of victimization be included in standard medical and psychological examinations and be considered in the development of individual treatment plans” (p. 134) and that the necessary training occur to enable such a change in psychologists’ practice.

The National Association of Social Workers adopted a statement on family violence in 1987, reaffirmed it in 1993, and redrafted it in 2000. No other social work organizations, including the American Board of Examiners in Clinical Social Work and the Clinical Social Work Federation, appear to have specific expectations regarding family violence training for their members.

Advocacy Groups

A number of coalitions and initiatives have been developed to foster knowledge in the area of family violence. Generally, these groups and efforts target a particular type of family violence and appear to have been involved in increasing education on family violence issues. These groups include direct providers at shelters, other victims’ services providers, members of grassroots movements that established those programs, and victims, as well as researchers and educators. However, their full impact is unknown. In addition, a number of advocates have expressed concerns about involvement with the health professions, believing health professionals may create obstacles to advocacy efforts and health professional education on family violence, if they do not understand or support the work the advocates are doing.

Systematic efforts were initiated in the 1960s and 1970s to integrate child maltreatment into the curricula of all of the health professions. The Child Abuse Prevention and Treatment Act of 1974 mandated the establishment of the National Center on Child Abuse and Neglect, which has since become the Office on Child Abuse and Neglect. The legislation resulted in part from efforts by advocacy groups to raise the awareness among helping professions about child maltreatment; it does not specifically address health professional training on child abuse and neglect.

Advocates were a primary force in bringing the issue of violence against women (including child sexual abuse and intimate partner violence) to the attention of health care providers. The first research by health professionals on the subject (outside psychiatry and psychology) was that of Carlson (1977) in social work, Parker and Schumacher (1977) from nursing and medicine, Stark and Flitcraft (1981) in medicine and sociology, Appleton (1980) in emergency medicine, and Campbell (1981) in nursing. Meanwhile, the 1970s were an era when the first battered-women’s shelters were being established in the United States (Schechter, 1982) and when advocates of preventing sexual assault were beginning to address the issue of child sexual assault and rape.

Notable among advocacy efforts is the work of the Family Violence Prevention Fund. This organization has developed an extensive model educational program for health care providers (Ganley, 1998; Warshaw and Ganley, 1998). The



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