MEDICAL AND PSYCHOSOCIAL CONSEQUENCES IN FAMILIES AFFECTED BY THE VIOLENCE PHENOMENON INSTITUTIONS INVOLVED IN PSYCHOSOCIAL REHABILITATION

Study made in Emergency Center “Violence in familiy” – St.Sava Foundations Buzau

“Violence in familiy” is a negative phenomenon of human relationships between members of the most important social core – the family – aspect that in the last century increase all over the world.

1. On the scale of the families characteristics, in Finns point of view, the last two types:
   – starched family and sinton
   – severs disturbed family, have important consequences on their children like affective disfunctions, chronic stress (Rutter) with anxiety and adaptative disfunctions.
2. The Emergency Center “Family Violence” is one of the project of “St.Sava” Fundation Buzau has the objective to solve the problems of this social phenomenon. There working team composed from doctor, social worker, priest, psychologist, nurse, educator who is trying to solve the conflict and to assure a normal family life.
3. The team analise each file and respect all the juridic steps to solve the most important aspects of the problems.
4. A big importance in solving the problems of those families is the strong relations between the Emergency Center and the Public Institutions (City Halls, Social Assistance Service).
5. From 96 families studies in Emergency Center, the team solved 75 cases (78% from all the cases). In the center families have for free acommodation, meals, social assistance, psyhological support, religious support and juridic assistance. People from the center have also education support amd meditation program.
6. Each case is individual analised and have a personal schedule for pils and reabilitation.

The specialists from the center try to find to keep the child in the family as lons as this is possible and to give an alternative for children for rehabilitation services (Day Center). To rehabilitate the disturbed behavior of children and to solve affective problems the specialists include the child into a special program of education.

INTRODUCTION

The phenomenon of family violence (or domestic violence) is the negative configuration of the inter-relationships existing among the members of the most important social nucleus – the family.

Family is a structured system where each person occupies a role and it has an inter-dependence with resonance on the other person. According to McMaster Model, family assessment is a complex endeavour considering the way it:

• solves problems, as a family;
• communicates;
• is emotionally involved in solving family problems;
• behaves and controls behaviour.

According to the Finish trend of thought, families are assessed on a scale of five characteristics:

Healthy family without conflicts, dominated by empathy among its members;

Slightly perturbed family with transitory conflicts, which may generate anxiety states and mild depressions among its components, the members preserving a clear appreciation of reality.

Neurotic family, which has frequent unsolved conflicts of mild or mediocre intensity. The inter-personal patterns inside such families are clear. Since the conflicts are repetitive to a certain degree, the family perception of the reality between the crises is still satisfactory.

Rigid family – syntonic with dysfunctions produced by unsolved and ignored conflicts, with a blurred delimitation of reality in perspective, achieving a rigid homeostasis.

Severely perturbed families that have open conflicts. Here, the level of anxiety is high and the trust among the members is low. In this type of family, the consequences on the children are disastrous. Intra-family relationships may be re-established, in general in a certain degree, but also with specialised intervention.

According to Rutter, chronic stress accompanied by chronic disorders develops when:

The child’s temperament changes, the youth proving to be unable to accommodate him/herself to the circumstances;

Generally, good relationships with a parent are preserved (with relatives, friends), therefore the coping mechanism is satisfactory;

Successes at the workplace, as well as school effectiveness start to decrease in time, in general for all family members.

The consequences of dysfunction in intra-familial, social, cultural relationships are clearly significant.

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In the last century, a host of scientists (psychologists, doctors, sociologists, etc.) such as Spitz, Bender, Bowlbi, Micheaux, Levi, and others, have become aware of the negative influence of conflict, neglect, failure to communicate, and especially of privation of affection. They have described the consequences of these negative aspects on the development of the other behaviours in children, starting from a very early age: motor behaviour, cognitive-verbal protocols of communication functions, receptive-expressive language and affective-adaptive behaviour. More recently, a group of psychologists from Boston, Robertson, Mayer, and Solovey, focused on more advanced stages in the development of personality, emphasizing especially the importance of clinically identified affective disorders in children by the syndrome of sadness, depression, detachment, etc. Deductively, these dysfunctions imply the following aspects:

A. Neglect:

1. child’s neglect concerning the physical side, thus he/she is deprived of food, medication, biological needs, etc.;
2. educational neglect, obliging the child to other activities leading to later school failure, rambling;
3. eemotional neglect entails ignoring the events in the child’s life.

