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Intimate Partner Violence and Child Custody Evaluation: A Model for Preliminary Clinical Intervention.

ABSTRACT: Intimate partner violence is defined by the World Health Organization as "any behavior within an intimate relationship that causes physical, psychological, or sexual harm to those in the relationship" and it refers to a specific relationship dynamic. In recent decades, an increasing number of studies have focused on this phenomenon, considering its exponential growth over time. Many studies have focused on risk factors for violence within the couple relationship. This paper specifically analyses the association between violence and separation or divorce. Although many interventions have been developed over the years, the effectiveness of extant interventions on violent behaviors is not yet empirically supported. Since clinical experience allows to affirm that both partners can be involved in treatment for intimate partner violence especially during mandated proceedings, the present study focuses on domestic violence in separated couples involved in a child custody evaluation process. In this case, literature supports the need for individualized assessment in order to promote the best intervention according to the specific conditions of each partner, whether the battered one or the perpetrator. However, little research has been done on child custody evaluation in the presence of violent couples. The aim of the present study is to present a model of couple clinical intervention with a separated violent couple in the context of a child custody evaluation. This model can be defined as relational-intergenerational and its main aim is to understand the exchange between familial generations and to search for factors that safeguard and care for family relations. Furthermore, according also to the therapeutic assessment approach, there is an intrinsic connection between assessment and "family transformative potential." This paper presents the specific working methodology underlying this model, through the description of a single clinical case. In particular, the proposed model provides a multi-dimensional assessment comprising three levels: individual, evaluating parents' history through representations, thoughts, and feelings; interpersonal, investigating the different relations; discussion and dialogue with the parental couple about findings.

SUBMITTER: Gennari M

PROVIDER: S-EPMC6107842 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Intimate Partner Violence and Child Custody Evaluation: A Model for Preliminary Clinical Intervention.

Gennari Marialuisa M Tamanza Giancarlo G Molgora Sara S

Frontiers in psychology 20180817

Intimate partner violence is defined by the World Health Organization as "any behavior within an intimate relationship that causes physical, psychological, or sexual harm to those in the relationship" and it refers to a specific relationship dynamic. In recent decades, an increasing number of studies have focused on this phenomenon, considering its exponential growth over time. Many studies have focused on risk factors for violence within the couple relationship. This paper specifically analyses ...[more]

PMID: 30174634

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Project description:BackgroundIntimate partner violence (IPV) is a serious public health issue that consists of physical, sexual, and psychological violence perpetrated by a current or former partner. Informal supporters (e.g., family and friends) of survivors are more often witness to IPV or are the first people a survivor will disclose abuse to and are more able to provide consistent ongoing support than professional services. Therefore, greater understanding of informal supporters is warranted to aid in reducing the risks experienced by survivors. This systematic review aimed to: (1) identify factors associated with either an increase or decrease in helping behaviour toward a survivor, (2), identify the most effective self-care strategies employed by informal supporters, and (3) consider the current theoretical approaches used to understand informal supporters help-giving behavioural intention.MethodsA systematic literature search was conducted following the PRISMA guidelines. The search included English language articles published between 2005 and 2021 in the databases Psych Articles, Scopus, Proquest Social Services Abstracts, and Ebscohost. Studies were included if the primary research aims explored the motivators and inhibitors of helping intention or self-care strategies of adult social network members of adult IPV survivors. Two reviewers independently screened all identified articles for inclusion suitability.ResultsOne hundred and twenty articles were subjected to full text screening resulting in 31 articles being identified as meeting inclusion criteria. Synthesis of the findings identified the following three key areas associated with help-giving behavioural intentions: normative factors, individual factors, and situational factors. There were no articles identified that considered self-care of informal supporters. Of the 31 articles, 22 had a theoretical underpinning. None of the utilised theories explained all three of the identified factors of help-giving behavioural intention.ConclusionThese results are integrated into a proposed Intimate Partner Violence Model of Informal Supporter Readiness (IPV-MISR), incorporating the identified factors associated with help-giving behavioural intention. This model provides a framework for conceptualising the readiness of an informal supporter to provide adequate support to IPV survivors. The model extends existing theoretical standpoints and has utility in both practice and research.

