Chapter 8 Sadly, domestic violence happens more often and to many more people than we think. Fear – for personal safety, of the unexpected, of stigma and of much more – can be paralysing for someone experiencing domestic violence and can prevent disclosure to a professional. Violence is never acceptable or excusable and those experiencing it will need to hear this. There are many reasons why women (and men) stay in abusive relationships. No matter what they are, those experiencing abuse are the experts in assessing their own safety and risk. Respecting this, and involving them in the process, will empower them to make healthy and lasting choices that improve their lives and help them exit the violent situation. This chapter outlines the role and expertise of community agencies and the different forms of advocacy that they carry out (see also Chapter 9). It considers the language you should use when identifying and responding to disclosures and it looks at the strength and resilience of the survivors themselves, who must be involved in any effective response to domestic violence. This will be considered in relation to you, the health care professional, who will best address domestic violence disclosures with effective partnerships and awareness of community work. It is difficult to hear stories of pain and suffering and to know how to support someone in danger. With the right supports from expert community agencies, listening and responding to domestic violence disclosures can help to positively change a woman’s life and those of her children. People working in health care can have a natural temptation to want to ‘fix’ the problems they encounter. However, domestic violence reaches beyond the realms of medical diagnoses and treatments and engages a community-integrated response. This chapter will shed some light on some appropriate methods of community partnership that you can utilise in your work. The most important element in community-based approaches to domestic violence is to keep the survivor’s safety central to any partnership or approach (see Figure 8.1). Figure 8.1 Model of community coordination with safety at the centre. Data from United Nations Coordinated Community Response Model, Centre to End Violence against Women and Girls, www.endvawnow.org (last accessed 12 February 2014). Domestic violence can be experienced by anyone. It is important to acknowledge that the central features are power, control and fear. These are mostly endured by women, and they endure them more frequently than their male counterparts. For this reason, gender-specific language is used in this chapter, although the principles are similar for same-sex and female-to-male violence (see Chapter 6). Advocacy on behalf of domestic violence survivors takes two forms: individual and strategic advocacy. The former looks at individual needs on a case-by-case basis and the latter considers the general political issues concerning large numbers of survivors. Most community agencies engage in both levels of advocacy, some focussing more in one area or the other. Advocacy is a key part of community work in the prevention of and response to domestic violence. Here, a woman is given a voice with which to express, request and receive appropriate care and responses to her needs. Research has found that intensive advocacy significantly reduces the risk of domestic violence, resulting in 67% of those who receive it remaining free of abuse (Howarth et al., 2009). Individual advocacy involves working directly with a survivor of domestic violence to make an effective plan of safety by accessing appropriate services and addressing individual needs (see Figure 8.2). An advocacy service can help to bridge the gap between a survivor’s needs and the varying services that may meet them. The individual issues and risks will be assessed by community agencies by reviewing with the individual her concerns, needs and desires for a future/safety plan. Community organisations specialising in domestic violence will engage with all of these services and coordinate their effective response to a survivor’s needs based on her plan of action. This is crucial to helping her to achieve the goals she sets out in a safe and expedient way, in an often chaotic and confusing web of services and procedures. Figure 8.2 Examples of advocacy bridging the gap between services and the needs of survivors. Advocacy is available to anyone experiencing domestic violence, regardless of their risk level. It is important to note that there are some services that provide service only to high-risk women. This is based on research into risk reduction. All stages of risk, however, are critical points of intervention, and low–medium risk levels can easily escalate. Strategic advocacy involves addressing broader issues of policy. It provides lasting improvements in policy and cross-sector partnerships that address issues of violence. Beyond engaging governments and responding to consultation papers, a community organisation will also engage local government bodies by offering training, attending meetings and linking into overall networking plans. This is done to improve other organisations’ levels of awareness and understanding concerning domestic violence and to create professional links with those who will be in contact with the same clients. Health care practitioners have the opportunity to form partnerships with the community. This is an excellent way of better understanding what community responses exist and how they might be engaged with when encountering domestic violence in their work. Preparation is critical; it is important to be equipped with suitable knowledge and tools before a crisis occurs. As a sympathetic practitioner, you will receive disclosures of domestic violence. Being prepared with knowledge of the available services will significantly increase the safety and support you can offer. Inevitably, you will not have the time or skills to address all of a woman’s needs and concerns, but knowing where to turn will ensure the best response. The words, tone and body language you use when approaching the subject are critical in determining whether a woman will feel safe enough to disclose to you (see Boxes 8.1 and 8.2).
Community-Based Responses to Domestic Violence
OVERVIEW
Background
Gender and language
Advocacy
Individual or personal advocacy
Strategic/political advocacy
Coordinated response: the practitioner and the community
Basicmedical Key
Fastest Basicmedical Insight Engine
