doctors, nurses, social workers, teachers, court personnel, employee as-
sistance counselors, psychiatrists, police, clergy, and all other healch,
social service, and criminal justice professionals. (E-42)

In the area of Research we recommend that. . .

_ the factors that aid in the prevention of spouse abuse should be
identified. (R-37)

research and demonstration projects should be designed for the
prevention of spouse abuse and woman battering. (R-38)

_ existing intervention and treatment programs should be evaluated.
(R-39)

_ the different dynamics and consequences of abuse for men and for
women — and the service implications of these differences — should
be identified. (R-40)

In the area of Services we recommend that. . -
_. . healeh and social service personnel should uniformly define spouse
abuse as any assault or threat of assault by a social partner, regardless
of gender or marital status and whether or not they are present or former
cohabitants. (S-60)

_ the empowerment of women should be supported by expanding
their social and economic options before and after the identification of
abuse and by addressing such vital issues and services as pay equity, the
enforcement of child support orders, adequate and low-cost housing,
child care, and job training. (S-61)

. model protocols for spouse abuse and woman battering should be
used in health setcings for the early identification of such abuse and for
aiding victims. (S-62)

_ . spouse abuse protocols need to be developed for secondary treatment
sites primarily concerned with alcohol and drug abuse, suicide preven-
tion, rape and sexual assault, emergency psychiatric problems, child
abuse, and the homeless. (S-63)

_. . federal, state, and local initiatives to prevent child abuse should be
mandated to directly address spouse abuse and woman battering as well.
(S-64)

. the Regional Centers established under the 1984 reauthorization
of the National Center for Child Abuse and Neglect should have spouse
abuse and woman battering added co their charters and the National
Advisory Board on Child Abuse and Neglect should be appropriately
renamed (e.g., the National Advisory Board on Family Violence) and
its membership expanded to represent these linked concerns. (S-65)

76
_ . shelters should be supported and encouraged to meet the emergency

needs of all victims, including protection, housing, and violence. (S-66)

. each governor should designate a state office or agency as the focal
point for programs and policies related to domestic violence. (S-67)

. . the criminal justice syscem must acknowledge rape and sexual assault
as crimes, regardless of the past or present marital relationship between
victim and perpetrator. (S-68)

_ . . bactered women need to be assured that the violence against them
will stop, and that they will receive equal protection under the law and
a swift resolution of their cases. (S-69)
.. . Congress should make sure that che full protection of the law in
matters involving domestic violence is provided for all families living
within exclusive federal jurisdictions. (S-70)

_ new programs in education, treatment, and counseling need to be
developed to help stop abusive men from committing further acts of
violence. (S-7 1)

 

77
Plenary Session V

Response to the Recommendations

Presented by C. Everett Koop, MD
Surgeon General, USPHS
Tuesday afternoon, October 29, 1985

This Workshop may be a new departure, but the sheer number of victims
— some 4 million — who cry out for help each year demands a public
health response. If prevention is the business of public health, where better
to focus attention than on this scourge of violence that permeates every
level of our society — where victims live not only in fear and dread, but
they also desperately try co sort out the shame and the guilt and the fear
that competes with their feelings of love and loyalty to their families.
While our attention has been directed primarily at interpersonal violence
within the family, we seek to address the causes and effects of such violence
outside che family as well.

Because this is the first Surgeon General’s meeting on the subject of
violence, the scope may be more diffuse than some would have wished.
We have focused on public health, with additional participants representing
the law, the criminal justice system, and social services. I would want the
next workshop to focus more directly on the partnership of health and
justice.

Your recommendations are just what I had hoped for. It should be
possible for individual health professionals as well as the leaders of major

79
health instirutions and associations to understand and act on them. Several
themes do recur in the recommendations from among the 11 work groups:
education of the public on the causes and effects of violence, education of
health professionals as to better care for victims and better approaches co
violence prevention, improved reporting and data-gathering, some addi-

tional research, and increased cooperation and coordination — ‘“network-
ing,” if you will — among health and health-related professions and
institutions.

Senate Hearing

I will begin carrying out that first recommendation of public education
tomorrow when I lead off the witnesses at a special public hearing before
Senator Paula Hawkins’ Subcommittee on Children, Families, Drugs, and
Alcoholism. I will also send your recommendations to the Secretary of
Education and will indicate your willingness to work with his Department
to get something accomplished in our public and private schools, colleges,
and universities.

As for professional education, in addition to a report in Public Health
Reports, 1 will post your recommendations on the Surgeon General’s elec-
tronic bulletin board as soon as possible. The bullecin board, which 1s part
of the American Medical Association's computerized Medical Information
Network, or MINET, reaches about 26,000 physician subscribers.

I will also convey your concerns to many other professional groups, such
as the American Nurses Association, National Board of Medical Examiners,
Association of State and Territorial Health Officers, American Academy of
Pediatrics, and the National Association of Social Workers.

As for the recommendations for research, | will convey them to the
Assistant Secretary for Health and to the heads of the five PHS agencies
who have the legal authority and the funds to conduct research. Several
work groups have suggested new prospective, longitudinal studies of vic-
tims and families. Such studies are complicated and costly to mount. I
honestly do not know how my colleagues will react to that, but I will
certainly give them the suggestions.

I would also like to respond to some specific recommendations.

» You asked that the Surgeon General undertake an informational cam-

paign about spouse abuse — something that I can and will do. I will

transmit to the American College of Obstetricians and Gynecologists
the recommendation for more sensitive evaluation and care for battered
spouses who are pregnant. That also has my strong support.

