MAL_PPT_070107

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MALTREATMENTS
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Module One The Hotline and the Allegation
Matrix

• Objectives
• Describe the Abuse Hotline procedures and
  reporting requirements.
• Name and analyze the specific elements of an
  Intake.
• Identify the uses, benefits, organization and
  information in the Allegation Matrix.

Module One The Hotline and the Allegation Matrix
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Abuse Hotline and Reporting Requirements

• What are the criteria for accepting an intake of
  child maltreatment?
• Besides child maltreatment, what other kinds of
  intakes are received by the Florida Abuse
  Hotline?
• Name some occupations that you think might be
  required by Florida Statute to provide their
  names when reporting abuse/neglect.
• What are the responsibilities of the Hotline and
  the District?

Module One The Hotline and the Allegation Matrix
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Abuse Hotline and Reporting Requirements

• During an open investigation or during
  supervision, when is a call to the Hotline
  required?
• When is an investigator/counselor not required to
  call the Hotline?
• How do Hotline counselors decide which calls meet
  the criteria for acceptance of an intake?

Module One The Hotline and the Allegation Matrix
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Abuse Hotline and Reporting Requirements

• F.S.39.201 (7) requires the review of calls and
  reports to the Hotline involving 3 or more
  unaccepted reports on a single child.
• To detect such things as harassment and
  situations warranting an investigation because of
  the frequency or variety of the course of the
  calls/reports.

Module One The Hotline and the Allegation Matrix
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Florida Abuse Hotline

• Receives all incoming intakes/referrals, 24 hours
  a day, 7 days a week (phone, TDD, Mail, Email and
  Fax)
• Seeks as much information as possible about the
  alleged maltreatment
• Gathers data regarding the subjects of the intake
  
• Uses allegation matrix to determine whether or
  not the allegation constitutes maltreatment
• Determines priority level of the investigation

Module One The Hotline and the Allegation Matrix
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Abuse Hotline (continued)

• Notifies district of intakes
• Checks for priors, current intakes and pervious
  service referrals
• Completes criminal background checks on named
  subjects
• Checks to determine familys involvement with
  other DCF programs

Module One The Hotline and the Allegation Matrix
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Penalties Related to Reporting

• Person who knowingly or willing fails to report
  or prevents another person from reporting first
  degree misdemeanor.
• Failure to report abuse (known or suspected)
  while residing in the same household as the
  victim is a third degree felony.
• Any person, age 18 or older, who knowingly and
  willfully fails to report the abuse or neglect,
  can be charged.
• An exception is in the case of a domestic
  violence situation or other mitigating
  circumstances39.205(2).

Module One The Hotline and the Allegation Matrix
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Mandatory Referrals to CPT

• injuries to the head, bruises to the neck or
  head, burns, or fractures in a child of any age
• bruises anywhere on a child five years or under
• any report alleging sexual abuse of a child
• sexually transmitted disease in a prepubescent
  child
• reported malnutrition of a child and failure of a
  child to thrive
• reported medical neglect of a child

Module One The Hotline and the Allegation Matrix
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Mandatory Referrals to CPT

• any family in which one or more children have
  been pronounced dead on arrival at a hospital or
  other health-care facility, have been injured and
  later died as a result of suspected abuse,
  abandonment, or neglect, when any sibling or
  other child remains in the home
• symptoms of serious emotional problems in a child
  when emotional or other abuse, abandonment, or
  neglect is suspected

Module One The Hotline and the Allegation Matrix
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F.S. 39.303(1)(a)-(j)

• CPT services include
• medical diagnosis and evaluation services
• telephone consultation services (emergencies
  and
• other situations)
• case staffings, case service coordination and
• assistance
• psychological and psychiatric diagnosis and
• evaluation
• expert medical, psychological and related
  professional
• testimony

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CPT Services

• training services
• educational and community awareness
• family psychosocial interviews
• specialized clinical interviews
• forensic interviews

Module One The Hotline and the Allegation Matrix
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When are face to face medicals NOT required?

