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What Social Workers Need to Know About Domestic Violence

Vonnie L. Hawkins, MSW

Agenda

Intro and Study findings (10 mins)
Basic Information (10 mins)
Facts and Theories (10 mins)
Safety Planning Exercise (7-10 mins)
Debriefing & Questions (5-7 mins)

Intro & Caveats to this Material

This material consists of information from my thesis study, the Louisiana Coalition Against Domestic Violence Training Manual, literature and texts from Danis & Lockhart, as well as general literature that I have collected in the past years. I have cited most of my sources and have an extensive bibliography which I can provide to anyone who asks. Some statistics are cited by LCADV without citation.

Use “she” because mostly male on female violence; but acknowledge that males are victims, and DV occurs in homosexual relationships as well. There is emerging research to suggest that more violence is mutual than first thought, rather than male on female. I have not explored this, but will keep an open mind.

There is a distinctly victim-focused perspective in most of the material in this presentation. There is emerging research that suggests more mutual violence than previously thought. My background and the bulk of the literature that I have integrated is victim-focused. This is an acknowledged limitation of my thesis and my approach, which I plan to remedy over time by balancing with more perpetrator-oriented literature, interventions and theoretical analysis. This is a work in progress.

Several theoretical perspectives are presented here. There is no single theory that explains DV, and in fact, the literature suggests the most appropriate approach is a multi-factoral or multi-dimensional approach. Additionally, the research says that victim and perpetrator experiences occur along a continuum, and are unique to each person, and to each couple, and therefore it is imperative that adequate biopsychosocial history and assessment be conducted. The models that are presented here are simply general frameworks to help in sorting through what the client tells you. You may even find that some terminology and concepts disagree or conflict. These are different ways to examine and categorize the behavior you observe or is reported to you, and it is up to you, to utilize your assessment skills to choose which approach is most helpful for each client.

The bottom line – avoid stereotyping clients experiencing domestic violence, and treat each client as unique because the range of their experiences is broad. This is something I think social workers are uniquely trained to practice, more so than mental health practitioners who operate from an individualistic approach, rather than an ecological perspective.

FINALLY – I have included what I thought was relevant, but there are hours and hours more of information, training and education, and I would encourage you to contact your local DV shelter to schedule in-service trainings on DV for your staff and interns, and update this training regularly.

What Social Workers DON’T Know about Domestic Violence Could Endanger Their Clients (Golden & Frank, 1994).

Advice to leave
Therapeutic “blind spots,” unprocessed feelings about violence in family of origin
Myths, incorrect facts
Ineffective response discouraging future help-seeking behavior

Working with domestic violence requires a specific skill set that is sometimes counter-intuitive to the linear, medical and “one right solution” modes of thinking employed to address mental illness and other areas of social work (Buchbinder, Eisikovits & Karnieli-Miller, 2004). Intuitively, we might want to advise a client to leave the danger, but that doesn’t work in domestic violence. An often cited statistic is that 65-75% of domestic violence murders occurs during or after leaving the situation!

With domestic violence, considerations for client safety, more so than competency and professionalism, demand that every student social worker receive correct information about domestic violence as a defined part of their curriculum before they graduate, and not as an option at the discretion of professors or instructors (Danis & Lockhart, 2003).
Studies suggest that as many as 69% of social workers come to the profession with therapeutic “blind spots” resulting from trauma they experienced in their family of origin (Sellers & Hunter, 2005).
When coupled with work with clients experiencing domestic violence, lack of preparation could traumatize the therapist or undesirably affect the therapeutic process with victims (Goldblatt & Buchbinder, 2003; Sellers & Hunter, 2005).
Further, past experiences of abuse by social work students could present barriers to learning and there is some research which suggests benefits to helping student social workers explore and process this information to put it in proper context (Wagner & Magnusson, 2005).
Myths and inaccurate knowledge about domestic violence which may be part of a social worker’s belief systems in the absence of corrective knowledge can compound the likelihood for inappropriate or ineffective response (Peters, 2003).
An inappropriate or ineffective response by a social worker could significantly affect the victim’s choices, resulting in greater endangerment or discouraging the victim from future help-seeking behavior (Goldblatt & Buchbinder, 2003).

What do Social Workers’ Need to Know?

Examine potential for bias, myth acceptance and victim blaming attitudes thru critical self-reflection.
Safety plan, as a bare minimum.
Screening- Ask the question, universal.
Intervention- Know theories, macro-level factors, know client experience.
Referral-Know your resources & use them.

