Dr. Dawn-Elise Snipes, PhD, LMHC

Objectives

~ Review the extent of the problem

~ Identify risk factors for violence

~ Review practice guidelines for working with survivors of DV

~ Identify primary, secondary and tertiary interventions

~ Explore components of an effective routine DV screening program

~ 2-4 million women battered each year

~ 20-30% lifetime risk for a woman to be battered

~ 1,500 women murdered/year by partners

~ 20-30% of women seen in medical setting may be abuse victims

~ 5-6% prevalence of elder mistreatment (1.8 million)

~ 1,100 childhood deaths from abuse each year

~ 140,000 childhood injuries from abuse each year

~ 1.7 million reports of child abuse each year

~ 250,000-450,000 cases of child sexual abuse/year

~ 16 percent of adult women report a history of sexual abuse by a family member

Economic Costs

Acute medical care for injuries or neglect, and their complications

~ medical complications from injuries with enduring effects

~ mental health and substance abuse care for victims, perpetrators and families

~ inappropriate medical care for unrecognized mental health problems (“distressed high utilizers”)

Criminal justice system

~ intervening, arrests, prosecution, incarceration, etc.

Legal system

~ separation, divorce, custody disputes, protection orders, etc.

Social welfare organizations

~ emergency shelters, housing, foster care, etc.

Impediments to work

~ absenteeism or poor productivity

Practice Guidelines

~ Implement routine, universal screening

~ in all health care settings

~ for all females 12 years of age and older

~ Skills to foster an environment that facilitates disclosure:

~ how to ask the question

~ how to respond

~ what to document

~ your legal obligations

~ Screening strategies and initial responses

~ respond to the needs of all women

~ take into account differences based on diversity

~ Use reflective practice to examine how your own beliefs, values, and experiences influence the practice of screening

Educational Guidelines

~ Mandatory educational programs in the workplace designed to increase:

~ knowledge and skills

~ foster awareness and sensitivity about abuse

~ Curricula incorporate content on abuse in a systematic manner

Organizational Recommendations

Develop policies and procedures

~ supporting routine universal screening & initial response

Work with the community at a systems level to improve collaboration and integration of services between sectors

Practice implementation requires:

~ adequate planning, resources, administrative support

~ appropriate facilitation

~ an assessment of organizational readiness and barriers

~ involvement of all members

~ dedication of a qualified single point of contact

~ ongoing opportunities for discussion and education

~ opportunities for reflection

Definition

~ Woman abuse is:

~ the intentional and systematic use of tactics to establish and maintain power and control over the thoughts, beliefs and conduct of a woman through the inducement of fear and/or dependency

~ The tactics include:

~ emotional, financial, physical and sexual abuse, as well as, intimidation, isolation, threats, using the children and using social status and privilege

Primary Prevention

~ Prevents disorders before they occur

~ May include such activities as:

~ educating patients about the domestic violence

~ teaching parents about appropriate discipline

~ educating children about respect and appropriate assertiveness

~ recognizing and referring patients at-risk for perpetrating abuse

~ assessing potentially ov