Family
Advocacy
Research
Digests

RESEARCH REVIEWCURRENT RESEARCH FOR FAMILY ADVOCACY PROGRAMS • VOL. 4, NO. 2 WINTER 2020
In this Issue

We present Research Review (RR), a publication of the Joining Forces Joining Families (JFJF) group.
RR consists of summaries of research on intimate partner violence (IPV) and child maltreatment thatis of interest to family advocacy, medical, and social service providers. IPV-related summaries include
the association of coercive control with women’s experience of violence, the health risks of strangulation, and reproductive coercion as a form of IPV. Child maltreatment-related summaries include therisk of client-perpetrated violence toward new family advocacy workers and research calling for amore nuanced understanding of the association between frequent residential moves and risk of childmaltreatment.

Reducing Client-Perpetrated Violence toward New
Family Advocacy Workers
Frontline child welfare workers, particularly the
newly hired, can be subjected to a variety of situations
with clients that result in worker distress and physicalinjury. Conducting home visits to monitor child safety
and coordinating services (e.g., mental health, substanceabuse) all require time and an experienced workforce.
Personnel performing investigations as well as home visits
in the military family advocacy program (FAP) may besimilarly exposed. In addition to the personal and professional challenges related to their cases, the organizational
environment may fail to provide the needed support.
The Florida Study of Professionals for Safe Families
longitudinal study of child protective investigators andcase managers found that among new child protective
service (CPS) workers with less than six months on thejob (n=1,501), 75% reported that workplace exposure to
non-physical violence (e.g., yelled at or sworn at) by theirclients was common. Thirty-seven percent received threats

Contents

Reducing Client-Perpetrated Violence toward New Family
Advocacy Workers…………………………………………… 1
How Should Child Welfare Workers Recognize and Respond ……
When Children are Exposed to Intimate Partner Violence?…… 2
When is Coercive Control Intimate Partner Violence?………… 3
Strangulation in Intimate Partner Violence Is a Risk for …Ill Healthand Homicide………………………………………………… 4

of violence, and 2.3% reported incidents of physical violence
perpetrated by their clients (Radey & Wilke, 2018). CPS
worker characteristics predictive of any violence exposure
included age (younger workers experience more violence),
race (Black and Hispanic workers experienced lower levelsof non-physical violence), college major (workers whose
highest degree was social work experienced less violence),and position type (investigators experienced higher rates ofviolence than case managers).
Supervisory and management practices play an important role in supporting all workers who are exposed to therisks of violence in their case work with families. Radey and
Wilke (2018) suggested three methods of preventing client violence. First, violence training and preparation can befocused on judging the potential for client-initiated violence.
Second, a culture of safety can be promoted by requiring
disclosure of violence encountered or threats thereof. Third,
Continued on page 3
Residential Mobility and Victimization Risk among Children… 5
The Army Family Advocacy Program: Implementation …………
Strengths and Challenges…………………………………… 6
PTSD is Associated with Violence Recidivism in Male
Perpetrators of Intimate Partner Violence …………………… 6
A Military-Specific Parenting Program Is Associated with ………
Improved Parenting and Child Adjustment…………………… 7
Reproductive Coercion and Intimate Partner Violence………… 8