Common Myths (Peters, 2003)

They could leave if they wanted to.
The victim provokes the abuse.
Women get abused because they keep arguing.
Some women unconsciously want their partners to control them.
Violence occurs when a partner loses their temper.
Women can avoid physical abuse if they give in occasionally.
Women return to abuser because they like it.

Terrebonne story. Evicted women.

Domestic Violence 101

Adapted from a Module Created by Fran Danis, PhD

Domestic Violence is…

A pattern of coercive behaviors that involves physical abuse or the threat of physical abuse.
It may also include repeated psychological abuse, sexual assault, progressive social isolation, deprivation, intimidation, or economic coercion.

This is a composite definition that recognizes the power and control one partner has over the other.

The difference between force and coercion – in force, there is no choice. In coercion, there is choice, but there are consequences.

This is a key element that most people do not understand about DV. The physical abuse is used to produce compliance, so that coercion works.

Terminology

DV is perpetrated by adults or adolescents against their intimate partners in current or former dating, married or cohabiting relationships of heterosexuals, gay men, lesbians, bisexuals and transgendered persons.
The terms domestic violence, domestic abuse, and intimate partner violence are often used interchangeably.
Battered, Victim, Client, Survivor, Empowerment, Advocacy

Literature uses victim and perpetrator

Social workers, advocates use survivor – for empowerment.

Power and Control Wheel

Dynamics of domestic violence” Power and control

DEFINITION OF THE PROBLEM:

Battering is a pattern of coercive control that one person exercises over another. Abusers use physical and sexual violence, threats, emotional insults and economic deprivation as a way to dominate their partners and get their way. Relationships in which one partner uses assault and coercion can be found among married and unmarried heterosexuals, lesbians and gay males.

Battering is behavior that physically harms, arouses fear, prevents a woman from doing what she wishes or forces her to behave in ways she does not want to. The statistics clearly indicate that battering is too common to be considered an emotional illness.

Susan Schechter, in Guidelines for Mental Health Practitioners in Domestic Violence Cases, 1987.

How Prevalent is Domestic Violence?

Lifetime estimates: 1 in 3 or 4
85-90% male on female
30% of female homicide victims as contrasted with 3% of male homicide victims
5.9 million incidents of physical assaults annually with approx. 76% perpetrated by current or former boyfriends, cohabiting partners or dates. (National Violence against Women Study)

The extent of the problem: depends on who you ask, who does the asking, how the question is asked, what is asked, how it is defined (Behind closed doors)

National VAWA Survey (tjadens & thoennes, 1998) 5.9 million incidents of physical assaults annually with approx. 76% perpetrated by current or former boyfriends, cohabiting partners or dates.

National Crime Victimization survey (Bachman & Saltzman, 1995), nearly are killed by their husbands, former husbands or boyfriends as contrasted with just over 3% of male homicide victims killed by wives, former wives or girlfriends.

CDC studies (Rand, 1997) more than 1/3 of adults have witnessed a man beating his wife or girlfriend; 50% of all ER Room visits of injured women involve partner abuse & ER incidents were more than 4X higher than estimates of dv that come to attention of law enforcement agencies.

National Center on Elder Abuse: 13.8% perpetrators of elder abuse or elderly spouses of victim (Brownell & Abelman, 1998).

Straus, Gelles & Steinmetz (1980) lifetime prevalence rates of male to female abuse, estimated at 14-50%

AMA says 1 in 3 women at some point in their lives FBI says 1 in 2.

ALL ABOVE STUDIES MEASURE ONLY PHYSICAL ABUSE, NOT EMOTIONAL ABUSE

Why Do Men Hit?

Learned behavior: Home, Community, School, Culture

Theories: culture of violence, evolutionary, ecological, intergenerational tx, systems, social disorganization, social learning/learned helplessness (Walker)

Because they can…risks do not outweigh the rewards

Theories: Exchange, investment, resource

Male privilege

Theories: Traumatic bonding, feminist

– It is all, none and any combination of these, depending on the person, the couple, the environment and their psychosocial developmental history…which makes thorough assessment of these factors critical.

There is no stereotype – victims and perpetrators experience domestic violence along a continuum of patterns, severity and frequency, and combination of psychological, physical and sexual abuse.

RISKS – batterer accountability

Present Ecological Model

Individual Perpetrator – witnessed abuse as a child
Relationship – sense of entitlement, dominates partner
Community – Institutions that condone abuse of women thru inaction/indifference.
Society – Norms granting men power and control over wives; use of violence as acceptable way of resolving conflict or correcting bad bx

95% of ppl believe spanking is okay;

religious norms which condone physical punishment of wives by husbands

Cultures which use violence politically/socially - WAR.

