Confronting Chronic Neglect: Education and Training of Health Professionals on Family Violence

369 Pages·2001·6.68 MB·English

by  Felicia Cohn, Marla E. Salmon, John D. Stobo, Committee on the Training Needs of Health Professionals to Respond to Family Violence, Board on Children, Youth, and Families

PREFACE i
CONFRONTING
CHRONIC NEGLECT
The Education and Training of
Health Professionals on Family Violence
Committee on the Training Needs of Health Professionals
to Respond to Family Violence
Felicia Cohn, Marla E. Salmon, and John D. Stobo, Editors
Board on Children, Youth, and Families
INSTITUTE OF MEDICINE
NATIONAL ACADEMY PRESS
Washington, DC
NATIONAL ACADEMY PRESS • 2101 Constitution Avenue, N.W. • Washington, DC 20418
NOTICE: The project that is the subject of this report was approved by the Governing Board of the
National Research Council, whose members are drawn from the councils of the National Academy of
Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the
committee responsible for the report were chosen for their special competences and with regard for
appropriate balance. The Board on Children, Youth, and Families is a joint effort of the Institute of
Medicine and the Division of Behavioral and Social Sciences and Education.
Support for this project was provided by the Centers for Disease Control and Prevention, U.S.
Department of Health and Human Services. The views presented in this report are those of the
Institute of Medicine’s Committee on the Training Needs of Health Professionals to Respond to
Family Violence and are not necessarily those of the funding agencies.
Library of Congress Cataloging-in-Publication Data
Board on Children, Youth, and Families (U.S.). Committee on the Training
Needs of Health Professionals to Respond to Family Violence.
Confronting chronic neglect : the education and training of health
professionals on family violence / Committee on the Training Needs of
Health Professionals to Respond to Family Violence, Board on Children,
Youth, and Families, Institute of Medicine ; Felicia Cohn, Marla E.
Salmon, and John D. Stobo, editors.
p. ; cm.
Includes bibliographical references and index.
ISBN 0-309-07431-2 (hardcover)
1. Family violence. 2. Medical personnel—Training of—United States.
[DNLM: 1. Domestic Violence—prevention & control—United States. 2.
Health Personnel—education—United States. HV 6626.2 B662 2002] I.
Cohn, Felicia. II. Salmon, Marla E. III. Stobo, John D. IV. Title.
RC569.5.F3 B63 2002
616.85'822—dc21
2002000875
Additional copies of this report are available for sale from the National Academy Press, 2101 Consti-
tution Avenue, N.W., Box 285, Washington, D.C. 20055. Call [phone] or [phone] (in
the Washington metropolitan area), or visit the NAP’s home page at www.nap.edu. The full text of
this report is available at www.nap.edu.
For more information about the Institute of Medicine, visit the IOM home page at: www.iom.edu.
Copyright 2002 by the National Academy of Sciences. All rights reserved.
Printed in the United States of America.
The serpent has been a symbol of long life, healing, and knowledge among almost all cultures and
religions since the beginning of recorded history. The serpent adopted as a logotype by the Institute of
Medicine is a relief carving from ancient Greece, now held by the Staatliche Museen in Berlin.
“Knowing is not enough; we must apply.
Willing is not enough; we must do.”
—Goethe
INSTITUTE OF MEDICINE
Shaping the Future for Health
National Academy of Sciences
National Academy of Engineering
Institute of Medicine
National Research Council
The National Academy of Sciences is a private, nonprofit, self-perpetuating society of
distinguished scholars engaged in scientific and engineering research, dedicated to the
furtherance of science and technology and to their use for the general welfare. Upon the
authority of the charter granted to it by the Congress in 1863, the Academy has a mandate
that requires it to advise the federal government on scientific and technical matters. Dr.
Bruce M. Alberts is president of the National Academy of Sciences.
The National Academy of Engineering was established in 1964, under the charter of the
National Academy of Sciences, as a parallel organization of outstanding engineers. It is
autonomous in its administration and in the selection of its members, sharing with the
National Academy of Sciences the responsibility for advising the federal government.