• When a child had been examined by another
  physician or other medical professional and a
  consult with the CPT medical director concludes
  that a further medical evaluation is not
  necessary.
• The investigator, with supervisory approval, has
  determined after conducting a safety assessment,
  that there are no indications of injuries as
  described in 39.303(2)(a)-(h).
• The CPT medical director determined that a
  medical evaluation is not necessary.

Module One The Hotline and the Allegation Matrix
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Four Most Crucial Steps in the Investigative
Process

• Step 1 Assessing the nature and severity of a
  reported injury or harm to a child.
• Step 2 Assessing the substantial likelihood of
  immediate injury or harm to a child.
• Step 3 Assessing the probability of further
  harm.
• Step 4 Determining what the finding of child
  abuse, neglect, or abandonment should be based on
  the evidence.

Module One The Hotline and the Allegation Matrix
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Allegation Matrix

• A description of the specific maltreatment
• Guidelines for evidence and documentation needed
  to determine the finding
• Contacts to make
• Factors to consider in determining whether or not
  abuse or neglect occurred
• An injury with no evidence to support that it was
  caused by abuse or neglect must have a finding of
  no indicators.

Module One The Hotline and the Allegation Matrix
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Module Two The Dynamics of Child Maltreatment

• Objectives
• Identify the contributing dynamics to child abuse
  and neglect in families.
• Describe ways to look further into situations to
  identify the warning signs of abuse and neglect.
• Describe the Decision-Making Model.

Module Two The Dynamics of Child Maltreatment
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Dynamics

• What is a dynamic?
• List some examples of dynamics that may be
  present in families who may abuse or neglect
  their children?

Module Two The Dynamics of Child Maltreatment
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Maltreatment Statistics

• Victimization rates (per 1,000 child victims) by
  Maltreatment Type, 2000 - 2004
• 7.3 - neglect
• 2.3 - physical abuse
• 1.2 - sexual abuse
• .3 - medical neglect
• .09 - emotional maltreatment
• 3.2 - other types of abuse
  
  (DHHS, 2006)

Module Two The Dynamics of Child Maltreatment
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Child Fatalities

• 45 had prior child protection involvement
• 68 died as a result of neglect
• 32 died of physical abuse
• Perpetrator caregiver statistics
• 52 were under the age of 29
• 54 were previous perpetrators of abuse/neglect
• 46 had history of substance abuse
• 69 had criminal history

Module Two The Dynamics of Child Maltreatment
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What is an indicator?

• How would you define an indicator as it applies
  to child abuse and neglect?
• Are indicators always obvious? If not, what
  kinds of indicators are more subtle?

Module Two The Dynamics of Child Maltreatment
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Relationship of child abuse/neglect indicators to
the decision-making process

• Probe further into situations when indicators are
  present to thoroughly assess the immediate and
  long-term risk to each child.
• Indicators may help identify needs that are not
  being met.
• A thorough investigation or assessment assists
  the investigator/counselor in determining the
  appropriate disposition decision and services
  needed.
• Weigh indicators against identified risk factors
  and protective factors when making decisions
  about child safety.
• An indicator helps the investigator/counselor
  look at possible root causes for the abuse and
  neglect.
• A finding of some indication means credible
  evidence was gathered to support that the injury
  was caused by abuse or neglect and by a caregiver.

Module Two The Dynamics of Child Maltreatment
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Making Decisions

• Decisions are made using a model that is
  applicable to all program areas
• The assessment of information gathered, along
  with all other information received, helps
  determine the actions to ensure continued child
  safety and evaluate the progress towards
  permanency.
• The decision making model is applied continuously
  in the case flow process

Module Two The Dynamics of Child Maltreatment
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Module Three Physical Abuse

• Objectives
• Identify physical abuse indicators.
• Link the identification of indicators with
  investigative decision-making.
• Decide what evidence/information to gather and
  document to determine whether or not
  abuse/neglect has occurred.
• Identify indicators of Shaken Baby Syndrome.

