Family Violence

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Family Violence
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Family Violence

• a term that includes the many different forms of
  abuse, mistreatment or neglect that adults or
  children may experience in their intimate,
  kinship or dependent relationships.

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There is no type of family that is exempt from
the threat of violence. Mothers and fathers abuse
and neglect children. Married and common-law
spouses beat and even kill their wives and
husbands. Brothers and sisters victimize one
another. Gay and lesbian partners fight and hurt
each other. Adolescents terrorize their parents.
Even the elderly are victims of their
children. (Vanier)
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What is domestic violence?

• The victimization of a person by one who has had
  an intimate, romantic or spousal relationship.
• Incidence
• 7 of Canadians either in a current or previous
  spousal union in 2004 experienced spousal
  violence in the past 5 years.

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What is it about?

• Domestic violence is about power and control -
  one persons power and control over another.
• These behaviours may exists alone or in
  combination with other forms of violence, such as
  slapping the spouse and/or kicking the spouses
  dog.

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Theories of Abuse

• No single theory explains abuse in families in a
  complete way no simple explanations.

• SITUATIONAL
• abuser under stress
• problem blames the victim

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Theories of Abuse (contd)

• SOCIAL EXCHANGE
• social interaction involves rewards penalties
• abuser uses violence as long as it is rewarding
• people with more power expect more rewards
• problemfails to explain the abuser who is
  dependent on the victim

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Theories of Abuse (contd)

• SYMBOLIC INTERACTION
• interaction between abuser the abused
• social learning modeling
• problemdoes not recognize outside influences

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Theories of Abuse (contd)

• FAMILY SYSTEMS
• learned patterns of interaction with families
• abused children grow up to be abusers
• problemmost abuse victims do not abuse others

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Theories of Abuse (contd)

• FEMINIST
• patriarchy allows men more power than women
• problemfails to account for gay/lesbian abuse or
  womens violence against men

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Theories of Abuse (contd)

• SOCIAL PERSPECTIVE
• many abusers from lower socio-economic levels,
  response to stress of poverty, unemployment, poor
  housing, sense of powerlessness
• problemfails to account for abusers who are well
  educated financially secure

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Forms of Abuse

• Physical violence
• Financial abuse
• Psychological abuse - threats of physical harm
• Sexual abuse
• Pet abuse
• Property abuse

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Others Types Of Abuse

• child witnessing domestic violence
• emotional abuse in custody cases
• child abuse
• sibling abuse
• parent abuse
• elder abuse
• partner abuse
• dating violence

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PROFILE OF ABUSER

• patriarchal attitude
• use violence as a means of control
• have difficulty dealing with emotions

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Social Isolation

• Some victims of spousal abuse are isolated from
  all family and friends. They are not allowed to
  talk to anyone without the abuser being present
  for fear that she/he may tell.
• What problems could this pose for nurses in
  labour and delivery or the emergency department?

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How Can you Recognize Domestic Violence?

• You need to have a high index of suspicion - is
  the injury consistent with the story?
• Should the ER doctors and nurses be asking each
  patient about abuse?
• Whatever you do to help a victim of domestic
  violence may also help any other victims that may
  be in the home or associated with the family and
  the abuser.

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Cycle of Violence

• Tension building phase
• the batterer is becoming increasingly angry
• victim will try to be compliant so he will not
  abuse her
• may find a victim that will be so frightened
  during this phase that she will precipitate the
  abuse just to get it over with

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Cycle of Violence (contd)

• Acute battering phase
• this is when the abuse occurs - it can include
  hitting, slapping, punching, kicking, stabbing,
  pushing
• the victim may go for help after this phase and
  is often quite willing to talk about the abuse
  (as long as the abuser is not with her)
• Be careful when interviewing victim - who is she
  there with?

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Cycle of Violence (contd)

• Honeymoon phase
• no tension, no battering
• Abuser is very loving and will buy flowers etc.
  Promises he will never do this again. (even
  though she made him hit her)
• At this point the woman is less apt to ask for or
  accept any help. She believes that he will never
  hurt her again because she desperately wants to
  believe him.

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Why do they stay?????

• Love
• Dependence
• Fear
• Learned helplessness
• Lack of self esteem
• Ethnic background
• Belief that he will change

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Love

• At least one partner in the relationship loves
  the other
• she/he believes that the other loves them just as
  much and will change
• easy to believe during the honeymoon stage

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Dependence

• Emotional dependency
• Financial dependence

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Fear

• Feel that asking for help will increase the
  violence
• Have found this to be true
• The most dangerous time for a woman is when she
  is trying to or does leave the relationship

• SHE IS THE BEST JUDGE OF HER OWN SAFETY - SHE
  DECIDES WHEN SHE CAN LEAVE

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Learned Helplessness

• People exposed to unpredictable and inescapable
  problems may become passive and unable to protect
  themselves or their children.
• They have chronic anxiety, self-blame, passivity
  and paralyzing fear at the first sign of danger
• Lack fight or flight response

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How often does the abuse occur?

• A study done by Dr. Peter Jaffe in London found
  that women will be beaten 25 to 35 times before
  they report the assaults to authorities

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Where can the victim go for help?

• Lynn Barkley Burnett (2001) cites a study where
  victims responded as follows
• would seek help from the police - 31.2
• did not know - 27.7
• would go to a hospital - 14.7
• would approach a family member - 10.7
• would go to a shelter - 10.7
• would forgo help and simply retaliate - 3.1

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The ER

• Some women come to the ER with acute domestic
  violence. These are the women whose complaints
  are directly related to an incident of abuse.
• Easily 15 of the women seen in the ER due to
  injuries are there because of abuse and that
  includes MVAs.

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• Think about
• the women who come to the ER because of repeated
  headaches with no physiological reason found.
• the women who come to the ER with abdominal pain
  that cannot be diagnosed.
• the women who come to the ER with injuries that
  do not match the story she gives on how the
  injury occurred.

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Screening for Violence

• Ask direct questions - do not ask if she is a
  victim of domestic violence because she probably
  doesnt realize that she is
• Ask
• Did someone hurt you? Did someone hit you?
• Do you feel safe at home?
• Is a past partner making you feel unsafe?
• Are you here today because of injuries from a
  partner?

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Problems you may encounter when interviewing
clients

• The batterer often comes with the victim to
  hospital - be careful when you are asking
  questions relating to abuse - the person doing
  the abusing may be there - not always the husband
  - could be brother or father
• Batterer often hovers and will not leave the
  client alone so that questions can be asked or
  answers all questions for her

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Problems (contd)

• Be sure to inform the client of any mandatory
  reporting requirements and explain about how
  confidentiality may be broken due to these laws.
  If she is pregnant you have 2 clients. Must
  report if children in the home
• If you must use a translator DO NOT use a family
  member but call the local multicultural society

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THE THREE Rs of INTERVENTION

• RECOGNITION
• be aware of S S
• RESPONSIBILITY
• legally have to report with children. Not with
  adults-urge them to seek legal assistance
• do not have to fix the problem
• RESPONSE
• investigation by the appropriate authorities e.g.
  CAS, police