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Register for a free to start saving and receiving special member only perks. This chapter examines the types of responses society has made to violence against women. There are a of ways to define and characterize prevention and intervention. This report uses one that best identifies the kinds of responses society can take and the research that can inform those responses. First, however, it notes several other classifications. The public health perspective classifies ''interventions" into primary, secondary, and tertiary prevention.
The goal of primary prevention is to decrease the of new cases of a disorder or illness. The goal of secondary prevention is to lower the prevalence of a disorder or illness in the population. The goal of tertiary prevention is to decrease the amount of disability associated with the disorder or illness. Although these three seem conceptually distinct, in practice there is disagreement over their use Institute of Medicine, Another classification is Gordon'sproposal for universal, selected, and indicated preventive measures.
Universal preventive measures are desirable for everyone in a population; selected preventive measures are desirable for those in the population with an above average. Because of frequent confusion over the meaning of the public health classifications, the Institute of Medicine recommended the use of a combination of it and Gordon's: preventive interventions, broken into three modeled after Gordon's; treatment intervention, which includes identification and standard treatments; and maintenance intervention, which aims at reducing relapse and recurrence and promoting rehabilitation.
This report adopts the Institute of Medicine's use of preventive interventions, but considers Women want sex tonight Gile Wisconsin and maintenance interventions together under the rubric of treatment interventions. Treatment interventions are separated into individual and community-level interventions: individual treatment interventions are those, such as counseling, that are targeted at the individual; community-level interventions represent more system-oriented interventions, such as criminal justice reforms, rape crisis centers, and battered women shelters.
Following this classification, the chapter first discusses preventive interventions. Second, it considers treatment interventions, both the services available to women victims of violence and those, including criminal justice interventions, for offenders.
Preventive intervention efforts have largely consisted of school-based programs on conflict mediation, violence prevention in general, dating violence, sexual abuse, and spouse abuse. There are few data available on how widespread these programs are or to whom they are offered. Sexual assault and rape education programs seem to be increasingly common on college campuses; conflict resolution programs have been in. The programs vary in length, in content, and in degree of theoretical underpinning. Evaluations are rare. The Women want sex tonight Gile Wisconsin evaluations that have been done of these programs generally test students' knowledge about and attitudes on relationship violence before and after the prevention program, as well as personal experience with dating violence Jones, ; Jaffe et al.
In Minnesota, the Minnesota Coalition for Battered Women developed a secondary school violence prevention program and trained secondary school teachers in the use of the curriculum. The approximately teachers who were willing to participate in the evaluation were stratified by junior or senior high, and by rural, suburban, or urban location. Teachers were randomly selected from each of the six subgroups, and their students became the sample for the evaluation. Control groups from the same or nearby schools were also tested.
Both groups were given preprogram and post-program tests to assess their knowledge about battering, their attitudes, and their knowledge about the resources available for help in addressing relationship violence. Students who were given the 5-day prevention program improved their knowledge scores ificantly more than the control group. However, attitudes among both experimental and control groups showed very little change.
There was a posttest ificant difference between girls' and boys' scores, with the girls' scoring more in the desired direction. The experimental groups also became more knowledgeable about general resources available for help with relationship violence, such as a hospital or mental health center, although they could not name specific local services Jones, Other studies have found attitudinal changes following school-based intervention programs. Students in four secondary schools in London, Ontario, were involved in a dating violence prevention program Jaffe et al.
The program involved a large group presentation followed by classroom discussion led by trained facilitators.
Questionnaires were. Overall, the evaluation showed ificant positive changes after intervention on knowledge, attitudes, and behavioral intention. A small group of males, however, showed change in an undesired direction. ificant decreases in attitudes justifying the use of dating violence were found in a study of a prevention program in a Long Island, New York, high school Avery-Leaf et al. The intervention consisted of five weekly sessions incorporated into a health class.