Module Three Physical Abuse
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Examples of Critical Indicators

• Injuries and Evidence
• Numerous alleged accidental injuries
• Escalating injuries
• Injuries inconsistent with explanation
• Frequent change of hospitals or physician
• Professional medical opinion contrary to facts

Module Three Physical Abuse
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Examples (continued)

• Child Vulnerability
• 5 years and younger
• Prior intakes
• Limited access to or contact with child by
  outside world

Module Three Physical Abuse
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Examples (continued)

• Target Child
• No observable signs of bonding with target child
• Flat or depressed affect
• Lack of peer relationships
• Subjected to unusual forms of discipline
• Only discipline used is physical
• Exhibits behaviors indicative of abuse or neglect
• Secretive about injuries

Module Three Physical Abuse
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Examples (continued)

• Parent/Caretaker Characteristics
• Overly charming, extremely cooperative
• Appears to make extreme progress
• Tells you what you want to hear
• Violent and aggressive behavior
• Unrealistic expectations of child
• Alienated from family no family support network
• Isolation, lack of social contacts

Module Three Physical Abuse
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Examples (continued)

• Parent/Caretaker History
• History of abuse and neglect as a child
• History of alcohol or other substance abuse
• History of mental illness
• History of frequent moves
• History of job instability
• Criminal history

Module Three Physical Abuse
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Examples (continued)

• Parent/Caretaker Relationship
• Boyfriends drifting in and out of home
• Relationship takes precedence over childs needs
• Imbalance of power
• Domestic violence
• No clear identification of roles
• Open hostility and/or negative perceptions

Module Three Physical Abuse
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Examples (continued)

• Physical Environment
• Environment poses safety risks
• Unsecured swimming pools/bodies of water
• Sleeping area for child is inappropriate
• Child is removed from others during common
  activities
• Home is physically isolated

Module Three Physical Abuse
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Adult Behaviors

• call a child offensive names or chronically
  ridicule them
• perform willfully malicious or violent acts
  directed toward a childs possessions, pets, or
  environment
• use crude, brutal, or severely misguided actions
  in the attempt to gain submission or enforce
  maximum control to modify a childs behavior
• have unrealistic expectations which are
  inappropriate to the childs developmental level
• have a need to always be in charge always
  critical
• totally reject a child or have obvious preference
  for one child over another

Module Three Physical Abuse
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Adult Behaviors (continued)

• have distant, shallow, or superficial
  relationships with family members, or are
  isolated from society
• are extremely disappointed regarding their babys
  gender
• fail to bond with infant
• suffer from acute tension, encounter chronic
  crises, or are easily frustrated
• have poor impulse control
• often blame the child for problems
• provide inaccurate, illogical, or conflicting
  explanations for a childs injury

Module Three Physical Abuse
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Adult Behaviors (continued)

• expose a child to repeated violent, brutal, or
  intimidating acts or statements
• leave a child in a hostile or dangerous situation
• fail to protect a child from inflicted injury
• abuse substance to the degree that they are
  unable to provide adequate care
• beat or corporally punish a child so that it
  leaves or it is likely to leave an injury
• kick, scratch, or punch a child

Module Three Physical Abuse
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Adult Behaviors (continued)

• hit or slap an infant
• pull a childs hair
• over medicate or poison a child
• tie a childs limbs together or to an object

Module Three Physical Abuse
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Variables Affecting Childs Response to Abuse

• Age of the child
• Length of time the child has been abused
• Frequency of the abuse
• Nature of the childs relationship with the
  abuser
• Type of abuse
• Availability to the child of support
• Constitutional factors

Module Three Physical Abuse
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Emotional Indicators