Reality is a complex interaction of any, some or all of these factors.

There is no stereotype – victims and perpetrators experience domestic violence along a continuum of patterns, severity and frequency, and combination of psychological, physical and sexual abuse.

Domestic Violence is Not Caused by:

Illness

Genetics

Alcohol or drugs

Out-of-control behavior

Anger

Stress

Behavior of the victim

Barbara Davidson’s story about abused woman who got husband to quit drinking, but then he was more accurate and could catch up with her, so he was able to hurt her more effectively.

Being Out of control is selective – Dr. Pepper story,

they don’t beat up their boss, the Circle K guy, the driver who cuts them off.

They beat up who they can get away with beating up.

The survivor/victim does not CAUSE the violence, no matter what the abuser says. The abuser will find a reason to get angry, so the victim is powerless to provoke or prevent the abuse.

Why Do Women Stay?

Why is this the wrong question to ask?

Economic Dependence
Children & Fear of Loss of Children
Promises of Change
No Place To Go/ Resources
Societal Attitudes
Traditional Value System
Isolation
Fear of Death
WOMEN DO LEAVE EVERY DAY

It is the wrong question to ask because it

Blames the survivor

Shames the survivor

Puts the Responsibility for the abusive behavior on the survivor

Deters Help seeking behavior

Possible one year lag time (Reidy & Van Korff, 1991)

Reluctance to Disclose (McFarlane et. al, 1991)

Increase help seeking when abuse escalates (Gondolf & Fisher, 1988)

Women do leave every day…women with economic resources are less likely to come to dv programs or other formal helping systems for assistance. As social workers we don’t see all the women who leave, we mostly see those who have few resources.

Tension Building Phase

Explosive Event

Honeymoon phase

loving & contrite

Cycle of Violence – Walker (1979)

I’m sorry…

I’ll never do it again!

Dynamics of Domestic Violence – The Cycle of Violence: Lenore Walker

Battering often occurs in the context of something that we call the Cycle of Violence. We have found that even though every relationship is unique, abusive relationships often follow similar cycles. In 1979, Lenore Walker interviewed 1500 battered women. She found that woman after woman described the same kind of cycle in her relationship. She identified this cycle of violence.

TENSION: We start the cycle in this relationship at the “okay” stage. The couple is basically okay, interactions are positive or close. Then, as “real life” sets in, tensions start building. We call this the tension building stage. These tensions may be anything from a bad day to major life changes like pregnancies or job loss. It’s good to note here that all relationships have periods of tension. In healthy relationships, the couple may disagree or argue, but both have equal power in the relationship. In battering relationships, the abusers need for power and control underlie anger and laming. The tension continues to escalate. Survivors often describe feeling like they’re “walking on eggshells” during this time.

EXPLOSION: Ultimately, there is an explosion or battering incident. Abusers may hit, attack, verbally assault, threaten, or scream at their partners. Many people feel battering incidents occur because someone is so angry or so drunk that they loose control of themselves. We hear comments like, “if she hadn’t kept nagging me I wouldn’t have lost my temper, or ”I was so out of it, I didn’t know what I was doing.” Actually, abusers TAKE CONTROL when they batter. They take control of the immediate situation, their partner, their physical space and usually the outcome of the situation. Domestic violence is a crime of power and control not passion out of control.

LOVING & CONTRITE: After the explosion comes the honeymoon or loving and contrite stage. The batterer is likely to have actually experienced a physiological release of tension. The batterer is frequently sorry, feeling guilty and willing to try anything to make up. There may be flowers or gifts, dates and romance as in the beginning of the relationship. The couple may even make love in an attempt to reestablish intimacy and security after the explosion. The batterer will also be blaming her for “having to hit her" and will minimize what just happened. She will be in shock, upset, possibly hurt. She will be confused and may feel guilty that somehow she may have caused it. She will want to believe his promises. Both partners deny how bad the abuse was and that it could happen again. We point out here that no woman wants a relationship to end, she wants the battering to end. In this loving and contrite stage, the increased intimacy and promises to get help or never do it again give her hope that things might change.

After a while, the loving stage fades again and we start around the circle once more. They both may believe that it will never happen again, that it was a one-time occurrence. The couple convinces themselves that each incident is isolated and unrelated to the next. There are two things we know about the cycle:

Without intervention, this cycle does not get better; it actually becomes more frequent.

