This chapter promotes a better understanding of women’s experience of abuse. It articulates strategies used in victim advocacy, and addresses the experiences and needs of female victims of intimate partner violence. The chapter examines common practices used and issues faced by victim advocates–who are often trained social workers–who work with women who have been victimized by a male intimate partner. It also highlights firsthand experiences of a victim advocate for female victims of intimate partner violence. Many women continue to be victims of intimate partner violence, and the work of victim advocates who serve these women is challenging. Advocates must be able to assess the needs of victims, refer them to appropriate services, protect their rights, empower them, and help them navigate the criminal and civil justice systems. These responsibilities require advocates to possess various personal and professional skills and to collaborate with many different professionals.
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This chapter defines emerging disabilities; explores medical, psychosocial, and vocational implications of emerging disabilities that distinguish them from traditional disabilities; and provides demographic characteristics of individuals who are most vulnerable to acquiring emerging disabilities. It examines some social and environmental trends that have contributed to the development of emerging patterns and types of disabilities including advances in medicine and assistive technology, globalization, climate change, poverty, violence and trauma, the aging American populace, and disability legislation. Psychological and physical trauma from warfare, violent crime, intimate partner violence, and youth violence can result in permanent physical, cognitive, and psychiatric disabilities. Diagnostic uncertainties, misdiagnoses, and skepticism on the part of medical providers are frequently associated with emerging disabilities. Women also represent a population that is at an increased risk of acquiring emerging disabilities and chronic illnesses. Rehabilitation systems are still not fully prepared to address the multifaceted needs of individuals with emerging disabilities.
This chapter discusses various types of violence and their impact on human health, functioning, and onset of physical and psychiatric disabilities, and identifies approaches and programs for treating individuals who have sustained disabilities from violent acts. It examines populations that are most vulnerable to violence, and explores trauma-informed approaches to providing services to these clients in all phases of the rehabilitation counseling process. Military sexual trauma (MST) is heavily confounded by military culture, making the decision to report sexual trauma extremely difficult. The functional limitations associated with disabilities acquired through violence can substantially impair survivor’s ability to achieve and maintain competitive employment. Outreach may be particularly necessary to inform individuals with violence-related disabilities about rehabilitation services. Frain et al. emphasized the importance of training in self-management techniques for veterans because they tend to have poor self-management skills.
This chapter discusses how the criminal justice system treats battered women over the past 40 years. In the United States, advocates who began working with battered women in the 1980s believed that the most important step to end threats of violence was to punish the batterer and hold him accountable for his misconduct. To do this the legal system had to be encouraged to take action whenever domestic violence was raised. A study of the needs for victims of intimate partner violence commissioned for the Colorado legislature found that over two thirds of the women in prison stated that they had been abuse victims. Other areas of the civil rights laws have also been used to better protect battered women. The gender bias, including sexism and racism, for women coming before the criminal justice system continues to make it difficult for women to seek safety and protection.
Attachment theory provides a rich conceptual framework for understanding issues that arise in intimate partner violence (IPV) that have not been well studied in adults. Attachment was initially conceived as a neurobiological-based need for the purpose of safety and survival. Moreover, through the attachment process individuals develop an internalized set of beliefs about the self and others, known as “internal working models”. In adult relationships, attachment processes are activated by way of a cognitive-affective-behavioral triad. Woman who engage in the commercial sex industry have a much higher risk of contracting a sexually transmitted disease. An interesting phenomenon that ties use of pornography on the Internet together with the sexual abuse of women and children has been found in the legal community. It is known that early sexualization of children may cause interpersonal difficulties that may make it more difficult to recognize the cycle of violence engaged in by the batterer.
The US Centers for Disease Control and Prevention (CDC) has conducted studies about adverse health conditions and health risk behaviors in those who have experienced intimate partner violence (IPV). The high numbers of women who report childhood abuse and IPV and receive no assistance in healing from the psychological effects obviously will be seen in medical clinics, often too late to stop a disease process that might have been prevented had their posttraumatic stress disorder (PTSD) responses been dealt with earlier. One of the most negative and lasting effects of IPV on women appears to be the impact on the women’s body image, which is related to their self-esteem. Although the health care system has attempted to deal with battered women, in fact both the structure and function are not set up to be helpful, especially when chronic illnesses are exacerbated by environmental stressors such as living with domestic violence.
This chapter analyzes the murder-suicide cases through a review of the newspaper reports of murder-suicides in the five major regions of the state of Florida. Guns in the home are the predominant weapons used in the murder-suicides in the United States. In countries where guns are not as accessible in the home, such as Great Britain, there is a lower murder and suicide rate. Jacqueline Campbell suggests that domestic violence is implicated in premature deaths of women from aggravated health conditions such as strokes, heart attacks, and other major illnesses that occur after being choked or strangled. The chapter also presents some murder-suicide case and self-defense case studies of women such as Ed and Linda, Nancy Kissell, Catherine Pileggi and Nellie Mae Madison. A recent study in Chicago offered some new information about the neuropsychological profile of men who killed an intimate partner as compared to those who kill others.
Battered women themselves are terrified about being labeled with a mental illness especially since so many are threatened into silence by their batterers who tell them that everyone will think they are “crazy”. While health service providers are now better trained in identification of both health and mental health needs of battered women and their children, there is still little understanding of what to do after identification. The Public Health Model for community distribution of health and mental health services may be a way to conceptualize all of the health services that battered women need to have in place for both prevention and intervention. The legal system also contributes to the primary prevention and intervention with women who are victims of intimate partner violence. Secondary prevention programs attempt to use the early identification of domestic violence victims as a way to prevent the development of further psychological and physical injuries.
This chapter discusses the agents and processes of gender socialization. Gender can differentially impact “susceptibility and exposure to mental health risks and mental health outcomes” and “deepen disparities associated with important socioeconomic determinants such as income, employment, and social position”. Social learning theorists describe socialization as a result of rewards and punishment for gender-appropriate behavior and vicarious learning through observation and modeling. Primary socialization, occurring in infancy and childhood, is the initial process of learning the ways of a society or group. Four most studied agents of socialization are family, peers, education, and media. Gender roles and stereotypes adversely impact women’s ability to achieve equal representation in some of the more influential leadership positions in society. Violence against women takes many forms including intimate partner violence, sexual assault, and sex trafficking. The division of household labor is a clear example of the feminist tenet that the personal is political.
The consequences of injuries can be extensive and wide ranging. They are physical, emotional, and financial; in the case of disabling injuries, the consequences are enduring. The magnitude of brain injury-related public health burden mandates that researchers delineate the contributing mechanisms of injury and recovery, evaluate and implement effective treatments, and accurately prognosticate outcome with effective assessment tools. Traumatic brain injury and other forms of acquired brain injury (
ABI) continue to be a health burden in the United States and internationally. This chapter addresses contemporary issues with conducting research in the population with ABI, structural care gaps that limit population-based research, and challenges with outcome assessment in this population. It highlights the importance of translational research and preclinical trials and evaluates challenges with conducting clinical trial and comparative effectiveness research in this population. The chapter discusses the federal research funding agencies and their priorities.