
  50. DONT's (abuse victims, interview)
    • 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
  51. What is part of the assessment portion for an abused client?
    • 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)
  52. What are some nursing interventions for suspected abuse?
    • Legal responsibility and mandated to report cases of child and elder abuse
    • Each state has specific guidelines for reporting
  53. What is part of primary prevention for abuse?
    Measures taken to prevent the occurrence of family violence
  54. What is part of secondary prevention for family violence?
    Early intervention in abusive situations to minimize their disabling or long-term effects.
  55. What are tertiary interventions for family violence?
    • Facilitating healing and rehab process
    • Providing support
    • Assisting survivors of violence to achieve their optimum  level of well-being
  56. What is part of a safety plan in a domestic violence situation?
    • 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
  57. What is part of the treatment plan after family violence?
    • Counseling
    • Case Management
    • Milieu therapy
    • self-care activities
    • health teaching
    • psychotherapy-individual, family, couple, group
Card Set:
Domestic Violence 2
2014-02-13 20:12:54
Bloc MCC

Psych Test 2 Block 4
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