Exam 2 Study Guide: Child Maltreatment & Domestic Violence

Physical abuse

the infliction of physical pain or injury, sexual assault or molestation, or the abuse of physical or chemical restraints for punishment

Neglect

A caregiver's failure to assist an elder's personal hygiene, failure to provide food, clothing, or shelter, or protect an elder from health and safety hazards

Psychological or Emotional abuse

the infliction of fear, agitation, or confusion through threats, harassment, or other forms of intimidating behavior

Financial abuse

the wrongful taking or use of an elder's funds, property, or other assets

Abandonment

the desertion of an elder by someone who is a caregiver

Isolation

the intentional prevention of an elder from receiving mail, telephone calls, or visitors

What minority is most vulnerable of IPV?

-Highest rates = Black (9.2%)

-2ndhighest rates = Hispanic / Latinx

-American Indian / Alaska Native (8.2%)

-White = 5.7%

Who is most vulnerable of IPV?

-Women ages 18-24 and 25-34 generally experience the highest rates of intimate partnerviolence.(Black et al., 2011)

-Women of sexual minorities experience higher rates of IPV

People of color experience higher rates of IPV(CDC)

4 types of IPV

physical violence, sexual violence, stalking, psychological aggression

Type of IPV: Physical violence

intentional use of force

Type of IPV: Psychological/emotional abuse

Use of verbal and nonverbal communication intended to mentally or emotionally harm and exert control

Type of IPV: Sexual violence

Committing or attempting to commit a sexual act against a partner without freely given consent or when the individual is unable to consent to or refuse sexual contact

Type of IPV: Stalking

repeated visual or physical proximity, nonconsensual communication, or verbal, written, or implied threats toward a specific person which lead to reasonable fear

Deeper look into psychological abuse: Gaslighting

less direct form of psychological abuse often perpetrated by using charming or 'joking' behaviors, manipulating the partner into questioning their own memory or perception of a situation

Deeper look into psychological abuse: Coercive control

continuous pattern of emotional victimization that tightens the perpetrator's control over a partner's everyday behavior

cycle of abuse

-) tensions building

-) acute explosion

-) Honeymoon

Tension building

Moody, nitpicking, isolates, criticizes, withdraws affection, puts down victim, yells, drinks/uses drugs, threatens, destroys property, becomes sullen, creates confusion ('crazy-making')

Honeymoon stage

Apologizes, begs for forgiveness, promises to change or seek help, brings gifts, enlists family support, declares love, shows affection.

Acute explosion

hitting, choking, humiliation, imprisonment, rape, use of weapons, beating

Tactics described in the Power and Control Wheel

1 Using Coercion & Threats

2· Using intimidation

3 Using emotional abuse

4 Using isolation

5· Denying, Minimizing, Blaming

6 Using children

7 Using Privilege

8 Using economic abuse

1. Using coercion and threats:

Making and/or carrying out threats to do something to hurt her, threatening to leave her, to commit suicide, to report her to welfare, making her drop charges, making her do illegal things

2. Using intimidation

Making you afraid by using looks, actions, gestures; smashing things; destroying your property; abusing pets; displaying weapons.

3. Using emotional abuse

Putting you down; calling you names; playing mind games; humiliating you; making you feel guilty; making you think you're crazy; making you feel bad about yourself.

4. Using economic abuse

Preventing them from getting/keeping a job. Make them ask for money.

5. Using privilege

Treating you like a servant, making all the big decision, being the one to define the roles or duties in the relationship, knowing what's best for you,

6. Using children

Making you feel guilty about the children. Using the children to relay messages. Threatening to take the children away. Telling you that you don't have parental rights

7. Denying, minimizing and blaming

Making light of abuse, saying it didn't happen, shifting responsibility, saying it's your fault, you deserved it. Accusing you of mutual abuse, saying it's just fighting not abuse, accusing you of making them abuse you

8. Using Isolation

Controlling what you do, who you see or talk to, limiting your outside activities, making you account for your whereabouts, saying no one will believe you, not letting you go anywhere alone

Purpose of the Equality Wheel

-Complements power & control but meant to show the opposite → what is missing in a relationship;

-highlights behaviors that would be present in an equal relationship;

-can help a survivor see what they deserve and what they can have in a relationship.

