Domestic Violence Scenario - Case Study Example

Domestic Violence Scenario Introduction Domestic Violence is traumatic for the whole family as they experience physical, mental, emotional and social damage if not addressed immediately. According to (Black, M.C., et al., 2010) in a study carried out by his team, “nearly three in every 10 women…..suffer physical violence by an intimate partner, related to forms of violent behavior in that relationship.” However, the impact of physical violence varies from individual to individual and depends on how a victim responds to it. There are many factors that contribute to stressful situations and this largely depends on how the person reacts to it and how resilient they are to cope with domestic violence. Every individual has a natural instinct to fight back and take control for survival, but gradually they become tired of fighting and succumb to their painful realities. Domestic violence can have a serious impact on the individual as well as other family members, especially children, if left unchecked for a long time. Besides, painful injuries, the victim experiences mental shifts that has adverse effects on one’s thinking processes, emotions, feelings and even their behavior. Domestic violence can also impact upon an individual’s mental stability, by increasing their chances of depression, increased anxiety and Post Traumatic Stress Disorder. The following case study would be examining a particular case of domestic violence in the family and the interventions used to treat the victim and the other members in the family and the attempts made to bring back stability into the family once again. Case Study – Background Anne White is the female patient in question who is 42 years of age. She lived with her husband John who was 45 years of age. Anne had two children – Dylan who was 11 years old and Jessica who was five. Anne’s mother Greta, 75 years of age, had recently undergone a CVA and needed a lot of care and attention during her recovery. Being the only child for her parents, Anne felt indebted and compelled to go and look after her mother till she recovered completely. John, Anne’s husband, suffered a back injury during his work and was now recovering at home from the same. In addition, Anne’s little daughter Jessica suffered from Asthma and had to be taken care of too. Anne decided to relocate the family to live with her mother for many reasons. Firstly, Anne felt that it was her duty to look after her ailing mother as she was her only child and at the same time she was happy to make the change because her mother stayed closer to the town in the Northern suburbs of Adelaide, and this made the doctor visits easier instead of the two long hour journey she would have had to make if she stayed at her own house. Secondly, she felt that it would be a change for her husband John since he was now recovering from his injury and did not go to work. Thirdly, Anne felt that enrolling her son Dylan in a new school would put and end to the problems he faced with his current group of friends and it would give him the opportunity to make new friends in the new school. Therefore, taking all the things into consideration, both Anne and John decided to relocate the family to go and live with her mother and this made Anne the primary caregiver for her mother as well as the other members in her family. In addition to this she had to care for a short haired cat and two dogs with long hair who were their pets. Psychological Factors Prior to all these changes, Anne had no medical history of poor health, except for an Appendectomy when she was a kid. However, now in her present situation, she seemed over burdened with work and responsibility and gradually it impacted upon her health. Moreover, Anne had always enjoyed a sense of freedom as she was employed as a hairdresser and this gave her a purpose in life as well as added income for the family to live comfortably. In the present situation, having to relocate from their home meant giving up her job and this curtailed their finances to a great extent. Things became more complicated when her husband John took to alcohol abuse and this made him constantly quarrel with Anne for relocating the family to her mother’s house. Anne was in great stress and found that it drained her of life. However, according to (Prof. Cary Cooper, NHS Choices) “Stress can be managed.” According to Cooper, people feel stress and pressure when they do not have control over their lives and this is unhealthy for the body as well as the mind. Anne, had to fit into too many roles of daughter, mother and wife and she was pulled from all quarters. She had absolutely no control over her life and the situation she found herself in and therefore experienced a lot of pressure and stress. Her mother Greta needed constant care as she was unable to care for herself and her daughter Jessica experienced regular bouts of Asthma and needed her attention and care too. She was so bogged down with responsibility and work that she found it quite impossible to balance the different roles. She was not happy in the present situation and found that she was pressurized with the different roles she had to play. Gradually, Anne, who was once a healthy individual slowly became highly stressed and slipped into depression. To counter this, she took comfort in food which served to make her over- weight and finally she was diagnosed with T2DM. However, according to Prof. Cooper, (NHS Choices) an individual can regain control over