B. Child abuse:

1. physical, with excessive corporal punishment
2. emotionally by:
   – verbal violence, insults, humiliation, denigration, rejection and denial.
   – isolation for several hours
   – threat
3. sexual assault (not rape); it is an act of satisfying sexual needs with incitement to prostitution.

INTERVENTION IN EMERGENCY requests:

1. setting up a team (the social worker, psychologist, police officer to determine the aggressor, and a representative of the City Hall as mediator, as well as a neighbour)
2. an intervention form (see a model in the Annex). It ends with the report of the interview with the child, which requires:- a neutral and quiet place to talk;
   – a parent, relatives, teachers or the class counsellor teacher to be present;
   – the consequences of abuse in children are assessed;
   – the types of questions being asked are directed at the different circumstances, pleasant or otherwise, which the child went through, at his/her behaviour, and the parents’ behaviour and at the parents’ response to their abuse on children.

   Some children are living with the grief of separation from parents and their being moved to another environment with intrusive procedures of the new family substitutes, with inappropriate expressions, and mistreatment, which generate even stronger stress.

   In these circumstances, the child has some specific needs as follows:

   – specific needs to overcome the crisis through which the child suffers in his/her effort to adapt to the new lifestyle.

   The child’s painful and confusing feelings, the conflicts he/she feels caught in, the mixture of love and hate, fear, pain and uncertainty require attention and involvement of the intervening psycho-pedagogues, social workers, counsellors, and substitutive families).

   – special needs relating to arrangements to be made in future concerning the child on which he/she has insufficient control and little information. Regardless of past behaviour of the family of origin and of the quality of relationships with family members, each child remains with the fantasy of returning to his/her own family and grow in “his/her house”.

3. It is important that professionals in social care system should understand the following:

• abused and neglected children are not offered protection and safety, as is, their ability to trust and form close relationships is diminished;
• they were ignored or treated as pawns in inter-relational conflicts of adults in violent families;
• to provide emotional support to children who experience such situations, it is necessary to develop empathy, to understand their needs, to help them express their suffering and to improve communication skills.

Notwithstanding the conditions reported above, the conflicts will generate the child’s, suffering which has a negative effect with repercussions on later brain dysfunction.

Stress is a psychological reaction that intervenes at environmental changes, and it is a mixture of emotional experien ces induced to a child when three conditions are fulfilled:

• The child’s binds with the family are interrupted;

• Unexpected events occur that require sudden accommodation capacity of the unprepared individual;
• The achievement of certain performance in a bleak, hostile, suspicious environment, which generates mental disorders such as depression and anxiety, is almost impossible.

There are several types of suffering:

1. Simple stress, which produces reversible neural-biological changes; in general, it is usually caused by a frustration that leads to neurosis, asthenia, fatigue;
2. Bereavement, is stress caused by a significant loss in the child’s life, especially of a loved person but also a deprivation of material objects, which the child has a special attachment to. Mourning takes the appearance of the crisis that has the following steps:
3. shock and denial (panic, loss of control, denial of the event, establishment of feelings of disaster and of helplessness, anger and destructive behaviour, burnout)
4. protest and despair (the individual becomes aggressive, hostile to others, is irritable, anxious, perceive the world as a dangerous place, neglects the people around, lives a sense of “emptiness”.

Coming out of the crisis may take two aspects:

1. positive, through reorganization, accepting loss, adjustment to the situation, rebuilding relationships and social life. This is a realistic vision, creating new relationships that will replace the loss;
2. negative – a chronic state of protest and depression.

Trauma. It is an experience of extreme intensity caused by events which challenge the survival of the individual. The catastrophe has an absurd, inexplicable size. In such cases the child needs explanations, needs to find the causes, the culprits, otherwise he/she will self-blame him/herself, will feel the need for revenge and develops a spirit of justice. Trauma generates post-traumatic stress situations that can occur within 2 weeks to 6 months after the traumatic event happened.

Daniel Marcelli in his treatise on “Child Psychopathology” makes the following comments in relation to post-traumatic stress syndrome in children:

The repetition syndrome, in which more than the reminiscence of the trauma itself, one may notice:

1. Repetitive games, in which one side of the trauma is staged (small car games, simulating an accident, abused dolls games, drawings with the same recurrent theme).
2. Nightmares, where the younger the child is, the more imprecise the content of the dream.
3. Reactions, sometimes inadequate by their intensity, at some fairy tale or imaginary story at school or even at home.