• Developmental delay and abnormal developmental
  patterns
• Remote, withdrawn
• No expectation they will be comforted
• Frozen watchfulness
• Fear of physical contact
• Appear to be autistic
• Clinging dependency
• Depressed, lack of emotion
• Preschool children easily frightened eager to
  please role reversal
• Adolescents lying stealing use of
  alcohol/drugs truancy running away

Module Three Physical Abuse
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Critical Indicators of Physical Abuse

• Frequent injuries.
• Multiple bruises and injuries.
• Bruises and injuries in inaccessible places.
• Injuries in different stages of healing.
• Injuries inconsistent with adult explanation.

Module Three Physical Abuse
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Investigative Techniques

• Always investigate, even if the explanation seems
  plausible.
• Check other areas of the childs body, not just
  the area of the injury.
• Interview all subjects of the intake
  individually.
• Check for and analyze all prior case histories
  and intakes.
• Refer the child to CPT.
• Notify Law Enforcement/SAO within mandated
  timeframes.
• Interview all persons in the environment who may
  have information.

Module Three Physical Abuse
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Investigative Techniques (continued)

• Make plans to obtain information from school
  personnel and family physicians.
• Get the childs version of what happened.
• Always probe deeper with each piece of
  information you gather. Each answer you receive
  is only a piece of the puzzle and should spark
  another question or clue to investigate.
• Always ask to see the physical source of the
  injury iron, stove, burner, rope, etc.
• Visit the site of the accident. Do the
  physical environment and explanation for how the
  injury occurred match?
• Visit and observe the entire home environment for
  clues, especially the childs bedroom.
• Take photographs

Module Three Physical Abuse
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Shaken Baby Syndrome

• Shaken Baby Syndrome is a serious brain injury
  that occurs when a frustrated caregiver violently
  shakes an infant, usually to stop him/her from
  crying.
• It is considered a serious form of child abuse.
• Shaking a baby can cause serious injuries or
  death.
• There are usually no outward physical signs.

Module Three Physical Abuse
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Module Four Sexual Abuse

• Objectives
• Describe the dynamics of child sexual abuse using
  the five phases.
• Describe the physical, behavioral, and emotional
  signs of child sexual abuse.

Module Four Sexual Abuse
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Sexual Abuse Statistics

• One out of every four women was sexually molested
  by an adult before she was 18. For men, one out
  of ten.
• Only one out of every ten cases of child sexual
  abuse is reported to law enforcement.
• For victims under age 12, the sexual offender was
  a family member in 47 of incidents, an
  acquaintance in 49, and a stranger in just 4.
• Child molesters are predominantly men.

Module Four Sexual Abuse
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Phases of Child Sexual Abuse

• Phase 1 Engagement
• Phase 2 Sexual Interaction
• Phase 3 Secrecy
• Phase 4 Disclosure
• Phase 5 Suppression

Module Four Sexual Abuse
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Types of Disclosure

• Accidental disclosure happens when the victim
  reveals by chance rather than deliberately.
• Purposeful disclosure happens when the victim
  makes a conscious decision to tell an outsider.

Module Four Sexual Abuse
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Module Five Mental Injury

• Objectives
• Identify the indicators of mental injury.
• Describe the types of mental injury.

Module Five Mental Injury
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Emotional neglect Psychological abuse Mental
Injury

Mental injury is often accompanied by or
embedded in other forms of child abuse and
neglect.
Module Five Mental Injury
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Types of Mental Injury

• Spurning (hostile rejecting/degrading)
• Terrorizing
• Exploiting/corrupting
• Isolating
• Denying emotional responsiveness (ignoring)
• Mental health, medical and educational neglect

Module Five Mental Injury
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Module Six Substance Abuse

• Objectives
• Define substance abuse and terms related to it.
• Define disease as related to substance abuse
  and describe its characteristics.
• Recognize the progression/stages of substance
  abuse.
• Continued on next slide

Module Six Substance Abuse
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Module Six Objectives, continued

• Describe behavioral indicators of substance
  abuse.
• Define and identify risk factors.
• Describe the protective factors.