» Both work groups on rape were concerned about the need for additional

80

 
research and recommended that a conference be held specifically to sort
out what needs to be done. I endorse that suggestion and convey it to
the Alcohol, Drug Abuse, and Mental Health Administration. You also
called for greater interdisciplinary cooperation in the field of rape, and
I agree that it is absolutely essential.

e In reference to assaule and homicide, I understand your emphasis on
paying special attention to the impact upon minorities. Rather than
responding now, I would first like to see how the recommendations
dovetail with those recently made by the Secretary’s Task Force on Black
and Minority Health.

« A number of recommendations concerning child abuse and child sexual
abuse might well receive a more appropriate response from the Depart-
ment’s Office of Human Development Services, a co-sponsor of this
Workshop. I intend to stay in close touch with chat Office, as you clearly
imply I should. I can say, however, that I agree completely with the
recommendation that the abused child be treated promptly according to
an evolving plan. The victim should not be seen merely as a pawn in
some legal chess game.

Meanwhile, the PHS Division of Maternal and Child Health is be-
ginning an aggressive public education campaign on child abuse and
child sexual abuse and in May 1986 will co-sponsor a conference on child
sexual abuse. The Division will also be disseminating materials related
to these problems; | will ask them to include the recommendations in
their mailings.

I'd like to add that I will carry che recommendations to certain other
groups, such as the American Red Cross, the Boy Scouts and Girl Scouts,
and the 4-H Clubs of America.
¢ From the day I was appointed in 1981, I’ve chosen che role of advocate
for vulnerable, threatened older people in our society. I assure you that
I will speak to this issue of elder abuse as well. I will deliver the
recommendations on elder abuse to the Administration on Aging in the
Department of Health and Human Services. The AoA interacts with
about 1,200 centers on aging, so it is an important ally for getting broad
exposure to the recommendations in this area. [ will also discuss research
in elder abuse with Dr. T. Franklin Williams, Director of the National
Institute on Aging.

One work group recommended, in effect, that the Federal Government
practice what it preaches, and I agree completely. Hence, I'm pleased
that we've had a strong delegation from the Department of Defense at
the workshop. They represent not only the policy function but also the

81
line function, the people who actually deliver health care to servicemen
and women and their dependents.

What PHS Can Do

Let me share what the Public Health Service itself can do, is doing, or
will do in respect to interpersonal violence. The National Health Service
Corps, for example, is a PHS organization of health care professionals
working in medically underserved areas, most of them remote rural areas
or distressed inner-city neighborhoods. The Corps will be absorbing as
many of the recommendations as possible into its continuing medical ed-
ucation program for the 3,100 NHSC officers in the field. And we have
agreement from the Indian Health Serivce that the same actions would be
useful for cheir personnel, too.

The 60,000 PHS employees are a cross-section of American society; they
also have their share of personal problems, for which we have an employee
counseling service. I understand chat domestic violence will be receiving
more attention from that counseling service during the coming year, in-
cluding the establishment of a support group for battered women within
PHS.

I believe the recommendations will be especially significanc for the Na-
tional Institute of Mental Health, which supports research in violence and
anti-social behavior. I'm sure your thoughts regarding trends and emphases
will be carefully studied by NIMH personnel and by the PHS people who
work with migrant health centers, community health and mental! health
centers, state and local health agencies, and so on. I'd like them to have
a heightened awareness of interpersonal violence in the conduct of the
important grass-roots programs in public health.

Regional Follow-Up

Some of the participants are thinking ahead to follow-up activities to
this Workshop. Regional meetings and some educational programs are
being discussed. I hope that you will drop me a note about subsequent
developments in this campaign against interpersonal violence. For my part,
I pledge that my Office will put that information together for a 6-month
follow-up report and a 12-month report. I agree with the strong recom-
mendation of greater coordination and information-sharing within — and
among — the health professions.

A final word. The causes of interpersonal violence, especially family

82
violence, are complex, multi-faceted, and extend into the social and cultural
fabric of society. Sometimes the etiologic agent may be far removed from
the narrower realm of health care. However, any remedies undertaken by
a health official, including — and especially — the Surgeon General, must
be consistent with his actual sphere of responsibility and influence and
moral persuasion. Several recommendations — thoughtfully conceived and
vigorously presented — are nevertheless well outside that public health
sphere. But I want to assure you that, when and where feasible, I will
transmit those recommendations as the sincere concerns of participants of
this Workshop, even though they address social and political problems
well beyond the influence of our colleagues in medicine, nursing, public
health, psychology, and health-related social services and of the Surgeon
General and the Public Health Service.

As long as I am Surgeon General, those who are victims of violence in
this country will have a strong advocate in my Office.

Thank you.

 

83
The “Delphi Survey”

In the spring of 1985, in anticipation of “The Surgeon General's Work-
shop on Violence and Public Health” scheduled for late October, the Public
Health Service decided to incorporate a Delphi survey in its pre- Workshop
planning. The contractor was Survey Research Corporation.

Delphi surveys are designed to measure the collective wisdom of a group
of experts. The participants are asked a series of questions, or exposed to
the group averages, and are then invited to reconsider their positions. The
process continues until a consensus emerges.

PHS felt that a Delphi survey preceding the Workshop would be of
value on three counts:

1. It would give a sense of shared purpose to participants who had no

prior contact with each other.

2. It would serve to clarify positions in advance of the Workshop,
thereby shortening the time needed to explore viewpoints. The Work-
shop could, therefore, go directly into action the moment it convened.

3. It would help sustain interest in the Workshop during the inactive
summer months.

Everyone on the invitation list was invited to participate in the Delphi

and virtually all agreed: an unusually generous response.

