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Psychiatric Social Work Practice With Victims Of Domestic Violence

domestic violence

TW: Mentions of domestic violence

Protection of Women from Domestic Violence Act, 2005 defines a victim of domestic violence as,

“an aggrieved person which means any woman who is, or has been, in a domestic relationship with a person who live or have lived at any point of time together in a shared household when they are related by consanguinity, marriage or through a relationship in the nature of marriage, adoption or are family members living as joint family and who alleges to have been subjected to any act of domestic violence such as physical, sexual, verbal, emotional, and economic abuse by her partner or family members residing in a joint family.”

The act identifies four different subtypes of domestic violence: physical abuse, sexual abuse, verbal and emotional abuse, and economic abuse. Given rising levels of violence against women United Nations has adopted “Orange the World: End Violence against Women Now!” as this year’s theme to raise awareness, promote advocacy and create opportunities for discussion on challenges and solutions.

Given rising levels of violence against women United Nations has adopted “Orange the World: End Violence against Women Now!”

In the case of domestic violence, primarily men are seen as perpetrators. Though men also experience domestic violence in societies where patriarchy prevails, domestic violence is usually associated with women as victims. Therefore this article will focus on domestic violence perpetrated against women only.

Studies related to domestic violence in India demonstrate that domestic violence is associated with education, employment status, caste, religion of women and sex of the firstborn child. India shares a significant global domestic violence burden, requiring sustained attention and efforts to deal with it.

Domestic violence is a public health concern and has adverse effects on women’s physical and mental health. Therefore, Psychiatric Social Workers have a significant role in the issues that arise out of this leading public health problem.

Domestic violence is a public health concern and has adverse effects on women’s physical and mental health.

The Potential Factors Behind Domestic Violence:

Cultural factors: It encompasses gender-specific socialization, cultural definitions of appropriate sex roles, belief in the inherent superiority of males, values that give men proprietary rights over women and girls, customs of marriage like dowry, acceptability of violence as a means to resolve conflict are cardinal factors that result into domestic violence against women.

Economic factors: Women’s economic dependence on men, poor implementation of laws regarding inheritance, property rights and maintenance after divorce or widowhood, limited access to employment in formal and informal sectors and limited access to education for women contribute to domestic violence.

Legal and Political factors: It is pertinent to mention that low levels of legal literacy among women, cruel treatment of women and girls by police and judiciary, under-representation of women in politics, notions of the family being private and beyond the control of the state, risk of challenge to status quo laws also contribute to domestic violence against women.

Domestic Violence Can Lead To These Consequences:

Physical trauma: Domestic violence can lead to physical injuries, gynaecological problems, unwanted pregnancies, miscarriages, internal organ damage, potentially leading to death which should be viewed as a homicide.

Psychological trauma: Psychological trauma can manifest in several forms like Post Traumatic Stress Disorder, anxiety, depression which can also impact the physical health of the victim, causing cardiovascular disease and hypertension.

Role Of Psychiatric Social Workers To Help Victims of Domestic Violence:

The role of the psychiatric social worker is to assist the victim in understanding what is happening, coping with significant trauma and explaining the options available to the victim so that the victim can make an informed decision about what she would like to do in the given circumstances.

Whatever decision the victim makes, staying in the abusive relationship or leaving, the role of the psychiatric social worker is to support the victim in that choice and assist her in dealing with the consequences that flow from that choice.

Psychiatric social workers need to be very careful about assigning a psychiatric diagnosis as the records can be subpoenaed and be used against the victim in court. A victim of domestic violence can experience and show emotional, behavioural and cognitive responses to abuse which should not be misinterpreted as psychiatric in origin instead as a consequence of abuse.

Psychiatric social workers need to assess the victims for potential suicide. Setting for suicide entails carefully asking questions to elicit a victim’s thoughts, possible suicide plans, and means of carrying out these plans.

How Can A Psychiatric Social Worker Help A Domestic Violence Victim At The Individual Level:

Validating: A psychiatric worker needs to validate the thoughts and feelings of the victim, but not always their behaviour. In the process of supportive care, a psychiatric social worker should continue to inquire about the abuse and its impact and help victims reassess their situation and safety needs, make use of resources, and reconsider choices about their lives.

Reassuring: Intervention begins by letting a victim know that you are concerned, that she is not alone, that she doesn’t deserve the abuse, and that help is available. However, reassurance should be used to a reasonable extent to avoid generating false hopes in a victim.

Reframing: Reframing can help a victim to look at the problem from a different perspective. The purpose behind reframing is to generate hopefulness in the face of challenges due to abuse.

Encouragement: A psychiatric social worker needs to encourage the victim to undertake small steps to deal with the challenges arising out of domestic abuse. Encouragement can be a powerful technique as research demonstrates that encouragement helps victims believe that their small steps can lead to positive outcomes. It’s also unethical to push a victim for taking giant steps, which can be emotionally draining.

A psychiatric worker needs to validate the thoughts and feelings of a domestic violence victim, but not always their behaviour. | Photo by Debsuddha Banerjee/Pacific Press/LightRocket via Getty Images

Educating The Victim About Available Legal Options:

Victims of domestic violence should be informed that domestic abuse is a crime and that help from the legal system is available. A psychiatric social worker should ask the victim if she wants you to call the police.

If she does, offer to call them or assist her in doing so. If a victim is ambivalent about calling the police, a psychiatric social worker can discuss the possible advantages and disadvantages of filing a police report.

If she chooses not to make a police report at this time, her decision should be respected. However, in certain conditions where reporting to police is mandatory, it is essential to inform the victim of this requirement, preferably at the beginning of the evaluation.

Conclusion:

Domestic violence happens in every community, as well as in every socio-economic group. Domestic violence requires the attention of early identification and intervention, which requires coordinated support from a whole range of agencies. The prognosis for victims of domestic violence is better for individuals who have a robust support system; hence participation in support groups needs to be encouraged by psychiatric social workers.

Tanveer Wani is a Psychiatric Social Worker and an alumnus of the National Institute of Mental Health & Neurosciences, Bengaluru. He can be reached at tanveer.nimhans@gmail.com

If you or someone you know is facing domestic violence you can reach out to the following places for support:

  1. Domestic Violence Helpline: 1800 212 9131
  2. Swayam: +91 98307 72814
  3. Aks Foundation: +91 8793 088 814
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