Violence in Families Assessing Prevention and Treatment Programs (1998) / Chapter Skim
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2 FAMILY VIOLENCE AND FAMILY VIOLENCE INTERVENTIONS
2 FAMILY VIOLENCE AND FAMILY VIOLENCE INTERVENTIONS
Pages 31-58
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From page 31... ...
How the nature of family violence is conceptualized has important implications for the ways in which interventions are structured and outcomes are measured in evaluating them. This chapter examines similarities and differences in research on child maltreatment, domestic violence, and elder abuse in definitions, measurement, risk factors, and interventions.
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From page 32... ...
The National Center on Child Abuse and Neglect (1988) recognizes six major types of child maltreatment: physical abuse, sexual abuse, emotional abuse, physical neglect, educational neglect, and emotional neglect.
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From page 33... ...
However, elder abuse definitions frequently go beyond those of child maltreatment to include financial abuse or exploitation. Elder abuse may also be a continuation of domestic violence in the relationship, in which case the issue of coercive control is pertinent.
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From page 34... ...
Adult Women 1985 National Family Violence 6,002 -- 116 Survey (Straus and Gelles, 1988) National Crime Victimization ~50,000 -- 9.3 Survey (Bachman and Saltzman, 1995)
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From page 35... ...
FAMILY VIOLENCE AND FAMILY VIOLENCE INTERVENTIONS 35 Severe Sexual Emotional or Physical Abuse or Psychological Fatal Violence Marital Rape Abuse Neglect Abuse -- 4.4 7.9 20.1 -- 2 <0.1 6 -- -- -- -- -- 0.0019 23 -- 63.4 -- -- -- 270a -- -- -- -- 160a -- -- -- 530 -- -- -- -- 34 12 74 -- -- -- 1 -- -- -- 48 not asked 74.8 -- -- -- -- b -- -- -- -- -- 11 4 --
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From page 36... ...
American society lacks a clear definition of caregiver responsibility for elders comparable to parental responsibilities for children, and conflicts may arise in certain cultures, classes, and social groups as to what types of arrangements constitute maltreatment. Recently, some researchers have questioned the legal and clinical definitions of elder abuse, suggesting that it is the older person's perception of a particular behavior, influenced by culture and tradition, that should be the salient factor in identification and intervention (Gebotys et al., 1992; Hudson, 1994)
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From page 37... ...
Dependence and Power Running through discussions of child maltreatment, domestic violence, and elder abuse is the idea of unequal power in the relationship between abuser and victim. In all three domains, abusers may use violence to control the victim.
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From page 38... ...
As a result of research studies and programs to change community attitudes toward the needs of battered women, definitions broadened beyond physical injury to include sexual and emotional abuse and threats of harm. Recent legislation now recognizes the stalking of estranged or former partners as domestic violence.
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From page 39... ...
There is no administrative data source for domestic violence that is comparable to the state child and elder abuse datasets, and surveillance efforts are often challenged by concerns about victim safety and confidentiality. Second, segments of the population at risk are subject to different levels of surveillance.
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From page 40... ...
The 1985 National Family Violence Survey found much higher rates of domestic violence: 116 per 1,000 women reported experiencing violence during the past year; 34 per 1,000 women reported severe violence; and 12 per 1,000 reported marital rape (Straus and Gelles, 1988)
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From page 41... ...
Research next focused on the traits of perpetrators. Although there appears to be a relatively high incidence of psychological and emotional problems among perpetrators of family violence, no characteristic profile of a child abuser, batterer, or elder abuser has emerged.
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From page 42... ...
In contrast to the National Family Violence Surveys, the National Crime Victimization Survey found women reporting much higher rates of victimization by partners or ex-partners than men reported. In 1992-1993, the average rate of physical and sexual violence by an intimate was 9.4 per 1,000 for women, but only 1.4 per 1,000 for men (Bachman and Saltzman, 1995)
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From page 43... ...
As noted above, poor families are more likely to be in contact with social service agencies and hence be under greater scrutiny, thereby increasing the likelihood that they will be reported for abuse or neglect. Nonetheless, the association between child maltreatment and poverty persists in self-report data as well as in official data (Straus et al., 1980; Wauchope and Straus, 1992)
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From page 44... ...
Both official report data and self-report survey data often report that child abuse and violence toward women are overrepresented among minorities. Data from the National Crime Victimization Survey indicate that the rate of domestic violence is essentially the same for whites (5.4 per 1,000)
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From page 45... ...
Although a consistent profile of parental psychopathology or a significant level of parental mental disturbance has not been supported (Melnick and Hurley, 1969; Polansky et al., 1981, 1992; Spinetta and Rigler, 1972) , a set of personality characteristics associated with child maltreatment has emerged with sufficient frequency to warrant attention.
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From page 46... ...
First, because so much of the research on family violence is cross-sectional, it is not clear whether social isolation precedes violence in the home or is a consequence of it. Second, social isolation has been crudely measured, and the purported correlation may be more anecdotal than statistical.
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From page 47... ...
. Men's drinking patterns, particularly binge drinking, are associated with domestic violence across all ethnic and social classes (Kantor, 1993)
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From page 48... ...
. Risk Factors for Victims Early research in domestic violence and child maltreatment looked for factors that differentiated victims from nonvictims.
