Social Work Intervention in Mental Health Issues - Dissertation Example

? Social Work Interventions Adult Mental Health Issues & Domestic Violence Submitted [Pick the Contents 3 Introduction 4 2.Literature Review 4 2.1 Causes of Mental Health Issues and Domestic Violence 5 2.2 Addressing Mental Health Issues and Domestic Violence 7 2.3 Social Work Interventions 8 3.Research Methodology 10 3.1 Research Objective 10 3.2 Research Questions 10 3.3. Research Methods & Its Limitations 10 4.Discussion and Findings 11 5.Conclusion 14 Bibliography 16 Abstract This dissertation is intended to examine possible causes and effects of domestic violence and their relation to mental health issues in adults. For this purpose, a critical literature review is performed that helps in identifying the interventions employed for addressing physical abuse and underlying issues. The research methodology used involves explorative study of secondary data present in the form of reliable publications such as peer-reviewed journals and books. Furthermore, the research also highlights the responsiveness of social work towards perpetrators, their mental health issues and interventions designed for male victims. 1. Introduction Social work and domestic violence agencies are perceived as a medium of protection of victims of domestic violence involving physical abuse. Where measures taken by these bodies are intended to restore the physical health of the victims, they also focus on reducing the impacts of trauma faced by the victim. This dissertation is aimed at identifying the possible causes of domestic violence in society and their related outcomes. Furthermore, this research attempts to develop a relationship between domestic violence and mental health issues in adults (Humphreys 2007 and Siemieniuk et al. 2012). The research identifies the interventions employed by social work bodies and categorizes them as primary and secondary interventions. To highlight the importance of identifying mental health issues associated with physical abuse and assist in preventing mental health disorders either by reducing the risk factors for adults with no diagnosed mental disorder (Leung et al. 2012) or by preventing relapse in people previously diagnosed with a mental health disorder (Howard et al. 2010), particularly those in disadvantaged and vulnerable groups (Cacciatore et al. 2011, and Shawahin, & Ciftci 2012) is the main purpose of this research. Other than addressing the issues of victims of physical abuse, this research will also highlight the behaviour of social work bodies towards perpetrators and male victims of domestic violence. 2. Literature Review Domestic violence has been one of the major issues that have caught attention of social work and government agencies handling domestic violence. It is important to note that domestic violence is a resultant of aggression underlying in childhood issues or complex relationship. Additionally, the degree of victimization is also dependent on the intimacy of the relationship. It has been observed through various case studies that in highly intimate relationships, tolerance for domestic violence is higher which further alleviates the risks for future damage leading to critical adult mental issues. On the other hand, children who have viewed violence in their childhood i.e. intense aggression among parents or have suffered abuse themselves are more prone to mental issues in their adult life. However, in order to address these issues, social work agencies have defined frameworks that deal with the early diagnosis of the problem leading to domestic violence that begins with the routine screening of the victim reported as a primary prevention intervention. Further interventions include attempts to reduce risks of repeat victimization, supporting the victim in enabling disclosure; reporting to authorities and supporting them regain mental health through selected interventions based on individual cases and group work (Hester and Westmarland, 2005). 2.1 Causes of Mental Health Issues and Domestic Violence Domestic violence is usually an outcome of a situation where one partner takes over the control of the situation in hand or tries to impose their dominance in the domestic settings. This behaviour is usually caused by lower-self esteem, difficulties in anger management or regulation of aggressive behaviour, and inferiority complex due to superior characteristics borne by the other partner such education, beauty etc. In some cases, cultural forces also play important role in imposing such behaviour. It is important to differentiate between domestic violence and domestic abuse as the later one includes physical and sexual abuse (domestic violence), verbal, non-verbal, economic and spiritual abuse along with infringement of privacy. According to Wolfe and Jeffe (1999), genetic biochemistry (Biological theory), individual dysfunctional personality (Individual Psychopathology theory), faulty family system (Couple and Family Interaction theory), violence as a learned behaviour (social learning development theory), and social imbalance (social structure theory) are the possible causes of domestic violence. Other than existence of power relations defined by culture and society, stress and depression can also cause this behaviour with later being more aggressive in this role. However, domestic violence is a learned intentional behaviour that develops over the period of time and has its roots in frequent exposure to violence or humiliation. Perpetrators often chose not to take responsibility for their violent actions and consider them an outcome of external agent i.e. situation or certain behaviour or action of the victim. Domestic violence is aggravated when victims accept it as a common norm or part of family values and traditions. In situations where such instances are