Case Studies in Family Violence Case Studies in Family Violence Edited by Robert T. Ammerman Western Pennsylvania School for Blind Children Pittsburgh, Pennsylvania and Michel Hersen Western Psychiatric Institute and Clinic University of Pittsburgh School of Medicine Pittsburgh, Pennsylvania Springer Science+Business Media, LLC Llbrary of Congress Catalogfng-ln-Publlcatlon Data Case studles in family violence I edited by Robert T. Ammerman and Michel Hersen. p. cm. Includes bibllographlcal references and Index. ISBN 978-0-306-43649-9 1. Family violence--United States--Case studies. I. Ammerman, Robert T. II. Hersen, Mlchel. H0809.3.U5C37 1990 362.82'92--dc20 90-49558 CIP ISBN 978-0-306-43649-9 ISBN 978-1-4757-9582-0 (eBook) DOI 10.1007/978-1-4757-9582-0 10987654 © 1991 Springer Science+Business Media New York Originally published by Plenum Press, New York in 1991 AII righ ts reserved No part of this book may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise, without written permission from the Publisher From Robert to his father From Michel to Victoria Contributors Robert T. Ammerman, Department of Research and Clinical Psychology, Western Pennsylvania School for Blind Children, Pittsburgh, Pennsylva nia 15213 Susan M. Andersen, Department of Psychology, New York University, New York, New York 10003 Teresa Ramirez Boulette, Santa Barbara County Mental Health Care Services, Santa Barbara, California 93110 Marla R. Brassard, Office for the Study of the Psychological Rights of the Child, University of Massachusetts-Amherst, Amherst, Massachu setts 01030 Susan E. Briggs, Harvard Medical School, Massachusetts General Hos pital, Boston, Massachusetts 02114 Angela Browne, Department of Psychiatry, University of Massachusetts Medical School, Worcester, Massachusetts 01655 Robert L. Burgess, Department of Human Development and Family Studies, Pennsylvania State University, University Park, Pennsylvania 16802 Naomi R. Cahn, Sex Discrimination Clinic, Georgetown University Law Center, Washington, D.C. 20001 Barbara A. Carson, Department of Criminal Justice and Criminology, Ball State University, Muncie, Indiana 47306 vii viii Contributors Judith A. Cohen, Department of Psychiatry, Western Psychiatric In stitute and Clinic, University of Pittsburgh School of Medicine, Pitts burgh, Pennsylvania 15213 Paul Cohen, Hutchings Psychiatric Center, Syracuse, New York 13210 Karen F. Drudy, John Merck Program, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, Pennsyl vania 15213 Ellen R. Fisher, La Casa de las Madres, San Francisco, California 94103 Barbara Forsstrom-Cohen, Syracuse Public Schools, Syracuse, New York 13210 Ronita S. Giberson, Graham B. Dimmick Child Guidance Service, Com prehensive Care Center, Lexington, Kentucky 40507 Edward W. Gondolf, Western Psychiatric Institute and Clinic, Univer sity of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213; and Department of Sociology, Indiana University of Pennsylvania, Indi ana, Pennsylvania 15705 Arthur H. Green, Department of Psychiatry, Columbia University Col lege of Physicians and Surgeons, Columbia Presbyterian Medical Cen ter, New York, New York 10032 David B. Hardy, Office for the Study of the Psychological Rights of the Child, University of Massachusetts-Amherst, Amherst, Massachusetts 01030 Stuart N. Hart, School of Education, Indiana University-Purdue Univer sity at Indianapolis, Indianapolis, Indiana 46202 Michel Hersen, Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213 Richard L. Judd, Emergency Medical Sciences, Central Connecticut State University, and Allied Medical Staff, New Britain General Hospital, New Britain, Connecticut 06050 Contributors ix Cheryl Carey Kent, Children's Evaluation Center, Los Angeles, Califor nia 90020 Dean G. Kilpatrick, Department of Psychiatry and Behavioral Sciences, Crime Victims Research and Treatment Center, Medical University of South Carolina, Charleston, South Carolina 29425 David J. Kolko, Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213 Lisa G. Lerman, Columbus School of Law, Catholic University of Amer ica, Washington, D.C. 20064 Martin J. Lubetsky, John Merck Program, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213 Bruce K. Mac Murray, Department of Sociology, Social Work, and Crimi nal Justice, Anderson University, Anderson, Indiana 46012 Anthony P. Mannarino, Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pitts burgh, Pennsylvania 15213 Edward R. McCarthy, Elder Home Care Services of Worcester Area, Worcester, Massachusetts 01603 R. Kim Oates, Department of Pediatrics and Child Health, University of Sydney, and Division of Medicine and Child Protection Unit, The Chil dren's Hospital, Camperdown, Sydney 2050, Australia Heidi S. Resnick, Department of Psychiatry and Behavioral Sciences, Crime Victims Research and Treatment Center, Medical University of South Carolina, Charleston, South Carolina 29425 Alan Rosenbaum, Department of Psychiatry, University of Massachu setts Medical Center, Worcester, Massachusetts 01655 Mindy S. Rosenberg, Private Practice, 1505 Bridgeway, Suite 123, Sau salito, California 94965 x Contributors Daniel G. Saunders, Department of Psychiatry, University of Wiscon sin-Madison Medical School, and Family Service Program to Prevent Woman Abuse, Madison, Wisconsin 53792 Amy H. Schwartz, Department of Psychology, New York University, New York, New York 10003 Janet Stauffer, Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213 Lois J. Veronen, Human Development Center, Rock Hill, South Carolina 29730 Catherine Walsh, Private Practice, Mt. Pleasant, South Carolina 29464 Rosalie S. Wolf, Institute on Aging, The Medical Center of Central Massachusetts, Worcester, Massachusetts 01605 Preface The past 20 years have seen the emergence of family violence as one of the most critical problems facing society. The alarming incidence figures of abuse and neglect directed toward family members justify this atten tion. For example, over 1 million children are thought to be abused and neglected each year. Similarly, almost 2 million women are victims of wife battering each year. Annual rates of elderly mistreatment are thought to be as high as 32 per 1000 population. Accurate epidemiologi cal data only now are being compiled on more recently recognized forms of mistreatment, such as psychological abuse, ritualistic abuse of chil dren, and child witnessing of adult violence. The pervasiveness of do mestic mistreatment makes it a priority for clinicians and researchers alike. For clinicians, intrafamilial violence represents a formidable chal lenge with respect to assessment and treatment. The etiology of abuse and neglect is multidetermined. There are numerous pathways in the development of family violence, and these interact and converge in a nonlinear fashion. The consequences of family violence are equally com plex and divergent. Victims of mistreatment can display a variety of physical injuries and psychological disturbances. No single psychiatric syndrome or symptom constellation has been consistently implicated in any form of family mistreatment. The perpetrators of family violence are equally heterogeneous in their clinical presentations. Illustrative dys functions in perpetrators include skill deficits, substance abuse, mental illness, and impulse-control disorders. The clinician must administer a comprehensive assessment battery, select the level of intervention (i.e., individual, family, or group therapy), and choose the appropriate treat ment. This is conducted within the context of the involvement of other professionals and organizations, including medical, legal, and social ser vices. Balancing the clinical needs of the family with the sometimes competing interests of other disciplines requires extensive and polished case-management skills. xi