Spouse / Partner Abuse > Chapter 4, Part A - Intervention Strategies

Chapter 4, Part A: Intervention Strategies

V. Intervention Strategies

Without intervention domestic violence will escalate and can lead to the serious injury or death of the victim and/or the batterer. (CAADV 2005)

When considering what interventions are best in cases of spousal/partner abuse the most important concern is the safety of the victim. This often involves action by the victim, the healthcare provider, law enforcement, community organizations and/or others. Prevention of abuse is the preferred intervention. One way to help prevent abuse is to educate the victim as to the danger he or she may be in. Because of the emotions involved it is difficult for somebody in a relationship to see what others outside of the relationship can see. This can include the threat of danger.They may be in an abusive relationship and not even be aware of it. For safety and determining if a relationship is abusive, the CAADV has developed useful guides.

The following are some questions from CAADV (2005) that a person can ask to determine if they are in an abusive relationship:

Does your partner:

  • Act extremely jealous of others who pay attention to you, or use jealousy to justify his/her actions?
  • Control your finances, behavior and even whom you socialize with?
  • Threaten to kill you or commit suicide?
  • Make you afraid by using looks, actions, and gestures like smashing things, destroying your property or displaying weapons?
  • Make all the decisions?
  • Stop you from seeing or talking to friends, family or limits your outside involvement?
  • Act like the abuse is no big deal; it’s your fault or even denies doing it?
  • Threatens to kill your pets?
  • Puts you down in front of other people, humiliates you, plays mind games and makes you feel as if you are crazy?
  • Prevents you from getting or keeping a job?
  • Takes your money or does not let you know about or have access to the family income?
  • Blame drugs or alcohol for his violent behavior?
  • Threatens to take the children away?

Do you:
  • Become quiet when he/she is around and feel afraid of making him/her angry?
  • Cancel plans at the last minute?
  • Stop seeing your friends and family members, becoming more and more isolated?
  • Find yourself explaining bruises to family or friends?
  • If you answered yes to any of these questions, you may be involved in a relationship that is physically, emotionally or sexually abusive.

You may be in an emotionally abusive relationship if your partner:
  • Calls you names, insults you or continually criticizes you.
  • Does not trust you and acts jealous or possessive.
  • Tries to isolate you from family or friends.
  • Monitors where you go, who you call and who you spend time with.
  • Prevents you from getting a job or learning English.
  • Threatens to have you deported.
  • Controls finances or refuses to share money.
  • Punishes you by withholding affection.
  • Expects you to ask permission.
  • Threatens to hurt you, the children, your family or your pets.
  • Humiliates you in any way.

You may be in a physically abusive relationship if your partner has ever:
  • Damaged property when angry (thrown objects, punched walls, kicked doors, etc.).
  • Pushed, slapped, bitten, kicked or choked you.
  • Abandoned you in a dangerous or unfamiliar place.
  • Scared you by driving recklessly.
  • Used a weapon to threaten or hurt you.
  • Forced you to leave your home.
  • Trapped you in your home or kept you from leaving.
  • Prevented you from calling police or seeking medical attention.
  • Hurt your children.
  • Used physical force in sexual situations.
You may be in a sexually abusive relationship if your partner:
  • Views women as objects and believes in rigid gender roles.
  • Accuses you of cheating or is often jealous of your outside relationships.
  • Wants you to dress in a sexual way.
  • Insults you in sexual ways or calls you sexual names.
  • Has ever forced or manipulated you into to having sex or performing sexual acts.
  • Held you down during sex.
  • Demanded sex when you were sick, tired or after beating you.
  • Hurt you with weapons or objects during sex.
  • Involved other people in sexual activities with you.
  • Ignored your feelings regarding sex.

A. Safety Plan

Another way to improve the safety of someone in an abusive relationship is to develop a safety plan. This plan helps to both prevent abuse from occurring, or in circumstances where violence is imminent, it provides the victim a plan of escape. Such a plan is provided below from the California Alliance Against Domestic Violence.

