Background
Domestic violence has occurred for as long as their has been a written record. This is evidenced by laws, usually permitting it, throughout antiquity. It has most likely existed since humanity began, as it is observed in our closest genetic relatives, and seems to be stimulated by very primal parts of the brain. The Journal of the American Medical association began to describe battered child syndrome in the 1960’s, and between the beginning of humanity and when domestic abuse began to be described as a societal problem, little if anything was done. Since then, the United States has done much writing about the problem, but intervention is slow on the uptake.
Factually, the United States is comparatively slow on addressing domestic violence, particularly when it comes to domestic violence, is slower than its European counterparts. It seems to be behind in interventions including the education of its society as to what constitutes domestic violence; in the healthcare, specifically when it comes to medical professionals not addressing the issue of abuse when they come in contact with a victim; the employment of professionals who are adequately trained to recognize signs of abuse, to alert the necessary authorities, and ensure the safety of those victims.
The disconnect between medical and public care leads to many patients slipping through the cracks of a dark cycle of domestic violence. There are three main reasons for this in the United States. First, the social status quo is to leave what happens behind closed doors stay behind closed doors. People in all types of intimate partnerships, heterosexual or homosexual, feel afraid to be the whistleblower, and usually do not have the means to make it on their own. Second, the bureaucracy and red tape, particularly when it comes to medical care, makes it far too easy for this sector to look the other way. Finally, regardless, of whether one is a victim, perpetrator, a neighbor, community member, or even a medical/public care professional, people just are not knowledgeable enough to know how to help.
Theory And Research
There are several theories related to why there is such a tremendous issue with domestic violence in the United States, and indeed throughout the world. The first notions toward attempting to explain aggression were first brought up by Sigmund Freud. He postulated that aggression was a call for attention, an extreme urge to be loved that was not being met by the person who was aggressed upon. Though this may describe a subgroup of abusers, most of his theories have been amended to a point beyond recognition. One of the primary substantive ideas to come out of his research regarding violence, aggression and abuse was that it came from a primal force.
This leads into the another theory, a really basic Reactive-Aggression theory. There are three simplistic observations that can be made from this pattern, and really, it is only a notch ahead of Freud’s theories. First, there is a stimulus. For example, a man come homes from work, to find that his partner has not made supper for him yet. Second, the man sees this as being selfish or even cruel on the partners behalf. He or she has ignored him. The negative emotional response, in which the person feels the need to aggress leads to him finally assaulting him or her (the third step). This theory is supported by neurobiological studies. If the aggressor has a hormonal imbalance, brought on through endogenous means (i.e. high testosterone) or exogenic means (i.e. elicit drugs), they are more likely to have these extremely negative responses. This can also happen if the perpetrator responds poorly to a hormonal imbalance or cycle on the partners behalf.
Further on down the line came another idea, the Social Learning theory. This means that the abuser grew up observing other people’s behavior. This could have been in their own home, it could have been what they witnessed watching television, playing video games, or by being beaten up by bullies throughout the aggressors childhood. It is suggested that the more a person witnessed or was a victim to domestic violence, the more likely they were to become either aggressors or victims in the future. Statistical and psychology studies bear out this theory.
Finally, and very importantly, came Feminist theory. This is slightly more indirect in nature, as it is more a message of liberation for women and children who are being abused, and for women to to stop being complicit with sub-par living standards. What makes this theory so important was and continues to be its call to action. Many feminist organizations are on the frontline of the battle against domestic abuse. Many sociological studies have been performed by prominent feminists, regardless of the gender or sexual orientation of the victim.
Best Practices Related To Domestic Violence
This is a very active area of research. The reason for this is that we just do not have a system that is working. The stigma associated with being the “family snitch” still outweighs the need to protect one’s self and family from violence in many people’s eyes for the social normative reasons. Ultimately, the victims, 87% of whom are women, are left feeling hopeless and defenseless. For these reasons, two of the three best practices we have focuses on the victim rather than on the gigantic social ethics issue focus on the victim.
The first victim-focused intervention is based on women-empowerment, enabling the woman or victim with the tools and skills to control an abusive situation. This in itself is multi-faceted. From a rhetorical approach, there are ways to talk down an aggressor, to calm them down, and normalize the situation. In a literal sense, women and other victims can take self-defense courses which give them the ability to fight back in an extremely hostile environment. Once an aggressor learns that they can be bested or matched in a combative situation, it becomes less likely for them to repeat their behavior.
