Screening for abuse in all clinical and counseling settings is the best strategy for offering women with disabilities a way to get help to resolve violence in their lives.
For women with disabilities, there are many barriers to finding and obtaining help to resolve violence in their lives. One of the biggest barriers is the stigma associated with revealing a violent relationship or situation. This, combined with the stigma of having a disability and the stereotype of being weak, vulnerable, and incapable of taking care of oneself, creates a shame that forces many women to deny or tolerate the violence or develop maladaptive coping behaviors.
Clinicians and counselors in all types of settings have a unique opportunity to establish trust and open channels of communication with women in such situations. This opportunity may be the women's first and only chance to talk about their fears and the dangers they face daily. Violent relationships may be a fundamental cause of the problems presented by these women, and once addressed, their progress toward achieving their goals is likely to improve significantly.
CROWD has developed a simple, brief, and useful tool for opening the door to conversations about abuse and violence. It consists of four items, the first two were developed and tested previously in a general population of women, the second two address abuse that is specifically related to having a disability. A copy of this screening instrument is available. To obtain documentation of the development and testing of the instrument, please see the abstract and article referenced below.
McFarlane, J, Hughes, R.B., Nosek, M.A., Groff, J.Y, Swedlund, N., Mullen, P.D. (2001) Abuse assessment screen-disability (AAS-D): Measuring frequency, type, and perpetrator of abuse towards women with physical disabilities. Journal of Women's Health and Gender-Based Medicine 10 (9) 861-866.
Objective: To determine the frequency, type, and perpetrator of abuse towards women with physical disabilities.
Design: Cross-sectional survey.
Setting: Public and private specialty clinics.
Participants: Multiethnic population-based sample of 511 women, age 18 to 64 years. Participants were interviewed in person following informed consent.
Main Outcome Measure: Detection of abuse status.
Results: The four question AAS-D detected 9.8 percent (50/511) prevalence of abuse during the last year. Using two standard physical and sexual assault questions, 7.8 percent of the women reported abuse (40/511). The two disability-related questions detected an additional 2.0 percent (10/511) of the women as abused. Women defining themselves as other than black, white, or Hispanic were more likely to report physical and/or sexual abuse, whereas, disability- related abuse was reported almost exclusively by white women. Perpetrator of abuse was most likely intimate partner for physical or sexual abuse. Disability related abuse was attributed equally to intimate partner, care provider and health professional.
Conclusions: Both traditional abuse-focused and disability-specific questions are required to detect abuse towards women with physical disabilities. Straightforward, routine clinical assessment is recommended as essential in preventing potential trauma, interrupting existing abuse, and protecting health.