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Chapter 12. Child Abuse, Spousal Abuse, and Sexual Assault. Child Abuse. 1,800,000 referrals alleging child abuse 896,000 children determined to be abused per year in the U. S. Physical abuse Sexual abuse General neglect Emotional abuse. CHILD ABUSE ACCOMMODATION SYNDROME. Abuse

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chapter 12
Chapter 12
  • Child Abuse, Spousal Abuse,
  • and Sexual Assault
child abuse
Child Abuse
  • 1,800,000 referrals alleging child abuse
  • 896,000 children determined to be abused per year in the U. S.
  • Physical abuse
  • Sexual abuse
  • General neglect
  • Emotional abuse
child abuse accommodation syndrome
  • Abuse
  • Secrecy
  • Accommodation
  • Disclosure
  • Suppression
  • All family members use defenses:
  • dissociation, repression, denial,minimization, externalization
crisis in child abuse
  • When secret is exposed, all go into crisis
  • Panic:
  • at losing child
  • losing parents
  • losing spouse
  • losing freedom
  • Reporting is mandatory when suspected
  • Must educate and reframe as the only way to help family
  • Very few children get taken from home
  • Very few abusers go to jail
  • Must stop abuse and protect child
  • Must be nonjudgemental
Children may benefit from play therapy or family therapy when ready
  • Parents often :
  • Need group and individual counseling
  • Often need drug and alcohol education and 12 step
  • May have to deal with divorce issues
adults who were sexually abused as children
Adults who were sexually abused as children
  • Remembering childhood abuse may precipitate a crisis in adulthood
  • May need immediate containment of anxiety
  • May have lived in a delayed PTSD state for many years
  • May benefit from long term therapy and support groups
elder abuse
Elder Abuse
  • Domestic, institutional or self-neglect or self-abuse
  • Physical abuse, sexual abuse, emotional abuse, neglect and financial/fiduciary /material exploitation by someone who has a special relationship with the elder
  • About 1 out of 10 older Americans may be victims of abuse yeraly
  • Mandatory reporting to Adult Protective Services
  • Multidisciplinary team approach needed
  • Public guardianships
  • Financial planning
  • Transportation
  • Assertiveness training
  • Self-advocacy
intimate partner abuse and domestic violence
Intimate Partner Abuse and Domestic Violence
  • 52% of women and 66% of men have been physically assaulted
  • Intimate partner abuse more prevalent for women than men
  • 76% for women, 18% for men
  • D.V. leading cause of injury for women ages 15-44
33% of women report being physically abused by intimate partner
  • 1 in 4 will be abused in her life
  • 97% of partner abuse is male to female
  • 3.3 million children are exposed to violence per year.
  • 40-60% of men who abuse women, abuse the children too.
why women stay
Why women stay
  • Fear
  • Religious beliefs
  • Profamily societal values
  • Economically dependent
  • No place to go
  • Children need a father
  • No support system
Hopes he’ll change
  • Believes it is her fault
  • Sees no other options
  • Feels insecure and unable to take care of herself
  • denial
the battering cycle
The Battering Cycle

1. Honeymoon Stage: The man and woman are getting along, are in love, and believe all is fine.

2. Tensions Stage: Man begins to complain, express stressful feelings, criticize. Woman walks on eggshells and tries to prevent him from getting angry.

3. Explosion Stage: Man screams, throws, punches, kicks, pushes, hits, and attempts to control woman. Woman thinking how to survive rather than escape.

4. Return to Honeymoon Stage: Man asks forgiveness, begs for another chance. Woman feels hopeful that he’ll change, and remembers his potential.

battered woman syndrome
  • After explosion, usually in such shock, doesn’t report it.
  • Over time, she uses defenses such as denial, introjection, learned helplessness, and numbing
  • She accommodates to avoid consequences of leaving
  • Empower
  • Provide choices
  • Outpatient groups
  • Shelters
  • Restraining orders
  • Pressing charges
  • Reframe
the batterer
The Batterer
  • Jealous
  • Sulks
  • Explosive temper
  • Critical
  • Difficulty expressing feelings
  • Drinks,uses drugs
  • Male role to be in charge
Contempt for women
  • Overly protective of partner
  • Controlling of partner’s behaviors and decisions
  • Breaks things, throws things
  • Hits, shoves, kicks partner when angry
  • Was physically and emotionally abused as a child
interventions with batterer
Interventions with batterer
  • Educate about types of abuse:
  • Intimidation
  • Isolation
  • Emotional abuse
  • Economic abuse
  • Sexual abuse
  • Using children
  • Using male privilege
  • Physical abuse
  • Power and control management groups
  • Anger and stress management
  • 1 in 4 women and 1 in 10 men will be sexually assaulted in their lifetime
  • Rape is not about sex, it is about control
  • Acquaintance rape is the most common type
  • Rapists are not usually psychotic or sick
  • Sexual act against one’s will.
  • It’s about consent.
  • Intercourse, oral sex, anal sex
  • It is a felony.
  • Most rapists don’t go to prison because it is not usually reported.
rape trauma syndrome
Rape Trauma Syndrome
  • Stage One: Immediate Crisis Reactions
  • Stage Two: Reorganization
  • Stage Three: Reintegration
  • Create strong rapport
  • Reassure and validate for seeking help
  • Open ended questions to get a clear idea of what happened
  • Not necessarily a full graphic picture
  • Assess for symptoms that might necessitate physician involvement
Understand her frame of reference
  • Validate her feelings
  • Assure her it wasn’t her fault
  • Educate about PTSD and RTS
  • Empower: move her from victim to survivor
  • Reframe as much as possible
Support groups
  • EMDR
  • Self-defense classes
  • Medical exam
  • Legal intervention (when she wants to)