Safety Planning for Battered Women
Artwork by TheRedMarker, Fort Refuge member; text by Carol E. Jordan. Borrowed from here
The harsh experience of violence against women can be witnessed in the face of its victims and measured in prevalence rates, underscoring that no woman stands immune from this form of victimization. Not only is the shadow cast by gendered violence long, but also the impact on a woman's health and mental health can be profoundly negative and enduring. Violence against women, particularly when perpetrated by an intimate partner, is associated with higher mortality rates, acute injury, and chronic illness in its victims. The 1998 National Violence Against Women Survey (NVAWS) reported that 41.5% of women physically assaulted and more than 36% of women sexually assaulted by an intimate reported injuries as a result of their most recent victimization; in a single year, half a million women sought medical treatment for their injuries. Studies in hospital emergency departments document that more than one third of women seeking emergency medical care for violence-related injuries have been injured by a current or former spouse. Violence against women leaves its mark in bruising and broken bones, and every year, thousands of women ultimately lose their lives to violence from an intimate partner. In fact, homicide is one of the leading causes of premature death for women in the United States.
The widespread nature of violence and the severity of its impact give compelling reason for criminal justice, health, and mental health professionals to attend to the reduction of risk for women and their families. Strategic safety planning is an important tool to help survivors of intimate partner violence achieve that risk reduction and live lives with improved safety. In the largest femicide study conducted to date, almost half of the murder victims had been observed in the criminal justice or mental health system during the year before their deaths. The message here is not only that danger is inherent in cases of intimate partner violence but also that professionals have an opportunity to prevent homicide if they attend to that risk.
Jordan, Carol E. "Safety Planning for Battered Women." Encyclopedia of Victimology and Crime Prevention. 2010. SAGE Publications
RISK, LETHALITY, AND REASSAULT
General Risk of Intimate Partner Violence
The assessment of risk is fundamental to safety planning, but more than one construct is important to the process (see Figure 1). First, although no woman is immune from victimization, the general risk of exposure to intimate partner violence is not the same across populations of women. For example, minority women, women who live in poverty, and women with severe mental illness may experience higher rates of violence. An elevated risk of exposure to certain forms of intimate partner violence may also be experienced by younger women. Research shows that battered women are at higher risk of sexual violence than the general population and that incidence rates among battered women in shelter samples are even higher. The implication of the general risk construct for professionals addressing safety is that universal screening for violence among all populations of women observed in health, mental health, and criminal justice settings is important and a particular focus on subpopulations of women may be warranted.
At a practical level, knowing which cases of violence will expose a victim and her children to the greatest degree of harm is fundamental to safety planning. "Lethality risk" can be defined as measuring not just who is at risk but also what kinds of cases are associated with the most danger. Studies of homicide of women give clues to which cases may pose greater risk, and the results suggest that the presence of such factors as the offender's access to a gun, previous threats with a weapon, having the offender's stepchild in the home, and physical estrangement or separation should give cause for concern. The abuse types experienced by the victim may also shed light on the risk level, as stalking, forced sex, and abuse of the victim during her pregnancy have all been identified as key markers of victim risk. Importantly, within some of these risk factors are indicators of both increased risk of physical harm as well as increased risk of homicide. For example, research finds that victims of intimate partner violence whose abuse includes rape by their partner will sustain greater physical injury than women raped by nonintimates; partner rape and rape during pregnancy have been identified as a risk marker in femicide research.
Studies on offenders also provide valuable insights into lethality risk. For example, research suggests that generally, violent offenders whose abuse is indiscriminant with respect to victim rather than being limited to an intimate partner pose a greater threat. Offenders with impulsive or angry dispositional traits have also been found to pose an elevated risk. Clinical features of the offender may also be telling, as studies find that substance abusing offenders, those who are jealous and obsessive, and those whose levels of depression are indicative of suicidality may also be more lethal to the women in their intimate lives.
Risk of Reassault
Studies find that more than two thirds of victims of intimate partner–related homicide were previously abused by the partners who killed them. As a result, the third construct central to safety planning is the risk of reassault, that is, the ability to identify contextual or situational factors that can assist in predicting when a woman's risk will escalate and violence reoccur. Historic factors, such as prior abuse, and contextual factors, such as separation, are two chief risk markers.
Among the contextual factors most salient to the risk of reassault is that of separation or estrangement of the intimate couple. Research has long made clear that batterers do not cease violence on the victim's departure, and in fact, criminal justice data show that the rate of intimate-offender attacks on women separated from their partners is about 3 times higher than that of divorced women and about 25 times higher than that of married women. Studies of women housed in battered women's shelters find that fully one third have been physically assaulted during their separation from the offender, and research finds separation-associated stalking and psychological abuse as well. Similarly, studies of intimate partner homicide show that the murder is frequently preceded by a history of physical and other domestic abuse and often involve a recent attempt at or completion of separation by the victim.