Risk factors for abuse

Female, Dementia, Abusive dependency, Social isolation, Physical disabilities

Higher homicide rates

Compared to non-Hispanic Whites, higher homicide rates for Black/African American persons, American Indian/Alaskan Natives, and Latinx persons (2002-2016)

Abuse rates in facilities

Abuse rates are often higher in long-term care facilities (e.g., nursing homes)

Financial abuse risk

If a senior lives with a child who is unemployed or suffers from substance abuse, they run a greater risk of financial abuse.

Power and control wheel

According to Dr. Saifan, a model illustrating the tactics used by perpetrators of intimate partner violence.

Mandatory Arrest Laws

If police are called for domestic violence and they have probable cause, an officer must arrest on the scene.

Impact of Mandatory Arrest Laws

-Research shows these laws don't increase safety or reduce IPV. -Disproportionately impact Black women and families; can put the survivor in more danger or lead to the incarceration of the survivor.

Mandated Reporting: Types of abuse to be reported:

Physical Abuse, Sexual Abuse or Exploitation, Emotional Abuse, Neglect, Willful Harm or Endangerment, Unlawful Corporal Punishment, Exposure to Domestic Violence.

When to Report Abuse

Reporter has a reasonable suspicion of abuse of a child, elder, or dependent adult, that they learn about in their professional capacity.

· reasonable suspicion (given facts and info)

· Reports should be in good faith

Process for Reporting Child Abuse

Make a phone report ASAP to Child Welfare, Law Enforcement, or County Probation Department (usually Child Welfare);

Written report (suspected child abuse report, or SCAR) within 36 hours.

Penalties for Not Reporting

6 months in county jail, $1,000 fine, or both;

In case of serious injury or death: 1 year in county jail, $5,000 fine, or both.

Investigators of Abuse

Law Enforcement, Child Protective Services.

(Not mandated reporters)

Features of Cultural Humility

1. A lifelong process of learning,

2. Attitude of openness,

3. Self-awareness & self-reflection,

4. Ability to acquire knowledge & info about specific groups of people,

5. Go beyond stereotypes to see people as individuals within a cultural context,

6. Acknowledge & address power dynamics,

7. Engage in professional conduct that opposes all forms of discrimination and oppression,

8. Be committed to challenging inherent inequities in social systems.

Secondary Traumatic Stress

Emotional distress and traumatic stress symptoms that follow exposure to another's experience of trauma.

Assessment of Abuse

Purpose: find out if abuse is suspected; help decide what action and treatment are needed.

Key Questions for Assessing Abuse

Is there reasonable suspicion of abuse? Is the client at risk? What treatment is needed?

Clinical Interview

A method used to gather information from a client through direct questioning.

Observations

A method involving watching and noting behaviors and interactions in a therapeutic context.

Self-report Questionnaire

A tool that allows clients to provide information about themselves through a structured format.

When to assess

At the very beginning of the therapy relationship, as part of intake, and/or when there is any suspicion of potential abuse.

Confidentiality with minors

It depends on how old the minor is and who consents to treatment.

Ethics 4.01

Explains therapy and confidentiality early on, structuring the relationship.

Ethics 4.02

Considers the person's preferences and best interests (Consent to Therapy).

Ethics 4.03

Clarifies who the client is in family or group settings.

Safety Planning

A written document that helps identify risk and points the client towards resources and appropriate coping strategies.

Goal of Safety Planning

To keep the client safe.

Considerations for Children

Use age-appropriate communication, decide if the child is old enough to understand, think about involving caregivers, and create a Family Safety Plan if caregivers are not the abusers.

IPV Survivors - Key Considerations

The survivor may be in an actively dangerous situation and disclosure of therapy or a safety plan could increase risk.

Three Levels of Prevention

Primary: Prevents the onset of a specific problem; Secondary: Early intervention to decrease prevalence; Tertiary: Treatment to improve quality of life after a disorder has developed.

Three Categories of Prevention

1. Universal: Targets the whole population;

2. Selective: Targets at-risk populations;

3. Indicated: Targets high-risk individuals showing early danger signs.

Gold Standard Treatment for Childhood Trauma

Typically involves children aged 3-18 years who have experienced trauma, lasting 12-16 sessions, with simultaneous child and caregiver sessions.

Three Phases of TF-CBT 1.

Cognitive skills phase (PRAC) Focus on. building skills to manage trauma symptoms.

Trauma treatment for adult: Cognitive Behavioral Therapy (CBT)

Theory of Change: Changing thoughts changes emotions and behaviors;

changing behaviors also impacts thoughts and emotions.

