This document provides information about rape and sexual assault definitions, statistics, and reporting guidelines. It defines rape as forced penetration and sexual assault as unwanted sexual contact. It notes that most victims are women assaulted by men they know. Statistics show high lifetime prevalence rates and negative health impacts for victims. The document discusses considerations for determining consent, such as age and capacity. It addresses common victim questions and clarifies that lack of consent due to factors like intoxication, unconsciousness or nonverbal refusal still constitute rape or assault.

1. RAPE
RAINN: Rape, Abuse, & Incest National Network
The exact definition of “rape,” “sexual assault,” “sexual abuse”
and similar terms differs by state. The wording can get
confusing, since states often use different words to mean the
same thing or use the same words to describe different things.
For a precise legal definition, you need to check the law in your
state, but here are some general guidelines based on the
definitions used by the U.S. Justice Department.
Definitions
Rape is forced sexual intercourse, including vaginal, anal, or
oral penetration. Penetration may be by a body part or an object.
Rape victims may be forced through threats or physical means.
In about 8 out of 10 rapes, no weapon is used other than
physical force. Anyone may be a victim of rape: women, men or
children, straight or gay.
Sexual assault is unwanted sexual contact that stops short of
rape or attempted rape. This includes sexual touching and
fondling. (Some states use this term interchangeably with rape.)
So, how can you figure if what happened was rape? There are a
few questions to consider.
There are three main considerations in judging whether or not a
sexual act is consensual (which means that both people are old
enough to consent, have the capacity to consent, and agreed to
the sexual contact) or is a crime.
Are the participants old enough to consent? Each state sets an

2. “age of consent,” which is the minimum age someone must be to
have sex. People below this age are considered children
and cannot legally agree to have sex. In other words, even if the
child or teenager says yes, the law says no.
Legal Age for Consent
In most states, the age of consent is 16 or 18. In some states,
the age of consent varies according to the age difference
between the participants. Generally, “I thought she was 18” is
not considered a legal excuse — it’s up to you to make sure
your partner is old enough to legally take part.
Because laws are different in every state, it is important to find
out the law in your state. You can call your local crisis center or
the National Sexual Assault Hotline at 1.800.656.HOPE to find
out more about the laws in your state.
Continued
Do both people have the capacity to consent? States also define
who has the mental and legal capacity to consent. Those with
diminished capacity — for example, some people with
disabilities, some elderly people and people who have been
drugged or are unconscious — may not have the legal ability to
agree to have sex.
These categories and definitions vary widely by state, so it is
important to check the law in your state. You can call your local
crisis center or the National Sexual Assault Hotline at
1.800.656.HOPE to find out more about the laws in your state.
Continued

3. Did both participants agree to take part? Did someone use
physical force to make you have sexual contact with him/her?
Has someone threatened you to make you have intercourse with
them? If so, it is rape.
It doesn’t matter if you think your partner means yes, or if
you’ve already started having sex — “No” also means “Stop.” If
you proceed despite your partner’s expressed instruction to
stop, you have not only violated basic codes of morality and
decency, you may have also committed a crime under the laws
of your state (check your state’s laws for specifics).
Common Questions that Victims Ask
I didn’t resist physically – does that mean it isn’t rape?
People respond to an assault in different ways. Just because you
didn’t resist physically doesn’t mean it wasn’t rape — in fact,
many victims make the good judgment that physical resistance
would cause the attacker to become more violent. Lack of
consent can be express (saying “no”) or it can be implied from
the circumstances (for example, if you were under the statutory
age of consent, or if you had a mental defect, or if you were
afraid to object because the perpetrator threatened you with
serious physical injury).
Common Questions, continued
I used to date the person who assaulted me – does that mean it
isn’t rape?
Rape can occur when the offender and the victim have a pre-
existing relationship (sometimes called “date rape” or
“acquaintance rape”), or even when the offender is the victim’s
spouse. It does not matter whether the other person is an ex-
boyfriend or a complete stranger, and it doesn’t matter if you’ve