Module Six Substance Abuse
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Substance Abuse Statistics

• Approximately 18 million persons abuse or are
  addicted to alcohol.
• 11 million persons abuse tranquilizers and other
  psychotropic drugs.
• 5.5 million get high on marijuana more than once
  a week.
• At least 2 million are addicted to cocaine or
  crack.
• Up to 1 million individuals use heroin.

Module Six Substance Abuse
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Definitions

• Substance Any chemical that modifies the
  function of living tissues, resulting in
  physiological or behavioral change.

Substance Use The desired effects of a drug can
be realized with minimal hazard, whether or not
used therapeutically, legally, or as prescribed
by a physician.
Substance Abuse Drugs are taken or administered
under circumstances at a dose that significantly
increases their hazard potential, whether or not
used therapeutically, legally, or as prescribed
by a physician.
Module Six Substance Abuse
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Addiction

• A disease entity with its own psychopathology
  characterized by compulsion, loss of control, and
  continued use in spite of adverse consequences.
• Addiction is progressive, potentially fatal if
  untreated, and incurable but remissible through
  abstinence and recovery.

Module Six Substance Abuse
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Characteristics of a Disease

• Primary the disease is not a secondary symptom
  of something else.
• Progressive the disease worsens progressively.
  The victim becomes physically, spiritually,
  emotionally, and psychologically ill.
• Chronic there is no cure. Recovery from the
  disease must be based on abstinence from mood
  altering chemicals.
• Fatal the disease can only be arrested. If it
  is not arrested, the person will die from it.

Module Six Substance Abuse
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Elements of Disease

• cause
• effect
• symptoms
• course of action
• predictable outcome

Module Six Substance Abuse
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Symptoms Associated with Stages

• First, people drink for relief.
• Second, social problems such as job loss or
  family problems become identified.
• In late stages, there is physical deterioration.
• Death usually occurs in 15 to 20 years.
• Recovery rates are 60 to 70 percent if treated in
  the middle stage.

Module Six Substance Abuse
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Stages of Substance Abuse

• Stage 1 Experimentation and social use
• Stage 2 Seeking the mood swing
• Stage 3 Harmful abuse
• Stage 4 Dependency addiction

Module Six Substance Abuse
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Substance Abuse A risk
factor is

• an attitude, belief, behavior, situation, and/or
  action that may put an individual, group,
  organization, or community at risk for
  experiencing drug use and its effects.

Module Six Substance Abuse
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Categories of Risk Factors

• Family
• Community/school
• Individual/peer/psychosocial

Module Six Substance Abuse
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Family Risk Factors

• Family Management Practices The way parents
  manage the family may increase the possibility of
  alcohol and drug abuse by the children.
• Family History of Alcohol and Drug Abuse If a
  parent has a history of alcoholism or other drug
  abuse, the children have an increased risk of
  becoming substance abusers.
• Condoning Alcohol and Other Drug Abuse The
  message that alcohol and drug abuse is acceptable
  increases the likelihood that substance abuse
  will occur. Parents who drink, smoke, and abuse
  other substances, set an example for the children.

Module Six Substance Abuse
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Family Bonding

• Strong relationship between parents and children
• Children feel safe, loved, and supported

Module Six Substance Abuse
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Protective Factors in Parents

• Consistent praise/low criticism
• Clear expectations/high expectations
• Stress management
• Quality time/sharing responsibilities
• Supportive adult relationships/extended family

Module Six Substance Abuse
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Protective Factors in Children

• Relationship with a caring, adult role model
• Opportunities to contribute or be a resource
• Success in work, play, and relationships
• Self-esteem
• Self-discipline
• Problem-solving skills
• Sense of humor
• Healthy expectations and positive outlook

Module Six Substance Abuse
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Module Seven Neglect

• Objectives
• Define neglect.
• Identify the types of neglect as defined in the
  Allegation Matrix.
• Identify indicators for each type of neglect.
• Recognize the indicators of neglect that
  represent a risk for significant impairment.
• Continued on next slide

Module Seven Neglect
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Module Seven Objectives, continued

• Distinguish between chronic and situational
  neglect.
• Describe the effects of neglect on toddlers,
  early school-aged children, and adolescents.
• Define failure to thrive.