Delphi I (the firse iteration) was launched in June. It contained three
broad questions representing the Workshop's areas of interest.

Q1 What is the role of education?

Q2 What should be done in research?

Q3 What should be done about the delivery of medical, health, and

social services?

Under each question, there were statements that asked for agreement or
disagreement on an 11-point scale. There was also space to propose addi-
tional statements for evaluation by the group.

The substance of statements proposed twice or more were included in
Delphi I and I (the next iterations). Neither the Public Health Service
nor Survey Research Corporation proposed or vetoed statements. Deiphi II
and III were, therefore, the products of the participants.

84
 

With Delphi III in lace August, the concentrations were well established
and there were no additional statements proposed. The Delphi survey was,
therefore, over.

Results

Response to the survey statements is measured by an 11-point scale used
as a continuous variable from “1” signifying total agreement to “11” sig-
nifying total disagreement. The midpoint “6” is che neutral position.

Two statistics are used co describe the results.

The first is the mean, or arithmetic average. It is interpreted as follows:

1-2: very close to complete agreement

3-4 : substantial or general agreement

5-7 : verging toward or in the neutral area
8-9 : substantial or general disagreement
10-11: very close to complete disagreement

The second is support level. This is the total number (of percent) on one
side or the other of the neutral position. The following is an example:

 

 

Scale Value Number of
Respondents
1 5
2 9
3 AGREEMENT 36
4 25
5 5 Total above 6 is 80
6 NEUTRAL 5
7 2 Total below 6 is 15
8 3
9 DISAGREEMENT 3
10 4
11 3
Total 100

In the example, the positive (agreement) support level is 80, the negative
(disagreement) support level is 15. The neutral position is 5. A positive
support level of 80 is high, since a substantial majority shows some level
of agreement with che position.

The mean and the support level taken together are usually an adequate

85
description of the results. In the few cases where they are not, the distri-
bution of the data will be given in the text.

The following results of the survey are shown in question/statement
order.

Ql What is the Role of Education?

The set of 14 statements under this broad question focused mainly on
action recommendations. In the few instances where theoretical positions
were offered, such as “education can change the mores,” there was a sig-
nificance but relatively unenthusiastic response. On the other hand, positive
support levels for training in recognition, reporting, and other situations
calling for direct action were all extremely high.

Qla Po.ice SHOULD Be TRAINED IN EFFECTIVE METHODS OF
INTERVENTION.
The mean is 1.8 and the positive support level is 9996: an extremely
strong showing for this and the two related statements that follow.

Qitb HEALTH PROFESSIONALS SHOULD BE TRAINED TO RECOGNIZE Do-
MESTIC VIOLENCE.
The mean is 1.6 and the positive support level is 100%.

Qic HEALTH PROFESSIONALS SHOULD BE TRAINED IN VIOLENCE-RE-
PORTING PROCEDURES.
The mean is 1.8 and the positive support level is 99%.

Qld HEALTH PROFESSIONALS SHOULD BE TRAINED IN VIOLENCE INTER-
VENTION PROCEDURES.

The mean is 2.9 and the positive support level is 95%: agreement with

the position but with some reservations. We speculate that chese may have

to do with the practical consideration of danger to the intervening person.

Qle INTRODUCE VIOLENCE PREVENTION IN FAMILY LiFE COURSES IN THE
SCHOOLS.
The mean is 2.3 and the positive support level is 96%.
Qlf EDUCATION CAN CHANGE THE MORES (AND SOCIAL Norms) THAT

DICTATE VIOLENT BEHAVIOR.

86
The mean is 4.1 and the positive support level is 81%. But there is a
substantial 38% cluster around the generally neutral 5-6-7 area.

Qlg EpucaTION CAN LEAD TO BETTER COMMUNICATION SKILLS AND
THEREFORE LESS VIOLENT BEHAVIOR.

The mean is 4.0, with positive support at 83%: a slightly better showing

than the preceding statement, but in the same area of general agreement.

Qlh_ Improve PuBLIC AWARENESS OF LEGAL RIGHTS AND AVAILABLE
SERVICES.
With a mean of 2.7 and a positive support level of 98%, agreement is
unequivocal. The next statement, which proposes a method to achieve this,
is even more acceptable.

Qli Use THE Mass MEDIA IN A PosiTIVE EDUCATION PROGRAM AGAINST
VIOLENCE.
The mean is 2.0 and the positive support level is 96%.

Q1lj TRAIN AND CerTIFY FORENSIC PSYCHIATRISTS AND PsYCHOLOGISTS.

The mean is 5.0 and the positive support level is 60%: a response that
tends toward the neutral position. Response to the next, related statement
is even more so. Several respondents wrote “why?” to both statements.

Qik TRAIN AND CERTIFY FORENSIC SOCIAL WORKERS.
The mean is 5.3 and the positive support level is 52%.

QU HEALTH EDUCATION, COMBINED WITH PosITIVE MODELING AND
SUPPORT FOR NON-VIOLENT RESPONSE, CAN LEAD TO Less VIOLENT
BEHAVIOR.

The mean is 3.9 and the positive support level is 85%: general but not
enthusiastic agreement.

Qlm Give CHILDREN ExPLiciIT EDUCATION IN NEGOTIATION TACTICS
AND CONFLICT RESOLUTION.
The mean is 2.9 and the positive support level is 95%: a clear acceptance
of the position.

Qin PROVIDE PROFESSIONALS DEALING WITH VIOLENCE WITH SENSI-
TIVITY TRAINING AND IN-DEPTH CASE CONSULTATION.
The mean is 3.5 and there is a positive support level of 83%; thus, there
is general, but not total agreement.