their lives by talking the problem over with a friend, counselor or doctor who could help her to put things in the right perspective. A person in stress could try to relax through meditation and Yoga techniques, exercises or just sitting in a quiet place like a beach or park. He also says that if stress is not attended to in time, it could lead to worse complications and this is clearly seen in our case study of Anne, who prolonged taking action for her stressful scenario. Sociological Factors Anne’s responsibility towards all her family members, not only curtailed her freedom, but also kept her occupied with caring and looking after the house. The loss of her employment only served to give her more time for taking care of the family and hence she had no free time for herself nor any other diversion and recreation to look forward to. These were some of the major sociological factors that impacted on her health and made her live the life of a recluse, as she did not prefer going out anywhere for fear of some catastrophe taking place in the family while she was away. She always experienced a sense of fear and anxiety when she left her home and therefore, preferred not going out and socializing in any way. Prior to making the move to her mother’s place, Anne loved socializing, going out and volunteering her services at the school. She went out of her way in helping in her children’s classes or at the School Tuck shop. But now, in her present depressed condition, she had no inclination to go out or meet people because she always felt a sense of fear and anxiety if she left the house, because she felt that Greta could not be left alone since she had a few falls which served to worsen her condition. John, her husband, who was suffering from a back injury, also needed her attention. In addition, he had started drinking heavily and fighting constantly with Anne for shifting the family, which made her situation even worse. She could not rely on him for support in any way and their relationship suffered miserably. Greta, Anne’s mother had suffered a couple of falls, which made her condition worse, that she needed to take care of her all the time. In addition she told Anne that some of her jewelry was missing from her room and this was quite shocking to Anne because only she and her mother used her room. Therefore, their relationship was strained and the mother became quite impatient with the situation. Also, she had to depend on monetary help from her mother since she had given up her job. Another sociological factor that impacted on Anne’s health was her poor relationship she shared with her children. Since, she was totally occupied with caring for the house and problems of each family member, the distance between her and her children widened and she suffered a lot of anxiety and fear due to this. (Dr. Sheila Shribman (NHS Choices) states that where domestic violence is concerned, the women are the ones most affected and the violence does not depend on one’s culture, wealth or background and “it can occur across the whole socio- economic spectrum. Impact of Violence on Anne’s bio-ecological Model Anne’s trauma increased as her husband John became a victim of alcohol abuse and instead of being a support to Anne, he increased her suffering and trauma by domestic abuse. Unable to cope with her situation Anne tries to suppress her depression by eating a lot and thereby gaining weight. The symptoms of her depression were feelings of sadness and hopelessness, weight gain, listlessness and with no motivation in life. Some of the behavioral symptoms include not enjoying the usual activities and not going out anywhere, relying on food for comfort and withdrawing from friends and family. (Harvey, A. Whiteford, 2008) One of the most common symptoms of domestic abuse is depression and Anne being a battered individual who could not cope with the situation finally decides to get the help of a counselor. Anne, explains to the counselor that she and her family are living with her mother for the past year, but feels that nothing is going the right way for them and therefore feels depressed and not capable of coping with the situation. She discusses about her relationship with her husband, stating that due to excessive drinking he has become abusive and his behavior is highly erratic. Their fights involve the move they made to look after her mother, the time spent in looking after her mother and the kids, and the lack of money to cover their bills. Therefore, she resorts to comfort herself by eating. Anne also discusses the problems she faces with her two children explaining that Jessica’s asthma is triggered mainly due to the change in weather and she feels that she is responsible for her having the asthmatic problem. She also worries that her son Dylan has grown more distant and therefore finds difficulty in trying to connect with him. Anne also explains about the fear and anxiety she feels for her mother especially when she goes out. Since of late her mother has become more agitated because she believes that money and jewelry are missing from her room. Anne is shocked and hurt because only she and her mother use her room. Even though her mother has had a few falls, she has mixed feelings of placing her in a high level care nursing home. She also explains about the poor financial condition of the family since she has given up her job, and her husband is not working due to an injury of his back and therefore there is never enough money to pay bills and look after the