considered as a private matter or perpetrators is considered as an influential figure with special privileges and benefits, intensity and frequency of such events increase. Domestic violence has a tendency of taking forms of physical, sexual or psychological abuse. It is important to consider that most of the time; situational factors are more aggressive in triggering violent behaviour than underlying issues. Hence, personal and community background, overall cultural forces and individual issues play important role in introducing such behaviour (Chemtob et al. 2011) In addition to that, children who have been victimized and have faced frequent or continuous violence also consider domestic violence as an effective medium of conflict resolution in their adulthood. Simple example is a violent behaviour from male individuals who have faced lack of respect from female figures when they were kids, towards female members of their family and society. In addition to that, substance abuse and alcoholism has a contribution in instigating aggressive and impulsive behaviour. However, it is important to note that this is not an underlying cause in many cases and thus, cannot be used as an excuse for domestic violence. Where possible causes of domestic violence have been mentioned above, it is significant to consider that domestic violence cannot always be caused by mental illness or distress and disorder. On the contrary, it can result in mental illness. Possible outcomes of such violence may include physical disorders, mental distress and problems that include sleeping disorders, depression, anxiety attacks, low-self-esteem, lack of trust, anger, poor relationships with other social figures, diminished physical and working capacity, substance abuse, risk of death and social inactivity (Benedictis et al., 2012). These mental health issues are further aggravated by prevailing health conditions. There is a strong association between domestic violence victimization and HIV infection which may result in ineffective interventions and reduced access to necessary healthcare (Siemieniuk et al. 2010). 2.2 Addressing Mental Health Issues and Domestic Violence In order to address the possible issues caused by domestic violence, it is important that victim must be removed from the continuous exposure of violence in the first place. Hence, prevention of domestic violence is the first step towards addressing mental health issues. There are three types of prevention strategies that can be adopted by social work and domestic violence agencies named as primary, secondary and tertiary prevention. According to Wolfe and Jaffe (1999), “Primary prevention involves efforts to reduce the incidence of a problem in a population before it occurs. The goal of secondary prevention is to target individuals to decrease the prevalence of a problem by minimizing or reducing its severity and the continuation of its early signs. Tertiary prevention involves attempts to minimize the course of a problem once it is already clearly evident and causing harm.” 2.3 Social Work Interventions Social work authorities have a special role in preventing domestic violence and related mental disorders. Possible interventions that can be used by social work agencies include primary diagnosis or reporting of violence and abuse (Danis & Lockhart, 2003; Weine, 2011). Other than prevention, overall community awareness and challenging underlying violent behaviour in such communities becomes an important part of these social work interventions. Supporting the victim to disclose and report violence becomes second phase of these interventions. Once the occurrence or recurrent exposure to domestic violence has been prevented, comes the third stage of social work treatment. This phase is intended to deal with the psychological distress, stigma, trauma and physical injuries caused by domestic abuse. These interventions may include crisis intervention. Crisis intervention is an intervention that is required by the victim immediately after the incident. It is intended to reduce the effect of physical damage through medical assistance and trauma recovery strategies. Another important social work intervention that is required by underlying mental issues caused by domestic violence is counselling. Here, social worker agencies tend to have a responsibility towards abuser as well as the victim. Basic interventions are intended to identify the possible causes of domestic violence and their effects on abuser and the victim. Part of such intervention is meant to reduce the stigma and trauma felt by the victim, therefore strategies to build and restore self-esteem, self-confidence, and trust in other social bodies and entities should be employed. This intervention is further intended to identify the measures and future course of action for and by the victim (Mojoyinola, 2006). Another addition in the umbrella of counselling can be spiritual healing (Bowland et al. 2012). Other than counselling and reducing the impact of the incident, safety of the victim is one of the major concerns for social work agencies. Since the abuser is already undergoing disturbed behaviour due to underlying factors therefore recurrence of violent behaviour is predictable. It becomes responsibility of social work agencies to help the victim identify alternate sources of living. This intervention will help the victim in having minimum risks of exposure to violence and will also help them in dealing with emotional distress caused earlier. Other social work interventions include psychotherapy, psycho-education, linkage with the community resources and community education. All these interventions are meant for reducing the impacts of emotional distress and trauma. Psychotherapy is meant for reducing the possible turmoil caused by the event. For this purpose, individual and group therapy