The violence escalates over time. Without intervention, the abuse gets worse, and the loving and contrite stages are less apologetic. Eventually the loving and contrite stage drops out entirely. When crisis callers describe a cycle of violence with no loving and contrite stage, we know she is probably in a great deal of danger.

Coping & Communication Skills in Violent Couples (Ronan et al 2004)

Social skill deficit models

Ineffective interaction patterns

Negative reciprocity patterns->escalation

Poor problem-solving skills in high-conflict situations; better problem-solving in neutral and low conflict situations.

Couples-based tx only appropriate after completion of Batterer Intervention
Consider contextual factors when selecting treatment protocols

Opposition to female-oriented DV research has suggested that the 85% female statistics are inaccurate, and that in fact, women are as combative and assaultive as men.

The basic fact remains, however, that husband-to-wife violence has more negative outcomes, including physical injury and psychological consequences (ie injury, depression, lowered self-esteem) than wife-to-husband violence. Female victims are significantly more likely to have lower self-esteem than females in non-violent relationships.

Physically aggressive couples have more ineffective interaction patterns that contribute to escalation of aggression and displayed more hostile affect than did verbally aggressive or withdrawing couples.

Ineffective interaction patterns = hi levels of anger, contempt and belligerence, difficulty ending negative interaction patterns, resulted in inability to negotiate compromises effectively.

Negative reciprocity patterns = angry behavior by one partner increased the chance the other partner would display the same behavior.

Risk Factors

Pregnancy

Increased risk of sexual victimization during pregnancy

If abused during pregnancy, likely abused prior to

Escalation

Look for a pattern of escalation in severity of abuse over time.

Poverty

Risk increased thru effects on conflict, women’s power and male identity.

Martin, et al (2004) Changes in Intimate Partner Violence During pregnancy. Journal of Family Violence. 19:4. pp.201-210. A North Carolina Study.

Jewkes (2002)

Pregnancy and Domestic Violence:

• Each year, about 324,000 pregnant women in this country are battered by their intimate

partners.xii

• Complications of pregnancy, including low weight gain, anemia, infections, and first and

second trimester bleeding are significantly higher for abused women,xiii xivas are maternal rates

of depression, suicide attempts, tobacco, alcohol, and illicit drug use.xv

• Pregnant and recently pregnant women are more likely to be victims of homicide than to die of

any other cause,xvi and evidence exists that a significant proportion of all female homicide

victims are killed by their intimate partners.xvii

Other Risk Factors

Cultural ideologies of male dominance

Lower social status of women leads to abuse

Alcohol and drug consumption
Much more frequent in societies where violence is usual in conflict situations and political struggles.

Martin, et al (2004) Changes in Intimate Partner Violence During pregnancy. Journal of Family Violence. 19:4. pp.201-210. A North Carolina Study.

Jewkes (2002)

Protective Factors

Resilience (Bogat, Levendovsky & von Eye, 2005; Bonanno, 2004)

hardiness

self-enhancement

repressive coping

positive emotion

Financial independence of women

Unless partner is not working, then greater risk

Jewkes (2002)

These are features of a survivor’s life that you can focus on for support, encouragement and development through the service plan to the family and recommendations to your OCS worker.

Protective Factors

Social Support

Indicators of value, source of support, assistance in crisis

High level of feminine empowerment

From education, income, community roles

Jewkes (2002)

These are features of a survivor’s life that you can focus on for support, encouragement and development through the service plan to the family and recommendations to your OCS worker.

Safety Plan

Lethality assessment to gauge danger
Assess for stalking
Getting help or getting away

Accessing transportation options

Accessing a link to outside helpers; teach kids to dial 911

Securing belongings

Determining a safe, alternative escape location; teach kids to go to neighbors’

Getting assistance from local DV agency

Safety Plan

Pack a bag & keep in safe place to provide options if violence escalates:

money/credit card (plan for squirreling away)

birth certificate/SS card (survivor & children)

clothing/diapers/formula

medication

extra keys

insurance paperwork-

Answer the question “I can’t leave because I don’t have…” and make sure that is in the bag, so it is not a reason they can’t leave

Have the client repeat back – nothing in writing!

Lethality Assessment

History
Depression, stressful life events?
Weapons, access to weapons
Obsession, social isolation
Expressions of rage
Drugs or alcohol?
Escalation of threats or actual violence
Access to her, knowledge of her location

A lethality assessment serves multiple functions. It is a way for the advocate to assess the most appropriate intervention or service to offer the victim. It is a way to help battered women see the subtle or hidden abuse within their relationships. The advocate can also use it as a teaching tool to give the battered woman a skill to protect herself in the future. There are many different ways of approaching lethality assessments.