ANALYSIS ON THE “VIOLENCE IN THE FAMILY” EMERGENCY CENTRE OF THE “Saint Sava” FOUNDATION, BUZAU

An important step at the Emergency Centre of the Foundation “Saint Sava” Buzau, is the complex medical examination of each family member hospitalized there by a physician specialized in INP and by the team of social workers. This examination is very important for an accurate decision taking into account the overall multiple causes that have generated the negative phenomenon.

1. The exam starts with the analysis of the social surveys, which should highlight the following aspects:

• Housing conditions
• Material and financial possibilities for sustenance of this family, specifying each parent’s contribution to this goal;
• Psycho-pathological features of conflicting parents such as: alcoholism, chronic somatic and neuropsychological, intellectual level, degree of emotional attachment to children, who often come from previous families;
• Details concerning situation of family establishment (legal marriage or cohabitation connections).

These factors, briefly stated, are the main generators of intra-family conflicts.

2. A statement of the child’s personal antecedents: psycho-somatic morbidity, especially a sequellary one, or a developing process (AD / HD, onset of psychosis, epileptic seizures, etc.) or another neurosis factor in the family.

In these conditions, for 12% of the children, clinical investigation by a multidisciplinary team, laboratory tests, imaging exams, etc. have been required in order to decide on a diagnosis. These investigations are very important in order to decide the placement of the children in a balanced environment in rehabilitation units (Day care centres) provided with recovery specialists: psycho-educators, speech therapists, kinetic therapists, therapists for people with NPM disabilities, etc.

I. A model for rehabilitating children in the “Violence in the Family” Emergency Centre “ is the Day Care Centre of the Foundation “Saint Sava”, constituted in the form of an “after school” facility.

Table 1. Dynamics of families admitted to the “Violence in the Family” Emergency Centre of the “Saint Sava” Foundation, Buzau from its establishment up to the present.

Analysing the dynamics admission peaks are in 2007, 2008, and 2009. The reduced number of admissions (2005, 2012) coincided with major repairs, with significant refurbishments of the Emergency Centre to ensure its optimal functionality.

II. The 193 beneficiaries come from 96 families. 97 beneficiaries were children, representing 50.2% of all beneficiaries.

• Children admitted with their mothers 98%;
• Children admitted alone 2%;
• Adults (mothers) admitted with their children 92.8%;
• Adults (mothers) – aggressed, admitted alone – 7.2%.

Table 2. Structure of admitted beneficiaries.

III. Origin of the families admitted to the Emergency Centre:

• urban environment – 53, reprezenting 55,2%;
• rural environment – 43 reprezenting 44,8%.

Table 3.  Origin of beneficiaries according to environment.

IV. Analysis of the causes of conflict in the family:

1. psychopathic traits, most commonly alcoholics, with bouts of extreme jealousy = 72 cases;
2. deficiencies in mental development: illiteracy, mental and neurological illness (hypophrenia, psychoses, disabling neurological diseases) cases = 54;
3. chronic diseases of internal organs and systems (diabetes, sequelae encephalitis, operated tumors, physical trauma, renal disease, chronic progressive hepatitis, asthmatic bronchitis, dyslipidemia) = 41 cases;
4. causes with negative influences are represented by the collateral members of the family: in-laws, friends, neighbours, siblings = 12 cases.

Table 4. Dynamics of morbidity aetio-pathogeny in the family (in the 98 families).

Psychopathic characteristics, frequently alcoholics, with bursts of extreme jealousy – 40.2%

Chronic diseases of internal organs (hepatitis, nephropathy, diabetes, dyslipidemia) 22,9%

Psychic and neurologic diseases: psychoses, psychic retardation, sequellae of inflammatory diseases, cranial traumas – 30,2%

Collateral causes, negative influences of the extended family – 6,7%

The dynamics displayed above shows that:

1. various aspects of morbid conditions intricate and are concomitant with other health issues;
2. extra-cerebral organic chronic and systemic diseases overlap;
3. mental suffering is generally of mediocre intensity, creating psychopathic traits in most cases.

V. Aspect of marriages:

Grafic 5. Legal status of the families.

• lawful 23 = 23.5%
• by consensus 73 = 76;
• Organised 23.5%;
• Disorganised (divorce, cohabitation) 76.5%.

