Domestic abuse is a serious public health issue which disproportionately affects women and children (Office for National Statistics, 2020). It is also a prominent risk factor in Serious Case Reviews where a child has died or been seriously injured (Brandon et al 2020). So, if we are to improve outcomes for children and families, then we must look for more effective ways of tackling domestic abuse and seek to understand what can make a difference.
The personal account below is written by Leah, a former FNP client who was enrolled onto the FNP programme when she was 16 years old. At that time, she was in an abusive relationship – now 9 years on, Leah is a qualified health professional. Here she describes the importance of having a relationship with a trusted professional who adopted a non-judgmental, trauma informed approach which enabled her to recognise and then leave an abusive relationship.
“I thought the relationship I was in was normal so didn’t realise it was abusive. I didn’t tell the truth as I didn’t know I was in an abusive relationship. Having general discussions about relationships with my family nurse allowed seeds to be sown about what a healthy relationship is.
“Domestic abuse work was trickled into other sessions e.g. baby weaning, safe sleeping, coping with lack of sleep, these sessions looked at how we would support each other in difficult times, I then started to realise he wouldn’t support me and that if he was tired he may kick off, this felt wrong.
"One of the FNP materials is about things you would/wouldn’t like your baby to get from you and the same from their Dad. I wrote ‘I don’t want her to be scared’ under my section. I just felt that was incredibly powerful: how the program can explore these things indirectly.
“The family nurse’s approach made a difference – she was calm about it, there was no blame or judgement like I felt there was with other professionals, she spoke to me like an adult. I felt she was the only professional I saw who actually ‘saw me’ instead of the fact I was a 16-year-old single mum who was in/had been in an abusive relationship. I got the impression from others ‘that I brought it on myself’ and was told at one point, by another professional, that I shouldn’t have continued with the pregnancy if I didn’t want to end up in that situation.
“During a session with the family nurse on attachment, I realised Ruby’s dad had a different attachment style to me. This made me understand his priorities in a relationship were not good, experiences were always about him, not Ruby, and this shone a light on his behaviour. The family nurse helped me understand the impact on Ruby if I’d stayed and how this would have negatively affected our positive attachment - this gave me strength to carry on with the court process.
“I knew I always had the family nurse to support me through the process of leaving him, without her I would have felt stuck and unable to leave, my parents didn’t know what was going on as I had been isolated from all my family and friends. The court process took 13 months and continued support from the family nurse allowed me to complete this without giving up. During this process I encountered self-blame which made me go two steps back and lose confidence in myself. The family nurse would review the relationship work again focusing on unhealthy relationships which allowed me to understand it was his fault, not mine, giving me renewed confidence. My family nurse encouraged me to continue by keeping my focus on Ruby.
“It took me a long time to start another relationship. I was now aware of the signs to look out for and because I knew what a healthy relationship was I was able to look for this. I also knew the warning signs to prevent me staying in a relationship that would be unhealthy. I am now in a healthy, happy and equal relationship”.
(names have been changed to protect identities).