Violence within the family, whether directed against children, partners or elders, profoundly disturbs our notions of what the relationship between the family and the discipline of general practice should be. GPs are doctors to whole families and yet their relationships with patients are individual ones, drawing their strength from the principles of confidentiality, mutual trust and positive regard. Violence and abuse within families necessarily challenges all of these, creating aprofusion of ethical, interpersonal and practical difficulties and dilemmas. At the same time the nature of general practice confers unique opportunities to deal effectively with family violence. GPs and GP registrars will find this book an invaluable and empowering resource. It brings together a broad range of expertise and opinion from relevant specialities and disciplines and sets family violence in its historical, epidemiological and societal context. It describes in separate sections, child abuse, domestic violence and elder abuse, its presentations, diagnosis and treatment; and suggests ways forward for its prevention and early detection. It draws throughout on the experience ofGPs, health visitors and social workers, providing practical safe and workable guidelines. Family violence can present to any member of the primary care team and there is much here that will be of relevance and interest to them all.
Part I: Introduction to family violence; Violence in society and in the family; Psychological causes of family violence; Family violence: the general practice context; Part II: Violence against children; The context; The Presentation and diagnosis of child abuse; Physical symptoms and signs of child abuse; Psychological and emotional presentations of child abuse; Child abuse and general practice 1: prevention & presentation; Child abuse and general practice 2: action; What happens next?; The investigation of child abuse; Legislative framework for child protection; The Child Protection Conference; Child protection: The family perspective; The aftermath; Legal options; Therapeutic options; Picking up the pieces; The late sequence of child abuse; The survivors of childhood abuse: why should primary care be involved?; Working with adult survivors of childhood abuse: the prevention and amelioration of psychological and physical problems; The future; Policy, empowerment and young people in primary health care; Working with young sexual abusers; Organising the primary health care team: practice-based training in child protection; Training issues in child protection; Part III: Violence against women by known men; The context; The meaning of domestic violence; The presentation and diagnosis of domestic violence; Onward referral: Introduction; The role of the Police; The role of Womens aid and refuge support services for women and children; Local authority housing departments; Local authority social services; Ethnic minority womens groups; Solicitors and law centres; The future; Part IV: Violence against older people; Context; The nature of elder abuse; The presentation and diagnosis of elder abuse; Onward referral: Introduction; The role of the District Nurse; The role of Social Workers and GPs; The role of the Solicitor; The future;
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