Interpersonal Violence

Case Study

When Claudia left her home country for the United States on a sponsored visa, she knew it was a ticket to a new life and a better education. Unfortunately, her dream would be cut short one year later after her visa expired and she was forced to marry Rodgers to protect her continued stay in the United States. Everyone advised her that it was the right thing to do and all she needed was do family planning to avoid getting pregnant for the man. Rodgers was very understanding and even agreed on using protection to prevent unwanted pregnancies. However, six months into the arranged marriage, they started having small arguments, which would continue as Rodgers blackmailed her with divorce and possible deportation. On top of it, Claudia has had to withstand sexual abuse from her husband who keeps on forcing himself into her. In the end, Claudia had to put up with the sexual assault, and as if that was not enough two months later, she realized that she was pregnant for her abusive husband. Torn between keeping the child and terminating the pregnancy, Claudia informed Rodgers who immediately forced her to have an abortion. As a strong Christian, this was not easy for her as she is now on the verge of depression on top of her domestic and sexual violence misery. Claudia does not want to leave her husband Rodgers because she feels that he is her only ticket to getting an education in the United States. Besides, she is afraid of facing deportation charges in case Rodgers files for a divorce and reports her to the authorities. When I met Claudia, she had come to the hospital as a patient seeking to have treatment for a sexually transmitted illness. Claudia, like so many other victims of sexual assault, find it hard reporting the matter to the authorities for fear of the perpetrators or the repercussions they are likely to face, not to mention stigmatization from the society. Most of them prefer seeking help anonymously, hoping they will be protected from their assaulters and get the necessary counseling. In light of this, this paper examines the feasible and viable option to intervene in Claudia’s case, while ensuring that her safety is guaranteed. It also evaluates various ways to deal with moral distress in case it becomes impossible for the officer helping Claudia to intervene in her case or if she is injured later.

Intervention

Domestic violence is a serious problem that usually has lasting and harmful effects on the victim, their family, friends, and the community. Awareness of domestic violence alongside its consequences has been on the rise among healthcare practitioners (Elliott, 2003). Unfortunately, although a majority of the caregivers and physicians agree to the seriousness of domestic violence, most of them do not have screen patients for the problem. The ultimate goal of domestic violence intervention is to stop it from happening in the first place and secondly to help the victim deal with the immense stress accrued from the trauma (Jenkins & Davidson, 2012). Nevertheless, the solutions to the domestic violence problems are as complex as the problem itself. In our case, the preventive strategy focuses on helping the victim and ensuring her safety. The strategies attempt to equip the victim with knowledge, awareness, or self-defense skills also known as risk education techniques to make sure that the perpetrator stops assaulting her while upholding her safety. Strategies focusing on the victim will also try to avert the risk of domestic violence to reduce the likelihood of the victim tolerating the vice.

Focusing on the Victim

Domestic violence poses several emotional and physical consequences for the victims. Emotional health consequences include post-traumatic stress disorders and depression, which are likely to affect the daily life of the victim requiring extended sessions of counseling and therapy. In order to prevent violence, it is important to implement various policies and programs that can avert the risk and increase protective elements. According to Anderson (2015), domestic violence usually takes different forms, and it is always all about power and control to the victim. However, in a bid to help victims of domestic abuse, the Affordable Care Act created new federal policies, to act as a guide in screening and assessment for domestic violence as an essential for women preventive health service. The Act recognizes the need to educate women on reproductive health issues including sexually transmitted infections, HIV, miscarriages, and other risky sexual health behaviors associated with domestic violence. In support of the efforts made by the Affordable Care Act, this study recommends providing health education materials on the implications of domestic abuse to women as a way of averting the risk. In addition to addressing the medical problems associated with the ladies health, it is also important to recommend victims to seek assistance for psychiatric symptoms. Another way that victims of domestic violence can be helped is through empowerment programs. It is assumed that by allowing access to information, education and other necessary support, victims can make informed decisions that reflect their needs. The empowerment program relies on knowledge dissemination, training, and counseling programs for a set of services that the victim can control such as risk minimization and post-victimization assistance. For this, an educational program within the community will need to be identified to empower the victim, where she can also interact with other victims of domestic violence. Encourage the patients to enroll in the local programs for abused women, which are provided free and are highly confidential. While there, the victim can also get help from local authorities and legal advice on the right way to approach her problem.

Follow-up Programs to Ensure Safety of the Patient

After domestic violence intervention, the next step for the victim is following-up to ensure that they are safe. In this case, follow-up programs can be in the form of phone calls to the victim or the facilitators of the local community programs where the victim is enrolled. A scheduled or unscheduled home visit to the victim’s place or at school will also help in determining the safety of the patient. As a safety precaution, a law enforcement officer, in this case, may accompany the intervention officer for the home visits provided the victim agree to it.

Handling Moral Distress

Sometimes, however much an individual may want to help victims of sexual assault, it becomes tough to intervene for them. Other times, the victims end up getting injured, a thing that would have been possibly prevented. When such a thing happens, one is usually left with feelings of moral distress. Moral distress is the intuitive response evoked from a situation that completely challenges the individual’s personal or professional ethics, standards, or principles (Laskowski-Jones, 2015). It is a feeling that comes from knowing that damage has already been done and the person’s inability to right the wrong. The individual is the faced with a situation where they feel that they cannot feel the guilt of allowing a wrong to be committed to the victim. In this case, dealing with the guilt of not doing something to help the victim is hard to deal with. According to Laskowski-Jones, some people choose to assume that the same outcome would have been the same even if the intervention was initiated. However as Laskowski-Jones goes on to explain, when faced with such a situation it is important to talk to trusted colleagues and counselors to let go the feeling of guilt and gain a varied perspective. Healthy coping with the situation involves finding a way to apply the situation constructively for problem-solving and help others not to repeat the same mistake again. As a parting shot, Laskowski-Jones advises against dwelling on the negative and focusing on the positive to avoid escalating the problem.

Interpersonal violence including domestic abuse is a common problem in the society. Helping victims of domestic violence is the moral obligation of every individual in the society. As compared to men, women represent the highest percentage of domestic violence victims. Empowering women through education, learning opportunities and legal literacy is one way of eliminating the vice. Besides, educating women on the effects of domestic violence on their health should be provided as a way of empowering them to make informed decisions. Community programs should also be enhanced to provide women with the required information and the right connection to legal redress regarding the issue.

References

Anderson, J.N. (2015). Effects of Education on Victims of Domestic Violence. Walden University Scholar Works. Retrieved from: http://scholarworks.waldenu.edu/cgi/viewcontent.cgi?article=1345&context=dissertations

Elliott, L. (2003). Interpersonal violence: improving victim recognition and treatment. Journal of General Internal Medicine, 18(10), pp. 871-872.

Jenkins, P. J., & Davidson, B. P. (2012). Stopping Domestic Violence: How a Community Can Prevent Spousal Abuse. Boston, MA: Springer US.

Laskowski-Jones, L. (2015). Dealing with moral distress. Nursing, 45(3), pp. 6.