Psychiatric Mental Health Nursing by Videbeck

214 Unit 3 CURRENTSOCIAL ANDEMOTIONALCONCERNS

the states have laws requiring police to make arrests

for at least some domestic violence crimes (ABA Com-

mission on Domestic Violence, 2002). Sometimes after

police have been called to the scene, the abuser is al-

lowed to remain at home after talking with police and

calming down. If an arrest is made, sometimes the

abuser is held only for a few hours or overnight. Often

the abuser retaliates upon release; hence, women have

a legitimate fear of calling the police. Studies have

shown that arresting the batterer may reduce short-

term violence but increases long-term violence.

A woman can obtain a restraining order(pro-

tection order) from her county of residence that legally

prohibits the abuser from approaching or contacting

her. Nevertheless, a restraining order provides only

limited protection. The abuser may decide to violate

the order and severely injure or kill the woman before

police can intervene. In one study, 60% of women

reported acts of abuse after receiving a protection

order, and 30% reported acts of severe violence (ABA

Commission on Domestic Violence, 2002). Holt et al.

(2002) found that permanent protective orders were

less likely to be violated in the following 12 months,

but likelihood of abuse increased with temporary

protective orders.

Even after a victim of battering has “ended” the

relationship, problems may continue. Mullen et al.

(1999) reported that stalking,or repeated and per-

sistent attempts to impose unwanted communication

or contact on another person, is a problem. Stalkers

usually are “would-be lovers,” pursuing a relationship

that has ended or never even existed. About 40% of

stalkers in Mullen’s study refused to accept the end

of the relationship and continued to intrude in their

former partners’ lives.

Battered women’s shelters can provide temporary

housing and food for abused women and their children

when they decide to leave the abusive relationship. In

Table 11-1

DOS ANDDON’TS OFWORKINGWITHVICTIMS OFPARTNERABUSE

Don’ts Dos

Don’t disclose client communications without the

client’s consent.

Don’t preach, moralize, or imply that you doubt the client.

Don’t minimize the impact of violence.

Don’t express outrage with the perpetrator.

Don’t imply that the client is responsible for the abuse.

Don’t recommend couples’ counseling.

Don’t direct the client to leave the relationship.

Don’t take charge and do everything for the client.

Do ensure and maintain the client’s confidentiality.

Do listen, affirm, and say “I am sorry you have been hurt.”

Do express: “I’m concerned for your safety.”

Do tell the victim: “You have a right to be safe and

respected.”

Do say: “The abuse is not your fault.”

Do recommend a support group or individual counseling.

Do identify community resources and encourage the

client to develop a safety plan.

Offer to help the client contact a shelter, the police, or

other resources.

Commission on Domestic Violence (1999). Domestic Violence Resources. http://www.abanet.org.domviol/stats/html.

Box 11-2

➤ SAFE QUESTIONS

• Stress/Safety: What stress do you experience in
  your relationships? Do you feel safe in your rela-
  tionships? Should I be concerned for your safety?


• Afraid/Abused: Are there situations in your rela-
  tionships where you have felt afraid? Has your
  partner ever threatened or abused you or your
  children? Have you ever been physically hurt or
  threatened by your partner? Are you in a rela-
  tionship like that now? Has your partner ever
  forced you to engage in sexual intercourse that
  you did not want? People in relationships/
  marriages often fight; what happens when you
  and your partner disagree?


• Friends/Family: Are your friends aware that you
  have been hurt? Do your parents or siblings know
  about this abuse? Do you think you could tell
  them, and would they be able to give you support?


• Emergency plan: Do you have a safe place to go
  and the resources you (and your children) need
  in an emergency? If you are in danger now,
  would you like help in locating a shelter? Would
  you like to talk to a social worker/counselor/me
  to develop an emergency plan?

Ashur, M. L. C. (1993). Asking about domestic violence:

SAFE questions. JAMA, 269,(18), p. 2367. © American

Medical Association.

when the woman is alone; the nurse can paraphrase
or edit the questions as needed for any given situation.

Treatment and Intervention

Every state in the United States allows police to make
arrests in cases of domestic violence; more than half