The experimental group of students were tested before and after the five-class program, and there was a control group of students whose health classes did not include the dating violence prevention program. While all of these programs may change knowledge or attitudes about physical and sexual violence between intimates, no longitudinal studies exist to document whether they have any short- or long-term impact on the commission of dating violence, date rape, or intimate partner violence later in life.
A review of evaluations of a broad array of prevention programs aimed at adolescents—including pregnancy prevention, drug abuse prevention, delinquency prevention—found that curricula that only provide information about risks and use scare tactics have little or no positive impact and may even result in more of the undesired behavior Dryfoos, ; National Research Council, Intensive programs that include social-skill training and follow-up booster sessions may hold more promise, particularly if classroom efforts are part of a more comprehensive, community-wide strategy Dryfoos, ; Webster, Public education campaigns, such as those mounted against smoking and drunk driving, are a universal preventive.
The Advertising Council, in conjunction with the Family Violence Prevention Fund, in June began a public education campaign against intimate partner violence. The campaign consists of television, radio, and print public service announcements "deed to Women want sex tonight Gile Wisconsin public awareness of battering and to motivate individuals to take action to reduce and prevent abuse" Family Violence Prevention Fund, The advertising campaign is being evaluated.
A preadvertising survey that measured attitudes toward battering was conducted; there will be several postadvertising surveys that will look at advertisement recognition and changes in attitudes about battering, willingness to intervene in battering, and knowledge of community resources Lieberman Research Inc. Separate from public service announcements and other advertising, television programming has the potential to convey antiviolence messages. The recent National Television Violence Study Mediascope, suggests that television could be used to send more prosocial messages about violence Women want sex tonight Gile Wisconsin showing the negative consequences of violent behavior and nonviolent alternatives to solving problems and by emphasizing antiviolent themes.
There has been no research on the effects of such television programming. To the extent that the threat of criminal justice sanctions deters people from engaging in violent behavior, they can be thought of as preventive interventions. The theory of deterrence is well established in the field of criminal justice for reviews, see Zimring and Hawkins, ; Geerken and Gove, ; Gibbs, ; Cook, ; Blumstein et al. The theory suggests that increasing the certainty of sanctions increases their deterrent effect Reiss and Roth, From this per.
For a more complete discussion of these types of interventions, see the section on Criminal Justice Interventions, below. The literature on rape prevention includes strategies for rape avoidance and rape resistance, which are considered by some—particularly in the criminal justice field—to be prevention through reduction of opportunity.
Rape avoidance entails strategies to be used by women to minimize their risk of sexual assault. These strategies include avoiding dangerous situations, not going out alone at night, keeping doors and windows closed and locked, and other precautions to be taken by women. Although these avoidance techniques may reduce a woman's risk of being sexually assaulted by a stranger, it is not clear they would reduce acquaintance attacks Koss and Harvey, These strategies are also criticized as restricting women's activities and as potentially placing the blame on women who are sexually assaulted for not taking adequate precautions Brodyaga et al.
The extent to which a woman chooses to use any particular avoidance strategy may depend on the importance she attaches to the perceived costs and benefits of the strategy Furby et al. An emphasis on rape avoidance may actually increase the fear of rape Koss and Harvey, Furthermore, avoidance strategies may do little to lower the overall rate of sexual assault; they may simply displace the assault from one potential victim to another.
Rape resistance strategies involve recommendations to women on what to do should they be attacked. Storaska popularized among law enforcement agencies the theory that women should remain passive in the face of an.
The majority of the research on resistance strategies, however, suggests just the opposite. Women who actively resist attack are more likely to thwart rape completion without increasing their risk of serious injury Women want sex tonight Gile Wisconsin, ; Bart, ; Quinsey and Upfold, ; Levine-MacCombie and Koss, ; Siegel et al. The success of resistance strategies also appears to be linked to situational factors, such as the proximity of others to the attack site, and offender traits Koss and Harvey, This report does not consider rape avoidance or rape resistance to be preventive interventions, the goal of which should be reduction in rates of perpetration.