focused on restoring confidence and helping in other outcomes of the event such as substance abuse, alcoholism, sleep deprivation and socially disturbed behaviour. As a compulsory component of Crime Prevention Program, social work agencies have introduced interventions that are intended to educate victims regarding occurrence of violence. It is important to increase an awareness that domestic violence is not acceptable and tolerating it will only result in further aggravation. Gaining support from community is another measure intervention that can be used by social and domestic violence agencies. Community awareness programs, community agents and collateral contacts within the community that will ensure that social work agencies can help the victim have supporting resources within their communities, familiar settings and trust circle. In addition to that, community awareness programs are an effective measure to reduce the instances of domestic violence. It is also stressed that these awareness programs address the needs of children in violent settings where parent has a mental illness causing violent behaviour (Cowling & Garrett, 2012; Willis et al. 2010). These interventions are intended to create an awareness that in no culture or social settings, excessive or unnecessary domestic abuse and violence can be treated as a normal behaviour. Cases involving violence needs to reported and necessary law enforcing actions needs to be taken to deal with perpetrators (Mojoyinola, 2006). 3. Research Methodology 3.1 Research Objective The main purpose of this research is to identify the role of social work interventions in reducing the possible impacts of domestic violence leading in mental health issues in adults. Where social work agencies, and their role has been gaining substantial importance in reducing the frequency of social abuse and domestic violence, it is significant to identify the interventions employed by the social and domestic violence agencies in doing so and also if these interventions are effective in the respective social settings. 3.2 Research Questions 1. What the main causes of mental health and domestic violence issues in society? 2. How would the issues of mental health and domestic violence be addressed effectively? 3. What is the nature of the gap that exists between the causes, effects, and solutions of mental health and domestic violence issues? 4. What have the professionals on mental health and domestic violence done with regard to alleviation of these issues? 3.3. Research Methods & Its Limitations Research methodology provides a set of instructions through which a research can be performed and conclusive evidences can be drawn out of its key findings. There are various research methods that can be used for conducting research however it is important to ensure that selected method serves the purpose of the research and is compatible with its nature. Furthermore, the selected method must also address the possible limitations inherent with the research’s nature. For this research, the method selected is explorative research. Such research is conducted by using data derived from secondary sources such as academic journals, books, reports, electronic articles etc. Although reliability of data is one of the major concerns related to using secondary data however using peer-reviewed publications and authentic literature obtained from reliable libraries has addressed this concern. 3.4 Research Design The research design for this dissertation is critical literature review. 3.5 Statement Linking Research Questions and Research Design Much information and data is available on the efforts of professionals and issues related to domestic violence and mental health. This warrants the use of critical literature review as the research design for this dissertation, which will ensure that credible and reliable data is obtained. 4. Discussion and Findings The literature review performed earlier recognizes the importance of social work and domestic violence agencies with relation to rehabilitation and alleviation of victims’ mental health. Social work interventions recognize the importance of prevention of social and domestic violence and consider it as the first measure in overall social work process. There are various researches that recognize and provide increasing evidence of chronic, severe and often long-term adverse mental health effects for victims (Macy et al. 2009). Therefore, recognition of occurrence of such events and prevention of their recurrence or removing the victim from the settings synonymous to those during the event is considered as a fundamental primary intervention. Social work professionals have done concrete study that addresses the possible steps or interventions for treating and physical injuries and mental distress. Crisis intervention teams play vital role in the events where victim has sustained physical abuse resulting in trauma. Contacting healthcare and medical authorities and acquiring necessary assistance focused on mitigating the effects of physical abuse and trauma is the primary responsibility of these teams. Further literature illustrates the role of social work authorities and individuals in addressing mental health issues which is considered as the core domain of social work. Encouragement, kind words, interventions provoking healthy social behaviour and involvement in group activities, individual treatment focused on treating post-event behaviour i.e. alcoholism, substance abuse sleeplessness etc, and other interventions meant for restoring self-esteem and confidence along with trust in other social relations, are the most common interventions used by social workers. Gaining community support and creating cultural and communal awareness is also another intervention which is expected to have a long-term impact and has a