How Should Child Welfare Workers Recognize and Respond
When Children are Exposed to Intimate Partner Violence?
Intimate partner violence (IPV) can result in significant
physical and psychological harm to children. They can be
involved in assaults if they attempt to intervene in an episodeof IPV. Psychological harm can occur as a result of witnessing assaults between parents, destruction of property, harmto pets, and stalking of the other parent and children. Suchexperiences can result in behavioral difficulties for children,
such as depression and aggression (Gonzales, MacMillan,
Tanaka, Jack, & Tonmyr, 2014; Joining Forces Joining Families, Spring 2019).
Child exposure to IPV by itself is generally not considered
a form of child maltreatment under most state laws; additional safety concerns (e.g., physical injury or risk of physical injury) or evidence of psychological harm are typically required
to substantiate such cases (Henry, 2018). Unintended consequences of these additional requirements include masking thetrue prevalence of child exposure to IPV.
Child welfare workers who respond to incidents of IPVneed to recognize the risks to children. A study of a California county child welfare agency’s response to 31 allegationsof children’s exposure to IPV between 2011 and 2012 showed
how they labeled, judged, and acted on referrals for child exposure to IPV (Henry, 2018). Because child exposure to IPV
is not a type of child maltreatment under California state law,workers could report the case as emotional abuse (IPV waspersistent and/or severe and likely to result in child internalizing or externalizing behavior), physical abuse (exposure
resulted in or was likely to result in injury), neglect (caregiver failed to intervene on child’s behalf despite knowledge thatthe child could be harmed), or multiple types of maltreatment. A review of case records found that workers initiallylabeled 94% of all IPV exposure-only referrals as emotional
abuse at the time of the referral. Seventy-four percent shouldhave met the criteria for a threat to the child’s safety, butsafety concerns were documented in only 36%. Twenty-nine
percent of child exposure cases were substantiated. Insteadof promoting referrals to case status in which the child andfamily would have received evaluation and follow-up, 87% of
exposure-only households were only referred to IPV service
Continued on page 4Child welfare workers, parents, and clinicians need to understand the many threats presented tochildren by IPV exposure including the risk of physical harm, adverse mental health, and otherphysical and psychological damages to them and their parents.

JOINING FORCES
Joining Families

RESEARCH REVIEW
EditorRonald J. Whalen, PhD, LMSW
Research Assistant Professor
Department of Psychiatry, USU
e-mail to ronald.whalen.ctr@usuhs.edu(301) 319-8003

Editorial Consultants
Joshua C. Morganstein, MD
Captain, US Public Health Service
Assistant Director, CSTS
Associate Professor and Assistant Chair
Department of Psychiatry, USU

Joining Forces Joining Families—Research Review isa publication of the Family Violence and Trauma
Project, Center for the Study of Traumatic Stress,
Department of Psychiatry, Uniformed Services
University, Bethesda, Maryland 20814, and the U.S.
Army Installation Management Command, Fort
Sam Houston, TX 78234.

James E. McCarroll, PhD, MPH
Research Professor
Department of Psychiatry, USU

2 • RESEARCH REVIEW | Joining Forces/Joining Families

Assistants to the Editors
Alexandra Burris, BA
Britany Mullins-Husain, BA

Winter 2020

When is Coercive Control Intimate Partner Violence?
Coercive control (CC) is a pattern of behavior meant toestablish dominance over another person through systematic
restrictions on their freedom and independence. There is noconsensus on the definition of CC or how CC should be measured, but examples are intimidation, isolation, and terrorinducing violence or threats of violence (Dichter, Thomas,
Crits-Christolph, Ogden, & Rhodes, 2018). When CC issevere, by increasing in frequency, severity, and chronicity,
it can be associated with trauma-associated mental healthsymptoms.
Dichter et al. (2018) sought to expand the current understanding of CC of women by examining (1) how specificforms of victimization (psychological, physical, and sexual)
differ between women who experience intimate partner
violence (IPV) with versus without CC; (2) how women’s useof violence differs between women who experience IPV withversus without CC; and (3) how the risk of future violencediffers between women who experience IPV with versus
without CC.
Participants in this research were 553 women recruitedfrom two emergency departments in Philadelphia, PA, who
had experienced at least one act of physical, psychological, or
sexual IPV. Thirty-two percent had experienced CC. Previous
3-month experiences of physical, psychological, and sexual
violence were significantly higher among women who had

a history of CC. Compared to the no CC group, the women
who were subjected to CC had a significantly greater risk ofreceiving psychological violence (88.2% vs. 70.6%), physical violence (42.9% vs. 7%), and sexual violence (24.3% vs.
4.6%). The CC group also perpetrated significantly more
physical violence against their partner (42.7% vs. 18.8%)
than the women who had not experienced CC, but there
were no significant differences in their use of psychologicalviolence (90.5% vs 92.5%, respectively) or sexual violence(7% vs. 4%, respectively).
The clinical implications of these findings include theneed to inquire about CC in women’s relationships as well as
the acts of IPV that they have experienced and perpetrated.
It is important that clinicians be aware that the use of violence by women in response to CC may put them at risk forinjury. Their use of violence may also reflect their fear, risk,
and isolation leading to the use of violence as a safety andsurvival strategy (Dichter et al., 2018).