The second victim based intervention is having support groups available. By bonding with other victims of abuse, the victim can build up their self-confidence in knowing that they are not alone. By participating in support groups, the victim has a healthy channel through which they can vent the pain and suffering they have been through, they can build a stronger community with each other, and they can be invaluable resources to each other inside of the group. They may even be able to escape their circumstances.
The last best practice available is community development through social education programs community awareness. This is where neighbors can learn that calling the police might not always be the best idea at the exact moment they suspect domestic abuse. People can learn how to communicate with people they suspect are being abused, find out ways to see what their needs are, and do the best they can to teach each other in order to help erase this ugly social norm. They can also learn how to act around a suspected abuser, so as to not ring any alarms in the perpetrators mind.
Human Service Professionals
There are three equally important human service professionals when it comes to domestic violence, once a case has been made and the right steps have been followed. One is the case manager. The case manager is in charge of making all arrangements for placement, safety, addressing what the client’s needs are. They are also usually at the forefront when it comes to having contact with an abuser, whether it is wanted or not. The case manager often needs to make very quick decisions, many of which can mean the life or death of the client. They are the ultimate negotiators, assessors, and the ones who make sure that all ethical standards are being followed. Case managers are the triage unit of helping the victims of domestic violence.
Second, client advocates come into play. These are the people who ensure that the victim was placed into the safest position possible. Advocates will take the next practical steps with the client. First, most client’s move from needing protection to being able to get back on their feet. An advocate can help with job placement. The victim will probably want remediation from the abuser if they decide they want to separate from the abuser, particularly if the abuser refuses to seek help for their issues. The client advocate is there to link the client with the best legal services. They are the internists who make the calls once a person is admitted into care.
Thirdly, counselors are the long term officials. Apart from money, permanent housing, and legal needs, the anguish and trauma a person goes through when they go through an abusive relationship, and the following trauma that ensues once a person makes the decision to leave that situation, can be life-lasting. The effects will be long lasting and detrimental to that person and to the entire remaining family if psychological or psychiatric treatment is not sought out or carried through. Counselors are the nurses and the practitioners the victims will probably see for a good portion of their life.
Model Intervention
When considering this novel intervention, it was hard not to pay mind to the fact that it will probably be a while before funds and other resources are increased. This is because of a congress that rejects any real budget transformation based on ideologies on both sides of the aisle, rather than pass anything worth while. Also, this particular segment of health and human services also has a difficult time attracting adequate professionals with the current red tape present. Generally speaking, we are above and beyond maximum capacity for meeting the needs of the community of domestic violence victims given the current way things are run. It is an uphill battle, but it is one that is possible to resolve without any anticipated budget increases, significant rise in professionals or cutting significant red tape.
The Affordable Care Act is contentious. Chances are, if one is from a state that enjoys the rights that it affords, they probably favor the passed, signed and ratified American law. If one is from a state where those rights are remanded, the person probably hates it. Regardless of where one falls though, it has proven very effective in one key category: efficiency. Doctor visits are shorter, less staff is needed, and more people are being helped in states where the law of the land is being legally practiced. The cornerstones behind this efficiency, as has been mentioned at various points behind this project, are education, prevention and less recidivism.
First, education must be defined. So far, it has been defined as a community effort, something that is somewhat intangible having a meeting at a community center, a meeting that will no doubt be unattended by the abuser or their family; pamphlets and mailers being sent around; possibly a billboard or church bulletin quoting a statistic that may or may not be meaningful to a victim or their perpetrator. Without maligning these things, as they certainly are important, it is not enough(Anderson, 2015). Furthermore, these things can sometimes be too costly when weighed against their effect. Education must go far deeper.
States need to mandate that domestic violence be taught about in classrooms. Every classroom in the country needs to be a safe space where a child can approach a teacher without the immediate fear that they are going to lose their parents. They need to learn about the risk of becoming abusers/victims themselves. From an age that is deemed appropriate by the state, kids need to be taught about the widespread impact and cycle of domestic abuse (Cohen, 2004). It is something that can be taught right along with other courses and tested over in the same way, so that we can help ensure that each child is aware of the harm abuse causes our society at every level (Anderson, 2015). Just as we have moved from teaching creationism to teaching evolution, so can move from a society that keeps domestic abuse a secret to one that has open discussion about it, a society that does not stand for it. A society that breaks the cycle. Only then can our country really move on to education directed toward every other level at society. It should be taught throughout the the healthcare sphere, the community sphere, organizational, familial and parental.
