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Domestic Violence Deepening Our Understanding as EAP Consultants Cecille del Gallego, LCSW, CEAP June 22, 2011.

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Presentation on theme: "Domestic Violence Deepening Our Understanding as EAP Consultants Cecille del Gallego, LCSW, CEAP June 22, 2011."— Presentation transcript:

1 Domestic Violence Deepening Our Understanding as EAP Consultants Cecille del Gallego, LCSW, CEAP June 22, 2011

2 Domestic Violence Training Objectives:  Refresh and build upon current knowledge of domestic violence  Identify the different typologies of domestic violence  Acquire alternative assessment and intervention techniques  Be reminded of the importance of self-care and managing transference and counter-transference

3 Domestic Violence “A pattern of behavior where one partner coerces, dominates, and isolates the other to maintain power and control over their partner.” (National Coalition of Anti-Violence Programs 2008, p.5) “It is an epidemic affecting individuals in every community, regardless of age, economic status, race, religion, nationality or educational background.” ( The Public Policy Office of the National Coalition Against Domestic Violence, NCADV) Domestic violence can result in “physical injury, psychological trauma, and sometimes death. The consequences of domestic violence can cross generations and truly last a lifetime.” ( The Public Policy Office of the National Coalition Against Domestic Violence, NCADV)

4 Prevalence and Statistics WOMEN  1 in 4 women will experience domestic violence in her lifetime  An estimated 1.3 million women are victims of physical assault by an intimate partner each year  85% of domestic violence victims are women  Historically, females have been most often victimized by someone they knew  Females who are 20-24 years of age are at the greatest risk of non-fatal intimate partner violence (The Public Policy Office of the National Coalition Against Domestic Violence, NCADV)

5 Prevalence and Statistics HOMICIDE Almost one-third of female homicide victims are killed by an intimate partner In 70-80% of intimate partner homicides, no matter which partner was killed, the man physically abused the woman before the murder RESTRAINING ORDERS Approximately 20% of the 1.5 million people who experience intimate partner violence annually obtain civil protection orders Approximately one-half of the orders obtained by women were violated  Domestic violence is one of the most chronically underreported crimes (The Public Policy Office of the National Coalition Against Domestic Violence, NCADV)

6 MEN AS VICTIMS  300,000 and 835,000 victims each year  Higher rates of domestic violence with male partners (same-sex) compared to men who are with female partners  Reluctant to report to you fear of ridicule, fear that they will be blamed for the abuse, embarrassment (National Healthy Marriage Resource Center Fact Sheet)

7 Same-Sex DV  Prevalence = 25 - 33%  Between 50,000 and 100,000 Lesbian women are battered each year  500,000 Gay men are battered each year  Same-sex victims receive fewer protections  Same-sex batterers use forms of abuse similar to those of heterosexual batterers. They have an additional weapon in the threat of "outing" their partner to family, friends, employers or community.  Many of these shelters routinely deny services to same-sex victims (University of Wisconsin-Stout, 2010)

8 ECONOMIC & PUBLIC HEALTH IMPACT  Over 18.5 million mental health care visits each year  Cost exceeds $5.8 billion each year  Victims lost almost 8 million days of paid work  There are 16,800 homicides, $2.2 million medically treated injuries (The Public Policy Office of the National Coalition Against Domestic Violence, NCADV)

9 DOMESTIC VIOLENCE STATE LAWS States differ on the type of relationship that qualifies under domestic violence laws. Most states require the perpetrator and victim to be current or former spouses, living together, or have a child in common A significant number of states include current or former dating relationships in domestic violence laws. Some states exclude same-sex relationships in their domestic violence laws. (The Public Policy Office of the National Coalition Against Domestic Violence, NCADV)

10 Domestic Violence TYPES OF ABUSE Physical Emotional/Verbal/Mental Sexual Financial Spiritual Cultural

11 POWER AND CONTROL Domestic Violence Intervention Project - Duluth, Minnesota (dvcc.delaware.gov)

12 DOMESTIC VIOLENCE TWO SCHOOLS OF THOUGHT Intimate Partner Terrorism Situational (Common) Couple Violence (Johnson 2008; 2005; 2000; 1995) - derived from RTI “The STOP Program” 2011)