SAFETY STRATEGIES FOR SURVIVORS OF ABUSE

If you are in an abusive relationship:
  • Think of a safe place to go if an argument occurs - avoid rooms with no exits (bathroom), or rooms with weapons (kitchen).
  • Think about and make a list of safe people to contact.
  • Keep change with you at all times.
  • Memorize all important numbers.
  • Establish a "code word or sign" so that family, friends, teachers or co-workers know when to call for help.
  • Think about what you will say to your partner if he/she becomes violent.
  • Have a set of clothes for yourself and for your children stored at a friend's house or at work in the event you need to flee your house.
  • Keep sets of important documents (savings account records/check books/safety deposit keys), birth certificates, school records, deeds, other legal documents) away from your house in a safe place that only you can access.
  • Remember you have the right to live without fear and violence.

If you have left the relationship:
  • Change your phone number.
  • Screen calls.
  • Save and document all contacts, messages, injuries or other incidents involving the batterer.
  • Change locks, if the batterer has a key.
  • Avoid staying alone.
  • Plan how to get away if confronted by an abusive partner.
  • If you have to meet your partner, do it in a public place.
  • Vary your routine.
  • Notify school and work contacts.
  • Call the Shelter for Help in Emergency.

If you leave the relationship or are thinking of leaving, you should take important papers and documents with you to enable you to apply for benefits or take legal action. Important papers you should take include social security cards and birth certificates for you and your children, your marriage license, leases or deeds in your name or both yours and your partners names, your checkbook, your charge cards, bank statements and charge account statements, insurance policies, proof of income for you and your spouse (pay stubs or W-2’s), and any documentation of past incidents of abuse (photos, police reports, medical records, etc.)
Thanks to the National Coalition Against Domestic Violence for this information

When working with a battered woman, service providers should assess the extent to which a woman has difficulty with everyday physical functioning and feels threatened to determine how these difficulties impede her ability to carry out a safety plan. (Macy, et al 2005)

When a violent or abusive incident occurs it is important for the victim to know what to do to get help. Victims should be aware that calling the police will help them in various ways: The police can protect the victim, help them and their children leave safely, can arrest the abuser, provide information of programs and shelters, and will investigate and make a report that can be used in court. Those who are abused are usually weaker than the abuser and vulnerable. The police help put the power advantage over to the victims side so they then have control of the abusive circumstances.

Another important resource are friends and family, and the victim should make them aware of the situation. The victim can get much needed support from friends and family, both with a place to stay temporarily, emotional support and, help with the children. Whereas the police will help provide immediate protection and intervention, family can provide ongoing help and support. They should be part of the safety protection plan and provide advice from those familiar with the victim and the abuser.

Another option that the victim may need to take to stay safe is to find a safe place to stay. This is difficult because the victim is having to leave their home and their belongings.They might very well feel they are being punished when not only innocent, but having just suffered a tragedy. This exacerbates the difficult emotions already relating to the abuse, but as safety is always the primary concern, it may be a necessary step to take. If families and friends are not available, local community shelters are.These resources can be linked from the police department or domestic violence hotlines. A list of resources is found at the end of this course.

If the victim has been injured they should seek medical attention at a hospital or doctor’s office. At the hospital the victim may be visited by advocates to help them with support and resources. The victim can ask a doctor to call a Domestic Violence Advocate for them. In addition to getting medical attention and linked to other resources, a medical report can be used in a court case against the perpetrator.

Sometimes a victim might not even know the extent of their injuries. A seemingly small injury may actually be very serious. One of the most serious injuries that can go undetected is that of closed head injury. Although there is no open wound, there can be bleeding internally that can cause brain damage or death. If any of the following occur after being hit in the head medical attention should be sought immediately: memory loss, dizziness, problems with eyesight, throwing-up and/or a headache that will not go away. (OCCCADV, 2005)

Having a medical record of any injuries and a police report can help the victim obtain an emergency protective order. In California, this is issued by a judicial officer if the police assert that the victim is “in immediate and present danger of domestic violence based on the person’s allegations of a recent incident of abuse or threat of abuse by the person against who the order is sought.” (CA Fam. Code 6250) Further restraining orders and personal protection orders can also be obtained as legal forms of protection.


B. Social Work Treatment in Shelters

The following treatment approaches by Roberts (1996) provide a clear approach to treatment of the battered woman:

Without other social supports such as family or friends who can assist, or who have the room to help, many women and children must resort to shelters for their immediate safety. Shelter today offer more than just a place to housed, but offer a wide range of services. One of the first women’s shelters was created by Erin Pizzy who began the Women's Aid Project in England by setting up a "refuge home" for women with personal problems, but within three years this refuge home was filled to capacity with battered wives. Currently, the shelter setting still remains the primary recourse available to women and children fleeing abusive situations.