preventive as well as curative nature. This research is intended to examine the relationship between causes and effects of domestic violence and possible interventions that have been designed to address these issues. The literature review undertaken earlier helps in reaching an understanding that domestic abuse is a resultant of underlying issues that may have taken place in the early childhood or adolescence (Bowland et al. 2012). However, not much attention has been paid to issues that take place in adulthood but have a tendency of altering complete human behaviour. Similarly, social work interventions appear to be mainly victim-oriented i.e. focus on victim’s welfare and pay less attention to restoring mental stability of the abuser. In addition to victim-oriented dimensions of the social-work interventions, these measures introduced neglect the possibility of reconciliation among the victim and abuser. Participation of law-enforcing authorities further instigates violent behaviour in the abuser and reduces the chances of positive outcomes. Furthermore, while performing literature review, it was also observed that most of the work done has been gender-directed where males are perceived as abusers. There is a limited literature or research that recognizes the possibility of male individuals’ victimization. There is a need to devise special interventions that can suit the needs of such victims. Responses of men towards domestic violence are different and more penetrating than females. In addition to these differentiated strategies, possible outcomes of domestic violence and related mental health issues may also vary demanding different level of attention (Douglas & Hines, 2011; Howard et al. 2010). Also, the role of parental trauma exposure and related mental health symptoms as risk factors for child maltreatment for parents involved with the child welfare (CW) system has received limited attention resulting in absence of suitable interventions addressing this issue (Chemtob et al. 2011). Another major issue highlighted during critical examination of available literature is the usage of Duluth model program. According to Corvo et al. (2010), “In spite of numerous studies of program outcomes finding little or no positive effect on violent behaviour, the Duluth model remains the most common program type of interventions with perpetrator of domestic violence. In addition, Duluth model programs often ignore serious mental health and substance abuse issues present in perpetrators. Where professional ethics are violated, perpetrators’ mental health also gets on stake and underlying problems may also aggravate. Hence, program efficacy is highly doubtful. Careful and critical analysis revealed that most of research available and interventions introduced are effective in reducing the impacts of domestic violence, trauma and related stigma. It further addresses the underlying mental health issues caused by domestic violence sustained in current settings and earlier life, and increases mental health of the victim by instigating healthy behaviour. However, most of these interventions are biased and show their orientations towards victims only where perpetrators are the causative agents in domestic violence and need equal attention in order to avoid recurrence of such events. Furthermore, possibility of men being victim is also considered as a lesser probable event therefore most of the interventions are designed to address issues in women and children. 5. Conclusion Social work is an effective field of work through which mental health and balance in society can be restored. Everyday hundreds of cases are reported to social work and domestic violence agencies reporting physical abuse. In order to address these issues, there are various contemporary theoretical and practical models that are intended to identify possible causes and effects of domestic violence leading to selection of suitable social work interventions intended to reduce the impacts of trauma and stigma sustained by the victim and avoid the recurrence of such events. Interventions like counselling, crisis intervention teams (CRT), community awareness programs, psychotherapy etc focus not only on healing the victim but also create community knowledge and awareness that has a long-term, more penetrating and beneficial impact. However, most of these social work interventions have only focused on the mental health of victims. Where other interventions focus on finding out the possible causes of violent behaviour in abuser and its possible effects, less attention has been paid to actually address these issues. In fact, isolating and separating victim from abuser is considered as the most convenient intervention. Furthermore, male victimization is highly undermined in social work interventions and related research. Bibliography Benedictis, T.D., Jafee, J. and Segal, J., 2012. Domestic Violence and Abuse: Types, Signs, Symptoms, Causes, and Effects. Available at: http://www.aaets.org/article144.htm [Accessed 30 December 2012] Bowland, S., Edmond, T., and Fallot, R., 2012, 'Evaluation of a Spiritually Focused Intervention with Older Trauma Survivors', Social Work, 57(1), pp. 73-82, Available at: Academic Search Premier, EBSCOhost [Accessed 30 December 2012]. Cacciatore, J., Carlson, B., Michaelis, E., Klimek, B. and Steffan, S. 2011. 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'Children Who Witness Violence: What Services Do They Need To Heal?', Issues In Mental Health Nursing, , [e-journal] 31(9), pp. 552-560, Available at: Academic Search Premier, EBSCOhost [Accessed 30 December 2012] Wolfe, D.A. and Jaffe, P.G., 1999. Emerging Strategies in the prevention of domestic violence. Domestic Violence and Children, , [e-journal] 9(3), Available at: Academic Search Premier, EBSCOhost [Accessed 30 December 2012]. Read More