13 Intimate Partner Terrorism (IPT)  Rooted in Feminist Theory of Power and Control  Views Patriarchy as cause of DV  Primary abuser is usually male  DV as a Gender issue  Female violence only seen as in the context of self-defense  Victims usually fit the ‘Shelter clientele’  Coercive control – general pattern of abuse  Fear = Motivation

14 Situational Couple Violence (Common)  Rooted in Family Conflict Theory  Violence is viewed as a result of family systems, psychological issues and psychopathology  Men and women seen as equally capable of violence  Pattern of violence is not generalized  Violence as a cathartic, reactive response vs psychological control or deliberate instilling of fear  Fear for life or safety is usually absent

15 Perpetrator Typologies  Generally Violent Anti-Social  Family-Only  Low-Level Antisocial  Emotionally Dysphoric/Borderline (Holtzworth-Munroe 2000 - derived from RTI “The STOP Program”, 2011)

16 Generally Violent Anti-Social  Generalized pattern of violence  Abuse tends to be severe, highly injurious and can be lethal  Usually Personality Disordered – AXIS II’s – Psychopaths, Sociopaths  “Under-Attached”

17 Family-Only  Violence is not generalized  Abuse is generally less severe  Little or no evidence of Psychopathology  “Poor partner-specific communication skills”  High on “Impression Management”

18 Low-Level Anti-Social Mix between Generally Violent Anti-Social and Family-Only

19 Emotionally Dysphoric/Borderline  Violence is seen as an impulse reaction to express distress and intense anger  Perceive relationship conflicts as threats of abandonment  Lack the skills to self-regulate  Anxiety-based rage  As a child - parental rejection, abuse, abandonment/loss  Emotionally volatile  Still tend to be violent only with their family  More socially isolated or socially incompetent  “Over-attached”

20 GENDER DIFFERENCES MEN More serious physical abuse More sexual coercion More coercive control behaviors More stalking behaviors (Derived from RTI “The STOP Program”, 2011)

21 GENDER DIFFERENCES WOMEN  Use equal levels of emotional and verbal abuse  More moderate physical violence (throwing something, pushing, shoving) ABUSE IS MOTIVATED BY  Self-defense  Fear  Defense of Children  Retribution  To gain control/assert authority  To express feelings (Derived from RTI “The STOP Program”,2011)

22 DOMESTIC VIOLENCE ASSESSMENT and INTERVENTION

23 VICTIMS STAGES OF CHANGE 1. Pre-Contemplation - Lacks any perceived need for change 2. Contemplation - Ambivalence and Inaction 3. Preparation - Balance of pros and cons begins to tip in the direction of change 1. Action - Putting the plan into action 2. Maintenance - The Aftermath (Prochasksa, DiClemente & Norcross, 1992 - Derived from RTI “The STOP Program”, 2011)

24 Why Do Victims Stay?  Fear  Hope  Denial  Shame  Children  Family, religious and cultural values  Lack of awareness of services  Lack of resources  Lack of support  Poor Self-esteem  Poor Self-efficacy  Medical, BH issues (e.g. depression, anxiety, PTSD)  Past trauma or abuse – normalization of violence/abuse

25 DELETE ME PLEASE

26 Why Do Victims Stay? “But I still love him/her” “Thoughts about” ex-partner “Urges” to reconcile with ex-partner Ongoing emotional attachment to the abuser Normalizing the recovery and grief process Need to Re-define definition of Love and Healthy Relationships

27 Self-Esteem  Oversimplifies the issue  Self-esteem is part of the problem – both for the victim AND the abuser  The victim’s responsibility is to examine her own “stuff” as it relates to mate selection and tolerance for abuse  Protect or Nurture self-esteem  Reinforce Strengths  Build on Resiliency

28 Cognitive Dissonance Theory developed in 1957 by Leon Festinger “The feeling of uncomfortable tension which comes from holding two conflicting thoughts in the mind at the same time” Sandra Brown (2009)  “Having two relationships going on at the same time”  “The inability to hold a consistent view of [the abuser] is wonderful or horrible

29 Cognitive Dissonance Examples:  I am a smart, strong woman. I feel worthless and helpless.  I believe children should feel safe, loved and protected. I continue to stay with my husband even though he physically abuses our children.

