PACTS Flashcards
(45 cards)
1
Q
define family violence
A
Any violent, controlling or threatening behaviour by past or present family members.
includes:
- Violent behaviour
- Threatening behaviour
- Controlling behaviour
- By any past or present family member
- Coerces another family member or makes them fearful
2
Q
who’s counted as family for family violence
A
- Present or past partners
- Parents
- Step parents
- Siblings
- Carers
- Grandparents
- Uncles and Aunts
- Others who are household member
3
Q
types of abuse
A
physical abuse sexual abuse emotional and psychological abuse neglect economic abuse spiritual abuse
4
Q
whats physical abuse
A
The use of physical force or objects against a person that results in physical injury eg pushing, hitting
5
Q
whats sexual abuse
A
Any completed or attempted sexual act, sexual contact or non-contract sexual interaction which includes penetration, touching a person inappropriately and exposure to sexual activity, filming or prostitution. Eg ouched when they don’t want to be touch, rape
6
Q
whats emotional abuse
A
any behaviour that conveys to a person that he/she is worthless, flawed, unloved, unwanted, or valued only in meeting another’s needs. Eg belittle
7
Q
whats neglect
A
failure to meet a persons basic physical, emotional, medical or educational needs. Eg not providing food, shelter, financial resources, medical resources
8
Q
whats economic abuse
A
not having access to finances
9
Q
whats spiritual abuse
A
not being able to practice spiritual activities
10
Q
who is at risk of family violence
A
- Women > men;
- Pregnant women > non-pregnant women;
- Young women > older women;
- Indigenous > non-indigenous populations;
- Culturally and linguistically diverse groups > non-CALD groups;
- Women with intellectual or physical disabilities > women without disabilities;
- Lesbian women > gay men;
- Women separating from their partners > Non separated women.
11
Q
things that make you think o intaminte partner violence
A
- Recurrent presentations of herself or with her children
- Anxious
- Ashamed or evasive
- Mentions in passing partner out of sorts or a bit angry sometimes
- Often drop cues to see if GP willing to listen “I’ve had a bad week”
12
Q
The role of healthcare professionals family violence
A
Paramedics: first point of contact for victims of violence. Can gather additional information from home environment.
Nurses, maternal and child health nurses and midwives: provide home visits, important during and shortly after pregnancy, issues during labour room or postnatal care can be observed.
Social workers: supporting parenting, educating young people and come into contact with victims.
Physio and OT: supporting children and families through rehab and ongoing role with mental health issues or physical disabilities. Clients build trust through ongoing relationship which is important for women and children of high risk.
General practitioner: major healthcare professional women talk to, assist the process of leaving or escaping family violence.
13
Q
what to do if there is signs of family violence
A
ask about violence
- no: are there clinical symptoms of concern
- no provide information on IPV in private area
- yes: give information on services and do not pressure to disclose
- Yes: offer first line support, interveiw in private, ensure confidentiality, give practical care, ask about history, help access information, mobiliise supot
- refer to treatment, psychological therapy, IPV advocacy, child witness to psychological therapy
14
Q
when to think of abuse with Women with disabilities/the elderly
A
- Unexplained trauma
- Untreated injuries
- Increased visits, calls or attendances
- Symptoms of poor nutrition
- Symptoms of poor hygiene
- Inadequately treated medical problems
- Increased agitation
15
Q
contributing factors to elder abuse
A
- Abuser is usually a family member
- Increasing dependency of the elder family member;
- Psychopathology of abuser;
- Alcohol and drug use of abuser;
- PH domestic violence;
- Stress for the carer.
16
Q
time of risk of family violence
A
- Natural disasters: drought, fire, cyclones; due to increased stress, perpetrators loss of control (loss of house, employment)
- Pregnancy: during pregnancy and shortly after birth associated with additional stress.
- War and conflict;
- Refugees and migration;
- Times of increased stress e.g. Financial loses, bankruptcy.