Reference

Dichter ME, Thomas KA, Crits-Christoph P, & Ogden SN.
(2018). Coercive control in intimate partner violence:
relationship with women’s experience of violence, use ofviolence, and danger. Psychology of violence, 8(5), 596-604.

Coercive control can be violent or non-violence. Examples of coercive control are
intimidation, isolation, and terror-inducing violence or threats of violence.
Reducing Client-Perpetrated Violence, from page 1
supervisor and peer support within the organization can
provide workers the opportunity to process incidents, andto connect workers to resources following an encounter ofviolence.
Supervisors in military FAP can also explore risk factors
in their community in addition to those found in this study
in Florida. Awareness of risk factors for maintaining a family
advocacy work force and supervision that is attuned to theserisks can improve worker morale and longevity. The authors
suggested the need for research on: the nature, details, andconsequences of client violence; building worker-client rapport skills; and determining changes over time in the natureand exposure to violence experienced by child welfare workers.

References

Radey M, & Wilke DJ. (2018). Client-perpetrated violence
among frontline child welfare workers . Journal of Interpersonal Violence. doi:10.1177/0886260518812792

New family advocacy case workers are sometimes exposed to physical and non-physicalviolence by clients. Supervisory and management practices play an important role in supporting
all workers who are exposed to the risks of violence in their case work with families.

http://www.CSTSonline.org

RESEARCH REVIEW | Joining Forces/Joining Families • 3Strangulation in Intimate Partner Violence Is a
Risk for Ill Health and Homicide
The prevalence of strangulation among intimate partners
is underestimated as many victims do not report it and it
is difficult to detect on examination in emergency departments. As a result, it is important for clinicians as well as
law enforcement personnel to be aware of the seriousness of
non-fatal strangulation that occurs in episodes of intimate
partner violence (IPV).
In IPV incidents in the U.S. in which police were involved, almost 68% reported being strangled at least once oron multiple occasions and almost 12% reported attempted
strangulation. As the severity of strangulation incidents
increased, a woman’s likelihood of seeking medical carefor IPV-related injuries also increased. Victims who had
been strangled multiple times were more likely than those
not strangled to report feeling powerless, suffering from a
miscarriage due to abuse, increasing severity or frequency of
their partner’s violence over the past year, and believing that
their partner is capable of killing them (Messing, Patch, Wilson, Kelen, & Campbell, 2018). The lethality of prior nonfatal strangulation was demonstrated in the six times greater

odds of attempted homicide and seven times greater odds ofcompleted homicide compared to controls who were physicallyabused or threatened with a weapon (Glass, Laughon, Campbell,
Block, Hanson, Sharps, & Taliaferro, 2008).
When IPV is suspected, women’s health care practitioners andemergency care personnel are ideally positioned to inquire aboutstrangulation, address associated adverse health outcomes, andrefer victims to appropriate services. Protocols need to be in place
for first responders, police, health care providers, and advocates tofacilitate screening and treatment for nonfatal strangulation.

References

Glass N, Laughon K, Campbell J, Block CR, Hanson G, Sharps
PW, & Taliaferro E. (2008). Non-fatal strangulation is an important risk factor for homicide of women. Journal of Emergency Medicine, 35(3), 329-335.
Messing JT, Patch M, Wilson JS, Kelen GD, & Campbell J.
(2018). Differentiating among attempted, completed, andmultiple nonfatal strangulation in women experiencing intimate partner violence. Women’s Health Issues; 28(1): 104-111.

Strangulation is a distinct mechanism of violence with the potential for severe injury or
death. Women’s health care practitioners and law enforcement personnel need to be alert for
strangulation due to its importance for health as well as for lethality.

How Should Child Welfare Workers Recognize, from page 2
providers. This often results in children not receiving careand follow-up when risks are not considered or recognized.
There are many requirements for child welfare workers
to consider when responding to children who have been
exposed to IPV. Henry (2018) suggested that better trainingof child welfare workers and law enforcement personnel isneeded to understand the potential harms of IPV-exposedchildren. Research is needed to better understand the typesof interventions necessary to help exposed children andthe agencies that are best positioned to deliver them. If theharms of IPV exposure to children were better understood,
policy and education of those involved in child welfare
would be improved.