A simple assessment looks at nine characteristics of abusers. When these characteristics appear in a group, there is reason to believe that there is an increased risk to the victim. It is not predictive, but it does give advocates a baseline measure from which to work in determining safety plans with battered women.

1. Does he have a history of threats of attempted homicide or suicide? Has he discussed murder/suicide pacts with the victim?

2. Is he depressed? Are there particularly stressful life events going on -- unemployment, poverty, death of a loved one, or job changes? Does he have a history of mental illness?

3. Does he have weapons or access to weapons?

4. Is he obsessed with the victim? Does he feel that he cannot live without her? Is he socially isolated, and does he feel hopeless about a future without her?

5. Does he express rage about her leaving?

6. Is he involved with or addicted to drugs and/or alcohol?

7. Is he stalking her? Does he continually harass her? Will he refuse to leave her alone?

8. Is there an escalation in his threats and/or actual physical violence?

9. Does he have access to her? Does he know her location? Can he get to her?

Ethnic & Cultural Competency Considerations

Race/Ethnicity
Sexual Orientation
Disabilities
Age/Older Women
Religion
Immigration Status
Rural Issues

What Should We Look For in Screening?

Typology – intimate terrorism vs. situational couple violence (Johnston & Leone, 2005)
Qualitative assessment of each clients’ experience
Identify Patterns and Escalation

Frequency

Severity

Behaviors over time-dating, after marriage, most recent incident

Lethality Assessment

Intimate terrorism –

Clear power differential
More severe, more frequent
More injury, more substance abuse by victim

Situational Couple Violence

Roughly equal power distribution
Tends to revolve around a recurrent issue
Poor conflict resolution leads to escalation to physical

ASK QUESTIONS that will pull out patterns and escalation –what was violence like when dating, after married, two weeks ago, most recent incident?

Choking is considered the last step before murder and represents high danger to victim.

What we SHOULD say…

It’s not your fault.
You don’t deserve this.
You are not alone.
I respect you and your decisions.
I am concerned for your safety.
If you want to talk, I’ll be here for you.

What we should NOT say…

“Have you tried couples counseling?” (Golden & Frank, 1994)
Don’t be tempted to tell her to leave.

65% of intimate homicide victims separated from the perpetrator prior to their death

Don’t be too confrontational - ease into it.

Examine how you present when you ask.

Don’t tell her what she should or must do (social work core values).
Don’t slam the abuser.
Don’t offer unrealistic reassurance.

Current Louisiana laws, like the Post-separation Domestic Abuse Act recognize that mediation and couple-related activities is dangerous when DV is involved, and provide exclusions in those cases.

Safety Plan Exercise-7-10 mins

Pick a partner to role play – one the counselor, the other the client.
Counselor asks the question “Are you experiencing any abuse in your relationships?” “Do you feel safe at home?”
Client responds (scenario) & discloses DV
Counselor

screens for lethality.

creates the safety plan.

affirms the client.

provides referral.

Switch

Debrief & Questions-5-7mins

My email for add’l info:

[email protected]

Did the safety plan exercise bring up any emotions for you? For the recipient?

• Did either of you have any past or current experience with domestic violence?

• Did completing this exercise have any impact on how you felt about domestic violence? Victims/

survivors of domestic violence? Batterers? Child witnesses to domestic violence?

• Did completing this exercise have any impact on how you feel about the ability of the criminal

justice or social service systems ability to keep victims/survivors safe?

• What did you learn about the role of informal helping networks to help victims/survivors?

• How well did this plan match the needs of your recipient? Was the plan suitable? Did it cover

all the needs of the recipients Was the plan culturally sensitive? Would this plan work with all

Some final thoughts…

Validate – Don’t revictimize – mindful of cultural competency, myths, personal values.
Provide information

Safety plan

Referral to local DV resources

What constitutes success in this exchange?

Client leaves with information.

You don’t have to be a DV expert – work with your local domestic violence agency!

Recap - What do Social Workers’ Need to Know?

Examine potential for bias, myth acceptance and victim blaming attitudes thru critical self-reflection.
Safety plan-as a bare minimum.
Screening-Ask the question, universally.
Intervention-Know theories, macro-level factors, evaluate client experience.
Referral-Know your resources & use them.
National Domestic Violence Hotline 1-800-799-SAFE