Family violence: Walking the tightrope between maternal alienation and child safety
Denise Wilson
Māori Health, Taupua Waiora Centre for Māori Health Research; School of Public Health and Psychosocial Studices, AUT University, Auckland, New Zealand
Karen McBride-Henry
Clinical Effectiveness Unit, Capital and Coast District Health Board; Graduate School of Nursing, Midwifery and Health, Victoria University of Wellington, Wellington, New Zealand
Annette Huntington
Associate Professor in Nursing, School of Health Sciences, Massey University, Wellington, New Zealand
PP: 085 - 096
Abstract
Mothers are often alienated from their children when child abuse is suspected or confirmed, whether she is the primary abuser of the child or not. An abusive or violent partner often initiates the process of maternal alienation from children as a control mechanism.
When the co-occurrence of maternal and child abuse is not recognised, nurses and health professionals risk further alienating a mother from her child/ren, which can have detrimental effects in both the short and long term. Evidence shows that when mothers are supported and have the necessary resources there is a reduction in the violence and abuse she and her children experience; this occurs even in situations where the mother is the primary abuser of her children.
The family-centred care philosophy, which is widely accepted as the best approach to nursing care for children and their families, creates tension for nurses caring for children who are the victims of abuse as this care generally occurs away from the context of the family.
This fragmented approach to caring for abused children can inadvertently undermine the mother-child relationship and further contribute to maternal alienation.
This paper discusses the complexity of family violence for nurses negotiating the 'tight rope' between the prime concern for the safety of children and further contributing to maternal alienation, within a New Zealand context. The premise that restoration of the mother-child relationship is paramount for the long-term wellbeing of both the child/ren and the mother provides the basis for discussing implications for nursing practice.
Keywords
maternal alienation; child abuse; family violence; co-occurrence of maternal and child abuse
References
Ahmann, E. 1994a, Family-centred care: The time has come, Paediatric Nursing, vol. 20, no. 1, pp. 52-53.
Ahmann, E. 1994b, Family-centred care: Shifting orientation, Paediatric Nursing, vol. 20, no. 2, pp. 113-117.
Ahmann, E. 1994c,Thinking critically about family-centred home care nursing, Paediatric Nursing, vol. 20, no. 6, pp. 588-590.
Apel, A. E. & Holden, G.W. 1998,The co-occurrence of spouse and physical child abuse: A review and appraisal, Journal of Family Psychology, vol. 12, no. 4, pp. 578-599.
Bell, L. 2003, Stabbed girls 'failed' by system, Dominion Post, 13 November, B7.
Bergman, B. & Brismar, B. 1991, A 5 year follow up of 117 battered women, American Journal of Public Health, vol. 81, pp. 486-1489.
Bohn, D. K. & Holz, K.A. 1996, Sequelae of abuse: Health effects of childhood sexual abuse, domestic battering, and rape. Journal of Nurse-Midwifery, vol. 41, pp. 442-456.
Bridgeman, J. 1999, How do nurses learn about family-centred care? Paediatric Nursing, vol. 11, no. 4, pp. 26-29.
Burke, C. 1999, Redressing the balance: Child protection intervention in the context of domestic violence, in J. Breckenridge & L. Laing (Eds), Challenging silence: Innovative responses to sexual and domestic violence (pp. 256-284), Allen & Unwin, St Leonards, NSW.
Campbell, J., Jones, A.S., Dieneman, J., Kub, J., Schollenbergen, J., O'Campo, P., Gielen, A.C., & Wynne, C. 2002, Intimate partner violence and physical health consequences. Archives of Internal Medicine, vol. 162, no. 10, pp. 1157-1163.
Chetwin, T., Knaggs, P., & Young, T.W.A. 1999, The domestic violence legislation and child access in New Zealand [On-line],Available: http://www.justice.govt.nz/pubs/reports/1999/domestic_violence/ex_summary.html [2002, Jan 14].
Collins, S. 2000, Never again: How we all failed James Whakaruru, New Zealand Herald, 1 July,A16-17.
