1. Chapter 12 Child Abuse, Spousal Abuse, and Sexual Assault

2. 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

3. CHILD ABUSE ACCOMMODATION SYNDROME Abuse Secrecy Accommodation Disclosure Suppression All family members use defenses: dissociation, repression, denial,minimization, externalization

4. CRISIS IN CHILD ABUSE When secret is exposed, all go into crisis Panic: at losing child losing parents losing spouse losing freedom

5. Interventions 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

6. 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

7. 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

8. 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

9. Interventions Mandatory reporting to Adult Protective Services Multidisciplinary team approach needed Public guardianships Financial planning Transportation Assertiveness training Self-advocacy

10. 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

11. 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.

12. Why women stay Fear Religious beliefs Profamily societal values Economically dependent No place to go Children need a father No support system

13. Hopes he’ll change Believes it is her fault Sees no other options Feels insecure and unable to take care of herself denial

14. 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.

15. 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

16. Interventions Empower Provide choices Outpatient groups Shelters Restraining orders Pressing charges Reframe

17. The Batterer Jealous Sulks Explosive temper Critical Difficulty expressing feelings Drinks,uses drugs Male role to be in charge

18. 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

19. Interventions with batterer Educate about types of abuse: Intimidation Isolation Emotional abuse Economic abuse Sexual abuse Using children

20. Threats Using male privilege Physical abuse Power and control management groups Anger and stress management

21. Rape 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

22. Definition 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.

23. Rape Trauma Syndrome Stage One: Immediate Crisis Reactions Stage Two: Reorganization Stage Three: Reintegration

24. Interventions 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

25. 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

26. Support groups EMDR Self-defense classes Medical exam Legal intervention (when she wants to)