30 Domestic Violence “Intimacy and psychopathology rather then gender alone generates relationship violence. It is because of intimacy that straight and gay rates of abuse are similarly high; the impact of attachment and related anxieties produce anger and abuse.” (Dutton, 2005 – derived from RTI “The STOP Program 2011”)

31 EAP CONSULTANT ROLE  Risk Assessment  Crisis Intervention  Triage  Supportive “Counseling”  Consultative Role  Psycho-education  Develop Safety Plan  Connect to Resources  Connect to EAP Counselor  Mobilize Support – friends, family, workplace  Advocacy  Follow-up

32 HARM REDUCTION “Harm reduction is a set of practical strategies that reduce negative consequences of drug use, incorporating a spectrum of strategies from safer use, to managed use to abstinence. Harm reduction strategies meet drug users "where they're at”, addressing conditions of use along with the use itself.” (Source: www.harmreduction.org)

33 HARM REDUCTION “Redefined in terms of domestic violence, harm reduction is a set of practical strategies that reduce negative consequences of certain survival, [defense] and coping mechanisms survivors use.” (Adapted from Eminism.org)

34 Harm Reduction Principles  Accepts, for better and for worse, that survivors learn to cope in whatever ways that reduce their pain and increase their sense of control, including those traditionally viewed as "unhealthy" [or dysfunctional].  Understands each method of coping as a complex, multi-faceted phenomenon that encompasses a continuum of behaviors from recklessly extreme to no action, and acknowledges that some ways of coping are clearly safer than others.  Establishes quality of life and well-being--not necessarily cessation of all activities deemed unhealthy or unsafe--as the criteria for successful interventions and policies.

35 Harm Reduction Principles  Calls for the non-judgmental, non-coercive provision of services and resources to victims  Ensures that survivors themselves--both those receiving services currently and those who have in the past--have a real voice in the creation of programs and policies designed to serve them.  Affirms victims as the primary agents of reducing the harms of their various coping methods as well as the authorities on their own experiences; empowers victims to share information and support each other.

36 Harm Reduction Principles  Recognizes that the realities of poverty, class, racism, social isolation, past trauma, discrimination and other social inequalities affect both victims’ vulnerability to and capacity for effectively dealing with the effects and aftermath of the abuse.  Does not attempt to minimize or ignore the real and tragic harm and danger associated with certain coping methods survivors may employ. (Adapted from Eminism.org)

37 WHAT YOU CAN SAY: “I am afraid for your safety” “I’m afraid for the safety of your children” “It usually only gets worse” “I’m/We are here for you” “You don’t deserve to be abused” “What, if anything, would you like to change?” “What might be most helpful to you right now?” “Where are you at with this relationship?” “What would you like to do?”

38 DIVERSITY  Sexual orientation  Race/ethnicity  Religion  Class  Economic status  Social standing  Education  Profession  Disability  Marital status  Parental status

39 DIVERSITY Be mindful of issues related to: Language Access issues Appropriateness of Resource Referrals Cultural Values specific or unique to the client.

40 DIVERSITY Guidelines Do not pathologize cultural values or communications styles that may be unique to the client The unspoken question “Do you really understand me?” (Wexler, 2011) Respect diversity issues but do not let this be used as an excuse when assessing and intervening with clients (Wexler, 2011)

41 TRANSFERENCE  Normal Dynamic  Therapeutically Valuable  Keeps us sharp and “in check”  Remind us to respect individual styles of coping

42 COUNTER-TRANSFERENCE  Normal dynamic  Therapeutically Valuable  Therapeutically Damaging  Two-fold process between Self-Awareness and Self-Care

43 COUNTER-TRANSFERENCE SELF-AWARENESS Be aware of your own trauma histories Examine your own biases and assumptions about DV, victims and perpetrators Examine your own Competency Gaps

44 COUNTER-TRANSFERENCE SELF-CARE Consult De-brief Seek Support Take a break Know your threshold and set limits Do your best then “let go” of the outcome Set realistic expectations Personal Self-Care

45 TAKE-AWAYS:  No “one size fits all” approach to DV  Victims and Perpetrators are not an Homogenous group  There is a Continuum of Violence (Perpetrators)  There is a Continuum of Responses and Coping Styles (Victims)  Harm Reduction vs. “Abstinence”  Stages of Change  Be mindful of Diversity issues  Recognize Transference and Counter-transference Dynamics  Self-Care as a lifestyle

46 EQUALITY WHEEL Domestic Violence Intervention Project - Duluth, Minnesota (dvcc.delaware.gov)


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