4. had sex in the past. If it is nonconsensual this time, it is rape.
(But be aware that a few states still have limitations on when
spousal rape is a crime.)
Common Questions, continued
I don’t remember the assault – does that mean it isn’t rape?
Just because you don’t remember being assaulted doesn’t
necessarily mean it didn’t happen and that it wasn’t rape.
Memory loss can result from the ingestion of GHB and other
“rape drugs” and from excessive alcohol consumption. That
said, without clear memories or physical evidence, it may not be
possible to pursue prosecution (talk to your local crisis center
or local police for guidance).
Continued
I was asleep or unconscious when it happened – does that mean
it isn’t rape?
Rape can happen when the victim was unconscious or asleep. If
you were asleep or unconscious, then you didn’t give consent.
And if you didn’t give consent, then it is rape.
I was drunk or they were drunk - does that mean it isn't rape?
Alcohol and drugs are not an excuse – or an alibi. The key
question is still: did you consent or not? Regardless of whether
you were drunk or sober, if the sex is nonconsensual, it is rape.
However, because each state has different definitions of
“nonconsensual”, please contact your local center or local
police if you have questions about this. (If you were so drunk or
drugged that you passed out and were unable to consent, it was
rape. Both people must be conscious and willing participants.)

5. Continued
I thought “no,” but didn’t say it. Is it still rape?
It depends on the circumstances. If you didn’t say no because
you were legitimately scared for your life or safety, then it may
be rape. Sometimes it isn’t safe to resist, physically or verbally
— for example, when someone has a knife or gun to your head,
or threatens you or your family if you say anything.
If you’ve been raped or sexually assaulted, or even if you aren’t
sure, contact the National Sexual Assault Online Hotline or the
National Sexual Assault Hotline (1-800-656-HOPE) for free,
confidential help, day or night.
Statistics
Stats
Who are the Victims?
Breakdown by Gender and Age
Women
1 out of every 6 American women has been the victim of an
attempted or completed rape in her lifetime (14.8% completed
rape; 2.8% attempted rape).1
17.7 million American women have been victims of attempted
or completed rape.1

6. 9 of every 10 rape victims are female.
U.S. Department of Justice, Office of Justice Programs, Bureau
of Justice Statistics
Violent crime
2003 - 7,679,050
2011 - 5,812,520
2012 - 6,842,590
Rape/sexual assault
2003 - 325,310
2011 - 244,190
2012 - 346,830
Continued
Serious violent crime
2003 2011 2012
2,395,950 1,854,840 2,084,690
Serious domestic violence
1,480,920 1,354,910 1,259,390
Serious intimate partner violence
1,040,290 850,770 810,790
Victims of Sexual Assault are
Victims of sexual assault are:8
3 times more likely to suffer from depression.
6 times more likely to suffer from post-traumatic stress
disorder.
13 times more likely to abuse alcohol.

7. 26 times more likely to abuse drugs.
4 times more likely to contemplate suicide.
Women & Race
Lifetime rate of rape /attempted rape for women by race:1
All women: 17.6%
White women: 17.7%
Black women: 18.8%
Asian Pacific Islander women: 6.8%
American Indian/Alaskan women: 34.1%
Mixed race women: 24.4%
Results
Pregnancies Resulting from Rape
In 2012, 346,830 women were raped.9 According to medical
reports, the incidence of pregnancy for one-time unprotected
sexual intercourse is 5%. By applying the pregnancy rate to
346,830 female survivors, RAINN estimates that there
were 17,342 pregnancies as a result of rape in 2012.
Children
Children
15% of sexual assault and rape victims are under age 12.3
29% are age 12-17.
44% are under age 18.3
80% are under age 30.3
12-34 are the highest risk years.
Girls ages 16-19 are 4 times more likely than the general
population to be victims of rape, attempted rape, or sexual
assault.

8. Men
Men
About 3% of American men — or 1 in 33 — have experienced
an attempted or completed rape in their lifetime.1
In 2003, 1 in every ten rape victims were male.2
2.78 million men in the U.S. have been victims of sexual assault
or rape.1
Reporting Rape
Should I Report My Attack to the Police?
We hope you will decide to report your attack to the police.
While there's no way to change what happened to you, you can
seek justice while helping to stop it from happening to someone
else.
Reporting to the police is the key to preventing sexual assault:
every time we lock up a rapist, we're preventing him or her from
committing another attack. It's the most effective tool that
exists to prevent future rapes. In the end, though, whether or not
to report is your decision to make.
Am I required to report to police?
No, you are not legally obligated to report. The decision is
entirely yours, and everyone will understand if you decided not
to pursue prosecution. (You should be aware that the district
attorney's office retains the right to pursue prosecution whether
or not you participate, though it is uncommon for them to
proceed without the cooperation of the victim. There are also
times when a third party, such as a doctor or teacher, is required