Commissioner for Children. 2000, Final report on the investigation into the death of James Whakaruruhau, Office of the Commissioner for Children, Wellington, New Zealand.
Cox, D. & Irwin, M. 1989, No place like home: Women's experiences of violence, Mental Health Foundation of New Zealand, Auckland, NZ.
Crane, P.A. & Constantino, R. 2003, Is email interaction feasible for intervention with women and child exposed to domestic violence? A literature review, Topics in Advanced Practice Nursing e- Journal, vol. 3, no. 3 [on-line] Available: http://www.medscape.com/viewarticle/459382_print (2003 Aug 18).
Darbyshire, P. 1995, Family-centred care within contemporary British paediatric nursing, British Journal of Nursing, vol. 4, no. 1, pp. 31-34.
Dubowitz, H., Black, M.M., Kerr, M.A., Hussey, J.M., Morrel, T.M., Eversons, M.D., & Starr, R.H. 2001,Type and timing of mothers' victimization: Effects of mothers and children, Paediatrics, vol. 107, pp. 728-735.
Eby, K.K. 2004. Exploring the stressors of low-income women with abusive partners: Understanding their needs and developing effective community responses. Journal of Family Violence, vol. 19, no. 4, pp. 221-232.
Edleson, J. 1999. Risk of physical abuse to children of spouse abusing partners. Violence Against Women, vol. 5, pp. 134-154.
Esposito, C.N. 1993,Abuse: Breaking the cycle of violence: The victims perspective, Trends in Health Care, Law & Ethics, vol. 8, no. 2, pp. 7-11.
Evans, S. 2003, Child abuse: Nurse identification of at-risk children, Nursing Praxis in New Zealand, vol. 19, no. 3, pp. 22-28.
Fanslow, J. 1996, The OASIS protocol: Guidelines for identifying, treating and referring abused women, Injury Prevention Centre, Auckland, New Zealand.
Fanslow, J.L., Spinola, C.G., Stewart, L. & Norton, R.N. 1996, An emergency department protocol study on partner abuse: Results from the formative, process and outcome evaluations. Injury Prevention Centre, Auckland, New Zealand.
Ferguson, L. 2000, Paying our debt to James, Sunday Star Times¸18 June, A9.
Fielden, J. 2000, Creating a child abuse policy that reflects an ethic of care, Nursing Praxis in New Zealand, vol. 16, no. 3, pp. 26-37 Nursing Praxis in New Zealand, vol. 19, no. 3, pp. 22-28.
Friedlander, M. L., Heatherington, L. & Marrs, A. L. 2000, Responding to blame in family therapy: A constructionist/narrative perspective, The American Journal of Family Therapy, vol. 28, pp. 133-146.
Gawson, P. 2002, Child protection, Primary Health Care, vol. 12, no. 41, pp. 32-38.
Howden-Chapman, P. 1994, Battered women's recent experiences of health professionals, Department of Public Health, Wellington, New Zealand.
Hutchfield, K. 1999, Family-centre care: A concept analysis, Journal of Advanced Nursing, vol. 29, no. 5, pp. 1178-1187.
Jenkins, H. & Donnelly, M. 1983, The therapist's responsibility: A systemic approach to mobilizing family creativity, Journal of Family Therapy, vol. 5, 199-218.
Johns, G. 2001. Help never came for a girl who lacked cuddles, Sunday Star Times, 20 May, C2,3.
Lawlor, C. & Mattingly, C. 1998, The complexities embedded in family centred care, The American Journal of Occupational Therapy, vol. 52, no. 4, pp. 259-267.
Leibrich, J., Paulin, J., & Ransom, R. 1995, Hitting home: Men speak about abuse of woman partners, Department of Justice, Wellington, NZ.
Le Tourneau, N. & Elliot, R. 1996, Paediatric health care professionals perceptions and practices of family-centered care, Children's Health Care, vol. 52, no. 4, pp. 259-267.