17
Q
indicator of family violence in adults
A
- Appear nervous
- Describe partner as controlling
- Seem uncomfortable or anxious in presence of partner
- Provide unconvincing explanation for injuries
- Display bruises
- Signs of neglect
18
Q
indicator of family violence in children and young people
A
- Bruises
- Fractured bones
- Poisoning
- Wearing long sleeves on hot days
- Displaying fearfulness towards parents/strangers
- Appearing passive
19
Q
Indicators of emotional abuse in children and young people:
A
- Low self eseem
- Withdrawn
- Highly anxious
- Difficulties relting to adults and peers
20
Q
What is risk assessment in family violence?
A
- A process of evaluating people and situations to determine:
- The presence or otherwise of safety and risk indicators for family violence
- The factors affecting the severity and the likelihood of the risk; that is, of family violence
- The possible consequences of the risk
- The options available to people to seek and maintain safety
- How a safety plan may be developed
21
Q
Why would I undertake a risk assessment?
A
- You are in a professional position where you can take action to assist people to be safe
- You have identified risk factors (see unit guide module 2)
- The patient/client is likely to trust you, particularly if they have disclosed violence to you
- To assist the client/patient to understand their risk and feel confident to seek support
- You have a duty of care
22
Q
A basic level of risk assessment requires you to:
A
- Identify possible indicators of violence in women and/or their children
- Develop a basic assessment of risk and safety
- Make relevant, appropriate and timely referrals to organisations such as specialist FV services, the police or child protection, depending on the level of risk accessed to exist.
23
Q
How do I undertake a basic risk assessment? and examples of questions
A
- Check what resources your organisation uses for risk assessment
- Use existing models and frameworks, such as the CRAF, to guide your risk assessment
- Adapt or create your own risk assessment template
- Ensure your risk assessment processes are consistent across time and across clients/patients
- Integrate risk assessment questions into your usual communication& conversational style with clients/patients.
Examples of questions you might ask - Will depend on how well you know the patient/client; the indicators you have observed; and other specific factors.
- How are things at home?
- Is there anything happening that might be affecting your health?
- When I see injuries like this, I wonder if someone could have hurt you?
24
Q
Risk factors from perpetrator
A
- History of violent behaviour, within the family and outside the home
- Access to lethal weapons
- Anti-social and aggressive behaviour
- Relationship instability, separation, divorce
- Life stressors such as unemployment
- Violent behaviour in family of origin
- Mental illness/mental health stressors
- Resistance/lack of motivation to engage with services
- Violence-supportive attitudes
- Rigid gender stereotypes & expectations
25
mental health after violence
- Depression
- Anxiety
- PTSD
- Suicide
- Eating disorders
- Somatisation disorders
- Personality disorders
26
Physical health after violence
* Unexplained gastrointestinal symptoms
* Unexplained pelvic pain
* Chronic pain
* Poorer overall physical health
* Traumatic injury
* CNS: headaches, poorer cognitive function and hearing loss
* Repeated health service use without a clear diagnosis
27
Reproductive outcomes
* Higher rates of pregnancy at a younger age
* Higher rates of unintended pregnancy
* Higher rates of termination of pregnancy
* Higher rates of multiple termination
* Prematurity
* Low birth weigh
28
Health behaviour after violence
* Increased drug use
* Increased alcohol use
* Increased smoking
* Higher rates of obesity
* Poorer rates of health screening
* Late antenatal care
29
Interventions that work
• Psychological interventions
CBT Adults with PTSD no longer in violence relationship Psychological “first aid” support for acute distress
Relaxation and physical activity for those with depressive symptoms Brief structured psychological treatments
- Interpersonal therapy
- CBT
- problem-solving treatment
• Antidepressant and benzodiazepam should not be used as an initial treatment in the absence of a mod-severe depressive disorder
30
three steps of questions to ask
Step 1: asking broad questions
Board questions can be an effective starting point in gauging whether violence occured.
Includes;
- How are things at home
- How are you and your partner relating
Step 2: asking specific questions
If client indicated willingness to talk you can ask more specific questions
Includes
- Im a little concerned because … id life to ask you some questions about how things are at home is that okay”
- When I see injuries like this I wonder if someone could have hurt you
Step 3: asking direct questions
If client further indicates a willingness to talk
- Are you ever afraid of someone in your famly or household
- Has someone in your family ever threated you
31
questions to ask younger children
- Sometimes children are good at keeping secrets. What type of secretes do you think children are good at keeping.