Module Seven Neglect
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Child Neglect

• What are some examples of neglect?
• With an allegation of neglect, what are some
  concerns for child safety?

Module Seven Neglect
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Chapter 39.01(44)(a)-(b)

• States that neglect occurs when a child
• is deprived of, or is allowed to be deprived of
  necessary food, clothing, shelter, or medical
  treatment, or when
• a child is permitted to live in an environment
  when such deprivation or environment causes the
  childs physical, mental, or emotional health to
  be significantly impaired or to be in danger of
  being significantly impaired.
• Neglect of a child includes acts or omissions.

Module Seven Neglect
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The foregoing circumstances shall not be
considered neglect

• If caused primarily by financial inability unless
  actual services for relief have been offered to
  and rejected by such person.
• A parent or legal guardian legitimately
  practicing his religious beliefs in accordance
  with a recognized church or religious
  organization who thereby does not provide
  specific medical treatment for a child shall not,
  for that reason alone, be considered a negligent
  parent or legal custodian.

Module Seven Neglect
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The Court Can

• Order the following services to be provided, when
  the health of the child so requires
• Medical services from a licensed physician,
  dentist, optometrist, podiatrist, or other
  qualified health care provider or
• Treatment by a duly accredited practitioner who
  relies solely on spiritual means for healing in
  accordance with the tenets and practices of a
  well-organized church or religious organization.

Module Seven Neglect
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The Types of NeglectRecognized by the Allegation
Matrix

• 37N Bizarre Punishment (Institutions)
• 39N Mental Injury
• 41N Substance Misuse
• 50N Inadequate Supervision
• 53N - Abandonment
• 55N Environmental Hazards
• 60N Malnutrition/Dehydration
• 61N Failure to Thrive
• 65N Medical Neglect
• 97N Failure to Protect
• 99N Death due to Neglect

Module Seven Neglect
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The IndicatorsAre Classified into Four Categories

• Physical indicators
• Environmental indicators
• Childs behavioral indicators
• Caregivers behavioral indicators

Module Seven Neglect
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Chronic Neglect

• Chronically neglectful caregivers often suffer
  from pervasive and profound character problems
  which result from their own severely emotionally
  impoverished childhood.
• Chronically neglectful families are often caught
  in a cycle of neglect. The caregivers were
  neglected as children and, in turn, lack the
  emotional capability and basic parenting skills
  to provide a nourishing environment for their own
  children.
• Additionally, chronically neglectful families
  usually share some or all of these
  characteristics
• large families with many children and limited
  financial support
• socially isolated
• very little extended family support or network of
  friends in the community

Module Seven Neglect
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Factors

• Many factors influence the severity of damage to
  a child
• childs age
• length of time of neglect
• frequency
• childs relationship with caretaker
• availability of support
• personality of the child

Module Seven Neglect
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A Child Suffers from Failure to Thrive when

• weight for height is below the 5th percentile of
  the population on a standard weight/height curve
  (some experts recommend 3rd percentile).
• actual weight is 20 or more below the ideal
  weight for height.
• weight gain is significantly slower than normal.
• triceps skin-fold thickness (a measurement of the
  total body fat) is below the 15th percentile for
  the population. (Schmitt and Mauro, 1989)

Module Seven Neglect
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Intervention