References

Gonzales A, MacMillan H, Tanaka M, Jack SM, & Tonmyr L.
(2014). Subtypes of exposure to intimate partner violence
within a Canadian child welfare sample: Associated risks
and child maladjustment. Child Abuse & Neglect, 38, 19341944.
Henry C. (2018). Exposure to domestic violence as abuse
and neglect: Constructions of child maltreatment in daily
practice. Child Abuse & Neglect, 86, 79-88.
Joining Forces Joining Families. (2019, Spring) https://www.
cstsonline.org/resources/resource-master-list/joiningforces-joining-families-spring-2019

Child welfare workers, parents, and clinicians need to understand the many threats presented tochildren by IPV exposure including the risk of physical harm, adverse mental health, and otherphysical and psychological damages to them and their parents.
4 • RESEARCH REVIEW | Joining Forces/Joining Families

Winter 2020

Residential Mobility and Victimization Risk Among Children
Residential mobility (multiple moves) has sometimes
been associated with an increased risk of child maltreatment(Desmond, Gershenson, & Kiviat, 2015). This association isthought to result from the disruption of family stability—the
ability of a family to operate as a cohesive unit with consistent activities and routines for children (e.g., school, peers,
sports). However residential mobility is often accompanied
by other stressors.
Merrick et al. (2018) argue that much of the researchdemonstrating an association between residential mobility
and child maltreatment confounds multiple stressors in the
lives of children. Data on children aged one month to 17
years were obtained from a cross-sectional study, the National Surveys of Children’s Exposure to Violence (NatSCEV).
The NatSCEV is a nationally representative sample of 12,935
cases (mean age=8.6 years) pooled from 2008, 2011, and2014. The investigators tested the effect of the number oflifetime moves on child victimization, but also included theeffects of other lifetime destabilizing factors on child victimization: natural disasters, homelessness, child out-of-homeplacements or changes in caretakers, parental incarceration,
unemployment, military deployments, and multiple marriages (Finkelhor, Turner, Shattuck, & Hamby, 2013). The
childhood victimization outcome measures were sexual
victimization, witnessing community or family violence,physical assault, property crime, and polyvictimization (morethan one type of child maltreatment).
Residential instability was not a statistically significant
predictor of childhood victimization when it was includedin the total model. However, the model without residential
mobility predicted increased odds of all types of past year vic-

timization. In other words, the results of this study show that
residential mobility alone is insufficient as a means to understand the ways in which multiple moves affect children. In
addition, multiple moves are not necessarily negative. They
can occur due to such factors as an increase in family size,
a better job or a promotion, or moving to a better school
district.
These findings show that several other family destabilizing factors are better predictors of child victimization thanmultiple moves. Similarly, interventions meant to mitigate
the risk of child maltreatment would likely need to examine
a wider array of destabilizing factors than residential mobility alone. The stresses of moving should not be underestimated, but when moves are contemplated, the array of family
destabilizing factors in a child’s life should also be considered.

References

Finkelhor D, Turner HA, Shattuck A, & Hamby SL. (2013).
Violence, crime, and abuse exposure in a national sample
of children and youth. JAMA Pediatrics; 167(7): 614-621.
Merrick MT, Henly M, Turner HA, David-Ferdon C, Hamby
S, Kacha-Ochana A,… Finkelhor D. (2018). Beyond residential mobility: A broader conceptualization of instability and its impact on victimization risk among children.
Child Abuse & Neglect, 79, 485-494.
Desmond M, Gershenson C, & Kiviat B. (2015). Forced
relocation and residential instability among urban renters.
Social Service Review, 89(2), 227-262.