Some researchers also consider rape prevention to mean minimizing the psychological impact of sexual assault; this report considers that topic under interventions for victims, not as prevention. There is no universal system of services available to victims of battering or sexual assault; they vary from community to community. Interventions may occur in the criminal justice system, the health care system, the social service system, the mental health system, or some combination of systems.
As noted above, the discussion of interventions is divided into those whose main focus is on the individual and those whose focus is institutional or community based; individual-level interventions seek to ameliorate the consequences of individual victimization; community-level interventions seek to change systems' responses to victims.
Individual counseling and peer support groups are probably the services most used by battered women. A survey of victims of battering in New York City who called for. However, few data exist on how many battered women actually seek counseling services: of those seeking counseling services in the New York City study, Taylor found approximately two-thirds actually received them.
Although specific therapy elements have been recommended for use with battered women e. Counseling services are also available for couples in which the woman has been battered or otherwise victimized, but there remains much debate in the field over the merits and advisability of couples counseling Dobash and Dobash, ; Edleson and Tolman, ; Gondolf, Many practitioners and researchers argue that couples counseling is never appropriate when violence is present because it endangers women.
Other counseling providers argue that couples counseling that is specifically deed to address the use of aggression may be beneficial for couples in discordant or mildly violent relationships Pan et al. Because couples counseling is generally viewed as an intervention for the perpetrator, evaluations of it are addressed below in the section on interventions for batterers. Mental health interventions with rape victims have received more study than those with battered women. Treatment approaches deed to address the postrape psychological consequences have been developed, and in some instances evaluations were undertaken to assess their effectiveness.
However, in a review of the rape treatment outcome studies, Foa et al. In most cases, there was no control group so it was not possible to determine whether improvements were a function of the passage of time or the intervention. The early studies that randomly ased victims to different conditions produced mixed.
Veronen and Kilpatrick devel. In contrast, a comparison of different six-session therapy approaches found that all three types of intervention produced improvement while victims on a naturally occurring waiting list did not improve Resick et al. Two more recently reported studies examined the effectiveness of specific treatments for victims suffering from posttraumatic stress disorder PTSD. Foa and colleagues compared stress inoculation training—a combination of cognitive-behavioral and relaxation techniques to teach clients to control their fear, prolonged exposure—reliving the rape scene in the imagination in order to confront fear, and supportive counseling.
They found that all treatments produced improvements at posttreatment, but at a 3-month follow-up, exposure appeared to be the most effective for PTSD symptoms. A cognitive processing approach deed to address maladaptive beliefs, as well as rape-related fears, reduced symptoms compared to a waiting-list control group Resick and Schnicke, These studies support the conclusion that treatment for rape victims can be helpful and that specific types of treatment may be more effective for certain symptoms.
A recent survey Plichta, found 1, programs, of which approximately 1, were shelters, targeted at battered women in the United States. The programs offer a variety of services including hotlines, temporary shelter services, group and individual counseling, legal advocacy, social service referral and advocacy, services for children of abused women, transitional housing, child care, and job training. Public edu. Little data exist on how many clients are served by the various programs or who those clients are. It does appear that the services are inadequate to meet the needs of all victims of battering who seek them.
For example, in New York City in Marchabout women and children a week were denied emergency shelter due to lack of space O'Sullivan et al.
There is some information on the women who do use shelter services. They tend to be from low socioeconomic groups, possibly because they have fewer resources available to them than women from higher socioeconomic groups. For example, in one study O'Sullivan et al.
In another large sample of women using services in Texas 1, battered women in shelters and battered women using nonresident shelter-based programsGondolf and Fisher found that a substantial portion lived in poverty. The women who sought only nonresident services tended to be from higher socioeconomic groups than those who sought resident shelter services. In a sample from a shelter in a medium-sized Midwestern city, 81 percent of the women were receiving some type of government assistance, and 60 percent lived below the poverty line Sullivan et al.Women want sex tonight Gile Wisconsin
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