1. 6/11/2016OT 460A1 Domestic Violence OT 460A Robin Underwood, PhD, OTR/L

2. 6/11/2016OT 460A2 Perspectives of Working with Survivors of Domestic Violence This is not mental health practice Women don’t want to be labeled and categorized into medical/psychiatric labels Women are viewed as having barriers towards doing what they need and want to do

3. 6/11/2016OT 460A3 Incidence Global: Violence against women by male intimate partners (domestic violence) accounts for more deaths and disabilities of women between the ages of 15 and 44 than cancer, motor vehicle accidents, war, and malaria added together (UNIFEM, 2007). United States: Approximately 5.3 million women are raped and/or physically assaulted by male intimate partners each year and these assaults exceed $4.1 billion yearly (National Coalition Against Domestic Violence, 2012)

4. 6/11/2016OT 460A4 Incidence of Domestic Violence Women comprise at least 85% of all family violence victims and it’s been estimated that they may even constitute 90% of all of the victims of domestic violence ( NCADV, 2012). It is estimated that women make up 84% of spousal abuse and 86% of abuse by boyfriends (NCADV, 2007). An estimated 1.3 million women will experience domestic violence in their lifetimes (NCADV, 2007). Domestic Violence occurs in every socio- economic status, race, religion, and ethnicity

5. 6/11/2016OT 460A5 Definition of Domestic Violence Against Women Domestic violence is defined as “the willful intimidation, physical assault, battery, sexual assault, and/or abusive behavior perpetrated by an intimate partner against another” (NCADV, 2012). DV is about establishing power and control over women This includes behaviors that intimidate, manipulate, humiliate, isolate, frighten, terrorize, coerce, threaten, blame, hurt, injure, or wound someone (Office on Violence Against Women, n.d.).

6. 6/11/2016OT 460A6 Causes of Domestic Violence Ten Risk Markers for Abusers: Abuser is unemployed Abuser has a blue-collar job Abuser didn’t graduate from high school Abuser is between the ages of 18 and 30 Abuser uses illegal drugs at least once a year The man and women are from different religious backgrounds The man saw his father hit his mother The man and woman cohabitate but are not married Either the man or woman use severe violence towards their children in the home The family income is below the federal poverty level Berry (2000)

7. 6/11/2016OT 460A7 Causes of Domestic Violence Factors that cause or contribute to domestic violence have been discussed and contested by social scientists for decades with very little agreement about the commonalities (Jewkes, 2005). Exception is poverty Poverty is the only factor that has consistently been found to be a key contributor to domestic violence (Davies, 2002; Jewkes, 2005; Josephson, 2005; Lyon, 2000; Lyon, 2002; Sokoloff & Dupont, 2005). It is often the key factor that causes a woman to return to the abuser

8. 6/11/2016OT 460A8 Causes of Domestic Violence Higher incidences have also been correlated with women who have: Been victims of child maltreatment, especially sexual abuse (becoming a high predictor) Low levels of education Disparities in income, education, race, and occupation between men and women Concentration of the power in the hands of the male Disabilities (Browne & Bassuk, 1997; Tjaden & Thoennes, 2000).

9. 6/11/2016OT 460A9 Why Women Don’t Leave and Return (Average = 7 times) She knows that the abuser is going to kill the children and her She has no money She believes what he tells her: she can’t function without him He’s isolated her from her family and friends

10. 6/11/2016OT 460A10 OT Interventions with Female Survivors of DV Issues to consider related to occupations Women have often not been allowed to perform certain occupations, for example, money management Women have frequently been unable to parent children the way they want to Emotional abuse has often lowered women’s confidence about performing any tasks

11. 6/11/2016OT 460A11 OT Evaluation Process Identification of what a woman wants and needs to do (COPM or other Occupational Profile Tools) Identification of underlying client factors that are barriers to performing meaningful occupations, including: Difficulties with executive functions Lack of education about options and procedures

12. 6/11/2016OT 460A12 OT Interventions Individual and group interventions that focus on: Learning and performing healthy occupations that women want and need to do, including budgeting, parenting, employment Building self-efficacy as women take on more challenges and achieve desired occupations

13. 6/11/2016OT 460A13 Persons with Disabilities Persons with disabilities are at a greater risk for abuse and neglect Abuse occurs in a variety of settings, with the home being the most prevalent place Dependence on others for meeting basic needs increases vulnerability

14. 6/11/2016OT 460A14 OT Role with Persons who are Abused Prevention Assist clients with decreasing dependence on others Train clients to be assertive (but be careful) Assist caregivers with finding respites from provision of care Consult to facilities regarding promotion of community support

15. 6/11/2016OT 460A15 OT Role with Persons who are Abused OTs are legally mandated reporters Become knowledgeable about the signs of abuse Be careful about asking the person about it; can increase the risk Don’t talk to woman about abuse with man present Don’t tell woman to leave and don’t make comments like, “Well, I’d never accept what he’s doing to you.” Believe in women’s ability to decide when it is safe to leave