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Violence and the Family: Report of the APA Presidential Task Force on Violence and the Family -- Executive Summary

The American Psychological Association's Presidential Task Force on Violence and the Family was convened to bring psychological research and clinical experience to bear on the troubling problem of violence in the family and to make recommendations for solutions. The task force faced a formidable challenge: Although considerable work has been done in areas such as child abuse, partner abuse, dating violence, elder abuse, and adult survivors of childhood abuse, only recently have the disparate forms of abuse that occur in the home been considered as part of a unified field of study with important cross currents and linkages. Furthermore, because standard definitions of key terms have not been adopted, communication across disciplines has been difficult, and much confusion has arisen when researchers and journalists attempt to draw conclusions by comparing studies in which different definitions are used. The task force defined family violence and abuse as including a range of physical, sexual, and emotional maltreatment by one family member against another; according to this definition, the term family includes a variety of relationships beyond those of blood or marriage, in recognition that similar dynamics of abuse may occur in these relationships.

Approaching the forms of family violence as a unified field of study underscores the common dynamic at the heart of them: the perpetrator's misuse of power, control, and authority. Because of this common dynamic, the odds rise that when one form of abuse occurs in the family, another form also is present--or may occur in the future unless helpful interventions take place. Unfortunately, all indications are that family violence and abuse are significantly under-reported at all levels of society. Especially likely to go unreported is abuse of women and children of color and of others outside the majority culture. Social and economic barriers and inequities, especially those that affect African Americans and other ethnic minorities, have significant effects on the rates of interpersonal violence, yet those same barriers lead to fear of reporting and limit access to help.

No specific profiles exist of those who perpetrate family violence, because, like their victims, they are a heterogeneous group. No one can say exactly why one person in a family may turn to violence while another in the same family does not, but the research suggests that a constellation of risk and resiliency factors influences the complex phenomena of family violence. Risk factors include specific sociocultural and interpersonal influences and factors such as alcohol and other drug abuse and a history of previous violence. Some people exposed to risk factors are resilient, however; and because of their psychological hardiness, they appear to be less vulnerable to the effects of violence.

Societal attitudes and practices regarding violence also have an influence on the risk of family violence. The presence of guns in the home increases the risk that a homicide will occur, and viewing violence in the media significantly affects attitudes and behaviors about violence. Research has shown that heavy viewing of violence on TV by children increases aggressive behaviors, and those behaviors persist into adulthood.

Society, in turn, reaps the terrible fruit of family violence. Violence in the home may well be the learning ground for later violence in other social settings and in other interpersonal relationships. For the victim and the family, violence and abuse may lead to destructive long-term psychological and physical consequences. Beyond the family, violence has serious economic and social consequences in society.

Adult Victims

Violence against adult family members may occur at any stage of family life, but it can be thought of broadly as occurring within four contexts: in dating relationships, during marriage or partnership, after separation, and against elders in the family. Violence that begins when a couple is dating is likely to continue and to escalate when the couple lives together or marries.

Battering is a pattern of physical, sexual, or psychological abuse in intimate relationships. Men batter women far more frequently than women batter men. Boys who witness or experience violence in their own homes as children are at major risk for becoming batterers. Alcohol use, especially binge and chronic use, is strongly associated with battering and its more serious aftermath, but it does not cause the violence. Both victims and perpetrators under report their use of nonprescription drugs.

Many people believe that a battered woman should leave a relationship with a man who batters them, but the violence does not necessarily stop when the relationship is terminated. Couples are particularly vulnerable during periods of separation and divorce. The risk of serious or lethal violence may actually increase after separation. When a marriage ends in divorce, the legal system may become a symbolic battleground where the batterer continues to abuse. Women who have been battered exhibit a range of measurable psychological effects. They generally resist their batterers in some way, but a variety of obstacles impede their attempts to avoid or escape the violence.

In addition to the pattern of physical, sexual, and psychological violence, elder abuse also includes emotional or psychological abuse or neglect, or financial and material exploitation of an older person by someone who has a special relationship with the elder. The abuse may take place in the older person's own home or in the home of a caregiver. Elder abuse is significantly under-reported, and little information is available to suggest how culture and ethnicity affect the likelihood of elder abuse or to describe the characteristics of perpetrators and victims. The majority of perpetrators of elder abuse are family members, and a surprisingly large number of male partners continuing their battering throughout the relationship. The majority of perpetrators of elder abuse are family members, usually adult children, but standard reporting systems do not reveal the extent of battering among elderly couples. Women are most often the caregivers for elderly persons and are reported most as perpetrators of abuse; however, when cases of neglect are removed from the statistics, men are the most frequent perpetrators of physical abuse against elders.

Child Victims

Tragically, child victims are vulnerable both to abuse within their families and to the failures of the systems intended to protect them. Historically, children have been regarded as the property and responsibility solely of their parents; this philosophy, however, places children of abusive parents in considerable danger. Public agencies and professionals have been given the authority to act to protect children, but because of resource scarcity and procedural issues, child protection agencies are not always able to intervene swiftly and decisively, much less to provide treatment or prevention programs to end the child abuse and maltreatment.