Little, L. & Kantor, G.K. 2002, Using ecological theory to understand intimate partner violence and child maltreatment. Journal of Community Health Nursing, vol. 19, no. 3, pp. 133-145.
MacFarlane, J., Parker, B., Soeken, K., Silva, C., & Reel, S. (1998). Safety behaviours of abused women after an intervention during pregnancy. JOGNN, vol. 27, no. 1, pp. 64-82.
McKibben, L., de Vos, E., & Newberger, E.H. 1989, Victimization of mothers of abused children: A controlled study, Paediatrics, vol. 84, no. 3, pp. 531-535.
McLoughlin, D. (1998, November).The canonisation of Tania Witika, Listener, pp. 32-41.
McMurray, A. & Moore, K. 1994, Domestic violence: Are we listening? Do we see? The Australian Journal of Advanced Nursing, vol.12, no.1, pp. 23-28.
Ministry of Health. 2002, Family violence intervention guidelines: Child and partner abuse, Ministry of Health, Wellington, NZ.
Morris,A. 1996. Women's safety survey, Victimisation Survey Committee, Wellington, NZ.
National Center for Injury Prevention & Control (NCIPC). 1999, The co-occurrence of intimate partner violence against mothers and abuse of children, [on-line], Available: http://www.cdc.gov/ncipc/factsheets/dvcan.htm (2002 June 19).
Risley-Curtis, C. & Heffernan, K.A. 2003, Gender biases in child welfare, Journal of Women & Social Work, vol. 18, no. 4, pp. 395-410.
Ryan, J. & King, C. 1992,Violence against women: Clinical issues, in National League for Nursing, Perspectives in Nursing 1991-1993 (pp. 127-133). National League for Nursing Publications, New York.
Schechter, S. 2002, Expanding solutions for domestic violence and poverty: What battered women with abused children need from their advocates [on-line].Available: http://www.vaw.umn.edu/FinalDocuments/expandin.asp (2004 July 23).
Shelton, T. & Stepanek, J. 1995, Excerpts from family-centred care for children needing specialized health and development services, Pediatric Nursing, vol. 21, no. 4, pp. 362-364.
Springer, K., Sheridan, J., Kuo, D. & Carnes, M. 2003, The long-term health outcomes of childhood abuse: An overview and a call to action, Journal of General Internal Medicine, vol. 18, pp. 864-870.
Stevenson, J. 1999,The treatment of the long-term sequelae of child abuse, Journal of Child Psychology and Psychiatry, vol. 40, no. 1, pp. 89-111.
Stirling, P. 2001, Lillybing's story, Listener, vol. 179, no. 3188, pp. 18-24.
Sullivan, C.M., & Bybee, D.I. 1999, Reducing violence using community-based advocacy for women with abusive partners. Journal of Consulting and Clinical Psychology, vol, 67, no. 1, pp. 43-53.
Tilden, V. P. 1989, Response of the health care delivery system to battered women. Issues in Mental Health Nursing, vol. 10, pp. 309-320.
Tjaden, P. & Thoennes, N. 2000, Extent, nature and consequences of intimate partner violence: Findings from the National Violence Against Women Survey, Department of Justice and Centers of Disease Control and Prevention.
Welch, D. 2004, Taking the stick. Listener, vol. 1931, no. 3336, pp. 16-20.
Wilson, D. 2000. Care and Advocacy: Moral cornerstones or moral blindness when working with women experiencing partner abuse. Journal of Nursing Law, 7 (2), 43-52.
Woods, S.J. & Campbell, J.C. 1993, Posttraumatic stress in battered women: Does the diagnosis fit? Issues in Mental Health Nursing, vol. 14, pp. 173-186.
United Nations. 1989, Convention on the rights of the child [on-line].Available: http://www.unhchr.ch/html/menu2/6/crc/treaties/crc.htm (2004 July 23).
United Nations Committee on the Rights of the Child. 1997, Concluding observations of the Committee on New Zealand. Geneva: United Nations.
eContent Home