9. to report to authorities if they suspect sexual abuse of a child,
or an elderly or disabled person. Visit ourMandatory Reporting
Databases for Children and the Elderly to learn more.
Many victims say that reporting is the last thing they want to do
right after being attacked. That's perfectly understandable —
reporting can seem invasive, time consuming and difficult.
Still, there are many good reasons to report, and some victims
say that reporting helped their recovery and helped them regain
a feeling of control.
How do I report the rape to police?
Call 911 (or ask a friend to call) to report your rape to police.
Or, visit a hospital emergency room or your own doctor and ask
them to call the police for you. If you visit the emergency room
and tell the nurse you have been raped, the hospital will
generally perform a sexual assault forensic examination. This
involves collecting evidence of the attack, such as hairs, fluids
and fibers, and preserving the evidence for forensic analysis. In
most areas, the local rape crisis center can provide someone to
accompany you, if you wish. Call 1.800.656.HOPE to contact
the center in your area.
Is there a time limit on reporting to the police?
There's generally no legal barrier to reporting your attack even
months afterwards. However, to maximize the chances of an
arrest and successful prosecution, it's important that you report
as soon as possible after the rape. If you aren't sure what to do,
it's better to report now and decide later. That way, the evidence
is preserved should you decide to pursue prosecution.
Some states have statutes of limitations that bar prosecutions

10. after a certain number of years. View information on your state.
What if I need time to think about whether I want to pursue
prosecution?
Understandably, many people aren't ready to make the decision
about prosecution immediately after an attack. It's normal to
want time to think about the decision and talk it over with
friends and family.
If you think you might want to pursue prosecution, but haven't
decided for sure, we recommend that you make the police report
right away, while the evidence is still present and your memory
is still detailed. The district attorney will decide whether or not
to pursue prosecution, however it is unusual for cases to
proceed without the cooperation of the victim. And if
prosecution is pursued, the chance of success will be much
higher if you reported, and had evidence collected, immediately
after the attack.
There's one additional consideration: If you are planning to
apply for compensation through your state's Victim
Compensation Fund, you will generally first have to report your
attack to police to be eligible. Contact your local rape crisis
center at 1.800.656.HOPE to learn about the rules in your state.
Domestic Violence Resources:
The Cycle of Violence
PHASE
ONE:

11. Tension
Building
PHASE
THREE:
Honeymoon
Period
PHASE
TWO:
Abusive
Incident
THE CYCLE
OF VIOLENCE
Phase One:
Tension Building
Phase Two:
Abusive Incident
Phase Three:
Honeymoon Period
Batterer experiences
increased tension
Batterer unpredictable; believes
he is losing control
Batterer is loving,

12. apologetic and attentive
Victim minimizes problems Victim is helpless; feels trapped
Victim has mixed feelings
Batterer increases threats Batterer highly abusive, incident
occurs
Batterer is manipulative
Victim withdraws Incidence of violence or threat
occurs
Victim feels guilty and
responsible
Batterer controls more Victim traumatized
Batterer promises change
Tension becoming
intolerable
Batterer blames victim Victim considers
reconciliation
Victim feels like they are
walking on eggshells
Victim often
recants/minimizes abuse

13. Poor communication
Office of the Kansas Attorney General
Jacqie Spradling, Domestic Violence Unit Director
120 SW 10th Avenue, 2nd Floor
Topeka, KS 66612-1597
785-368-8404
[email protected]
www.ksag.org
Hasmik Chakaryan
Teaching counselors advocacy for intimate partner violence
victims and survivors
*
Domestic Violence:DV is a pattern of abusive and coercive
behaviors, including physical, sexual, and psychological
attacks, as well as economic coercion, that adults or adolescents
use against their intimate partners. (ODVN)Physical and/or
emotional abuse comprises any form of violence that causes
bodily harm, pain, assault, isolation, deprivation, and
psychache. Intimate Partner ViolenceIPV is a serious,
preventable public health problem that affects millions of
Americans. The term "intimate partner violence" describes
physical, sexual, or psychological harm by a current or former
partner or spouse. This type of violence can occur among
heterosexual or same-sex couples and does not require sexual
intimacy. IPV can vary in frequency and severity. It occurs on a