Because women can only stay in shelters temporarily, further concerns than the abuse must be addressed as many who are discharged must face getting a poorly paid job, collecting welfare, living off the kindness of families and friends, finding another relationship, or depending once again on their abuser.

Because of the lack of funding of shelters there are challenges in running them and providing adequate services. One result of this is that there is a very limited amount of days that a women can stay in a shelter—a rather short time to reestablish a life with residence, work, basic needs, etc. In addition, the severe violence that prompts women to seek help is likely to have occurred late at night, on weekends, or during holidays, and often during these hours the shelter is minimally staffed (Roberts and Roberts, 1990) .Many women who come to shelters are from out of town, presumably to get away from the abuser, and therefore have little local family support, if any existed in the first place.Furthermore, because of the limited funds and overcrowding, there is often little privacy. Crisis intervention is a short-term treatment, and its emphasis on limited time and concrete goals is well suited for use in the shelter.

When treatment is provided at the shelter, research has found that once a woman has received help and support, she is less likely to return to her abuser, but as Schecter ( 1982) explained,

[T]he issues facing many battered women are so overwhelming, medical problems, loneliness, children with emotional scars, poor housing and jobs, that they may decide to go back to their husbands. Many women want to reunite with their husbands for emotional, as well as, economic reasons and they hope the violence will cease. (p. 283)

Having developed coping skills for survival in an intense and abusive relationships, sometimes it is difficult for that battered women to adjust to more appropriate interactions patterns when in a shelter.A lot of times they will leave the shelter after a few days, going back to the abusive relationship, because she is more comfortable there.

In addition, the amount of time that a qualified counselor can spend with the client and the number of sessions available may also be limited by the client's decision to return to her spouse. This makes effective short-term treatment essential to help bring the battered woman out of a crisis state, to establish a safety plan, and to give her needed referrals.

Those working with women in shelters have found that short term treatment focused on solving immediate problems are the most helpful, as opposed to introspective approaches to therapy.

The Theoretical Model

The theoretical model recommended for this kind of short-term treatment is based on crisis intervention and cognitive--behavioral techniques.

The following are the basic principles of crisis theory and intervention:

  • An individual (or family, group, or community) is subjected to periods of increased internal and external stress throughout his normal life span that disturb his customary state of equilibrium with is surrounding environment. Such episodes are usually initiated by some hazardous event that may be a finite external blow or a less bounded internal pressure that has built up over time.The event may be a single catastrophic occurrence or a series of lesser mishaps that have a cumulative effect.
  • The impact of the hazardous event disturbs the individual’s homeostatic balance and puts him into a vulnerable state, marked by heightened tension and anxiety.To regain his equilibrium, he goes through a series of predictable phases. First, he tries to use his customary repertoire of problem-solving mechanisms to deal with the situation. If this is not successful, his upset increases and he mobilizes heretofore untried emergency methods of coping.However, if the problem continues and can neither be resolved, avoided, nor redefined, tension continues to rise to a peak.
  • At this point, a precipitating factor can bring about a turning point, during which self-righting devices no longer operate and the individual enters a state of active crisis, marked by disequilibrium and disorganization. This is followed by a period of gradual reorganization until a new state of equilibrium is reached.
  • As the crisis situation develops, the individual may perceive the initial and subsequent stressful events primarily as a threat, either to his instinctual needs or to his sense of autonomy and well-being; as a loss of a person, an attribute (status or role), or a capacity; or as a challenge to survival, growth, or mastery.
  • Each of these perceptions calls forth a characteristic emotional reaction that reflects the subjective meaning of the event to the individual: threat elicits a heightened level of anxiety; loss brings about feelings of depression, deprivation, and mourning; challenge stimulates a moderate increase in anxiety plus a kindling of hope and expectation, releasing new energy for problem-solving.
  • Although a crisis situation is neither an illness nor a pathological experience and reflects a realistic struggle to deal with the individual’s current life situation, it may become linked with earlier unresolved or partially resolved conflicts.This may result in an inappropriate or exaggerated response. Crisis intervention in such situations may provide a multiple opportunity: to resolve the present difficulty, to rework the previous difficulties, and/or to break the linkage between them.
  • The total length of time between the initial blow and final resolution of the crisis situation varies widely, depending on the severity of the hazardous event, the characteristic reactions of the person, the nature and complexity of the tasks that have to be accomplished, and the situational supports available. The actual state of active disequilibrium, however, is time-limited, usually lasting four to six weeks.
  • Each particular class of crisis situation (such as the death of a close relative or the experience of being raped) seems to follow a specific sequence of stages that can be predicted and mapped out. Emotional reactions and behavioral responses at each phase can often be anticipated.Fixation and disequilibrium at a particular point may provide the clue as to where the person is “stuck” and what lies behind his inability to do his “crisis work” and master the situation.
  • During the unraveling of the crisis situation, the individual tends to be particularly amenable to help. Customary defense mechanisms have become weakened, usual coping patterns have proved inadequate, and the ego has become more open to outside influence and change.A minimal effort at such time can produce a maximal effect; a small amount of help, appropriately focused, can prove more effective than extensive help at a period of less emotional accessibility.
  • During the reintegration phase, new ego sets may emerge and new adaptive styles may evolve, enabling the person to cope more effectively with other situations in the future.However, if appropriate help is not available during this critical interval, inadequate or maladaptive patterns may be adopted that can result in weakened ability to function adequately later on.(Golan, 1986)