Child abuse occurs across all segments of the population, but affluent middle-class abusers may be less likely to be the subject of formal abuse reports. Although poverty may be the most significant risk factor for children, other factors also seem to put children at risk. These factors include family structure, being unwanted, resembling someone the parent dislikes, and having physical or behavioral traits that are different or that make the child especially difficult to care for. Parents are more likely to maltreat their children when the parents abuse alcohol and drugs, or when they have been sexually abused as children. Abused children may show a variety of initial and long-term psychological, emotional, and cognitive effects, but not every child demonstrates such long-term effects. Children who are exposed to parental violence, even if they themselves are not the targets of this violence, have reactions similar to those of children exposed to other forms of child maltreatment.

When abused children are not given appropriate treatment for the effects of abuse, the lifetime cost to society per abused child is very high. For example, adult survivors of child abuse make up a large percentage of adults who seek psychotherapy and other mental health treatment. These survivors may demonstrate significant long-term effects of the trauma, especially if they received no helpful interventions at the time of the abuse. In their adult relationships, frequently survivors of child abuse are battered by their partners and exploited by other adults in positions of trust. Resolving the symptoms in adult survivors of child abuse may require treatment that deals with the original trauma as well as its after effects.

Intervention and Treatment for Victims

To mitigate both the individual and societal effects of family violence, appropriate treatment must be widely available. Intervention and treatment efforts must be customized to meet the complex needs of many individuals who are victims of family violence. Psychologists have developed new models for intervention and treatment for each kind of violence and for families in which multiple forms of abuse and trauma occur. Recent treatment techniques emphasize the strengths that victims have developed to cope with abuse and maltreatment. Families with the greatest need often do not have access to high-quality treatment services by professionals trained to understand the effects of violence. In addition, people who have been severely traumatized through childhood abuse may need inpatient or long-term outpatient psychotherapy, which may not be available because of financial limitations.

Interventions for battered women often have been designed by community-based battered women shelters and advocacy groups, sometimes with the collaboration of psychologists. Initially a place of safety and support, shelters for battered women now often serve as the locus for a network of legal, psychoeducational, and social services for the woman and, increasingly, for her children as well.

Much more must be done to safeguard the welfare of abused children, both in the immediate aftermath of a report of child abuse and for the long term. The most common intervention for abused children is to remove them from their homes and place them in other environments and, eventually, foster care. This is not always a useful strategy and often may not even be safe, because children may be at risk for abuse by adults and by other children while living in foster homes. Promising alternative approaches include the placement of a helpful person in the child's own home.

Specialized interventions for victims of elder abuse or neglect are based on the principle of invoking the least restrictive alternative in determining environmental and legal protections. The problem of elder abuse is complex, however, and new forms of intervention are needed to respond to elder abuse as a part of the continuum of violence within a family.

Treatment for Perpetrators

Treatment of those who perpetrate family violence is essential, not only to end current violent behavior but to prevent future violence by the abuser. A variety of methods are used to assess and treat perpetrators of family violence, depending on the clinician's theoretical orientation. Researchers have not yet concluded that any approach is significantly more effective than others, assuming equivalent training of the providers and a comprehensive treatment strategy. Most treatment programs include some type of cognitive-behavioral psychotherapy techniques, although the specifics vary with the types of abuse for which the perpetrator is being treated. Treatment must address the perpetrator's use of power and control as well as attitudes and perceptions that support acts of violence.

Legal Issues

Most victims of family violence will have some contact with the legal system that is not well designed to handle such cases. In addition, inequities in the application of the law, racial and class bias, and inadequate investigations have harmed rather than helped many families. The low priority given to funding for implementation of child protection laws results in a legal system that frequently fails to work. Many battered women find themselves in dangerous positions because the courts often do not give credence or sufficient weight to a history of partner abuse in making decisions about child custody and visitation. Racial bias often influences the court's decision about whether to order treatment or to imprison offenders.

Abuse at the point of and after separation is so serious that courts must pay attention to ways of keeping battered women safer. Researchers indicate that the use of mediation is not appropriate when family violence is an issue. Child custody and visitation decisions must be made with full knowledge of the previous family violence and potential for continued danger, whether or not the child has been physically harmed. Most lawyers, judges, and others in the justice system are not trained in the psychology of family violence and abuse.

Future Directions

Because family violence has been a discrete area of study for a relatively short time, there are still gaps in the knowledge about ways to prevent family violence. There is general agreement that prevention efforts are needed to address the societal conditions that contribute to family violence, and intervention and treatment efforts must take place in every community if family violence is going to be reduced or eliminated.

Psychology has a key role to play in building the community-based coalitions that can prevent and treat family violence. The best way to promote violence-free families is to stop the development of abusive behavior, especially in boys and men; to strengthen and empower potential victims to resist or avoid victimization; and to change the environment that promotes the use of violence.

A single complimentary copy of the 156-page report can be obtained by writing to:

 

Public Interest Initiatives
American Psychological Association
750 First Street, NE
Washington, DC 20002-4242

202/336-6046

The cost for each additional copy is $5.00, payable in advance. Please make checks payable to the American Psychological Association.

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