Good for the Women or the Children?  

Changing the way we view and fund treatment in abused families…

By Linda Toche-Manley

Domestic violence affects all of us – in our bodies, our emotions, our relationships and our children.

To effectively tackle the impact of domestic violence, it must be addressed as a serious family problem – not as a “women’s” problem. This means using a multi-agency approach that often involves complex partnerships across child welfare and mental health agencies, medical, law enforcement, and criminal justice organizations. Unfortunately, most agencies that provide domestic violence services tend to operate as separate systems with only informal agreements to share information. When agencies do attempt to collaborate, poorly coordinated services and inefficient communication are common as each agency has its own goals and wanted outcomes.

This combined with the dismal state of funding of services that support women and children who are survivors of abuse perpetuates the perception that violence is acceptable and that services are not so badly needed by survivors. As a result, professionals, survivors and volunteers run many DV agencies with few monetary resources. All too often, the formal funding base for domestic violence consists of “one-shot” block grants that allow for the “building to be built” but often provides little in the way of ongoing revenue to provide services. As a result, agencies serving abused women often are forced to close down in the communities that need them the most.

But by focusing on working with communities to develop multi-layered agency partnerships to provide and fund services for abused women and families, a couple new events may occur. One, with more entrance points into treatment via medicine, the courts, child welfare and other agency partnerships, it is likely that more women and their children will be served. Second, the collection of data on these partnerships’ outcomes becomes more critical to attract richer financial players such as corporate sponsors, and public agencies such as child welfare to supplement grants and other traditional revenue sources that funds services for abused women and families.

These changes will require new planning and assessment tools. We have recently been awarded from the National Institutes of Health a three-year grant for the development of a web-based assessment tool to support system level change towards agency partnership to address abused women. In this project, assessments are completed on the Internet and clinical reports are generated. Reports show women’s co-morbid mental health problems, strengths as well as factors associated with relational schema that will help women avoid victimization in future relationships. Other tools have been designed by our group to evaluate the impact of abuse on children and to move them towards successful permanency.

Multi-agency partnerships require on going case and program data to support them in coordinating the correct intensity of services for women and children. If agencies are to work together to improve care for women and families recovering from the aftermath of abuse, they must be able to communicate and share data effectively. The data itself provides a language that shows from the voice of the survivor what she thinks is important to focus on in treatment and what she thinks are her strengths. This is the beginning of truly including the survivor in treatment planning. This person-centered approach to treatment planning reaffirms to her that others want to hear her voice and empowers her that she can change things for herself as well as for her children.

As interagency collaboration grows we can envision that multi-agencies with pull together to form advocacy groups that shift policy to support empowered thinking and services that serve the survivor and their children. But, I believe, it requires data to show the mental impact of abuse, the impact on relationships, and the impact on our children. Policy makers and those with the money strings to support abused women and families must see with their own eyes the incredible pain and need in the voices of those who have been abused. We hope that this project will support the development of these interagency collaborations at the medical, DV-child welfare and legal levels and yield a more firm financial and policy foundation for all of us devoted to supporting women and families from the recovery of abuse.
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Linda Toche-Manley, Ph.D., is the Principal Investigator/Principal for the domestic violence and child welfare systems at Polaris Health Directions, PA. She consults on multi-system change in youth and adult systems of care. Please contact her at Linda@polarishealth.com to find out more about the NIH project and/or to discuss other possible collaborations