87
Q2 What Should Be Done in Research?

The 16 statements under this question were a mix of specific projects
and generalized approaches. In general, the group showed strong support
for practical rather than theoretical projects and for the study of environ-
mental rather than biological factors in violence. For example, statements
that called for the development of intervention field models or for the
evaluation of existing programs had mean values of 2.6 and 1.9, while
those that dealt with verbal skills or the structure of genes had values of
5.0 and 7.7.

Q2a NEUROPSYCHOLOGICAL AND BIOMEDICAL AREAS HAVE BEEN
NEGLECTED.
The response is neutral, with a mean of 5.8.

Q2b ANALYSIS OF STRUCTURAL (ENVIRONMENTAL) PROBLEMS 1S THE KEY
TO BETTER RESEARCH.
There is general support for the statement with a mean of 4.2.

Q2c RESEARCH SHOULD BE FOCUSED ON THE Mor_E VULNERABLE, HIGH-
Risk POPULATION GROUPS.
The mean is 3.7 and the positive support level is 85%, which indicates
a favorable position on the statement.

Q2d DErTERMINE THE FUNCTION OF Poor VERBAL SKILLS IN RELATION
TO VIOLENCE.
The mean is 5.0 and the positive support level is 58%, a marginally
neutral response.

Q2e DETERMINE THE RELATIONSHIP BETWEEN VIOLENCE AND THE ABUSE
OF DRUGS AND ALCOHOL.
The mean is 3.0 and the support level is 93%. Evidently there is con-
siderable interest in exploring the drug-alcohol-violence hypothesis.

Q2f THOSE DOING RESEARCH ON VIOLENCE SEEM TO KNOW LITTLE ABOUT
Ir.
The mean is 6.3 and the negative support level is 31%. Most of the
response—60%—is in the 5-6-7 neutral range. Clearly, the respondents
were not able to express a clear judgment here.

88
Q2g Privacy Laws HINDER RESEARCH ON VIOLENCE.

The mean is 5.6 and 52% are at the neutral (6) point. Some of the
write-in comments indicate chat the subject is a mystery to many of the
participants.

Q2h More INTERDISCIPLINARY RESEARCH Is NEEDED.
With 95% positive support and a mean of 2.6, the response is unequivocal.

Q2i More RESEARCH ON INNATE CHARACTERISTICS, SUCH AS GENE
STRUCTURE.
The position is generally rejected: a mean of 7.7 and a negative support
level of 72%. (See also the related Q2a.)

Q2j CONCENTRATE ON APPLIED RATHER THAN PurRE RESEARCH.
There is substantial agreement with the position at a mean of 4.1 and
a positive support level of 67%.

Q2k Devetop FiELD MODELS OF EFFECTIVE INTERVENTION.
The positive support level is 97% and the mean is 2.6. There is no
doubt that the group is strongly in favor of this kind of pragmatic research.

Q21 INVESTIGATE VIOLENCE AS NORMATIVE BEHAVIOR.
There is substantial agreement with a 3.8 mean and a support level of
84%.

Q2m__ INVESTIGATE THE RELATIONSHIP BETWEEN STRESS AND VIOLENCE.
92% agree, with a mean of 2.8.

Q2n INVESTIGATE THE ETIOLOGY OF COPING SKILLS.
There is substantial agreement with a mean of 3.6 and 84% support.

Q2o0 DETERMINE THE RELATIONSHIP BETWEEN ABUSE IN CHILDHOOD AND
HiGH Risk IN ADULTHOOD.

Strong agreement at a mean of 2.8 and a support level of 93%. The
importance of this research may be stronger than the statistics indicate,
since some who disagreed did so on the grounds that the relationship had
already been established.

Q2p EvaLuaTE EXISTING PREVENTION AND INTERVENTION PROGRAMS.
100% support and a mean of 1.9 for this pragmatic approach.

89
Q3 What Should Be Done About the Delivery of Medical,
Health, and Social Services?

These 14 statements were extremely diverse, as they dealt with specific
actions and procedures. All the proposals were given varying degrees of
support, except for the location of shelters in or near hospitals, which was
viewed neutrally. Real enthusiasm, however, was reserved for the expansion
of shelter and crisis facilities, for bringing schools and the justice com-
munity into the violence prevention network, and for creating multidis-
ciplinary teams at the local level.

Q3a_ CREATE A CENTRAL DATABANK FOR CHECKING AND SHARING Hos-
PITAL RECORDS.
There is substantial agreement at a mean of 4.3 and a support level of
78%.

Q3b Devetop MORE SHELTERS FOR VICTIMS OF DOMESTIC VIOLENCE,
BotTH ADULTS AND CHILDREN.
There is strong agreement at a mean of 2.9 and a support level of 93%.

Q3c LOCATE SHELTERS FOR Victims IN oR NEAR HOsPITALS.
The group is neutral at a mean of 5.5 and 58% in the 5-6-7 scale range.

Q3d_ IMPROVE MEDICAL-SOCIAL SERVICES COOPERATION By DEFINING
AREAS OF RESPONSIBILITY.
There is substantial agreement with the position at a 3.1 mean and a
93% support level.

Q3e IMPROVE THE QUALITY OF PERSONNEL ENGAGED IN EMERGENCY
MEDICINE.
87% agree at a mean of 3.3.

Q3f DEFINE TYPES OF EMERGENCY ROOM PATIENTS WHO REQUIRE THE
ASSISTANCE OF A SOCIAL WORKER.
The mean is 3.2 and the positive support level is 91%.