• Early intervention is essential.
• Collaborate with medical personnel.
• If child remains in the home, intensive support
  of the family is necessary in addition to
  continuous monitoring of the infant on a daily
  basis if necessary.
• The decision to leave an infant in the home (or
  not) is based on the following criteria
• the severity of the infants condition
• the caregivers openness to intervention
• the establishment of a safety plan that includes
  the involvement of a relative, neighbor, or
  friend who can assist the caregiver in caring for
  the infant

Module Seven Neglect
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Module Eight, Part I Domestic Violence

• Objectives
• Identify indicators of domestic violence.
• Recognize the relationship between domestic
  violence and child abuse.
• Relate domestic violence behavior to neglect of a
  child.

Module Eight, Part I Domestic Violence
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FS 39.902(1)

• Domestic violence is any assault, battery,
  sexual assault, sexual battery, or any criminal
  offense resulting in physical injury or death of
  one family or household member by another who is
  or was residing in the same single dwelling unit.

Module Eight, Part I Domestic Violence
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Domestic violence is

• a pattern of assaultive and coercive behaviors,
  including physical, sexual, and psychological
  attacks, as well as economic coercion, that
  adults or adolescents use against their intimate
  partner.
• (Ganley Schechter, 1995)

• Key Points
• Pattern of assault and coercion
• Many forms of abuse
• Affects people in all types of intimate
  relationships

Module Eight, Part I Domestic Violence
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Physical Abuse

• The most obvious form of domestic violence is
  physical abuse.
• Batterers are aware that visible physical
  evidence could draw the wrong kind of attention,
  so they selectively hit the victim in areas that
  will not be so readily seen. Batterers might
• pull the victims hair
• bang the victims head against the wall
• shake the victim violently
• Serious internal or neurological injury might
  occur.

Module Eight, Part I Domestic Violence
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Emotional/Psychological Abuse

• This type of abuse does not directly kill the
  victim but can be the driving force behind
  physical abuse or the victims belief that she
  might be physically harmed.
• The batterer may make covert threats.
• The batterer may intimidate the victim by
  threatening to take the children because she is
  an unfit mother.
• Driving forces behind emotional abuse
• The victim believes that what the batterer says
  is true.
• The victim believes that the batterer can do all
  that he threatens.
• Enduring emotional abuse and the isolation that
  comes with it is worse than enduring physical
  abuse.

Module Eight, Part I Domestic Violence
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Sexual Abuse

• Any attempt to force a partner to act against his
  or her will (Marital rape is punishable by law in
  Florida).
• Sexual battering consists of a wide range of
  behaviors including
• pressured sex when the victim does not want sex
• coerced sex through manipulation or threats
• violent sex
• Victims may be forced to perform acts they do not
  like
• sex with third parties
• painful sex
• acts which are offensive to them

Module Eight, Part I Domestic Violence
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Sexual Abuse (continued)

• Victims may be forced to have sex at
  inappropriate times
• when they dont want it
• in front of the children
• when theyre asleep
• Victims may comply to avoid punishment or may be
  punished for resisting.
• Sexual abuse is profound and may be difficult for
  the victim to discuss.
• Some victims are unsure that the sexual abuse is
  really abuse, and, for others, it is the ultimate
  betrayal.

Module Eight, Part I Domestic Violence
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Economic Coercion

• Batterers attempt to control the adult victim by
  controlling the family finances.
• This limits the victims access to other
  resources such as
• food
• shelter
• clothes
• transportation
• other necessities of life
• The batterer may expect the victim to keep all
  records and handle all transactions while
  granting limited permission to pay bills.
• Batterers will often hide all financial
  information from the victim.
• Adapted from Schechter and Ganley, 1995.

Module Eight, Part I Domestic Violence
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Use of Children to Control Adult Victim

• using the children to spy on the victim
• forcing the children to assault the victim
• making children watch the degradation/abuse of
  victim
• using the children as pawns
• physically assaulting or threatening to assault
  children in order to control the victim

Module Eight, Part I Domestic Violence
84
Child Abuse Related to Domestic Violence

• Striking a child who tries to intervene.
• Forcing a child to witness or participate in
  beatings.
• Threatening to beat a child who discloses.
• Hitting the child with objects intended to strike
  the adult victim.

