ABUSE AND VIOLENCE

FAMILY VIOLENCE
• Spouse or partner abuse
• Child abuse or maltreatment
• Elder abuse
• Marital 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.

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 CHARACTERISTICS

Abuser Victims

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

➢ 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?

S
• 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?

A • 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?

F • 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?

E
• 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?

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 DO’S AND DON’TS OF WORKING WITH VICTIMS OF PARTNER ABUSE
Don’ts
• Don’t disclose client communications without the
client’s consent.
• Don’t preach, moralize, or imply that you doubt
the client.
• Don’t minimize the impact of violence.
• Don’t express outrage with the perpetrator.
• Don’t imply that the client is responsible for the
abuse.
• Don’t recommend couples’ counseling.
• Don’t direct the client to leave the relationship.
• Don’t take charge and do everything for the client.
Do’s
• Do ensure and maintain the client’s confidentiality.
• Do listen, affirm, and say “I am sorry you have
been hurt.”
• Do express: “I’m concerned for your safety.”
• Do tell the victim: “You have a right to be safe and
respected.”
• Do say: “The abuse is not your fault.”
• Do recommend a support group or individual
counseling.
• Do identify community resources and encourage
the client to develop a safety plan.
• 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 child’s mother often perpetrate
abuse
➢ Types:

1. Physical abuse
- results from unreasonably severe corporal punishment or unjustifiable punishment
- burning, biting, cutting, poking, twisting limbs, or scalding with hot water
- old injuries

2. 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

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 4. Neglect
- malicious or ignorant withholding of physical, emotional, or
educational necessities for the child’s well-being
- most prevalent type of maltreatment
- refusal to seek health care or delay doing so; abandonment; inadequate supervision; reckless dis-
regard for the child’s safety; punitive, exploitive, or abusive emotional treatment; spousal abuse
in the child’s 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

➢ Treatment and Intervention

KEY: recognize when the child’s behavior is outside what is normally expect-
ed for his or her age and developmental stage
• ensure the child’s 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

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 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 child’s history during the evaluation by
either the child or the adult
• Unusual injuries for the child’s 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 caregiver’s stress and providing additional re-
sources
• removal of the elder

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 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 elder’s
• 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 elder’s treatment when it is not the caregiver’s
money being spent
Neglect Indicators
• Dirt, fecal or urine smell, or other health hazards in the elder’s 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

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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 elder’s 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 • Fear

aroused by the pain of their
victims
• Exploitive predators who
impulsively use their victims
as objects for gratification
• Inadequate men who believe
that no woman would
voluntarily have sexual
relations with them and are
obsessed with fantasies about
sex
• Men for whom rape is a
displaced expression of anger
and rage
• Helplessness
• shock and disbelief
• guilt
• humiliation and
embarrassment
• avoid the place or
circumstances of the rape
• give up previously
pleasurable activities
• experience depression
• sexual dysfunction,
• insomnia
• impaired memory

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 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 can’t 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
• women’s advocacy groups and other local resources
• supportive therapy
• individual therapy
• group therapy

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 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 won’t 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

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