14. continuum, ranging from one hit that may or may not impact the
victim to chronic, severe battering. (CDC)Domestic violence
and IPV are often used interchangeably.
DEFINITIONS
One in four women will be victims of domestic abuse in their
lifetimes.1.3 million women are victims of physical assault by
an intimate partner every year!1/3rd of female homicide victims
are killed by an intimate partnerThe cost of domestic violence
exceeds $5.8 billion each yearDomestic violence is one of the
most chronically underreported crimes¼ of physical assaults,
1/5th of all rapes, and ½ of stalkings committed by an intimate
partner are reported to the police.
Because the prevalence of female victims is much higher, as
statistics indicate, we are going to address the problem of
Intimate Partner Violence with a focus on female victims in this
presentation. However, this in no way undermines the fact that
men also become victims of IPV.
DOMESTIC VIOLENCE IN THE UNITED STATES
Missouri Statistics 2012 Nearly 19,000 turned away from full
shelters42,484 adults, youth and children received
domestic violence services25,016 requests for services were
unmet
due to a lack of resources95 percent of those aided by domestic
violence
programs said it enhanced their safety and
knowledge of community resources
STATISTICS
By a show of hands, how many of you have received specific
domestic violence training?By a show of hands, how many of
you have had a client affected by domestic violence?See the

15. difference?
Barriers to Detection of DV exist due to the lack of
professionals’ knowledge, preparation, confidence in skills and
time
ARE WE EDUCATED TO SERVE THISPOPULATION?
It is estimated that as few as 3% of cases are actually
reported.The highest prevalence of domestic violence cases
occurs within community clinics and emergency departments.
The mental and physical health consequences are so severe, yet
there is no published domestic violence screening protocols for
behavioral health care providers. What does this mean? There is
no best practice in detecting domestic violence, but it is
estimated that domestic violence effects 1.5 to 4 million people
annually in the United States.
Are we educated to serve this population?
What does domestic violence look like?
DV Is the Systematic Pattern of Intentional Intimidation
Through the Use of Threats and Violence for the Purpose of
Gaining Power and Control Over One’s Partner in an intimate
relationship
THE POWER AND CONTROL WHEEL
CYCLE OF VIOLENCE
Physically-- broken bones, facial and neurological trauma,
cardiovascular and gastrointestinal conditions, injuries to head,
neck, chest, breasts and abdomen, as well as injuries during
pregnancy (abuse during pregnancy has twice the prevalence of

16. toxemia)
What happens to the woman?Psychiatric SymptomsMost
commonlyDepressionPTSD; Panic AttacksSuicidal
ideation/attemptsSleep disordersEating disordersAddictionBWS
(Battered Woman Syndrome) as formed by Lenore
WalkerPhysiological SymptomsNeck to thighInjuries can be
hiddenIndicates abuser is in controlVisible injuriesSign of
escalating abuseIndicate abuser is out of control
Other possible symptoms: Premenstrual syndrome and painful
periods, Chest pain, Morning stiffness, Cognitive or memory
impairment, Numbness and tingling sensations, muscle
twitching, swollen extremities, & skin sensitivities, Dizziness
and impaired coordination
*
Six SymptomsThe victim re-experiences the battering if it is
occurring again. The images and feelings are real to them. The
victim attempts to avoid the psychological impact of battering
by avoiding activities, people, and emotions. They ignore the
ways of their old life in attempt to make all the negative
feelings go away. Hyperarousal or hypervigilanceDisrupted
personal relationshipsBody image distortions or other somatic
concerns (migraines)Sexuality and intimacy issues are present
Battered Woman Syndrome
Limited access to routine and/or emergency medical care
Noncompliance with treatment regimeNot being allowed to
obtain or take medicationMissed appointments Frequent
accidents Lack of independent transportation, access to
finances, ability to communicate by phoneFailure to use
condoms or other contraceptivesPartner is not told that he/she is
infected with HIV or other sexually transmitted diseasesPartner