The National Academy of Engineering also sponsors engineering programs aimed at
meeting national needs, encourages education and research, and recognizes the superior
achievements of engineers. Dr. Wm. A. Wulf is president of the National Academy of
Engineering.
The Institute of Medicine was established in 1970 by the National Academy of Sciences
to secure the services of eminent members of appropriate professions in the examination
of policy matters pertaining to the health of the public. The Institute acts under the
responsibility given to the National Academy of Sciences by its congressional charter to
be an adviser to the federal government and, upon its own initiative, to identify issues of
medical care, research, and education. Dr. Kenneth I. Shine is president of the Institute of
Medicine.
The National Research Council was organized by the National Academy of Sciences in
1916 to associate the broad community of science and technology with the Academy’s
purposes of furthering knowledge and advising the federal government. Functioning in
accordance with general policies determined by the Academy, the Council has become the
principal operating agency of both the National Academy of Sciences and the National
Academy of Engineering in providing services to the government, the public, and the
scientific and engineering communities. The Council is administered jointly by both
Academies and the Institute of Medicine. Dr. Bruce M. Alberts and Dr. Wm. A. Wulf are
chairman and vice chairman, respectively, of the National Research Council.
COMMITTEE ON THE TRAINING NEEDS OF
HEALTH PROFESSIONALS
TO RESPOND TO FAMILY VIOLENCE
JOHN D. STOBO (Chair), University of Texas Medical Branch at Galveston
MARLA E. SALMON (Vice Chair), The Nell Hodgson Woodruff School of
Nursing, Emory University
ELAINE J. ALPERT, Boston University School of Public Health
JACQUELYN C. CAMPBELL, Johns Hopkins University School of Nursing
MICHAEL I. COHEN, Department of Pediatrics, Montefiore Medical Center,
Albert Einstein College of Medicine
DEBORAH EPSTEIN, Georgetown University Law Center
SHERYL HERON, Department of Emergency Medicine, Emory School of
Medicine
SUSAN R. JOHNSON, University of Iowa College of Medicine
RICHARD D. KRUGMAN, University of Colorado School of Medicine
MARK S. LACHS, Division of Geriatrics and Gerontology, Weill Medical
College of Cornell University
GARY B. MELTON, Institute on Family and Neighborhood Life, Clemson
University
GREGORY J. PAVEZA, School of Social Work, University of South Florida
GEORGINE M. PION, Vanderbilt Institute for Public Policy Studies,
Vanderbilt University
MICHAEL A. RODRIGUEZ, Department of Family and Community
Medicine, University of California, San Francisco
ROBERT S. THOMPSON, Department of Preventive Care, Group Health of
Puget Sound
Study Staff
FELICIA COHN, Study Director
MAURA SHEA, Senior Project Assistant
Scholar-in-Residence
ELENA NIGHTINGALE
v
BOARD ON CHILDREN, YOUTH, AND FAMILIES
EVAN CHARNEY (Chair), Department of Pediatrics, University of
Massachusetts Medical Center
JAMES A. BANKS, Center for Multicultural Education, University of
Washington
DONALD COHEN, Child Study Center, Yale University
THOMAS DEWITT, Children’s Hospital Medical Center of Cincinnati
MARY JANE ENGLAND, President, Regis College
MINDY FULLILOVE, School of Public Health and Department of Psychiatry,
Columbia University
PATRICIA GREENFIELD, Department of Psychology, University of
California, Los Angeles
RUTH T. GROSS, Professor of Pediatrics (emerita), Stanford University
KEVIN GRUMBACH, Department of Family and Community Medicine,
University of California, San Francisco/San Francisco General Hospital
NEAL HALFON, School of Public Health, University of California, Los Angeles
MAXINE HAYES, Washington State Department of Health, Olympia
MARGARET HEAGARTY, Department of Pediatrics, Harlem Hospital
Center, Columbia University
RENEE JENKINS, Department of Pediatrics and Child Health,
Howard University
HARRIET KITZMAN, School of Nursing, University of Rochester
SANDERS KORENMAN, School of Public Affairs, Baruch College
CINDY LEDERMAN, Juvenile Justice Center, Dade County, Florida
VONNIE MCLOYD, Center for Human Growth and Development,
University of Michigan
GARY SANDEFUR, University of Wisconsin-Madison