Module Eight, Part I Domestic Violence
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Children and Domestic Violence

• Children experience terror from witnessing family
  violence that changes them for life.
• Domestic violence can be a factor in some child
  abuse deaths.
• Preliminary research and data indicates that some
  child abuse begins with the battering of a spouse
  then escalates to include the children.
• The overlap between households with both domestic
  violence and child abuse ranges from 40 to 60
  percent1.
• The risk of child abuse is 1500 greater in homes
  where there is domestic violence2.
• When there is an indication of domestic
  violence there are concerns of possible child
  abuse or neglect.
• 1 A Nations Shame Fatal Child Abuse and
  Neglect in the United States, p. 12.
• 2 National Woman Abuse Prevention Project,
  Domestic Violence Fact Sheet, n.d.

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Module Eight, Part II Safety Planning

• Objectives
• Analyze the term safety plan and its effects on
  the adult victim, the child, and the worker.
• List essential elements of a good safety plan.
• Describe techniques used to create safety plans
  with children.
• Explain the purpose and use of injunctions under
  s. 741.30, F. S.
• Develop a personalized safety plan using a case
  scenario.

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87
Safety planning is

• the act of finding ways to protect the child
  from immediate harm when the childs safety is
  threatened. Examples are

• Finding a relative or adult who can protect the
  child when it appears the violence may occur or
  is occurring.
• Teaching a child to call 911 when there is danger
  or when violence occurs.
• Escaping the home or calling the police when
  there is danger.
• The plan should never be so complicated that the
  child cannot remember it in an emergency.

Module Eight, Part II Safety Planning
88
Domestic Violence and Safety Planning

• For the child
• For the adult victim
• For the worker

Module Eight, Part II Safety Planning
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Worker Safety

• Important points to remember about worker safety
• The incidence of violence increases going into a
  domestic violence situation.
• When batterers perceive their control is
  threatened by counselors interventions, they are
  likely to lash out.
• Exercise caution when leaving a home or the
  office.
• Notify co-workers when a potentially dangerous
  person is coming to the office.
• Contact law enforcement if the batterer has a
  criminal record involving violent offenses.

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Essential Elements of a Safety Plan

• Plan for safety when the batterer is still in
  the home.
• Plan for safety when the adult victim or children
  must leave the home.
• Plan for safety after leaving.

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Safety Planning with Children

• Include written and verbal instructions for the
  children (when age-appropriate).
• If the child does not know how to carry out the
  tasks listed on the handout, talk them through it
  and ask the mother for help unless this will
  jeopardize the childs safety.
• Reassure the children that they are not
  responsible for the domestic violence or for what
  happens after the domestic violence is disclosed.
• Children need to know that it is important for
  them to be safe when their mother is assaulted,
  and that they should not intervene during an
  assault.
• If they blame themselves for the violence or for
  not protecting their mother, reassure them that
  these are common reactions, but the violence is
  not their fault.
• Keep things simple and have the children practice
  and explain what they are to do.

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Safety Planning

• If the child is in imminent danger
• arrange for immediate removal of the child or the
  offending adult, or
• arrange some other type of protective
  intervention
• A thorough initial assessment is directly related
  to effective safety planning.
• A continual, ongoing assessment of the situation
  is necessary to ensure child safety, no matter
  where the child is in the home or in out-of-home
  care.
• Periodic reassessment and updates of the safety
  plan must be documented in the chronological
  notes.
• Reassessments should answer the following
  questions
• Is the safety plan appropriate to the current
  circumstance?
• If a safety plan is not in place, does the
  current situation require one?

Module Eight, Part II Safety Planning