Q3g BRING SCHOOL HEALTH FACILITIES INTO THE VIOLENCE PREVENTION

NETWORK.
Strong agreement at a mean of 2.2 and a 97% support level.

90
 

Q3h CREATE MULTIDISCIPLINARY TEAMS AT THE Local LEVEL.
96% support the position at a mean of 2.5.

Q3i DeEvELOP STANDARDS THAT DEFINE WHAT Is ABUSE OF OLD PEOPLE.
There is substantial agreement at a mean of 3.1 and a support level of

91%.

Q3j BRING THE JUSTICE COMMUNITY INTO THE VIOLENCE PREVENTION
NETWORK.
100% agree, with a mean value of 2.0.

Q3k IMPROVE THE QUALITY AND AVAILABILITY OF SHORT-TERM CRISIS
INTERVENTION FACILITIES.
99% agree. The mean is 2.0.

Q3l CREATE LOCAL COORDINATING Bopigs TO PREVENT THE DUPLICA-
TION OF SERVICES.
78% agree and the mean value is 3.7. Some write-in comment feared
this would mean further regulation.

Q3m_ DeveLop STANDARDS OF CARE FOR OFFENDERS.
With a mean value of 4.0 and a support level of 76%, agreement is

unenthusiastic.

Q3n Make Quality Day CARE AVAILABLE TO ALL.
74% agree and the mean value is 3.6,

 

91
List of Participants

Faye G. Abdellah, RN, EdD, DSc. Depucy Surgeon General and Chief Nurse Officer,
USPHS, Washington, DC.

(R) Sergeant Jean Albright, USAF. Bureau Chief, Stars G Stripes, Bitburg, West Germany.

Carole Anderson, RN, PhD. Associate Dean for Graduate Studies, University of Ro-
chester School of Nursing, Rochester, NY.

Laura Anderson, MPH. Health Services Coordinator, Health and Human Services De-
partment, City of Berkeley, CA.

Margaret Long Arnold. Coordinator of Women's Activities, American Association of
Retired Persons, Washington, DC.

Constance Avery-Clark, PhD. Clinical and Research Associate, Masters and Johnson
Institute, St. Louis, MO.

Rosemary Barber-Madden, EdD. Associate Professor and Director, Maternal and Child
Health Program, Center for Population and Family Healch, Columbia University, New

York, NY.

Amy C. Barkin, MSW, MPH. Director, Employee Counseling Service Program, USPHS,
Rockville, MD.

Judith V. Becker, PhD. Director, Sexual Behavior Clinic, New York State Psychiatric
Institute, New York, NY.

Douglas J. Besharov. Adjunce Scholar, American Encerprise Institute, Washington, DC.

Captain Edgar R. Blount, MD. Special Assistant for Medical Affairs, Office of the Assistant
Secretary of Defense (Health Affairs), Washington, DC.

Major Linda Boone, USMC. Family Programs Officer, Headquarters, U.S. Marine Corps,
Arlington, VA.

Anthony V. Bouza. Chief of Police, Minneapolis, MN.

Gary L. Bowen, PhD. Assistant Professor, School of Social Work, University of North
Carolina, Chapel Hill, NC.

Lee P. Brown, PhD. Chief of Police, Houston, TX.

 

(R) Work-Group Rapporteur

92
Mary Pac Brygger. Executive Director, Domestic Abuse Project, Minneapolis, MN.

* Ann W. Burgess, RN, DNSc. Van Ameringen Professor of Psychiatric Mental Health
Nursing, University of Pennsylvania School of Nursing, Philadelphia, PA.

Jane N. Burnley, PhD. Associate Commissioner, Children’s Bureau, Washington, DC.

Martha R. Burt, PhD. Director, Social Services Research Program, Urban Insticute,
Washington, DC.

John A. Calhoun. Executive Director, National Crime Prevencion Council, Washington,
DC.

Jacquelyn C. Campbell, RN, MS. Wayne State University College of Nursing, Detroit,
MI.

Elaine Hilberman Carmen, MD. Professor, Department of Psychiaery, University of North
Carolina Schoo! of Medicine, Chapel Hill, NC.

David L. Chadwick, MD. Senior Vice-President/Medical Director and Director, Child
Protection Program, Children’s Hospital and Health Center, San Diego, CA.

Jane R. Chapman. Director, Center for Women Policy Studies, Washington, DC.

Danny Chin, MD. Acting Medical Director, South Cove Community Health Center,
Boston, MA.

Dante Cicchetti, PhD. Associace Professor of Psychology, University of Rochester, and
Director, Mt. Hope Family Center, Rochester, NY.

J. Jarrett Clinton, MD. Department Assistant Secretary of Defense for Professional Affairs
and Quality Assurance, OASD (Health Affairs), Washington, DC.

Anne H. Cohn, PhD. Executive Director, National Committee for Prevention of Child
Abuse, Chicago, IL.

Jon R. Conce, DSW. Assistant Professor, School of Social Service Administration, Unt-
versity of Chicago, IL.

* Theodore O. Cron, MAT. Special Assistant to the Assistant Secretary for Health and
the Surgeon General, USPHS, Washington, DC.

Phyllis Old Dog Cross, RN, MS. Psychiatric Nurse Clinician, Regional Mental Health
Services, Indian Health Service, USPHS, Rapid City, SD.

Lynn A. Curtis, PhD. President, Eisenhower Foundation, Washington, DC.

Bruce Cushna, PhD. Associate Director, Developmental Evaluation Clinic, Children's
Hospital, Boston, MA.

