Domestic Violence and the Healthcare System Flashcards
Domestic Violence types
> child abuse
family violence
intimate partner violence
elder abuse
Definition of Intimate Partner Violence
A pattern of violent or coercive behaviors that one
partner uses to gain and maintain power and control in their relationship
This person is intentionally creating a power imbalance so you know “who’s boss”
There are many different forms of domestic violence but the kind of violence those we serve are usually experiencing is ___
intimate partner terrorism
situational couple violence
things may escalate to violence in the situation, but this is typically because both partners are not good communicators and do not know how to argue without resorting to verbal aggression or physical violence
differs from intimate partner terrorism because one partner is not trying to consistently control the other
Domestic Violence Includes…
- Physical Abuse
- Emotional Abuse
- Psychological Abuse * Sexual Abuse
- Economic Abuse
- Stalking
cycles of abuse over time
seduction = apologies, promises, vulnerability, love
tension = anxiety, fear, anticipation, confusion
violence = physical, emotional, psychological, sexual
Reasons for Staying in or Returning to an Abusive Relationship
- Children
- Finances
- Friends and Family * Safety
- Love
- Hope
- Dependence
- Comfort
- Fear
Risk Factors
- Planning to leave or has recently left an abusive relationship
- Previously in an abusive relationship
- Poverty
- Physical or mental disability
- Isolated socially from family and friends
- Abused as a child
- Witnessed domestic violence as a child
- Pregnancy
- Younger than 25 years
- Stalked by a partner
Physical Signs of Domestic Abuse
- Frequent injuries described as “accidents”
- Unusual clothing to hide bruises
- Unexplained bruises, burns, or fractures
- Complains of soreness or moves uncomfortably
Emotional Signs of Abuse
- Low Self-Esteem
- Depression
- Anxiety
- Post-Traumatic Stress Disorder
Behavioral Signs of Abuse
- Substance abuse
- Nervous/Fearful
- Hesitant to leave children with partner
- Changes in eating or sleeping patterns
- Self-Harm/Suicidal
- Withdrawn
- Aggressive
Cause of Domestic Violence
behavior learned through:
experience
observation
> family
> communities
> culture
reinforcement
Characteristics of Abusers
- Control
- Entitlement
- Selfishness/Self-Centeredness
- Superiority
- Possessiveness
- ConfusionofLove/Abuse
- Manipulation
- ContradictoryStatements/Behaviors
- Denial/Minimization/VictimBlaming
Why We Need Your Help
can provide universal education to all patients for the prevention of intimate partner violence, reaching populations that domestic violence organizations cannot
opportunity and obligation to identify and support those who are being abused
Seeing a healthcare provider may be the only chance they have to receive help
Most healthcare providers screen for child abuse because of mandated reporting laws, but rarely screen for domestic violence among adults
CUEs
C = confidentiality
U/E = Universal Education
S = support
Confidentiality =
Explain confidentiality policies and mandated reporting requirements
Offer confidential resources prior to interviewing about abuse
Confidentiality can save a life, breaking it can end one
Universal Education for Prevention
- Discuss with all patients
- Normalize
Interviewing Should Be
- Conducted orally during face to face encounter
- Included in any written questionnaires
- Conducted in a direct and non-judgmental way
- Conducted in private
- Assisted, if needed, with interpreters but not friends or family members
When Should Interviewing Not Occur
- If no private space is secured
- If there are concerns that screening is unsafe for either patient
or provider/If the abuser is present - When children are present (< 3 years old OK)
- If provider is unable to secure an appropriate interpreter
- When friends, family, or partner are present
Barriers to Interviewing
- Time
- Comfort level of asking about abuse
- Uncertainty of what to say when someone discloses abuse
- Uncertainty of who to refer to once abuse is disclosed
Recognize Triggers
To create a safer space for survivors, physical therapists can:
- Assume possible trauma
- Seek consent prior to physical touch & encourage patient to let
you know if they feel uncomfortable - Alert patient if you are going to touch them when they may not
see you approaching (like from behind) - Be aware of physical or emotional responses to physical touch
like a startle response, pulling away, etc. - Avoid violent language and using guiding vs directive language
Helpful Things to Say
- “I am sorry this happened to you.”
- “I believe you.”
- “It is not your fault.”
- “You are not alone, there are people available to support you.”
Guiding Principles of Safety planning with Survivors
- Meet the survivor where they are at.
- Respect the fact that the survivor is THE expert on their situation.
- Reserve judgment –It is about the survivor and their perception of the experience. Be aware of own biases.
- Empower the survivor with information, resources and support (don’t overwhelm). Offer choices.
- Respect the need for confidentiality.
- Offer a private space for someone to talk, especially away from
where children or others cannot hear. - Help the survivor plan for and access safety.
- Be consistent, but not pushy.
Steps to End Domestic Violence
- Hotline
- Emergency & Transitional Housing Services
- Economic Justice and Emotional Support Groups
- Legal Advocacy
- Children and Youth Services
- Support Groups
- Education and Prevention