Residential mobility is often thought to be negative for children, but when other factors
are considered, it may be a proxy for other destabilizing factors. In many cases, residential
mobility is positive.

http://www.CSTSonline.org

RESEARCH REVIEW | Joining Forces/Joining Families • 5

The Army Family Advocacy Program:
Implementation Strengths and Challenges
The evaluation of program implementation and the effectiveness of interventions to treat child and adult maltreatment victims and offenders are among the many challenges
facing program administrators. While the Army Family
Advocacy Program (FAP) provides assessment and intervention in cases of maltreatment, there are both strengths andbarriers to program implementation and evaluation.
A recent evaluation of 226 FAP cases (35% intimate
partner violence (IPV), 35% child maltreatment, and 30%
IPV and child maltreatment) closed in 2013 revealed casemanagement strengths as well as areas for improvement(Aronson, Perkins, Morgan, Cox, & Robichaux, 2018). A
majority of cases complied with case management protocols.
For example, 100% of offenders and victims were interviewed
separately by credentialed providers and 90% of all FAP cases
included a risk assessment and safety plan. An assessment ofvictims was completed in 85% of combined IPV/child abusecases, 74% for IPV only, and 52% for child abuse only cases.
An assessment of the perpetrator was completed in 78% of
combined IPV/child abuse cases, 77% for IPV, and 67% forchild abuse. Medical records were in the files in 60-65% ofcases. Military command was almost always (99%) involvedin cases.
Treatment referrals for IPV and/or child abuse included
individual counseling (40%), parenting groups (25%), marital
counseling (20%), anger management (20%), and substanceabuse treatment (20%); however, few referrals were madefor other services that could have helped such as financial
management, emergency relief funds, or relocation services.
Also, few referrals were made to community-based civilian
providers.
Levels of treatment participation varied markedly between soldiers and civilians. Soldiers referred toviolent offender groups completed 74% of sessions (mean=11.16; SD=9.37), and 79% of anger management sessions(mean=5.84; SD=4.68). However, civilian family members
referred to anger management completed only 33.3% ofsessions (mean=1.89; SD=2.81). Treatment participation for
civilian family member offenders and victims and military
victims is voluntary, but is mandatory for military offenders.
There are many barriers to treatment completion thatare related to military family life. Military personnel can beordered to attend treatment, but unit needs often take priority. Aronson et al. (2018) urged greater adoption of strategies
to increase family engagement and treatment participation, as
well as the use of evidence-informed treatment protocols.

Reference

Aronson KR, Perkins, DF, Morgan NR, Cox CA, & Robichaux R. (2018). Military family advocacy in the U.S. Army:
Program service outcomes and family participation. Journal of Child and Family Studies, 27(1), 218-226.

Understanding the processes involved in the effective delivery of social service interventions
has become increasingly important given the common gap between what is known about
effective services and interventions and what is actually provided to consumers.

PTSD is Associated with Violence Recidivism inMale Perpetrators of Intimate Partner Violence
Post-traumatic stress disorder (PTSD) is associated withperpetration of intimate partner violence (IPV) (Smith,
Smith, Violanti, Bartone, & Homish, 2015). A recent study
examined the relationship between PTSD symptoms, IPV
treatment engagement and post-treatment recidivism among
male offenders (Miles-McLean et al., 2018). A total of 293
male perpetrators of IPV attended a 20-session, 2-hours per
week, IPV treatment program between 2006 and 2011. The
questions addressed were (1) whether men with higher levelsof PTSD symptoms would display greater difficulty engaging in treatment than men with lower levels, and (2) whether
6 • RESEARCH REVIEW | Joining Forces/Joining Families

men with higher levels of PTSD symptoms would have worse
outcomes in violence recidivism (IPV perpetration andcriminal violence) two years later.
Initial assessment included lifetime trauma exposure,current PTSD symptoms, depression, alcohol abuse, illicit
drug use, and perpetration of violence. Treatment engagement measures included participants’ perceptions of groupcohesion, compliance with homework, and an evaluationof the client’s and therapist’s perception of the treatment
alliance. Thirty-two men (10.9%) met criteria for a probableContinued on page 7
Winter 2020