family expenses. She explains that due to all the stress and depression she undergoes, she cries a lot and has taken to eating food for comfort and because of her depressed condition, she feels her relationship with her children suffers miserably and she finds there is a huge distance between them and herself. Her husband John adds to her anxiety and fear of the future by fighting with her all the time, over they move they made to her mother’s place, about the lack of money for their finances, about the children and about his drinking bouts. Anne feels trapped with no place to turn to and finally decided to get some help from a counselor through the local community health center. Diagnosis and Treatment Following her discussion with her counselor, Anne makes a visit to her GP Dr. Mary Louis the next day, and informs her of her discussion with her counselor. Anxiety and Depression are considered to be the most common mental disorders and it is important to get effectively treated because it could lead to problems that could become worse. (CRUfAD) Dr. Louis wastes no time and puts Anne through the K10 program, which includes a set of 10 crucial questions about her present psychological condition of the patient. The Kessler Psychological Distress Scale (K10) is a common tool used for clinical and epidemiological purposes. (Andrews, G Slade, T. 2001) For common mental health disorders, the K10 questionnaire is widely used as a tool for measuring the extent of psychological distress the person is suffering and it is also used for measuring the outcomes that follow the treatment. Each question has a value of five and each response is measured from 5 to 1 based on the patient’s answer. The maximum score of 50 indicates the patient is in high distress, while the minimum score is 10 indicating no distress. Discussion Anne was diagnosed with T2DM (Type 2 Diabetes Mellitus) because of being obese. In this condition, the pancreas of the individual is not capable of producing enough insulin or the body is unable to make use of the insulin produced. It becomes insulin resistant and gradually over a period of time, the increased glucose levels damage the nerves and blood vessels of different parts of the body and could lead to a stroke or a heart attack. (WebMD, Diabetes Health Center) According to (Benjamin Edwards and Daryl J. Higgins, 2009) the caretakers of family members with disabilities, are at great ‘risk of poor mental health and vitality’ when compared to those who do not render care. In our case study, we find that Anne was the primary caretaker in her family who rendered care to three family members with disabilities and hence was highly at risk for poor mental health and loss of vitality. Conclusion Anne White’s case is a typical one that was brought about by caring for three family members with disabilities. However, she was fortunate enough to identify that she faced major problems and reached out for help in time. Presently, the Australian Government are coming out with many initiatives to render help to those exposed to the risk of poor mental health and vitality. In the year 2000, the Australian Government and the Victorian Governments have established a national Depression Initiative, ‘beyondblue’(Hickle IB, 2002) to decrease the burden of depression making use of effective, preventive and early interventions. References ANDREWS, G SLADE, T. Interpreting score on the Kessler Psychological Distress Scale (K10). Australia and New Zealand. Journal of Public Health: 2001; 25:6: 494-497. www.ncbi.nlm.nih.gov/pubmed/11824981 BENJAMIN EDWARDS, DARYL J. HIGGINS. Is caring a Health Hazard? The Mental Health and Vitality of Carers of a Person with a disability in Australia. Med J Aust 2009; 190 (7): 61. BLACK, M.C., BASILE, K.C., BREIDING, M.J., SMITH, S.G., WALTERS, M.L., MERRICK, M.T., CHEN, J., & STEVENS, M.R, The National Intimate Partner and Sexual Violence Survey (NISVS): 2010 Summary Report, (2011), Atlanta, GA: www.cdc.gov. Dr. Dr. SHRIBMAN SHEILA Domestic Violence. (NHS Choices) Accessed in May 2014. http://www.youtube.com/watch?v=OOdPLr4zyNU EFFECTS OF DOMESTIC VIOLENCE. Joyful Hearts Foundation. Web. Accessed in May 2014 www.joyfulheartfoundation.org/.../domestic-violence/effects-domestic HARVEY, A. WHITEFORD, (2008) Depression and Primary Care. Med J Aust 2008; 188 (12 Suppl): S97–S144 HICKLE IB. Responding to the Australian Experience of Depression. Med. J. Aust. 2002, 176 (10 Suppl) S61 –S62 PROF. COOPER CARY. Coping with Stress. NHS Choices. Professor of Organizational Psychology and Health. Lancaster University. http://www.youtube.com/watch?v=ZVVWhROm7z8 THE CLINICAL RESEARCH UNIT FOR ANXIETY AND DEPRESSION (CRUfAD) A Research Unit focused on online Education and Treatment for Health and Wellbeing. www.crufad.org TYPE 2 DIABETES: Symptoms, Causes, Treatments and more…Diabetes Health Center. Web, Accessed in May 2014. www.webmd.com/diabetes/guide/type-2-diabetes Actual and Potential Impact of Domestic Violence on the Family Conclusion 10 pages, Harvard What psychological factors contribute to John’s use of violence and Anne being a victim of violence? What sociological factors contribute to John’s use of violence and Anne being a victim of violence? What impact does domestic violence have on Anne’s own bio-ecological model? (You may wish to refer back to the resources you used in case 2.) What actual and potential impact does domestic violence have on the bio-psycho-social health of Anne and John and the rest of their family? Read More