 

* Member of the Planning Committee

93
Howard Davidson, Esq. Director, National Legal Resource Center for Child Advocacy
and Protection, American Bar Association, Washington, DC.

Jane Delgado, PhD. National Executive Direcror, COSSMHO (Nationa! Coalition of
Hispanic Health and Human Services Organizations), Washington, DC.

Major Gloria Deniz, USAF Nurse Corps. Pediatric Nurse Practitioner, Wilford Hall
Medical Center, Lackland AFB, San Anconio, TX.

Ruth E. Dennis, PhD. Associate Professor, Meharry Medical College, Nashville, TN.

Sara Reed DePersio, MD, MPH. Chief, Maternal and Child Health Service, State De-
partment of Health, Oklahoma City, OK.

Karla M. Digirolamo. Executive Director, Governor's Commission on Domestic Violence,
Albany, NY.

Lt. Joseph DiPaolo, MSC, USN. Head, Family Advocacy Program, Naval Medical Com-
mand, Washington, DC.

Marlene Echohawk, PhD. Associate Magistrate, CER Court of Indian Offenses, Oklahoma
City, OK.

Jean K. Elder, PhD. Commissioner, Administration on Developmental Disabilities, Wash-
ington, DC.

Robert A. Fein, PhD. Program Director, McLean/Bridgewater Program, McLean Hospital,
Belmont, MA.

Fern Y. Ferguson, MSW. President, National Coalition Againsc Sexual Assaule, East St.
Louis, IL.

Harvey V. Fineberg, MD, PhD. Dean, Harvard School of Public Health, Boston, MA.

Paul J. Fink, MD. Medical Director, Philadelphia Psychiacric Center and Chairman,
Department of Psychiatry, Albert Einstein Medical Center, Philadelphia, PA.

David Finkelhor, PhD. Associate Director, Family Violence Research Program, University
of New Hampshire, Durham, NH.

Anne H. Flitcraft, MD. Assistant Professor of Medicine, University of Connecticut Health
Center, New Haven, CT.

William H. Foege, MD. Assistant Surgeon General and Special Assistant for Policy
Development, Centers for Disease Control, Atlanta, GA.

Peter W. Forsythe, Vice-President and Direccor, Program for Children, Edna McConnell
Clark Foundation, New York, NY.

Henry W. Foster, Jr., MD. Chair, Departement of Obstetrics and Gynecology, Mebarry
Medical School, Nashville, TN.

94
Shervert H. Frazier, MD. Director, National Inscitute of Mental Health, USPHS, Rock-
ville, MD.

SuEllen Fried. Founder, STOP VIOLENCE Coalition, Shawnee Mission, KS.

Richard J. Gelles, PhD. Dean of Arts and Sciences and Professor of Sociology and An-
thropology, University of Rhode Island, Kingston, RI.

Henry Giarretto, PhD. Executive Director, Institute for Community as Extended Family—
Parents United, San Jose, CA.

Jean Goodwin, MD, MPH. Professor of Psychiatry and Director, Joint Programs, Medical
College of Wisconsin and Milwaukee County, Milwaukee, WI.

* Margaret T. Gordon, PhD. Director, Center for Urban Affairs and Policy Research,
Northwestern University, Evanscon, IL.

(R) Christine Grant, RN. University of Pennsylvania School of Nursing, Philadelphia,
PA.

Ellen F. Greenberg, PhD. Administrative Officer for Health Policy, American Psycho-
logical Association, Washingron, DC.

Nahman Greenberg, MD. Executive Director, CAUSES, and Member, National Advisory
Board on Child Abuse and Neglect, [Hinois Masonic Medical Center, Chicago, IL.

Fernando A. Guerra, MD, MPH. Medical Direccor, Barrio Comprehensive Family Health
Center, San Antonio, TX.

Philip A. Harding. Vice President for Social and Policy Research, CBS Broadcast Group,
New York, NY.

Isadora Hare, MSW, ACSW. Senior Staff Associate, National Association of Social Work-
ers, Silver Spring, MD.

Col. Jesse Harris, DSW. Consultant to the Army Surgeon General, Social Work Service,
Walcer Reed Army Medical Center, Washington, DC.

* David E. Heppel, MD. Chief, Child and Adolescent Primary Care Branch, Division of
Maternal and Child Health, USPHS, Rockville, MD.

Jean Hilsman. Director, Family Policy Office of the Department of Defense, Washington
DC.

Lee Ann Hoff, RN, PhD. Associate Professor, Northeastern University College of Nursing,
Boston, MA.

Captain Bartholomew T. Hogan, MC, USN. Head, Psychiatry Department, Naval
Hospital, Naval Medical Command, Bethesda, MD.

Helen V. Howerton. Director, National Center on Child Abuse and Neglect, Washington,
Dc.

95
Peter A. Howland, MD, MPH. Director, West Virginia University Child Protection
Team, Morgantown, WV.

Janice Humphreys, RN, MS. Wayne State University College of Nursing, Detroic, MI.

Juanita K. Hunter, RN, EdD. Chair, Cabinet on Human Rights, American Nurses
Association, and Clinical Assistant Professor, School of Nursing, Stace University of New
York, Buffalo, NY.

Terry Hunter. Executive Director, Association of American Indian Physicians, Oklahoma
City, OK.

Charles F. Johnson, MD. Director, Child Abuse Program, Children's Hospital, Columbus,
OH.

Ms. Eddie Bernice Johnson, RN, MPH. Vice President, Government and Community
Affairs, Visiting Nurses Association, Dallas, TX.

LaVohn Josten, RN, PhD. Director of Public Health Nursing, State Deparment of
Public Health, Minneapolis, MN.