Familiarity with the three constructs of risk, lethality, and reassault are central to laying the groundwork for the step-by-step planning that becomes the focus of strategic safety planning with victims.
What Is Strategic Safety Planning?
Strategic safety planning involves a crisis-oriented approach, informed by the presence of risk factors that focus attention on both achieving and maintaining safety for the victim of intimate partner violence and her children. It is not a singular or one-time event; rather, it is an ongoing process that adapts as contextual and clinical factors associated with the women's situation change and the danger potential increases or decreases (e.g., contextual factors such as the offender's loss of a job, initiation of stalking the victim, or his increase in alcohol consumption; or clinical factors, such as his growing depression or the beginning of suicide ideation, would necessitate changes in the safety plan).
Safety planning also cannot be confined to just the logistics of physically separating from the violent partner. Separating from an abusive partner is an important option for a victim, but it may not be the one she views as safe or viable at the time the safety plan is being drawn. It is critical to remember that leaving does not automatically stop violence (and, in fact, it can be associated with its escalation), so professionals should not force that goal on the survivor with whom they are creating a safety plan.
Strategic safety planning should be understood for the complex process it is: Risk assessment measures more than one thing (i.e., both lethality and reassault), and it is measuring a level of risk that is influenced by multiple variables (historic, clinical, dispositional, and contextual factors). Additionally, strategic safety planning is not just a tool for professionals to use or provide to their clients; rather, it is a dynamic partnership that professionals and survivors enter into as a way to achieve and maintain greater safety.
STAGES OF STRATEGIC SAFETY PLANNING
Step 1: Risk Appraisal
The first step in organizing a strategic safety plan necessarily starts with a process of identifying cues that risk exists or is increasing in the victim's environment. This process involves scanning the environment, evaluating the offender's behavior or noticing key changes in what he does or says, and recognizing threatening circumstances. This risk appraisal process is unique to every victim, as personal history and the immediate context of the violence means the same behavior that is threatening to one woman will not attach that same meaning to another.
The risk appraisal process also changes over time as a woman's experience with the offender teaches her to associate certain actions or cues with subsequent violent behavior (e.g., when he drinks or becomes more depressed, that is most often when the abuse occurs). Victims and survivors may also learn more subtle cues over time, such that a glance or a nondescript behavior that is unnoticeable to another person conveys significant threat to her. A change in the appraisal process may also occur during a woman's pregnancy or when she has children in the home. What a victim can tolerate for herself in the way of threat may not be tolerable if it seems to expose her children to a risk of harm.
This more sophisticated understanding of the offender's behavior and its meaning is critical to the effectiveness of safety planning. This means that the victim herself serves as the greatest source of expertise to the safety planning process. Women who have suffered repeated exposure to violence are best positioned to understand the offender's behavior in the context of their relationship and prior history and to identify the subtle cues to heightened risk. Ironically, however, the very experience that creates the expertise to assess risk can also impair a victim's intuitiveness. This is particularly true for women who have been exposed to egregious psychological abuse, which robs a woman of her ability to appraise cognitively her relationship to the world. Risk assessment skill on the part of the victim can also be hindered by her use of alcohol or drugs and by the long-term effects of trauma exposure and related psychological distress reactions.
Step 2: Identification of Resources and Protective Factors
The second step in the safety planning process focuses on what can be done. It is the process by which victims contemplate their options in light of elevated risk and begin decision making regarding concrete steps that should be taken. As in the case of primary appraisal, the victim's perspective is imperative. Not only does she need to identify the cues or "red flags" of risk, it is her appraisal of the consequences of taking any remedial actions that will have the greatest impact on what steps she takes. If she does not perceive herself as worth saving or that available resources are viable or safe, she may be stymied from action. For some women, for example, experience has taught them that contacting law enforcement will bring swift and lethal retribution from an abusive partner. In that case, knowledge of how to contact 911 is not useful because she perceives that police protection is not a viable safety resource.
The safety planning process includes identification of concrete steps that can be taken or implemented by a woman and her children. Tangible, specific steps that women are encouraged to take include the following:
- Practice quick exits from the shared residence with the abusive partner.
- Have children participate in the safety plan, which includes teaching them how to telephone police and fire departments. This can also include setting up a code word or signal for children or friends or both so they will know that the situation has become dangerous.
- Keep car keys near the door or in a location where they can be readily accessed and keep an extra set of keys hidden.
- Hide a purse with extra cash and sources of identification.
- Store important documents in a safe place, which include birth certificates and social security numbers.
- Keep a suitcase packed and stored in a safe place at home or at a friend's home.
- Keep an accessible list of important telephone numbers to call, including police and fire departments, battered women's shelters, mental health crisis lines, and numbers for professionals assisting on her case including attorneys, victims advocates, therapists, physicians, or others.
- Know how to access Internet safety resources in a safe, nontraceable way.
- Have ready access to copies of civil orders of protection or court orders related to the case.
Strategic safety planning, in a real way, is a means to end intimate partner violence, one woman at a time.
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