A Military-Specific Parenting Program Is Associated with
Improved Parenting and Child Adjustment
A behavioral training program given to previously
deployed parents with children ages 4-12 resulted in significantly improved parenting and was associated with improvements in child adjustment (Gewirtz, DeGarmo, & Zamir,
2018). This is the first known randomized controlled trial ofan evidence-based parenting program specifically tailored tomeet the needs of military families following deployments to
Iraq or Afghanistan. This research is important since somedata suggests that infants and children are at increased risk
for maltreatment following a parent’s return from deployment (Taylor et al., 2016; Strane et al., 2017). Post-deployment parenting interventions with service members andtheir spouses could help mitigate child maltreatment among
military families.
The study was conducted with 336 primarily National
Guard and Reserve families (Gewirtz, DeGarmo, & Zamir, 2018). After Deployment, Adaptive Parenting Tools(ADAPT) is a 14-week parenting program delivered in
2-hour weekly sessions to groups of 6 to 15 parents pergroup. Six core strategies are addressed: teaching through encouragement, discipline, problem solving, monitoring, positive involvement with children, and emotional socialization.
The model provided military-specific material (e.g., discussion and role play of deployment-specific family scenarios).
Parent-child interaction quality was rated by trained coders
as they observed parents and children in a series of 5-minute structured tasks to assess parent use of social interaction
learning skills (e.g., problem-solving, skill encouragement,
monitoring) at baseline and again at 1-year follow-up. Childadjustment measures included age- and gender-normed
self-report scores of school problems (e.g., negative attitude

toward school) and loneliness scores. Parent and teacher
reports of child adjustment were used to assess behavioral
problems in children.
Families that were randomly assigned to ADAPT showedsignificant increases in effective parenting at 1-year relative
to the control group as assessed by trained coders observing
parent-child completion of structured tasks. These changes
predicted improvements in child adjustment reported byparents, teachers, and the children. The authors added that,in addition to the changes in parenting and child adjustment,
parents showed an improved sense of control, which led toreductions in parental depression, PTSD symptoms, and suicidality six months later. The important lesson of this study
is that teaching more effective parenting can improve wellbeing and functioning for both children and their parents.

References

Gewirtz AH, DeGarmo,DS. & Zamir O. (2018). After Deployment, Adaptive Parenting Tools: 1-Year outcomesof an evidence-based parenting program for militaryfamilies following deployment. Prevention Science, 19(4),589-599.
Strane D, Lynch KG, Griffis HM, Taylor M, Harb GC, Mi L.
…Rubin DM. (2017). Family characteristics associatedwith child maltreatment across the deployment cycle.
Military Medicine; 182(9): e-1879-e1887.
Taylor CM, Ross ME, Wood JN, Griffis HM, Harb GC, Mi L,…Rubin D. (2016). Differential child maltreatment risk
acrosss deployment periods of US Army soldiers. American Journal of Public Health; 106(1): 153-158.

Teaching more effective parenting can improve child outcomes.
PTSD is Associated with Violence Recidivism, from page 6
PTSD diagnosis. Participants with a probable PTSD diagnosis reported lower homework compliance during therapy
and lower perceptions of group cohesion and group task
orientation late in therapy. When IPV recidivism was examined, 15.6% of those with probable PTSD engaged in IPV
recidivism compared to 7% of those without probable PTSD.
This difference was not statistically significant. Criminal
recidivism (violence directed toward someone other than an
intimate partner, other charges such as drug possession) was
15.6% for those with probable PTSD compared to 2.7% andthis difference was significant.
http://www.CSTSonline.org

While this study did not involve the treatment of PTSD
per se, it does show that, for perpetrators of IPV, probable
PTSD is associated with both reduced treatment engagement
and an increased likelihood they will perpetrate additional
acts of violence following treatment. Providers treating IPVperpetrators may wish to include routine assessment for
PTSD symptoms and use of trauma-informed interventions for offenders with PTSD. IPV interventions which
include discussions of the role of trauma may help to increase
Continued on page 8

