Issues Paper 4.docx

1、Issues Paper 4Issues Paper 4 2001Working with women: Exploring individual and group work approachesDr Lesley LaingIntroductionThis issues paper explores individual and group work approaches to intervention with women subjected to violence and abuse in their intimate relationships. There is considera

2、ble debate, particularly amongst feminist practitioners, about the use and meaning of terms such as counselling and therapy to describe the types of interventions which comprise much of the focus of this paper. Some practitioners regard the use of such terms as inappropriate for describing the empow

3、ering practice they engage in with individual women, while others are more comfortable in defining their work with women within a framework of counselling/therapy. This dilemma about terminology reflects some of the debates and controversies which are canvassed in this paper. Hence the terms practic

4、e and intervention are used where possible to talk about working with women affected by domestic violence, because these terms are broader than the terms counselling and therapy, and can therefore more fully encompass the dimensions of working with women.In preparing this paper, it became clear that

5、 the literature on working with men who perpetrate violence, and on working with children who live with violence, is rapidly increasing. However, much less is being written about working with women, other than in their role as mothers of children who have lived with violence1. One reason for this li

6、es in the history of the recognition of domestic violence as a serious social problem. This paper begins, therefore, with a discussion of this historical context and its role in shaping ideas about the role of counselling/therapy in responses to women subjected to violence in their intimate relation

7、ships.The recognition of domestic violence as a serious social problem is an achievement of second wave feminism, a social movement originating in the late 1960s and early 1970s. Feminist activists provided safety and shelter for women and children escaping violence, and located the roots of domesti

8、c violence in gender inequality in social relationships. This formulation challenged the existing medical model which located the causes of domestic violence within the pathology of individual men and women. From a feminist perspective, women escaping violence were in need, not of counselling or the

9、rapy, but of legal redress for crimes committed against them, and of access to income support, housing and other resources to enable them to establish lives free of violence and abuse. The longer term solutions to violence against women lay in the reform of gender relations and measures that fostere

10、d womens social and economic autonomy. Given this historical context, reservations about the contribution of counselling or therapy to working with women, are understandable. Carlson (1997) identifies four concerns underlying these reservations. Firstly, offering counselling may imply that the woman

11、 has pre-existing personality deficits which somehow contributed to her victimisation. Hence there is a danger that counselling responses may perpetuate victim-blaming and obscure the responsibility of perpetrators. Secondly, many women report judgemental and unhelpful contacts with mental health an

12、d other therapeutic service providers. Thirdly, the inherent power imbalance in the therapeutic encounter replicates the power imbalance in the abusive relationship, and thus creates a problematic context for facilitating empowerment. Finally it is argued that the focus of efforts to address domesti

13、c violence must be on changing the systems economic, health, legal and welfare which fail to provide abused women and children with the resources they require to live safely. An alternative view is that living with abuse and violence under a regime of coercive control can have serious effects on wom

14、en, and that counselling can play a role in assisting women to overcome these effects (Styles, 1991). This view is supported by two Australian research projects which explored the needs of women affected by domestic violence (Bagshaw, Chung, Couch, Lilburn, & Wadham, 2000; Keys Young, 1998). Both fo

15、und that women expressed a need for emotional support, to assist in overcoming the impact of their experiences of abuse. People tell stories differently, at different stages of their experience. I can talk to you about this now without shaking. But I couldnt have done this a year ago without shaking

16、. I needed specialist help. I needed to trust people again. (survivor cited in Keys Young, 1998, p. 61)It is important to note that the sharing of experiences, and the linking of womens experiences with the experiences of other women, was an important part of the work of the womens refuge movement.

17、For the first time women were able to talk about the abuse and violation to which they had been subjected, to be listened to, to be believed, and to find that they were not alone. In this approach lay the foundations of group work, which continues to be by far the most common form of intervention wi

18、th women affected by domestic violence. It is now recognised that living with violence, abuse and controlling behaviours can severely impact on womens mental health (Herman, 1992; Laffan, 2001; Roberts, Lawrence & Williams, 1998). In order to access assistance for women, refuges are increasingly att

19、empting to develop links with mental health services, although the different cultures of each service system can present formidable challenges to developing approaches which meet the needs of abused women (Incoll, 2000; Shelton-Bunn, 2001). It appears then, that the issue is less about whether or no

20、t there is a role for counselling/therapy, than about the type of practice which is engaged in when working with women, whether this contact with women is called counselling, therapy, support, or advocacy (a term widely used in the United States). Practice in working with women needs to avoid the pi

21、tfalls identified by Carlson: pathologising the woman, assuming that counselling alone is a sufficient response to domestic violence, or failing to locate responsibility for the violence with the perpetrator. Avoiding pitfall such as these requires awareness of the values and perspectives underlying

22、 and informing practices in working with women.The broader emphasis on practice and the attention to the values and perspectives underlying this practice, make it possible to include in this discussion other important dimensions to working with women affected by domestic violence. For example, many

23、service providers who come into contact with abused women, while not in a formal or structured counselling role, can nevertheless play an invaluable role in countering the self-blame and isolation imposed by the perpetrator. This is seen in a study of abused womens contact with the health system. Ge

24、rbert et al. (1999) identified the importance to the women of interactions characterised by a non-judgemental attitude and caring manner on the part of the health care provider:The women.described how (with or without direct identification or disclosure) validation from a health care provider had “p

25、lanted a seed”, leading to turning points or epiphanies in their relationships with the abusers. Validation served to slightly shift their mental landscape, which in time helped them to see the relationship and themselves differently. (Gerbert et al., 1999, p. 130)Such interventions can in fact be v

26、ery influential in a womans understanding of issues of responsibility and in her assessment of potential resources in her attempts to deal with the violence she faces. Central to the debate about practice with women, is the fact that domestic violence is at the same time, both a personal problem and

27、 a social issue:Because violence against women is so deeply embedded in the institutional fabric of society, wife abuse is both a social problem and a personal issue, as it is perpetrated by men against women in their social locations as wives and/or intimate partners. As a social problem, it can be

28、 viewed as a point of convergence of broader patterns of economic, social, and political discrimination against women. (Lempert, 1996, p. 269)This raises dilemmas and debates about at which level the individual or the social to best focus our interventions. Does working with individual women re-priv

29、atise and hide the issue of domestic violence as a social problem? On the other hand, does change at the social and political level reach down to improve the situation of individual women? The womens refuge movement developed a form of intervention which encompassed both levels of intervention, capt

30、ured succinctly in the slogan: the personal is political. As Wensing explains: we see our work in the community as being as important as our work within services. (2001)Dilemmas about the level at which to focus intervention do not just arise with respect to counselling interventions. Similar dilemm

31、as have been identified, for example, with legal interventions such as evidence based or no drop prosecutions2 where criminal proceedings against a perpetrator of violence may proceed against the express wishes of the woman. While some support such policies on the grounds that they ensure that the S

32、tate treats domestic violence as a serious crime (social change), others argue that such policies are disempowering to individual women and increase the danger to women from disadvantaged social groups (Mills, 1999). Melanie Shepard (1999, p. 120) from the Duluth program provides an example of this tension between different levels of intervention: Advocates have argued for policy reforms (e.g., prosecution of cases) only to turn around and ask for exceptions for individual battered women. The next section of this issues paper outlines some competing views about women who experience