Blair Justice, PhD. Chair, Standing Committee on Interpersonal Violence, University of
Texas Health Science Center, Housron, TX.

Arnold S. Kahn, PhD. Adminiscrative Officer for Social and Ethical Responsibility,
American Psychological Association, Washington, DC.

Luella Klein, MD. Director, Maternal and Infant Care Project and Professor of Gynecology
and Obstetrics, Emory University School of Medicine, Atlanta, GA.

Karil S. Kiingbeil, MSW, ACSW. Assistant Professor and Director of Social Work,
University of Washington, Seattle, WA.

C. Everett Koop, MD. Surgeon General, USPHS, Washington, DC.

Jordan I. Kosberg, PhD. Professor of Gerontology, University of South Florida, Tampa,
FL.

* Thomas L. Lalley. Deputy Chief, Center for Studies on Anci-Social and Violent Behavior/
NIMH, Rockville, MD.

Norman Landsem, MSW. Director, Social Services and Mental Health, Bemidji Program
Office, Indian Health Service/USPHS, Bemidji, MN.

Barry D. Lebowitz, PhD. Chief, Center for Studies of the Mental Health of the Aging/
NIMH, Rockville, MD.

Howard B. Levy, MD. Chairman of Pediatrics, Mc. Sinai Hospital and Medical Center,
Chicago, IL.

Sheidon Levy, PhD, MPH. Director, Behavioral Sciences, Pediatric Ecology Program,
Mt. Sinai Hospical and Medical Center, Chicago, IL.

96
Dorothy Otnow Lewis, MD. Professor of Psychiatry, New York University School of
Medicine, New York, NY.

Dodie Truman Livingston. Commissioner, Administration for Children, Youth, and
Families, Washington, DC.

Ann Maney, PhD. Center for Anti-Social and Violent Behavior/NIMH, Rockville, MD.

Terry W. McAdam. Program Director and Vice President, Conrad N. Hilton Foundation,
Los Angeles, CA.

(R) Lawrence T. McGill. Center for Urban Affairs and Policy Research, Northwestern
University, Evanston, IL.

* Robert G. McGovern, MD. Direceor, Division of Ambulatory Pediatrics, Southwestern
Medical School, Universicy of Texas Health Science Center, Dallas, TX.

Laura Smith McKenna, RN, DNSc. Clinical Specialist in Psychiatric and Mental Health
Nursing, University of California at San Francisco, San Francisco, CA.

Ramona T. Mercer, RN, PhD, FAAN. Professor of Family Health Care Nursing, School
of Nursing, University of California at San Francisco, San Francisco, CA.

J. Ronald Milavsky, PhD. Vice President, News and Social Research, National Broad-
casting Company, Inc., New York, NY.

* Georgia K. Millor, RN, DNSc. Assistant Professor of Pediatric Nursing, University of
Rochester School of Nursing, Rochester, NY.

William Modzeleski. Chief, Family Violence Program, Office for Victims of Crime,
Department of Justice, Washingron, DC.

Commander Richard C. Moore, Jr., MD, MPH. Chief, Medical Operations Branch,
U.S. Coase Guard Headquarters, Washington, DC.

Suellen Muldoon. Assistant Director, Human Behavior Department, American Medical
Association, Chicago, IL.

Karin Murray. Policy Coordinator, Office of Family Policy of the Department of Defense,
Washington, DC.

Toby Myers, EdD. Director, Staff Development/Continuing Education, Houston Incer-
nacional Hospital, Houston, TX.

* David Nee. Executive Director, Florence V. Burden Foundation, New York, NY.

* Eli H. Newberger, MD. Direceor, Family Development Program, Children’s Hospical,
Boston, MA.

David M. O'Hara, DASS. Director of Social Work, Kennedy Institute, Balcimore, MD.

97
K. Daniel O'Leary, PhD. Professor of Psychology, State University of New York, Scony
Brook, NY.

William Oltman. Executive Assistant to the Assistant Attorney Gencral, Office of Justice
Programs, Deparrment of Justice, Washington, Dc.

(R) Frieda Outlaw, RN. Veterans Administration Medical Center, Haverford, PA.

(R) Barbara Parker, RN. Assistant Professor, University of Maryland School of Nursing,
Catonsville, MD.

* Delores L. Parron, PhD. Associate Director for Special Populations, Alcohol, Drug
Abuse, and Mental Health Administration, USPHS, Rockville, MD.

(R) Laurie Anne Pearlman, MA. Psychology Deparcmenc, University of Connecticut,
Scorrs, CT.

Lee Pearson. Assistant Coordinator, Criminal Justice Services, American Association of
Retired Persons, Washington, DC.

Charles S. Petty, MD. Director, Southwestern Institute of Forensic Sciences, and Chief
Medical Examiner of Dallas County, TX.

Lt. Rosemary Pezzuto, USCG. Chief, Family Programs Section, U.S. Coast Guard Head-
quarters, Washington, DC.

Karl Pillemer, PhD. Research Scientist, Family Research Laboratory, University of New
Hampshire, Durham, NH.

Marie Kanne Poulsen, PhD. Director of Training and Education, Center for Child
Development and Developmental Disorders (UAF), Children’s Hospital, Los Angeles,
CA.

(R) Bruce D. Poulter, RN. Staff Office of che Director, National Health Service Corps,
USPHS, Rockville, MD.

Deborah Prothrow-Stith, MD. Assistant Professor of Medicine, Boston University School
of Medicine, and Attending Physician, Boston Youth Program, Boston, MA.

