This chapter includes brief historical, political, and cultural perspectives on violence against women as well as the current state of this issue. It discusses various forms of violence against women that impact their emotional, physical, and psychological well-being. Clinical implications include an overview of the clinical foundation in working with survivors of violence and the three layers of the counseling process: prevention, intervention, and restoration. The chapter discusses the impact of this work on the counselor, along with how to promote posttraumatic growth in clients. The movement toward ending violence against women has gained significant momentum since the end of the 20th and the beginning of the 21st centuries. The emotional effects of domestic violence (DV) can have devastating impacts on survivors. Although sexual violence is often present within DV, it also occurs outside of intimate relationships. Legally, sexual violence is often referred to as sexual assault or rape.

The philosophy around domestic violence has undoubtedly evolved in the past several years. While most scholars studying the epidemiology of domestic violence agree that violence occurs in homes across all demographic groups, more people who are poor appear in domestic violence courts than those who have money. Early in the development of batterers’ intervention programs, both a feminist and cognitive behavioral model was developed to integrate sociocultural political and individual factors. There are three major models of treatment programs that are usually court ordered around the country. The first is the Duluth model and the second model is the combination of treatment for domestic violence and mental health problems that is represented by AMEND from Denver and EMERGE from Boston. The third model comprises mental health treatment programs that are not integrated with a sociocultural feminist perspective.

In 1980, the battered women advocates attempted to take control of what loosely was called “the battered woman’s movement” away from the professionals. However, some of those women who already have been identified with a mental disorder that is exacerbated by the abuse or those who develop battered woman syndrome and posttraumatic stress disorder from the abuse itself may need some psychotherapy to help them heal and move on with their lives. The link between sex trafficking and domestic violence has also become much better known within the last 10 years. The history of society’s newest interest in the eradication of violence against women and children demonstrates both the intricacies of the problem and the difficulties in dealing with it. Although shelters do provide safety for only a small number of women and children, their presence in a community sends a message about zero tolerance for such abuse.

This chapter addresses the complex relationship between child abuse and domestic violence. The Convention on the Rights of the Child (CRC) was developed by the United Nations over a 10-year period to protect the human rights of the child by banning discrimination against children and affirming special protection and rights appropriate to minors. Forensic mental health experts who specialize in child custody evaluations come more from the perspective of child protection and rarely understand how to support and reempower the mother who has been abused. Posttraumatic stress disorder (PTSD) is the most commonly diagnosed disorder in abused children, although some of the symptoms are not easily seen in young children who often show dysregulation of their body functions. Newer psychotherapy strategies called “trauma-specific treatment” may help children who have been abused heal from the trauma.

Today, the debate over the misinterpretation of the term “learned helplessness” is less important, particularly since the originator of the theory, Martin Seligman, has looked at the less controversial flip side, learned optimism. In any case, the discussion about the theories of learned helplessness and learned optimism is relevant to finding a theory that many can embrace that helps explain the complex relationships found in domestic violence. This chapter adapts the theoretical concept of learned helplessness to help explain why women who could develop such intricate and life-saving coping strategies found it so difficult to escape a battering relationship. The concept of learned helplessness has been quite useful in expert witness testimony to help jurors understand how difficult it is for women to leave the relationship and why some women become so desperate that they must arm themselves against batterers.

The research over the past 40 years led to the validation that living in a domestic violence family can produce psychological effects called the battered woman syndrome (BWS). Over the years, it has been found that the best way to understand violence in the home comes from listening to the descriptions obtained from those who experience it: victims, perpetrators, children, or observers. The understanding of domestic violence reported was learned from the perceptions of the courageous battered women who were willing to share intimate details of their lives. The theory of learned helplessness suggests that they give up the belief that they can escape from the batterer in order to develop sophisticated coping strategies. Learned helplessness theory explains how they stop believing that their actions will have a predictable outcome. The abuse of alcohol and perhaps some drugs is another area that would predict higher risk for violent behavior.

This chapter addresses some negative effects on children when exposed to violence against their mothers by batterers. It focuses on teenagers as more data have become available about teens, delinquency, and violence in their homes. In the 40 years since the original battered woman syndrome (BWS) research, there has been plethora of data collected about children who have been exposed to domestic violence, particularly by their fathers or father-like substitutes abusing their mothers. The child abuse experts began a study funded by the US Centers for Disease Control and Prevention (CDC) to retrospectively assess for relationship between adverse childhood events and lifetime prevalence of health concerns. To eradicate domestic violence and violence in the community, we must stop modeling both sexist and violent behavior and change the divorce laws to empower children and abused women so they are no longer victimized by the abusers.

Child maltreatment is defined as the causation of a nonaccidental injury. It may be physical or sexual abuse. Inflicts or allows to be inflicted: a physical or sexual offense against a child. Child neglect is defined as the omission in care of a child’s basic needs that may result in harm or potential harm. It is a significant cause of morbidity and mortality in children. Domestic violence is significantly correlated with child maltreatment. Girls who are abused as children may be more likely to become victims of violence as adults. Boys abused as children may be more likely to commit acts of violence as adults. Child maltreatment tends to be repetitive and frequently will escalate over time. It is essential that every child, regardless of race, religion or socioeconomic background be screened for child maltreatment in their primary care office.

There is no question that the presence of domestic violence and child maltreatment poses significant problems for the family court and child custody evaluators. In fact, the largest number of complaints filed with licensing boards and malpractice insurance carriers deal with child custody evaluations. Research demonstrates the lack of knowledge of judges and child custody evaluators in protecting women and children when domestic violence and child abuse are reported as compared to battered women advocates and legal aide attorneys. There are several ways to minimize the domestic violence that include blaming the victim for her behavior, artificially dividing domestic violence into different types of behavior and then assuming that certain types do not have negative impact, ignoring or misinterpreting signs of abuse, or alleging some factitious disorder like Munchausen by proxy or the nonexistent parental alienation syndrome or disorder.

Women were less likely to be able to leave a domestic violence relationship if they had substance abuse problems. Linking alcohol abuse with batterers and battered women, then, is a natural association. The relationship between substance abuse and aggression and/or interpersonal violence is more complex because of the pharmacological and physiological interaction of the different substances. Several studies have associated cocaine, crack, amphetamine, and methamphetamine use with increased violence. Individuals who abuse psycho stimulants may be inherently aggressive, antisocial, or psychopathic sensation seekers. And women who abuse substances to self-medicate from the symptoms of posttraumatic stress disorder (PTSD) and battered woman syndrome (BWS) need specialized treatment for the abuse they have experienced in addition to treatment for alcohol and other drugs. Cognitive rehabilitation as well as trauma treatment and drug treatment are all needed, especially for those who have been abusing substances over a long period of time.