Generally in assessing a crisis the following steps are taken:

Implications for Practice

  • The search for the precipitating event and its meaning to the client.
  • The search for coping means utilized by the client.
  • The search for alternate ways of coping that might better fit the current situation.
  • Review and support of client’s efforts to cope in new ways; evaluation of results.
(Parad, Selby and Quinlan, 1976)

It is rather reasonable to state that women who have run away from an abusive relationship to seek for safety in a shelter are in need of immediate crisis intervention. A practitioner in a shelter must have "an understanding of crisis theory and the techniques of crisis intervention" in order to meet the client's needs.”

The three most common precipitating or hazardous events that bring abused women into the shelter for treatment are (1) acute battering resulting in severe injury, (2) serious injury inflicted on the woman's child or children, and (3) the temporary impairment of hearing, vision, and/or thought processes resulting from the battering (Stith, Williams, & Rosen, 1990).

The goal in the crisis intervention is to not only help the client regain her previous level of coping and functioning, but to grow and gain new skills of coping. This will enhance future abilities to handle difficult situations. Roberts and Roberts (1990). This type of crisis intervention usually requires from one to six sessions (Puryear, 1979), and because of the time and goal-limited focus, it can provide an excellent therapeutic milieu for a woman living in a shelter.

Cognitive-Behavioral Therapy

Another form of brief short-term treatment that has been shown to be effective for victims of domestic violence is cognitive-behavioral therapy. As Webb ( 1992) explained, "distorted beliefs interfere with the abused women's ability to manage their lives effectively" (p. 206).

From a cognitive-behavioral perspective, the "assumption that maladaptive behaviors are learned and maintained in accordance with principles of conditioning" is emphasized (Getz et al., 1974, p. 7). In cognitive-behavioral therapy, the causal relationship of thinking, feeling, and behaving is highlighted, on the belief that people experience emotional distress as a result of faulty thinking ( Webb, 1992).

Women in treatment for domestic violence generally have distorted beliefs about both themselves (including their self-worth, ability to survive on their own, and responsibility to an abusive partner) and others ( Bolton & Bolton, 1987; Webb, 1992; Wodarski, 1987) The use of cognitive therapy is appropriate for most abused women because they have a need to regain control of how they see and think about themselves and their situations (Walker, 1992).

Albert Ellis's rational emotive therapy (RET), which is based on cognitive therapy, is a form of short-term treatment that can be used with domestic violence victims. Geffner and Pagelow (1990) described the use of RET to reduce irrational beliefs such as the idea that "violence, intimacy, love, sex, and affection are intermingled" (p. 129). RET techniques can be useful in conjunction with crisis intervention, for example, when a client is "catastrophizing" ( Getz et al., 1974). In RET, irrational unrealistic thoughts are identified, and the client is taught how to extinguish them (Ellis & Grieger, 1977). It is a short-term procedure, which "begins to work promptly" in most cases only oriented toward homework assignments" and other active-directive techniques such as role playing, assertion training, and conditioning and counter-conditioning procedures (Ellis, 1979, p. 44).