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From page 49... ...
Older children are most likely to be underreported as victims of abuse. Marital Partners Being female is the most consistent risk factor for being a victim of domestic violence (Hotaling and Sugarman, 1986)
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From page 50... ...
, or the conditions under which persons in need of services do not have access to appropriate care. Victims of domestic violence, for example, may be seen by emergency department personnel, other health care providers, court officials, and battered women's shelter staff, but rarely do these service or agency staff members have an opportunity to collaborate, review, or understand the full dimensions of the victim's needs and experiences.
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From page 51... ...
TABLE 2-2 Array of Services for Family Violence by Service Sector and Purpose Short-Term Victim Case Identification/ Protection/Risk Long-Term Sector Prevention Risk Factor Detection Assessment/Treatment Intervention Social services Education programs Surveys Shelters Peer support groups Service provider training Case reports Batterers' treatment Education and job training programs programs Community coordinating Child protective Family preservation Housing (transitional and councils services services permanent) Comprehensive community Parenting practices and Child and elder services family support placement Community support groups Health Service provider training Health reports Home visitation and Mental health services for victims programs family support Emergency room Mental health services for procedures offenders Diagnostic protocols FAMILY VIOLENCE AND FAMILY VIOLENCE INTERVENTIONS Law enforcement Service provider training Uniform crime reports Temporary restraining Offender incarceration programs orders National crime Arrest procedures Sentencing guidelines victimization surveys Batterers' treatment Prosecution procedures programs Victim advocates Conditions of probation and parole SOURCE: Committee on the Assessment of Family Violence Interventions, National Research Council and Institute of Medicine, 1998.
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From page 52... ...
. It is the last known federal interdepartmental review of programs focused on child abuse and neglect, domestic violence, and elder abuse; it identifies nine federal departments and three independent agencies that provide services or sponsor research relevant to family violence (see Table 2-3)
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From page 53... ...
FAMILY VIOLENCE AND FAMILY VIOLENCE INTERVENTIONS 53 TABLE 2-3 Federal Programs That Provide Services or Sponsor Research Relevant to Family Violence Department of Health and Human Services Social services Project SHARE Community services block grant Office of Human Development services Coordinated discretionary funds program Social services block grant Child welfare services Foster care and adoption assistance Head Start program Runaway and homeless youth program Developmental disabilities program Native Americans program Older Americans program Child abuse and neglect prevention and treatment program National Center on Child Abuse and Neglect Advisory Board on Child Abuse and Neglect Health Medicaid (Title XIX) Primary care block grant Maternal and child health block grant Alcohol, Drug Abuse and Mental Health Services block grant Preventive Health and Health Services block grant Centers for Disease Control and Prevention Adolescent Family Life Program Indian Health Service Program National Institute of Mental Health National Institute on Aging National Institute on Alcohol Abuse and Alcoholism National Institute on Drug Abuse National Institute on Child Health and Human Development Income support Aid to Families with Dependent Children Supplemental Security Income Program Department of Agriculture Food stamps Extension Service Americorps The Foster Grandparent Program Retired Senior Volunteer Program Volunteers in Service to America (VISTA)
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From page 54... ...
Service providers who participated in the survey that was part of the 1981 DHHS report indicated that they refer victims of spouse abuse to other service providers (such as shelters or adult protective services programs) for direct help with the problem of domestic violence (U.S.
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From page 55... ...
Yet it is known that the injuries and mental health problems that occur in the wake of family violence have imposed a heavy burden on a broad range of service providers, including women's shelters, schools, hospitals, mental health clinics, police stations, and district attorney's offices. Responses to reports of domestic violence or the endangerment of children, for example, involve time-consuming and costly investigations to determine program eligibility by a broad range of social service programs, including child protective services, children and family resource programs, child welfare, and foster care offices.
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From page 56... ...
TABLE 2-4 Estimated Annual Costs of Family Violence Annual Cost Estimate (for U.S., unless Study Costs Included otherwise noted) Straus, 1986 Data related to intrafamily violence $1.7 billion Daro, 1988 Medical costs $20 milliona Rehabilitation and special education $7 million Foster care $7.1 billion Lost productivity $658 million-$1.3 billion Meyer, 1992 Short- and long-term medical $5-$10 billionb treatment and lost productivity Dayaratna, 1992 National health care costs generated as $6.5 billionb a function of $326.6 million annual health care costs for Pennsylvania Blue Shield Zorza, 1994 National costs generated as a function $31 billionb of $506 million annual health care medical costs for New York City Miller et al., Medical bills; out-of-pocket expenses; $67 billionb 1994 property losses; productivity losses at home, school, work; pain, suffering, and lost quality of life aIncludes only costs of child maltreatment.
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From page 57... ...
The Centers for Disease Control and Prevention, for example, is involved in an effort to define intimate violence in a form that could be used to establish national baseline rates. An interagency task force on child abuse and neglect is conducting a similar effort to define child maltreatment so that common data elements could be established in research studies in this field.
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From page 58... ...
Thus, their cost estimate of $77 billion for child abuse and domestic violence still underestimates the total costs of family violence each year. What is also unknown in reviewing these cost estimates is the extent to which existing expenses associated with health, social services, and legal services could be reduced if effective preventive interventions were in place.
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