Project description:BACKGROUND:Intimate partner violence (IPV) is a significant public health problem with many negative consequences, particularly for pregnant women. This randomized trial investigated the effectiveness of an IPV preventive intervention embedded within the Nurse Family Partnership (NFP) program. MATERIALS AND METHODS:Participants enrolled over a 20-month period and were interviewed at baseline and 1- and 2-year follow-up. Eligibility criteria included first pregnancy, eligible for the nutrition program Women, Infants, and Children (WIC), English or Spanish speaking, and at least 15 years of age. All women initially referred and screened were randomized to either intervention (NFP+) or control (NFP only) condition. The final sample consisted of 238 women completing baseline assessments; retention was 81% at 2-year follow-up. RESULTS:Analyses indicated that there were no main effects: the intervention affected participants differently depending on their baseline experience with IPV. For physical violence victimization, an interaction between baseline victimization and treatment was found; the intervention reduced victimization at 1 year (and approached significance at 2 years), but only among women who had not experienced past-year physical victimization at baseline. For sexual violence victimization, another interaction emerged; women in the intervention group were more likely to report sexual violence victimization at 2-year follow-up, but only among participants who had reported sexual victimization at baseline. The only effect on IPV perpetration was psychological perpetration at 2-year follow-up; again, the treatment effect was moderated by baseline perpetration. The intervention reduced psychological perpetration for participants who were nonperpetrators at baseline, but had no effect on those reporting perpetration. CONCLUSIONS:Overall, findings suggest that the intervention was effective in reducing some forms of violence among those not experiencing IPV at baseline, but was ineffective or potentially harmful for those already experiencing IPV.

Project description:IntroductionKey measures in preventing spread of the virus that causes coronavirus disease 2019 (COVID-19) are social distancing and stay-at-home mandates. These measures along with other stressors have the potential to increase incidences of intimate partner violence (IPV), sexual assault, and child maltreatment.MethodsWe performed a retrospective review of county police dispatches, emergency department (ED) visits, Sexual Assault Nurse Examiner (SANE) consults, Domestic Violence Healthcare Project (DVHP) team consults, and Child Protection Team consults at a large, tertiary, Level I trauma center. We queried International Classification of Diseases Revision 10 codes most specific to IPV, sexual assault, and child maltreatment from March-October 2020 compared to 2019. Similarly, the number of consults performed by SANE, DVHP, and our Child Protection Team were collected. We compared all ED visits and consultations to total ED visits for the reviewed time period. Finally, the total number of calls and referrals to a child advocacy center and resource call line for victims were recorded during this timeframe.ResultsPolice dispatches for IPV-related assaults increased by 266 reports from 2019 to 2020 (P = 0.015). Emergency department visits related to IPV increased from 0.11% of visits in 2019 to 0.15% in 2020 (P = 0.032), and DVHP consults increased from 0.31% in 2019 to 0.48% in 2020 of ED visits in the first three months (P < 0.001). Child maltreatment visits increased from 0.47% of visits in 2019 to 0.81% of visits in 2020 (P = 0.028), and a higher percentage of patients required Child Protection team consults from 1% in 2019 to 1.6% in 2020 (P = 0.004). Sexual assault-related visits and SANE consults both showed a small increase that was not statistically significant. Fewer calls and referrals were made to our child advocacy center and resource call line, decreasing by 99 referrals and 252 calls, respectively.ConclusionDespite decreased ED volumes throughout the pandemic, we observed an increase in police dispatches, ED visits, and utilization of hospital consult services related to IPV and child maltreatment following the initiation of stay-at-home orders. However, use of community resources, such as the local child advocacy center, declined.