17. accompanies the patient, insists on staying close, and answers
all questions directed to victimReluctance of a patient to speak
or disagree in front of partnerIntense irrational jealousy or
possessiveness expressed by partner or reported by
patientDenial or minimization of violence by partner or
patientExaggerated sense of personal responsibility for
relationship, including self-blame for violence
The following indicate a lack of control in a relationship and
should trigger the provider to consider domestic violence
Laughing – “tittering”No eye contactCryingSighingMinimizing
statementsSearching – engaging eye contact (fear)Anger -
defensiveness
Behaviors Suggestive of AbuseAnxious body languageStanding
to leaveDrooped shouldersDepressedComments about emotional
abuseComments about a “friend” who is abused
NEVER have anyone in room when screening. This could put
the client in immediate danger. Multiple scales existComposite
Abuse Scale -- Measures four dimensions of domestic violence
including physical abuse, emotional abuse, combined abuse, and
harassmentConflicts Tactic Scale – Longer, rates negotiation,
psychological aggression, physical assault, sexual coercion, and
injury HITS Scale – Mostly used by family doctors. Assesses
hurt, insult, threaten, and scream Women’s Experience with
Battering Scale– Ten question survey assessing feelings
associated with battering.
Screen for Domestic Violence
Do you mean in cases of in-home or couple’s counseling?
*

18. By using the Domestic Violence Survivor Assessment (DVSA),
a counselor can see what areas they need to focus on in
treatment and how far they have come in treatment. The DVSA
modifies the change stages into committed to continuing the
relationship, committed but questioning, considering change:
abuse and options, breaking away, and establishing a new life.
Using this assessment will aid the counselor in seeing what
stage the client is in for different dimensions. These dimensions
include attachment, seeking legal sanctions, triggers, views of
relationship, accessing help, self-identity, and feelings.
How can we assess it?
Demographics
Anyone can be a perpetrator or victim of domestic violence,
regardless of
their:Race/ethnicityClassEducation/occupationAgePhysical
abilitySexual orientationPersonality traitsIt is vital that the
counselors are culturally sensitive to the diverse population of
IPV, educate themselves about the specific cultural components
of their clients, ask questions to learn from their clients,
practice non-judgmental attitude and patience while working
with victims and survivors.
MULTICULTURAL SENSITIVITY
Most importantly provide:Immediate safetyPrivacyPrompt
medical and psychological assessmentSupportive, non-
judgmental environment
Before any specific treatment is agreed upon
Caring, empathetic questions may open the door for later
disclosure

19. Ask questions in private - apart from male partner; - apart from
family or friends
Explain issues of confidentiality
Be aware of mandatory reporting laws in your state and inform
the woman of themFear, embarrassment/shame, mistrust,
dependence on perpetrator, lack of support system may cause
victims to answer no to the questions asked by the professional.
INTERVENTIONS
Is anyone in your family hitting you?
Has anyone hit you while you were pregnant?
Have you ever received medical treatment for any abuse
injuries?
Does your partner ever threaten you?
Does your partner prevent you from leaving the house, getting a
job, or returning to school?
What happens when your partner doesn’t get his/her way?
Does your partner threaten to hurt you when you disagree with
him/her?
Does your partner destroy things that you care about like family
photographs, clothes, pets?
Are you forced to engage in sex that makes you feel
uncomfortable?
Do you have to have intercourse after a fight to make up?
Does your partner watch your every move?
Does your partner call home ten times a day?
Does your partner accuse you of having affairs with everyone?
Do you know where you could go or who could help you if you
were abused or worried about abuse?
*
The following assailant behaviors, especially in a cluster,
should lead the provider to warn the victim and see that he/she
has a safety plan:Abuser has history, threats, or fantasies of
homicide or suicide attemptsDepression and situational stresses,