The next step is rethinking prevention. As a society, we should be moving past the “if you see something, say something” attitude, specifically when it comes to domestic violence. If we saw something, in terms of domestic violence, then it is, in a very real way, already too late. The cycle has begun in that relationship or family. Furthermore, saying something to authorities without really knowing the entire situation can be harmful to the partner-victim or child. The abuser could be paranoid, and place the blame on the victim, and accuse them of telling people, which could deepen the problem (Whitaker, 2006).
Prevention manifests itself in many other ways. At the community level, safe places need to be established inside stores. This has already taken place in larger cities, but remains to be seen in rural areas. Safe places are locations where the person can go to hide, typically inside a a convenience store, and the clerk will call the police if the abuser tries to seek out that individual. At the organizational level, particularly when it comes to medical and public care, most professionals are taught to recognize signs of abuse (Drauker, 2002). Direct intervention from a case manager, advocate, or counselor can be initiated then and there. What is more, generally it is safer to bring authorities into the picture in a healthcare setting because it is very public. This could prevent future abusive situations from happening to the victim. This leads to the next improvement, decreasing recidivism.
It should be noted, by now, that these interventions go hand in hand. They are building blocks to constructing a society that reinforces the stigma around the abuser, not the victim. Recidivism prevention is the last major component to this new model intervention. Just as a heart attack patient may be consulted by a dietician, it is important that victims learn how to avoid both going back to their abuser, or falling into yet another abusive relationship. This is a separate pattern that is just as vicious as the overall cycle of abuse under the Social Learning Theory (Trevillion, et al, 2012). As a community, the ideals of a partner that treats the other person equally need to reinforced At the professional level, a strategy can be developed on how to notice the signs of a healthy versus an unhealthy relationship. At the familial level, positive feedback should be encouraged when the victim finds a healthy relationship. At the partner level, boundaries need to be made very clear from the start (Miller, Drake, Nafzinger, 2013).
It should be said that the abuser is not necessarily doomed to be that type of person their entire life. Actions can be taken to make sure that they have positive feedback for fostering good, nurturing and safe relationships in the future. Though the crime cannot be undone, and whatever prison sentence they are given ought to be served to its fullest, the focus should transition to rehabilitation, and ensuring that the person will not be a repeat offender. In many ways, this is just as important to breaking the cycle of abuse as everything else.
There are other things that are important to this model intervention. The red tape needs to go away. Bureaucracy is impeding our ability to help victims recover from the violence they’ve endured. A victim should not be forced to wait through lines, sign paper after paper, all the meanwhile giving them another opportunity to decide it is just too much work and too dangerous.
Hopefully, all of these interventions will mean more freed up money to be spent on building more shelters and funding more programs for victims to get back on their feet. Domestic violence will continue to be an epidemic here in the United States until drastic measures are taken. We have not done enough; this is exemplified by the fact that only one third of victims actually report any abuse. This is the day and age where atrocities like this need to end. Half-measures need to stop, and real intervention needs to occur, one where, education, prevention, and prevention against recidivism take a front seat in the battle, and inefficient waste of resources ends. Any major social change that has occurred in the US has begun with a huge groundswell of passion and support. People need to be passionate about domestic violence, and just as abuse can be a learned social behavior, so can healthy and loving relationships.
References
Anderson, J. (2015). “Effects of Education on Victims of Domestic Violence.” Walden
Cohen, E. (2004). “The Role of Early Childhood Programs.” National Child Welfare
Resource Center For Family-Centered Practice. Paper 2/3 Retrieved from
http://www.uiowa.edu/~socialwk/publications.html.
Drauker, C. (2002). “Domestic Violence: The Challenge for Nursing.” The Online
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/Volume72002/No1Jan2002/DomesticViolenceChallenge.html
Miller, M., Drake, E., & Nafziger, M. (2013). What works to reduce recidivism by domestic
violence offenders? (Document No. 13-01-1201). Olympia: Washington State Institute
for Public Policy. Retrieved from www.wsipp.wa.gov
Trevillion, Kylee, et al. (2012). “Experiences of Domestic Violence and Mental Disorders: A
Systematic Review and Meta-Analysis.” PLOS One. retrieved from
Experiences of Domestic Violence and Mental Disorders: A Systematic Review and
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Whitaker, D, et al. (2006). “A critical review of interventions for the primary prevention of
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