Mental Health and Domestic Violence: 'I Call it Symptoms of Abuse'

Correspondence to Dr Cathy Humphreys, School of Health and Social Studies, University of Warwick CV4 7AL, UK. E-mail: c.f.Humphreys{at}warwick.ac.uk Summary Research evidence now clearly shows a direct link between women'sexperiences of domestic violence and heightened rates of depression,trauma symptoms, and selfharm. A research project based in Women'sAid outreach services provides further evidence of women's experiencesof severe emotional distress. However, their experiences ofmental health services were often found to be negative. A numberof practices within the medical model of mental health wereunhelpful including: the lack of recognition of trauma or provisionof trauma services; making the abuser invisible through focusingon the woman's mental health reified from her experiences ofabuse; blaming the victim; offering medication rather than counsellingsupport; the negative, consequent effects on child contact andchild protection proceedings if the woman is labelled with mentalhealth problems. Alternatively, women found services, oftenin the voluntary sector, helpful when they provided the followinginterventions: helping women name domestic violence; activelyasking about the abuse; attending to safety planning; respondingto women's specialist needs; and actively working with womento recover from abuse experiences. Support for her childrenwas also seen as very helpful. Implications for practice includethe commissioning of further services in the voluntary sector,addressing the inadequate response within the medical model,and increasing the sensitivity of responses to women's emotionaldistress across all sectors.     

Domestic Violence and Substance Use: Tackling Complexity

Domestic violence and substance use are issues which pervadesocial work practice, yet are often on the margins of the knowledgebase for practitioners and their managers. This article providesan overview of the literature on substance use and domesticviolence, highlighting the problems with the separation of bothpractice and policy in these areas. Research on substance useand the needs of women survivors of domestic violence are explored,alongside the more substantial literature on perpetrators ofdomestic violence and patterns of substance use. The problemsof a simplistic analysis which suggest that there is a causallink between substance use and domestic violence are highlighted.Using data from an on-going research project, the sources ofthe continuing and dysfunctional separation of work in theseareas are explored.     

Theory in the Bedroom: A Report from the Macquarie University AIDS and Heterosexuality Project

The political and social questions raised by AIDS/HIV are particularly complex ones, concerned as they are with changing the sexual practices of both the heterosexual and the homosexual population. In many ways these questions have tested the limits of orthodox policy-making processes. The Macquarie University ‘AIDS and Heterosexuality’ project is one of a small number of research projects which have attempted both to analyse critically existing AIDS policy assumptions and to provide alternative conceptual methods for understanding the processes of changing sexual practices. The Macquarie University project is particularly concerned with the way that women have been represented within mainstream policy: this paper describes this representation and presents some alternative suggestions for understanding the place of women in preventing transmission within the heterosexual population.     

'The Tip of the Ice Berg': Children's Complaints and Advocacy in Wales--An Insider View from Complaints Officers

This paper is based on findings of a Welsh Assembly Governmentfunded review of children’s independent advocacy servicesin Wales with reference to their involvement in complaints madeby children, or by their parents or carers on their behalf,about local authority social services. It draws, primarily,upon qualitative interviews with local authority children’scomplaints officers, whose task is to receive complaints orconcerns, field these to appropriate social services staff,maintain oversight of their progression and keep complainantsinformed of developments. The paper describes the challengesthat complaints officers perceive children encounter in movingcomplaints forward, especially in a context where independentadvocacy services are involved and where these services areviewed with some suspicion by social services staff. It suggeststhat complaints officers play a pivotal part in managing thesometimes contested and complex interface between service providerand child and may do so from a position of limited authorityand influence. The role of complaints officers in engaging withcomplainants and their advocates, and with those colleaguesimplicated in complaints, has rarely been the topic of research.This paper provides accounts from these key staff that helpilluminate the tensions and difficulties that can enter thechildren’s complaints process.     