Three phases of TF-CBT 3.

Treatment consolidation and Closure Phase (ICE) In vivo exposure to trauma reminders (safely). Focus on safety planning and moving forward.

Three Phases of TF-CBT 2.

Trauma Narrative and Processing Phase (T): Helping the client tell and process their trauma story;

Cognitive Triangle

Thoughts, Behavior, and Emotion all influence each other.

Key strategy of CBT: Cognitive Restructuring

Identify and challenge distorted or unhelpful thoughts

Key strategy of CBT: Behavioral Activation

Increase engagement in positive, meaningful activities

Cognitive Processing Therapy (CPT)

Structured form of CBT tailored for trauma.

Helps identify and reframe maladaptive beliefs that block trauma recovery.

Stuck Points

Rigid, unhelpful beliefs that block trauma recovery (e.g., self-blame, guilt)

ABC Worksheet purpose

Helps clients recognize the link between activating events, Belief/stuck point, and Consequences.

Identify patterns

Challenging Beliefs Worksheet

Guides clients in testing the accuracy of beliefs and replacing them with more balanced thoughts.

Prolonged Exposure (PE)

Specific type of CBT that helps clients work through avoidance related to trauma

Reduce PTSD symptoms: Assisting the person in gradually facing trauma-related memories and situations

In Vivo Exposure

Facing avoided, safe situations in real life

Imaginal Exposure

Repeatedly revisiting and describing the traumatic memory

CBT for Perpetrators of Child Abuse

Goals include changing the way perpetrators think about violence and the circumstances which lead to violence

MST-CAN for perpetrators of child abuse

Intensive home-based treatment targeting the entire family

Tailor interventions to the specific risk factors that contribute to child physical abuse and neglect for each individual

MST-CAN Treatment Goals

1. Keep families together safely

2. Prevent re-abuse and neglect

3. Reduce mental health difficulties

4. Increase natural social supports

Key features of MST-CAN

Intensive Home-Based Therapy

Focuses on the whole family system

Includes services like parenting help, school support, and mental health care

Structure: Support in MST-CAN

A full-time case manager helps with housing, jobs, school, budgeting, drug screens, etc.

Structure: Psychiatric Access in MST-CAN

20% of psychiatrist/nurse time for medication or crises

Structure: Service Frequency in MST-CAN

Families get services at least 3x per week, reducing as they improve

Structure: MST-CAN Duration

Treatment lasts 6-9 months, depending on family needs

Treatment for perpetrators of IPV: Duluth Abuse Intervention Project

Include promoting safety for survivors and accountability for abusers.

Group based sessions, FOCUS ON POWER AND CONTROL DYNAMICS, CHALLENGES MALE ENTITLEMENT AND ABUSIVE BEHAVIOR PATTERRNS

CBT for IPV Treatment for perpetrator

include reducing abusive behavior by changing thoughts, feelings, and behaviors.

Teaches emotional regulation, anger management

Cognitive Triangle

A model illustrating the relationship between thoughts, feelings, and behaviors

Restorative Justice Approaches

-For incarcerated men, focus on offender accountability, violence prevention, survivor impact, and restorative justice

-40 hrs per week, rigorous education, and a peer-to-peer mentoring model

-Learn how to stop violent behavior, given opportunities to understand, take responsibility for, and repair the harm.

Restorative Justice Goals

Repair harm, take accountability, and restore relationships (when safe and appropriate)

Restorative Justice Features

Includes voluntary participation

dialogue between the survivor and perpetrator (if the survivor agrees)

Focus on healing and community involvement

Fight response characteristics

Crying

•Hands in fists, desire to punch

•Tight jaw, grinding teeth

•Fight in eyes (glaring)

•Fight in voice (anger)

•Desire to stomp or kick

•Feelings of anger/rage

•Homicidal/suicidal feelings

•Knotted stomach/ nausea,burning stomach

Flight response characteristics

Restless legs and feet

•Numbness in extremities (legs,head)

•Anxiety/shallow breathing

•Big/darting eyes

•Fidgety-ness, restlessness,feeling trapped,

•Tense•Sense of running in life, oneactivity to the next

Freeze response characteristics

Feeling stuck in some part ofbody

•Feeling cold

•Feeling numb, pale skin

•Sense of stiffness, heaviness

•Holding breath/restrictedbreathing

•Sense of dread, heart pounding

•Decreased heart rate (cansometimes increase)