20. such as job lossWeapons possession or past use of weaponsRage
over the victim leavingObsession about partner (“I can’t live
without him/her”) and her centrality to the batterer’s life (Is the
batterer so isolated that loss of victim represents a sense of
hopelessness?)Drug/alcohol consumption in state of fury and
depressionAccess to the battered individualContinually hunting
down and harassing victimEscalation of the abuser’s threats and
violence
LETHALITY ASSESSMENT
Empower the victim, validating her abuse and affirming that
This is not her fault
No one deserves to be treated this way
Does she want to talk about it?Acknowledge that it is
frightening, humiliating and painful to be hit. Let victim know
you have an emotional and intellectual response to the abuse.
The first step toward ending an abusive relationship is for
victim to feel it is intolerable.Be specific and immediate in your
suggestionsWhere are you going to stay tonight?Are you and
children safe for the next 24 hours?How can you get money?
PROVIDING RESPONSE
Your concern for her (and her children’) safety
Help is available to her. Begin providing further interventions
as applicable.
The IPV victim is the one who will choose when and how much
to disclose. Give her back her right to make choices. Don’t feel
overwhelmed, frustrated and impatient when she chooses not to
disclose, not to leave her abusive partner, not to move out or
anything else that you find are best options for her.She is
ultimately the one in the situation and knows best what is safer
for her. She needs your support and empowerment in whatever
choice she makes.Be aware of coping and defense mechanisms

21. that victims may utilize.Do not make assumptions: every
situation is distinct and unique. Validate that.Give her resources
she can choose from when she is ready. Help her come up with a
plan for either case: staying or leaving.
EMPOWER THE VICTIM
Shelters, housing, food stamps, hotlines, legal options, etc.
*
Leaving your house safely (statistics show that perpetrators’
violence increases when victim shows signs of leaving and they
are more likely to use more lethal methods to remain in control.
Stalking and homicidal behaviors become more prevalent)Extra
copy of house and car keysDevelop a code wordCopy important
documents & prepare a bag to give to a trusted personUse your
instincts and judgment when it is safe and the best time to
leaveDial 911 in emergency Suggest victim prepare a “natural
disaster” or “hurricane” bag to keep available.Keep in easily
accessible locationInclude birth certificates, immunization
records, pet records, medications, bank information, important
belongings
SAFETY PLANNING
Can money be hidden for emergency use?
Can victim run to neighbor’s house or work out a signal so
neighbor calls the police?
How can healthcare provider safely call victim? How should
provider identify self? What should provider do if batterer
answers phone?
If victim moves, should prevent abuser from finding him/her by
making long distance calls from different phone, asking
agencies/schools not to reveal address.
*

22. Clinical records can be subpoenaed. Obtain legal
consultation.Keep records concise, brief and report clinically
significant information exactly as shared by the
clientDocumentPhysical evidence Verbal statementsPhotographs
(with consent)Body map showing injuriesComplex psychosocial
stressorsBe aware of all resources available to the IPV victims
and to the professional for consultation and
guidance.http://www.mocadsv.org/Publications.aspx
DOCUMENTATION AND REPORTING
National resources for victims of domestic violence:
National Domestic Violence Hotline
(800) 799-SAFE (7233) / (800) 787-3224 (TTY)
(http://www.ndvh.org)
National Coalition Against Domestic Violence
(303) 839-1852 (http://www.ncadv.org)
National Resources for Health Care Professionals
National Health Resources Center on Domestic Violence
(415) 678-5500 (http://www.endabuse.org/health)
*
USE YOUR CLINICAL JUDGMENT
Apply RADARRoutinely screen every patientAsk directly,
kindly, nonjudgmentallyDocument your findingsAssess the
patient’s safetyReview options and provide referrals
(Massachusetts Medical Society, 1992)
Domestic Silence revisited: Abuse victims lacking shelter?
(2012). The Columbus Dispatch. Retrieved from
http://www.dispatch.com/content/stories/local/2011/11/27/lacki
ng-shelter.htmlOhio Domestic Violence Network. (2012).
Retrieved from http://www.odvn.org/Centers for Disease
Control and Prevention. (2012). Retrieved from