Domestic violence and child protection: exploring the role of perpetrator risk assessments

This article explores the issue of severity in relation to domestic violence and provides a number of reasons for the necessary engagement by workers with such a contentious issue. The specific role that the assessment of the risks posed by the perpetrator which has now developed in some police forces in the United Kingdom is examined, and its relevance to child welfare intervention discussed. A range of factors are identified that heighten the risks of increased violence. These include prior sexual assault; stalking and controlling behaviour; substance misuse and mental‐health problems; separation and child contact disputes; pregnancy; escalation including the use of weapons and psychological abuse; attempts and threats to kill; child abuse; isolation and barriers to help‐seeking. The ways in which perpetrator risk assessment can be used to inform the filtering of referrals to the statutory child care agency, enhance multi‐agency working, provide a structure for the assessment of the perpetrator, enhance partnership‐working with survivors (usually women) and inform the protection strategies for workers are explored.     

Constructing a Life That Works: Part 2, An Approach to Practice

The 1st article (C. Campbell & M. Ungar, 2004) of this 2‐part exploration of postmodern approaches to family therapy and narrative approaches to career counseling explored the differences between traditional trait and factor counseling models and postmodern approaches using life narratives and social constructionism. In this 2nd article, the authors discuss 7 aspects of their practice as postmodern career counselors that ask clients to (a) know what you want, (b) know what you have, (c) know what you hear, (d) know what constrains you, (e) map your preferred story, (f) grow into your story, and (g) grow out of your story. Several case studies demonstrate the applicability of these theories to practice.     

Termination: When the therapist leaves

Despite an expansion of our knowledge about loss and grief little has been written on the experience and techniques employed during a forced termination. This article examines the theory, applications of theory, and transference/countertransference issues surrounding the author's experience as she moved to another state and transferred or terminated with her patients.Paper presented at the Fourteenth Annual Symposium of the New York Center for Psychoanalytic Training, March 1989.     

Police-reported intimate partner violence during pregnancy: who is at risk?

The objective of this retrospective cohort study was to determine risk factors for police-reported intimate partner violence (IPV) during pregnancy among Seattle residents with a registered live birth or fetal death in Washington State. Logistic regression was used to calculate adjusted odds ratios (aOR) and 95% confidence intervals for the association between demographic, behavioral, and obstetric history risk factors and any, physical, and non-physical police-reported IPV. Significant risk factors for any police-reported IPV during pregnancy included unmarried status (aOR 2.36), public health program use (aOR 1.33), smoking or alcohol use during pregnancy (aORs 1.45 and 1.80, respectively), previous live birth (aOR 1.39), and previous spontaneous or induced abortion (aORs 1.39 and 1.34, respectively). Risk factors for physical IPV varied only slightly from those for any IPV, and fewer factors were associated with nonphysical IPV. Demographic, behavioral, and obstetric history risk factors are potential markers of IPV risk during pregnancy.     

Clustering transformed compositional data using K-means,with applications in gene expression and bicycle sharing system data

Although there is no shortage of clustering algorithms proposed in the literature, the question of the most relevant strategy for clustering compositional data (i.e. data whose rows belong to the simplex) remains largely unexplored in cases where the observed value is equal or close to zero for one or more samples. This work is motivated by the analysis of two applications, both focused on the categorization of compositional profiles: (1) identifying groups of co-expressed genes from high-throughput RNA sequencing data, in which a given gene may be completely silent in one or more experimental conditions; and (2) finding patterns in the usage of stations over the course of one week in the Velib' bicycle sharing system in Paris, France. For both of these applications, we make use of appropriately chosen data transformations, including the Centered Log Ratio and a novel extension called the Log Centered Log Ratio, in conjunction with the K-means algorithm. We use a non-asymptotic penalized criterion, whose penalty is calibrated with the slope heuristics, to select the number of clusters. Finally, we illustrate the performance of this clustering strategy, which is implemented in the Bioconductor package coseq, on both the gene expression and bicycle sharing system data.