Next Steps: A Guide to Effective Action
Following consideration of the categorical program plans outlined above, the workshop participants highlighted three steps that could be taken to address the problem of violence in American families. These steps can provide the basis for future research and program plans.
Step 1. Development of a public education campaign would foster understanding of the complex dimensions of family violence. Such a campaign would include national conferences involving researchers, service providers, government officials, and child and other victim advocates, as well as a broad-scale media education effort focused on family violence. The purpose of such a campaign would be to raise the visibility of the scope and significance of family violence, publicize significant research findings, establish agency positions on ways to address the problem, and foster collaborative efforts among health, social service, and criminal justice professionals. Such a campaign would provide a forum that could examine best practices and lessons learned from program efforts in family violence, emphasize the importance of family violence issues in professional education, and encourage community support for further work designed to identify and develop remedies for gaps in the research and knowledge base. The campaign should be broad-based, including a focus on the relationship between family and community violence, the issue of gun control, the role of violence in American culture, and the use of corporal punishment as an aspect of violence in American families.
Step 2. Efforts are needed to bridge the gap that now exists between research resources and policy needs in addressing the problem of family violence. One way to address this gap is to develop rigorous evaluations of public-sector programs designed to treat or reduce incidents of child and spousal abuse and abuse of the elderly. Over the past decade, various types of interventions have been designed, tested on a pilot basis, and implemented in diverse communities to respond to or prevent different forms of family violence. Such efforts include home visitation programs, family preservation and family support services, battered women's shelters, and mandatory arrest programs for domestic violence cases. Yet the evaluation literature on these studies is seriously incomplete. As a result, government officials lack clear conclusions on the strength and limitations of selected efforts, and they are not able to develop programs on a strong base of scientific knowledge. Research that is oriented toward the evaluations of relevant program interventions needs to be identified and highlighted to synthesize and disseminate important lessons learned from past efforts to reduce family violence. More knowledge is also needed about the costs of family violence, in terms of health care, school performance, employment productivity, and so forth.
Step 3. The integration of preventive measures for family violence into a comprehensive, community-based program of family support services across a spectrum of developmental milestones is needed. Although such an integrated program is desirable, its dimensions remain vague and the barriers to implementation are enormous. Further work needs to be stimulated to identify the underlying processes that contribute to family violence and to clarify the extent to which families who are characterized by violence experience other forms of behavioral and social disorders (such as substance abuse, juvenile delinquency, crime, etc.). Research and program development are also needed to identify the essential features of successful comprehensive community-based programs and the extent to which such programs should seek to combine the diverse range of family counselling and family support activities now fragmented in a wide range of categorical programs (including child protective services, Head Start, maternal and child health care, child care, and job training programs).
Some elements of the concept of comprehensive, community-based programs can be encouraged within the existing structure of services, for example, by distributing information about women's emergency shelter programs to hospital emergency room personnel who may treat victims of domestic violence. However, the goal of comprehensive services goes beyond information-sharing and seeks to simplify access to services that address common family needs. Many comprehensive services focus on the mother-child relationship following an infant's birth. But in dealing with family vio-
lence, other developmental periods also have significance (marriage, pregnancy, adolescence, retirement, etc.) that present opportunities for intervention by service providers. An elderly person's registration for Medicare, for example, could represent an appropriate time for health and social service interventions designed to support healthy family functioning.
The dimensions and long-term costs of family violence are just beginning to emerge in American society. By exposing the limitations of scientific knowledge in dealing with this complex problem, new efforts can be designed to develop a broad range of program and policies.