ELIZABETH SPELKE, Department of Brain and Cognitive Sciences,
Massachusetts Institute of Technology
RUTH STEIN, Department of Pediatrics, Montefiore Medical Center, New York
ELEANOR E. MACCOBY (Liaison, Division of Behavioral and Social Sciences
and Education), Department of Psychology (emerita), Stanford University
WILLIAM ROPER (Liaison, Institute of Medicine), School of Public Health,
University of North Carolina, Chapel Hill
Staff
MICHELE D. KIPKE, Director
SONJA WOLFE, Administrative Associate
Scholar-in-Residence
ELENA NIGHTINGALE
vi
REVIEWERS
This report has been reviewed in draft form by individuals chosen for their
diverse perspectives and technical expertise, in accordance with procedures ap-
proved by the National Research Council’s Report Review Committee. The pur-
pose of this independent review is to provide candid and critical comments that
will assist the institution in making its published report as sound as possible and
to ensure that the report meets institutional standards for objectivity, evidence,
and responsiveness to the study charge. The review comments and draft manu-
script remain confidential to protect the integrity of the deliberative process. We
wish to thank the following individuals for their review of this report:
Robert A. Burt, Yale University
Linda Chamberlain, Alaska Family Violence Prevention Project
Lynn Mouden, Arkansas Department of Health
Barbara Parker, University of Virginia
Desmond K. Runyan, University of North Carolina, Chapel Hill
Pat Salber, Kaiser Permanente
LuAnn Wilkerson, UCLA School of Medicine
Rosalie Wolf, The Medical Center of Central Massachusetts
Although the reviewers listed above have provided many constructive com-
ments and suggestions, they were not asked to endorse the conclusions or recom-
mendations nor did they see the final draft of the report before its release. The
review of this report was overseen by Neal A. Vanselow, Tulane University,
appointed by the Institute of Medicine and Luella Klein, Emory University School
of Medicine, appointed by the National Research Council’s Report Review Com-
mittee, both of whom were responsible for making certain that an independent
examination of this report was carried out in accordance with institutional proce-
dures and that all review comments were carefully considered. Responsibility for
the final content of this report rests entirely with the authoring committee and the
institution.
vii
Preface
This report is not the first recent National Academies’ report to focus on the
issue of family violence. It is the third and, regrettably, it may not be the last.
Family violence continues to plague society and we have not yet developed either
the practical interventions or evidence base to address this important social issue.
When Congress passed the Health Professions and Education Partnerships
Act of 1998, it issued an important challenge to government and the health
professions. The bill’s language suggested that education of health professionals
is an important first step in mitigating the problem of family violence. The Board
on Children, Youth, and Families of the Institute of Medicine and the Division of
Behavioral and Social Sciences and Education of the National Research Council
responded to this challenge by establishing the Committee on the Training Needs
of Health Professionals to Respond to Family Violence.
The committee’s point of departure for its work was to adopt three funda-
mental principles: (1) family violence is a health issue; (2) education of health
professionals about the issue is therefore important; and (3) while education of
health professionals about family violence is necessary to address the problem, it
is not by itself sufficient. Other individuals and entities outside the health profes-
sions are involved in addressing issues related to family violence, and this larger
societal context must not be forgotten.
As the committee began its deliberations, we quickly became aware that
education of health professionals in family violence is not a consistent priority
across or within health professions education curricula. The challenge of even
identifying curricular content or strategies was compounded by the almost com-
plete absence of either educational research or evaluation relating to family vio-
ix