What are some different kinds of abuse?
Control of Resources
What are some assessments for child abuse?
o Bruises/Wounds not consistent with child’s developmental or physical age.
o Fear of Adults
o Typically does not cry/show emotion when examined
o Regressive behavior
What are some partner abuse assessments??
o Injuries, accidents and inconsistent stories
o Frequent visits to ED
o Ask client “Do you feel safe?”
o Assess for Safety Plan
What are some assessments for elder abuse?
o Inconsistent injuries
o Bed sores
o Frequent Illness
o Withdrawn, passive and dis-engaged
What are some interventions for child abuse?
o Report any suspicions of abuse
o Assure client that they are not at fault
o Tell client that they are safe
o Develop therapeutic relationship
What are some interventions for partner abuse?
o Provide physical and emotional support
o Provide information regarding shelters and community resources
What are some child neglect assessments?
o Physical appearance un-kept, malnourished, hoards food
o Frequent absences from school and activities
o Signs of exhaustion due to unregulated sleep schedules
What are some elder neglect assessments?
o Physical appearance un-kept
o Smell of urine or feces
What are some interventions for sexual abuse?
· Assess for physical injury
· Stay with client
· Re-assure client they are safe
· Client may seem withdrawn, quiet and un-communicative. This is a normal response to a traumatic event
· Remember your client is the focus!
· Signs of PTSD may occur such as flashbacks, “out of body experiences” and development of fears or phobias
What are some characteristics of violent families?
(Never get invited to their house)
Power and control by abusive member
(Control is EVERYTHING)
(Very common by both abuser and victim)
Intergenerational transmission process
Who is most at risk for violence and abuse?
Poverty or unemployed
communities with inadequate resources
Social isolation of familie
What is the cycle of abuse?
Tension Building Phase
What does SAFE stand for in partner abuse?
S - Stress and Safety
A - Afraid and Abused
F - Friends and Family
E - Emergency Plan
What are some treaments/interventions for partner abuse?
What are some assessment for sexual abuse of child?
What are some interventions for sexual abuse of a child?
Teach appropriate Boundaries
Work on underlying causes
Assure they and their families are safe
What are 3 types of crisis?
Crisis due to mental stage (midlife crisis)
What is the plan, outcome and intervention for crisis?
Deal with immediate stressors
Return to normal function
What are some physical assessments for Anorexia?
o Yellowed skin color
o Poor skin turgor <3
o Decreased body temperature
o Possible Dysrhythmias
o Decreased body weight ( less than between 75%-85% of ideal weight)
What are some behavioral/psychosocial assessments for anorexia?
o Family Enmeshment
o Unrealistic view of appearance
o Family Sexual Abuse (possible)
Preoccupation with food, calories exercise
o Rigorous exercise rituals
o Need to be in control
What are some physical assessments for Bulimia?
o Normal weight or slightly overweight
o Russell’s sign ( callouses on back of hands)
o Enlarged parotid glands (chipmunk face)
o Dental caries/Enamel erosion
o Electrolyte imbalances
o Constipation (due to laxative abuse)
o Chronic sore throat
What are some behavioral/psychosocial assessments for Bulimia?
o Outgoing, friendly, “life of the party”
o Guilt and Shame
o Aware of Problem
What are some interventions for anorexia?
o Physical First!!
o Monitor for Re-feeding Syndrome
o Monitor for Dysrythmias
o Monitor weight, I &O and Vital Signs
Remember weight gain is slow and should not be over-emphasized. What is our goal?
o Provide Time for Journaling
o Involve Family in Therapy
o Provide objective feedback for physical appearance/body image disturbances
o Encourage client decision making to allow for sense of control
What are some interventions for Bulimia?
o Physical First!!
o Obtain and monitor baseline Electrolyte levels
o Monitor elimination patterns
o Monitor for 1 hour following meals if actively purging
o Encourage positive self-image
o Provide information regarding health risk
o Administer Prozac if ordered
What is a medicine that could be used for anorexia or bulimia?
(Works for OCD and can be given in higher doses)