Project description:In this study, we analyze first whether there is a common spatial distribution of child maltreatment (CM) and intimate partner violence (IPV), and second, whether the risks of CM and IPV are influenced by the same neighborhood characteristics, and if these risks spatially overlap. To this end we used geocoded data of CM referrals (N = 588) and IPV incidents (N = 1450) in the city of Valencia (Spain). As neighborhood proxies, we used 552 census block groups. Neighborhood characteristics analyzed at the aggregated level (census block groups) were: Neighborhood concentrated disadvantage (neighborhood economic status, neighborhood education level, and policing activity), immigrant concentration, and residential instability. A Bayesian joint modeling approach was used to examine the spatial distribution of CM and IPV, and a Bayesian random-effects modeling approach was used to analyze the influence of neighborhood-level characteristics on small-area variations of CM and IPV risks. For CM, 98% of the total between-area variation in risk was captured by a shared spatial component, while for IPV the shared component was 77%. The risks of CM and IPV were higher in neighborhoods characterized by lower levels of economic status and education, and higher levels of policing activity, immigrant concentration, and residential instability. The correlation between the log relative risk of CM and IPV was .85. Most census block groups had either low or high risks in both outcomes (with only 10.5% of the areas with mismatched risks). These results show that certain neighborhood characteristics are associated with an increase in the risk of family violence, regardless of whether this violence is against children or against intimate partners. Identifying these high-risk areas can inform a more integrated community-level response to both types of family violence. Future research should consider a community-level approach to address both types of family violence, as opposed to individual-level intervention addressing each type of violence separately.

Project description:ImportanceIntimate partner violence (IPV) is a serious and prevalent public health issue that is interconnected with experiences of trauma, mental and physical health difficulties, and health disparities. Strength at Home (SAH) is a group intervention for persons using IPV in their relationships. Although previous studies have provided evidence of SAH's effectiveness in reducing IPV, its patient outcomes as implemented within organized health care have not been examined.ObjectiveTo evaluate patient outcomes from implementation of SAH in the Department of Veterans Affairs (VA) health system.Design, setting, and participantsThis quality improvement study evaluated patient outcomes from a national implementation and training program conducted between December 11, 2015, and September 24, 2021. Data were collected as part of treatment and submitted by clinicians at 73 VA health care facilities. Patients were 1754 veterans seeking care aimed at addressing and/or preventing their use of aggression in intimate relationships. They completed 1 pretreatment assessment and 1 follow-up assessment in the immediate weeks after group completion.InterventionStrength at Home is a 12-week trauma-informed and cognitive behavioral group intervention to address and prevent the use of IPV in relationships.Main outcomes and measuresChanges in IPV were measured with the Centers for Disease Control and Prevention 2010 National Intimate Partner and Sexual Violence Survey. Changes in posttraumatic stress disorder (PTSD) symptoms were measured with the PTSD Checklist for DSM-5, and alcohol misuse was measured with the Alcohol Use Disorders Identification Test.ResultsThe study included 1754 participants (mean [SD] age, 44.3 [13.0] years; 1421 men [81%]), of whom 1088 (62%) were involved with the criminal legal system for IPV charges. Analyses indicate that SAH was associated with reductions in use of physical IPV (odds ratio, 3.28; percentage difference from before to after treatment, -0.17 [95% CI, -0.21 to -0.13]) and psychological IPV (odds ratio, 2.73; percentage difference from before to after treatment, -0.23 [95% CI, -0.27 to -0.19]), coercive control behaviors (odds ratio, 3.19; percentage difference from before to after treatment, -0.18 [95% CI, -0.22 to -0.14), PTSD symptoms (mean change, -4.00; 95% CI, 0.90-7.09; Hedges g = 0.10), and alcohol misuse (mean change, 2.70; 95% CI, 1.54-3.86; Hedges g = 0.24).Conclusions and relevanceIn this quality improvement study of the patient outcomes after implementation of SAH, results suggested that the program was associated with reductions in IPV behaviors, PTSD symptoms, and alcohol misuse. Results also suggest that IPV intervention in routine health care at VA health care facilities was successful; extension to other organized health care systems could be warranted.

Dataset Information

Intimate Partner Violence and Child Custody Evaluation: A Model for Preliminary Clinical Intervention.

Publications

Intimate Partner Violence and Child Custody Evaluation: A Model for Preliminary Clinical Intervention.

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