Barbara Rawn. Executive Director, Virginia Chapter, National Committee for the Pre-
vention of Child Abuse, Richmond, VA.

Robert Ressler. FBI, VICAP, National Center for che Analysis of Violent Crime, FBI
Academy, Quantico, VA.

Clare Marie Rodgers, RN, CPNP, MSN. Pediatric Nurse Practitioner, Secretary, Nacional
Association of Pediatric Nurse Associates and Practitioners, Annapolis, MD.

Reymundo Rodriguez. Executive Associate, Hogg Foundation for Mencal Health, Austin,
TX.

98
(R) Helen Rosenberg. Center for Urban Affairs and Policy Research, Northeastern Uni-
versity, Evanston, {L.

* Mark L. Rosenberg, MD. Chief, Violence Epidemiology Branch, Centers for Disease
Control, Atlanta, GA.

Sandra Rosswork, PhD. Technical Director, Navy Family Advocacy Program, Department
of the Navy Headquarters, Washington, DC.

Louis Rowitz, PhD. Professor of Community Health Sciences, University of Illinois School
of Public Healch, Chicago, IL.

Robin Rushton. Legislature Assistant to Senator Paula Hawkins and Professional Staff
Member, Senate Subcommittee on Children, Family, Drugs, and Alcoholism, Wash-
ington, DC.

David A. Rust. Executive Secretary, Office of the Secretary of Health and Human Services,
Washington, DC.

Susan E. Salasin. Deputy Associate Director, Office of Stace and Community Liaison/
NIMH, Rockville, MD.

Jose M. Santiago, MD. Chair, Departmenc of Psychiacry, Kino Community Hospital,
Tucson, AZ.

Douglas A. Sargent, MD, JD. Chair, AMA Advisory Panel on Child Abuse and Neglect,
Grosse Pointe Farms, MI.

Johanna Schuchert. Executive Director, Parents Anonymous of Virginia, Inc., Richmond,
VA.

Theoharis K. Seghorn, PhD. Associate Administrator, Massachusetts Treatment Center,
Bridgewater, MA.

* Saleem A. Shah, PhD. Chief, Center for Scudies on Anti-Social and Violent Behavior/
NIMH, Rockville, MD.

Barbara Shaw. Chair, National Coalition Against Domestic Violence, Springfield, IL.

Lawrence W. Sherman, PhD. Professor of Criminal Justice/Criminology, University of
Maryland, College Park, MD.

James C. Shine. Vice President, Prosecution Services and Research, American Prosecutors
Research Insticute, Alexandria, VA.

Jan Sinnott, PhD. Guest Scientise, Gerontology Research Center, Francis Scott Key Med-
ical Center, Baltimore, MD.

Gloria R. Smith, MPH, PhD. Director, Michigan Department of Public Healch, Lansing,
MI.

99
Marti H. Speights. Family Advocacy Program Coordinator, Department of the Army,
Headquarters, Alexandria, VA.

Evan Stark, PhD. Assistane Professor of Health Care Administration, Rutgers University,
New Brunswick, NJ.

Robert L. Stein H. Acting Director, Milicary Family Resources Center, Office of the
Assistant Secretary of Defense for Manpower, Reserve Affairs, and Logistics, Arlington,

VA.

Suzanne K. Steinmetz, PhD. Professor of Individual and Family Studies, University of
Delaware, Newark, DE.

George G. Sterne, MD. Chair, Commitcee on Early Childhood, Adoption, and Dependent
Care, American Academy of Pediatrics, New Orleans, LA.

Murray A. Straus, PhD. Director, Family Research Laboratory, and Professor of Sociology,
University of New Hampshire, Durham, NH.

Harry R. Tanner, MSW. Executive Director, Community Council of Greater Dallas, TX.

Robert ten Bensel, MD, MPH. Professor and Director, Program in Maternal and Child
Health, University of Minnesota, Minneapolis, MN.

Joyce N. Thomas, RN, MPH. Director, Division of Child Protection, Children’s Hospital
National Medical Center, Washington, DC.

(R) Sara Torres, RN. University of Texas, Austin, TX.

Major Henry F. Vader, USAF. Family Advocacy Program Manager for che Air Force
Surgeon General, Brooks AFB, TX.

Leonore Walker, PhD. Presidenc and Psychologist, Walker & Associates, Denver, CO.

R. Dale Walker, MD. Associate Professor and Director of Social and Cultural Psychiatry,
Universicy of Washington, Seattle, WA.

John B. Waller, Je., DrPH. Director, Health Department, Detroit, MI.

(R) Priscilla Kiehnle Warner. Center for Urban Affairs and Policy Research, Northwestern
University, Evanston, IL.

Martin Wasserman, MD, JD. Director, Arlington County Deparcment of Human Services,
Arlington, VA.

Vicki Weisfeld. Communications Officer, The Robert Wood Johnson Foundation, Prince-
ton, NJ.

Richardson White, Jr. Research Director, Police Executive Research Forum, Washington,

DC.

100
Marvin E. Wolfgang, PhD. Professor and Director, Sellin Center for Studies in Crimi-
nology and Criminal Law, University of Pennsylvania, Philadelphia, PA

Bruce A. Woodling, MD. Consultant, Ambulatory Forensic Medicine, Ventura, CA.

* Alan Wurtzel, PhD. Vice President, Broadcast Standards and Practices, American
Broadcasting Companies, Inc., New York, NY.

Laura X. Executive Director, National Clearinghouse on Marital Rape—Women’s History
Research Center, Berkeley, CA.

Marlene A. Young, PhD. Executive Director, National Organization for Victim Assist-
ance, Washington, DC.

 

 

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