When using RET with abused women, the ABCDE format is followed. That is, A is the activating experience, B is the belief about A, and C is the consequence (emotional, behavioral, or both). It is the irrational or faulty belief that causes C, not the activating experience. The treatment also includes D, which is the disputation of distorted beliefs, and E, the new effect or philosophy that evolves from the rational belief that replaces the faulty belief (Ellis & Grieger, 1977). RET sees behavior as "habituated" and "irrational" thoughts as present in all people. As a treatment model, RET is relatively confrontive yet respectful of the client, and it works to increase the client's independence and positive self-regard.

The State of the Victim entering a Shelter

When a woman comes to a shelter the following circumstances often exist:

  • The victim probably has medical injuries. Examples of physical abuse run the gamut from pinching to hitting, burning, choking, mutilating, and destroying a beloved pet ( Schecter, 1988).
  • Several studies show that pregnant women are more likely to suffer abuse, perhaps because they are more vulnerable while pregnant ( Geffner & Pagelow, 1990; Walker, 1984; Wodarski, 1987).
  • The victim is likely to have suffered a sexual assault, and the negligence of a sexual assault could result in serious consequences for the women based on the implementation of inadequate or incomplete treatment plans ( Geffner & Pagelow, 1990).
  • The incident of abuse that prompts the victim to go to a shelter averages several hours in length, and physical abuse is coupled with psychological and emotional abuse ( Walker, 1984).
  • The victim may also be dealing with psychiatric difficulties and alcohol and/or drug abuse and may be suffering posttraumatic stress disorder or a dissociative reaction in response to pain ( Geffner & Pagelow, 1990, p. 117; Walker, 1984, p. 25).
  • Some researchers compare the victim's behavioral and emotional reactions with those of hostages. Those exhibiting symptoms of the Stockholm syndrome react with "frozen fright" and "psychological infantilism," in which the victims suppress their rage for survival purposes and suffer a "traumatic depression" after their escape. To do this, the victim takes the perspective of the victimizer ( Graham, Rawlings, & Rimini, 1988).
  • The victim's behavior may be characterized by low self-esteem, denial of the abuse, an inability to trust, and dependence on the victimizer ( Bolton & Bolton, 1987).
  • Because of all the things that may have happened to the victim, it is important to assess him or her for the possibility of suicide. One-half of all battered women have considered suicide, and one-fourth of all suicide attempts are directly related to abuse ( Geffner & Pagelow, 1990). Many times these women view suicide as a permanent solution to a seemingly unsolvable problem.
    • The intervention must be immediate (deal with the victim immediately, in the hospital or police station if necessary)
    • It must be action oriented.
    • It must set limited goals
    • It must offer support to the victim.
    • It must assist with focused problem solving.
    • It must begin to assess and help the client increase her self-image.
    • It must assign to the woman as much independence and responsibility for her own actions as possible.


  • Because of the circumstances mentioned above, the principles that need to be observed in the treatment's first session are

_______________________________________________________________________________
Question No.16. Service providers must assess whether the victim’s biospsychosocial functioning may impede the carrying out of a safety plan:

a. True
b. False

Question No.17. A safety plan includes the following except:

Finding a room with exits when arguments occur in case of violence.
Keeping change on them at all times.
Establishing safe people to contact.
Keeping weapons available to fight off the abuser.
Establishing code words with friends or family so they know when to call for help.

Question No.18. The police can help victims of abuse in which of the following ways:

a. Help them and their children leave safely
b. Arrest the abuser
c. Provide information of programs and shelters
d. Investigate and make a report that can be used in court.
e.All of the above

Question No.19. The purpose of a safety plan is to do the following except:

Prevent abuse from occurring
Provide a plan of escape when violence is imminent.
Protect the victim and any children from harm.
Help a victim feel comfortable living in an abusive relationship.

 
Spouse / Partner Abuse > Chapter 4, Part A - Intervention Strategies
Page Last Modified On: June 19, 2015, 10:48 PM