The situation of the Emergency Centre beneficiaries was favourable: there were 75 solved cases, in agreement with the proposed objective: the behaviour of the patients has changed due to counselling, and intra-familial degree of tolerance increased.

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Persons who arrive at the Emergency Centre benefit from the following services:

• Medical care: consultations and provision of appropriate medication. A physician and a nurse provide this service, both of them being volunteers;
• Psychological support: The psychological counselling of both the victims and of the entire family in order to assure an appropriate environment. A psychologist, also as a volunteer, delivers this service;
• Social care support: Performing social surveys following both discussions with the victims and as a consequence of visits at their homes. A social worker assures this service;
• Coordination of daily activities by educational, recreational programmes, as well as by keeping contact with the school (where there is the case) in order not to interrupt the educational activity;
• Securing housing for the victims of domestic violence for a period of maximum 14 days. The victims are accommodated in two dorms with four beds in each room;
• Securing free meals: Preparation of the food necessary for three daily meals plus two snacks. Two cooks assure the service as volunteers of the “Saint Sava” Foundation;
• Security for the victims during their admission to the Emergency Centre by two supervisors (day and night) who come as volunteers;
• Reintegration within the family and society of the abused persons. This service is assured with the help of the social worker;
• religious assistance (confession, guidance, psychological rehabilitation). This service is delivered with the help of the President of “Saint Sava” Foundation – Pr. Prof. Dr. Milea Mihail.

„Violence in the Family” Emergency Centre is organised and functions based on the following principles:

• Equality of chances for each member of the family;
• Respect for each person’s dignity;
• Securing privacy for every beneficiary;
• Assuring confidentiality;
• Recognition of each human being’s value; mutual respect among the members of the family.

The functions of the Emergency Centre are:

• Reception – assessment – discharge – information;
• Multidisciplinary temporary assistance;
• Data archiving;
• Assuring housing conditions – security and accessibility, familial type ambiance, hygiene through two sanitary facilities, dorms, common spaces, facilities for food preparation and meal serving;
• Assuring personal care;
• Re-socialization – rehabilitation activities;
• Family and community reintegration through counselling;
• Right to complaints, protection, autonomy assurance, taking decisions in full agreement with the members of the family;
• Provision of qualified staff, necessary to the process of supplying services in the “Violence in the Family” Emergency Centre.

The general aim of the Emergency Centre is to respond to the specific necessities of the vulnerable population within this category of persons.

DISCUSSIONS

A. Psychologist Dan Valentina, focusing on the atmosphere existing in families with conflicts, describes the experiment of psychologist Edgar N. Jackson involving 100 persons coming from aggressive-violent families. Out of this total, 20 persons presented reactive depressions, 30 persons had emotional problems in their couple and 50 mothers had very serious emotional traumas. The same author estimates that, in the USA, 3 million women are victims of physical violence and a third of this lot has been affiliated religiously, thus becoming more vulnerable to abuse.

In Romania, there are very many cases of women victims of physical abuse. The main cause is the exaggerated jealousy and the victim develops the feeling of trauma, of guilt, trying to supress the anger of the aggressor. Some aggressors, after an abuse crisis, become calmer, following the phase of the “honeymoon” cycle. Some victims fall ill during the “stress crisis” with indigestion, migraine, altralgy (pains in the joints) or rachialgia (pain in the vertebral column), dizziness, allergic rashes, etc.

The so-called “cycle of violence” is described where abuse generates a person’s attempts to be in control of the other person through an intimidating behaviour. Couple abuse or domestic violence operates in successive cycles having three distinct phases:

1. Accumulation of tension;
2. Outburst followed by anger, which generates physical violence due to a lack of emotional control, the expression of the face acquiring sometimes terrific alterations;
3. “Honeymoon” or a state of bliss with oaths requests for forgiving and after that the abuse becomes more and more violent, the victims start to believe that they are really guilty.

The aggressor’s profile is the same, irrespective of the level of professional training. They are egotistic, narrow-minded, seeking permanent personal comfort, continuous attention and require unconditioned devotion. They are also possessive, anxious, irritable, with a fear of being abandoned, cannot stay alone, need permanent approval, manipulate and take advantage of others, are suspicious, dependent, unstable, emotionally immature and like to be perceived by others as powerful, independent individuals.