- Some children can get scared at home, what do you think makes them scared
32
how to response to discolours of violence
- Provide safe, non-judgemental setting that is respectful and sensitive to a patients, their feelings and experiences is paramount in ensuring appropriate environment for patients to disclose violence.
33
internal barriers to disclosing violence
Internal barriers: refer to ways individuals are experiencing violence internalise this violence
- Feelings of shame
- Self blame
- Feelings of responsibility
- Shame of martial or relationship failure
- Belief that family violence is a private matter
34
external barriers to disclosing violence
External barriers: refer to expected or actual responses from informal and formal support to disclosures of violence
- Fear of stigmatisation from others
- Fear that others will not believe them
- Belief that they will be judged or criticised
- Belief that no help is available
- Fear of retaliation violence
35
whats Trauma informed care (in primary health care
Service provision which acknowledges and makes changes to its delivery because of the high prevalence of traumatic experiences for patients and clients;
• Primary health care professionals who have a thorough understanding of the neurological , physical, psychological and social effects of trauma;
• Primary care health professionals who act to rebuild a sense of control and empowerment with their patients or clients
36
key principles for trauma informed practice
- Safety – Physical and emotional;
- Trust – Usually built over time;
- Empowerment and skill acquisition;
- Maximise patient/client choice and control;
- Collaboration – sharing power and control;
- Building positive relationships;
- Knowing about trauma and how to act;
- Accepting patient/client complexity;
- Care for staff
37
tips for responding to disclosure of violence
- Listen: being listened to and providing an opportunity to speak about experience can be empowering for someone who has experienced family violence.
- Communicate belief: important in validating the patients experience of violence “that must have been very frightening for you”.
- Validate the decision to disclose: acknowledge difficulties and challenges they have overcome in telling their experience. “it must have been difficult for you to talk about this”.
- Emphasise that the violence is unacceptable: reinforce that the violence that they have experienced is unacceptable and not their fault.
- Offer asssitance and help: it is important to inform patients of options for help. Inform range of services
38
What not to say
Do not place blame or responsibility on the individual
- “what could you have done to avoid the situation?”
“why did he/she hit you?”
- “why do you stay with a person like that?”
39
What to do if they don’t accept assistance
:
- Provide them with contact details for specialist family violence service
- Consider discussing the idea of safety planning
- Try to arrange ongoing opportunities to monitor and discuss violence perhaps through future appointments
40
Developing a referral and resource network:
Being aware of:
- Legal protections and options available to patients or clients as well as what they can expect when contacting the police and have further contact with the criminal justice system
- Counselling and support groups for individuals who are victims or perpetrators of family violence
- Substance abuse and mental health programs
- Childcare services
41
whats the four types of management pathways
Pathway 1: If client is in immediate danger and is willing to receive assistance you can refer them to the police and or a specialist family violence service for further assessment.
Pathways 2: if client is not in immediate danger and is wiling to receive assistance you can refer them to a specialist family violence service for further assessment
Pathway 3: if patient is in immediate danger but is not willing to receive assistance you can consider referral to the police
Pathway 4: if client is not in immediate danger and is not willing to receive assistance you can provide information. About help that is available and monitor the situation closely.
42
whats specialist family violence service
```
Provides a holistic response to individuals who have experience family violence, including practical, legal, financial and emotional support
In addition to specialist family violence service other services that might be referral include:
- Outreach family violence services
- Emergency accommodation and refuges
- Counselling programs
- Family relationship centres
- Drug and alcohol services
- Mental health services
```
43
personal strategies for looking after yourself
- Maintaining a balance in life
- Maintain a positive outlook on life
- Promoting wellness and wellbeing though lifestyle choices such as relationships
- Creating and sustain connection with social support systems
44
professional boundaries for looking after yourself
- Creating clear boundaries between work and home
- Engaging in further training and clinical practice
- Maintaining professional development
45
organisational boundaries for looking after yourself
- Having a safe and secure work environment
- Taking adequate leave from work
- Engaging in team work to manage patients/clients who experience violence
- Utilising formal supports such as counselling, supervision, debriefing and employee assistance program