RESEARCH REVIEW | Joining Forces/Joining Families • 7

Reproductive Coercion and Intimate Partner Violence
Reproductive coercion (RC) is a form of coercive control.
It can take the form of pregnancy pressure, pregnancy coercion, and/or birth control sabotage. It is generally defined as
behavior that interferes with the contraceptive and pregnancy
choices of women by male partners. RC can also be directed
toward men such as when a female partner attempts tobecome pregnant when the male partner does not want it tooccur (Park, Nordstrom, Weber, & Irwin, 2016).
RC is prevalent in both adolescents and adults, in heterosexual and same-sex relationships, and in those with andwithout a history of physical or sexual violence (Park, Nordstrom, Weber, & Irwin, 2016). Sixteen percent (n=103) ofwomen 18-44 years old in a large obstetrics and gynecology
clinic in 2012 reported pregnancy coercion or birth control
sabotage. Of those who reported RC, 32% also reported
intimate partner violence (IPV) (Clark, Allen, Goyal, Raker,& Gottlieb, 2014). Similarly, 11% of women veterans in
2014-2016, 18-44 years of age, reported RC in the past year
(Rosenfeld, Miller, Zhao, Sileanu, Mor, & Borrero,2018).
A qualitative study of 17 experienced health practitioners
in Australia described RC as complex and hidden (Tarzia,
Wellington, Marino, & Hegarty, 2018). They focused on two
topics: the understanding and perceptions of the practitioners with regard to RC and the ways practitioners responded
to it in practice. The themes identified in this study were that
there is an intersection between RC and IPV and the context
of control in women’s relationships, behaviors that undermined or sabotaged a woman’s control over her body, and alack of practitioner knowledge about RC, including healthcare providers. The authors stressed the importance of raisingawareness of RC as a hidden form of violence against women.
The legal and social status of RC is complex. In somecircumstances, RC can be considered sexual abuse or sexual
coercion (Douglas & Kerr, 2018). Birth control sabotage has
been proposed as an act of IPV entailing the possibilities oftort and criminal charges. There are also complex arguments

around issues of unwanted pregnancy, fraudulent misrepresentation of the use of birth control, the value of a child to society(particularly when conceived under RC circumstances), andissues for parents of bringing a child into the world as a resultof coercion, and its costs to the caretaker (Trawick, 2012).
Care providers who encounter or suspect IPV should also beconcerned about RC in women of childbearing age and assist
victims in considering solutions to address these issues.

References

Clark L, Allen, RH, Goyal V, Raker C, & Gottlieb AS. (2014).
Reproductive coercion and co-occurring intimate partner
violence in obstetrics and gynecology patients. American
Journal of Obstetrics & Gynecology, 210(1), 42 e41-48.
doi:10.1016/j.ajog.2013.09.019
Douglas H, & Kerr K. (2018). Domestic and family violence,
reproductive coercion and the role for law Journal of Law
and Medicine, 26(2), 341-355.
Park J, Nordstrom SK, Weber KM, & Irwin T. (2016). Reproductive coercion: uncloaking an imbalance of social
power. American Journal of Obstetrics & Gynecology,
214(1), 74-78. doi:10.1016/j.ajog.2015.08.045
Rosenfeld EA, Miller E, Zhao X, Sileanu FE, Mor MK, &Borrero S. (2018). Male partner reproductive coercion
among women veterans. American Journal of Obstetrics& Gynecology; 218(2): e231-239 e238. doi:10.1016/j.
ajog.2017.10.015
Tarzia L, Wellington,M, Marino J, & Hegarty K. (2018). “A
huge, hidden problem”: Australian health practitioners’
views and understandings of reproductive coercion. Qualitative Health Research. doi:10.1177/1049732318819839
Trawick SM. (2010). Birth control sabotage as domestic
violence: A legal response. California Law Review, 100(3),721. doi:10.15779/Z38VX19PTSD is Associated with Violence Recidivism, from page 7
perpetrator treatment engagement and lead to a better
therapeutic outcome. These findings highlight the need todevelop and investigate trauma-sensitive approaches to IPV
offenders who have significant trauma histories and PTSD
symptoms.

References

Miles-McLean HA, LaMotte AD, Semiatin JN, FarzanKashani J, Torres S, Poole GM., & Murphy C.M. (2018).

8 • RESEARCH REVIEW | Joining Forces/Joining Families

PTSD as a predictor of treatment engagement andrecidivism in partner abusive men. Psychology of Violence. doi:10.1037/vio0000161
Smith KZ, Smith PH, Violanti JM, Bartone PT, & Homish
GG. (2015). Posttraumatic stress disorder symptom
clusters and perpetration of intimate partner violence:
Findings from a U.S. nationally representative sample.
Journal of Traumatic Stress, 28(5), 469-474.

Winter 2020