23. http://www.cdc.gov/violenceprevention/intimatepartnerviolence/
definitions.htmlDienemann, J., Campbell, J., Landenburger, K.,
& Curry, M. (2002). The domestic violence survivor
assessment: A tool for counseling women in intimate partner
violence relationships. Patient Education and Counseling, 46,
221-228.Dienemann, J., Glass, N., Hanson, G., & Lunsford, K.
(2007). The domestic violence survivor assessment (dvsa): A
tool for individual counseling with women experiencing
intimate partner violence. Issues in Mental Health Nursing, 28,
913-925.Domestic Violence Facts. (2007, July). Retrieved from
http://www.ncadv.org/files/DomesticViolenceFactSheet(Nationa
l).pdfHamberger, K.L. & Phelan, M.B. (2004). Domestic
Violence Screening and Intervention in Medical and Mental
Healthcare Settings. New York, NY: Springer Publishing
Company, Inc.Howard, L., Trevillion, K., & Agnew-Davies, R.
(2010). Domestic violence and mental health. International
Review of Psychiatry, 22(5), 525-534.Matevia, M. L., Goldman,
W., McCulloch, J., Randall, P.K. (2002). Best Practices:
Detection of Intimate-Partner Violence Among Members of a
Managed Behavioral Health Organization. Psychiatric Services.
3(5), 555-557.Massachusetts Medical Society. (1992).
Massachusetts Medical SocietyPunukollu, M. (2003). Domestic
violence: Screening made practical. Journal of Family Practice,
52(7), 537-543.Walker, L. (1980). The battered woman. New
York, NY: Harper & Row Publishers, Inc.
Resources
*
Other possible symptoms: Premenstrual syndrome and painful
periods, Chest pain, Morning stiffness, Cognitive or memory
impairment, Numbness and tingling sensations, muscle
twitching, swollen extremities, & skin sensitivities, Dizziness
and impaired coordination
*
Do you mean in cases of in-home or couple’s counseling?

24. *
Is anyone in your family hitting you?
Has anyone hit you while you were pregnant?
Have you ever received medical treatment for any abuse
injuries?
Does your partner ever threaten you?
Does your partner prevent you from leaving the house, getting a
job, or returning to school?
What happens when your partner doesn’t get his/her way?
Does your partner threaten to hurt you when you disagree with
him/her?
Does your partner destroy things that you care about like family
photographs, clothes, pets?
Are you forced to engage in sex that makes you feel
uncomfortable?
Do you have to have intercourse after a fight to make up?
Does your partner watch your every move?
Does your partner call home ten times a day?
Does your partner accuse you of having affairs with everyone?
Do you know where you could go or who could help you if you
were abused or worried about abuse?
*
Shelters, housing, food stamps, hotlines, legal options, etc.
*
Can money be hidden for emergency use?
Can victim run to neighbor’s house or work out a signal so
neighbor calls the police?
How can healthcare provider safely call victim? How should
provider identify self? What should provider do if batterer
answers phone?
If victim moves, should prevent abuser from finding him/her by
making long distance calls from different phone, asking
agencies/schools not to reveal address.
*
National resources for victims of domestic violence:
National Domestic Violence Hotline

25. (800) 799-SAFE (7233) / (800) 787-3224 (TTY)
(http://www.ndvh.org)
National Coalition Against Domestic Violence
(303) 839-1852 (http://www.ncadv.org)
National Resources for Health Care Professionals
National Health Resources Center on Domestic Violence
(415) 678-5500 (http://www.endabuse.org/health)
*
and common definition
-an unwanted act of
oral, vaginal, or anal penetration committed though
the use of force, threat of force, or when
incapacitated
Against Women Survey (National
Institute of Justice and Centers for
Disease Control, 1998)
experienced an attempted or completed rape (in the
United States)

26. -33% of women and 10-15% of
men experienced an attempted or completed rape
(in the United States)
was an intimate, relative, friend, or acquaintance
which leads to underreporting
reported
Abuse/Rape Survivors
nature, intensity, and extent from other forms of crisis
ation of violence
themselves and humiliate their opponents

27. actors of Rapists
ngs of anger toward women and seeks to
control them
he most
destructive myth of all.
occurs
victims rather than perpetrators
n happen
to anyone

28. or by strangers with weapons.
es not resist, she must have
wanted it.
sexual abuse of boys.
homosexual or rapists.
son experiences sexual arousal, this
means it is not rape.
heightened sexual activity and sexual victimization in
dating.
oth the survivor and the
perpetrator) is a risk factor for acquaintance rape.

29. Other Forms of Rape
school level, have been recommended as preventive
measures in reducing acquaintance rape.
-term.
May feel humiliated
-term trauma
center
anding without pressure regarding further
sexual contact

30. reporting the rape
he trauma without
disclosing the information to others
• Rape ranks second in the potential for
PTSD
• EMDR as a first option for treatment
• Cognitive-behavioral treatment
• Exposure treatment
• Affect regulation
• Cognitive therapy
enation
-image

31. se due to multiple ways
it may manifest
the current environment
client’s family
t with childhood
developmental tasks

32. a result of the absence of the reinforcement
Restructuring
Grief Resolution
reconnecting
abuse

33. -behavioral Therapy
Trauma Systems approach
ion on the process
-offending
Parents
-victimization
dual Counseling

34. Chapter Nine: �Sexual AssaultBackgroundThe Scope of the
ProblemThe Dynamics of RapeThe Dynamics of Rape
Cont.Myths About RapeMyths About Rape Cont. Date and
Acquaintance RapeIntervention Strategies for Rape in the
Immediate AftermathIntervention Strategies for Rape in the
Following Three Months Intervention Strategies for Rape in the
Following Three Months Cont.Adult Survivors of
Childhood�Sexual AbuseIntervention Strategies for �Adult
SurvivorsIntervention Strategies for �Adult Survivors Cont.
Sexual Abuse in ChildhoodIntervention Strategies �With
ChildrenProsecuting the PerpetratorCounseling
Background
ture has a role in the definition of partner violence
-physical violence perpetrated by one person on
another
-general term that describes the unequal power
relationship within which the assault occurs
-verbal and behavioral threats to others, pets, or
property
-any act of assault by a social partner or

35. relative, regardless of marital status
Incidence of Partner Violence
ate of Mississippi, 1824
calls in which the possibility of violence exists to both
civilians and police
Incidence of Partner Violence Cont.
on women and 830,000 men were victims of
intimate violence in the United States
occurred and about 7 million have witnessed severe
violence
Emerging Approaches to
Partner Violence
Coalition of Battered Women Service Groups (United States)
luth,

36. Minnesota (Duluth Model)
and
enhanced legal protection
1994
Psychosocial and Cultural Dynamics
Ecological Theory
Dynamics of Partner Violence

37. cal problems
Dynamics of Partner Violence Cont.
ly only
-social
-level anti-social
oportions
Myths About Battering

38. Battered women are masochists
-income and working-class families
experience violence
Myths About Battering Cont.
revenge
pregnant
ttering is confined to mentally ill people
dangerous
Realities for Abused Women
clothing, and
shelter.
-concept is dependent on the relationship.

39. al with a
reduction
in her financial freedom.
batterings
and remember only the good times.
believe that
relationships exist in no other way.
Realities for Abused Women Cont.
discourage
separation or divorce.
raise, or
lack job skills.
geographically, or
financially
isolated that she has no resources.
leave.
without her
may compel her to stay.
ous negative experiences with the

40. authorities, she
may believe she has no options.
her
abuse.
Leaving an abusive relationship is one of the most dangerous
things the victim can do.
Intervention Strategies
Shelters
seling women at shelters

41. -up
-unite with the abuser
-term follow support (6 months)
ow-up may increase violence
Intervention With Children
• Create an alliance with the parent
• Provide psycho-education to both parent and child
• Restore the parent’s self-esteem and confidence
• Establish a safe environment for the child to express thoughts
and feelings
• Relieve the child’s symptoms, including difficulty with living
transitions, sleeping, nightmares, and other trauma symptoms
• Reestablish the child’s previous level of cognitive functioning
and
attachment with the caregiver
• Reassure that what has happened is not the child’s fault
• Help the child to regain emotional regulation
• Provide stress reduction strategies
Courtship Violence

42. f courtship
relationships
the highest positive correlation
correlation
interpreted violence in courtship as a sign of love!
higher the degree of violence
Gay and Lesbian Violence
violence
Treating Batterers

43. A Typical 24-Session Anger
Management Group
ertion
����Chapter Ten: �Partner ViolenceBackgroundIncidence of
Partner ViolenceIncidence of Partner Violence Cont. Emerging
Approaches to �Partner ViolencePsychosocial and Cultural
DynamicsDynamics of Partner Violence Dynamics of Partner

44. Violence Cont.Myths About BatteringMyths About Battering
Cont.Realities for Abused WomenRealities for Abused Women
Cont. Intervention StrategiesSheltersIntervention With
ChildrenCourtship ViolenceGay and Lesbian ViolenceTreating
BatterersA Typical 24-Session Anger Management Group