Although they adopt an attitude of superiority, their inner life is marked by fear, general anxiety and low self-esteem.

Outside the family they lead a double life, being pleasant, jovial, polite, mannered and are considered reliable, respected and appreciated in society; some of them want to dominate (“like father”, the so-called masculine model). In such families, the children bear premature emotional burdens.

In family metamorphosis, role changes have been found, which the specialists named “paternalization of children” because they are forced by circumstances to assume the adult’s responsibility, neglecting their own needs, becoming tough and rigid. Women victims, with a history of elitism in their families and abuses at reluctance, are taught not to contradict, thus becoming victims of such conflicts. They display a difficulty in exploring the emotional universe, thus feeding abuse. Based on religious principles, these women’s mentality, is shaped to soften the “rough corners” through kindness and patience, and in this way abuse increases.

B. It is necessary to present some documentation data that have helped us develop some therapy models.

1. Psychotherapy of the children hospitalized together with their mothers in the “Violence in the Family” Emergency Centre after having been diagnosed with reactive psychic disorders (as described above) aims at:

• changing the type of relationship in the family, imposing a certain disciplined behaviour that should be observed by the child and supervised by the mother;
• helping the children to take responsibility of their own actions;
• offering support in the control of the child’s emotional problems and, with mother’s help, finding methods to cope with the stress generated by such problems. The therapist must find the significance of the frequent symptoms that have been discovered: lying, truancy, vagrancy, etc.;
• improving the child’s “self-esteem”, which is conditioned by many factors.

Violent children are provided with help in order to

• learn how to control anger;
• express anger, frustration;
• become accountable for their actions;
• accept the consequences.

The therapeutic plan involves the following phases:

• Initial phase – making child realise the existing relationships and motivating him/her for change;
• Middle phase when the child realizes his/her relational capabilities;
• Terminal phase in which the child becomes autonomous with a range of affective relationships: with family members, with school, with the Foundation.

Types of psychotherapy:

• Individual therapy, focused on the child’s social behaviour. Reinforcing this behaviour is a gratification from parents, teachers and the child even signs a contract;
• Punitive techniques, involve the withdrawal of rewards, “time- out”. The child gives back the symbols and the points earned, etc.;
• Super-correction, involves the return of rewards, repetition of the appropriate behaviour, positive reinforcement of good behaviour;
• Training the child’s skills through interactions aiming to develop his/her social skills by providing models, that is, offering awards or providing pleasant social activities.

Group Therapy

It is applied to solitary children that fear the others or are afraid of the unknown. In this therapy, the patients are stimulated by common toys, with rules that are require them to develop particular themes, and especially by games with puppets.

Counselling of the children’s parents:

• It is applied to hyperkinetic children with attention deficit;
• It aims to explain to the child and family that treatment requires a long time;
• It analyses the causes of disturbed behaviour syndrome;
• The Commission should find the self-esteem model for the child;
• Mother is warned on the inappropriate attitudes to her child.

Basic rules in psychotherapy of the child with affective disorders

It should be remembered that:

• The child must be removed from the traumatic environment;
• Permanent emotional contact with the child must be achieved;
• The therapist must enlighten the family on the conditioning of the disorder evolution and on the help he/she needs in recovery;
• The techniques of attracting the child affectively to various programs should help to stimulate him/her, first by creating a relaxing atmosphere. E.g.: Using the exciting Dexter type test as fun game, it calms the child, helping him/her to focus, to learn new words. It stimulates pleasant activities, attention, perception, memory, thinking, etc.

The analysis of the child’s drawings should observe the rules the govern the assimilation by the child of the concepts of age.

The analysis of clay modelling – here we may see the child’s emotional reactions.

Music plays also an important role in relaxing the child. It attracts the child, it helps. The therapist can also find ways to stimulate musical resonance “by the aquarium with distilled water” which stimulates the perception of sounds, determining the child to learn simple songs.

Mirror-games train the child, are attractive, correct posture, stimulate the perception of a joyful image, are comforting.

Toys, puppet shows, mobile pictures actions of a story, a poem or a song are attractive and relaxing for the child, increasing his/her ability of cognitive assimilation.

• The Spanish surgeon A. Escudero applied noesitherapy to young children. By association with relaxing games, he stimulates the patients with music, determines them to assimilate the reactions of emotional balancing, reinforcing these reactions by verbal excitation, mimicry, gestures, using moulds and masks that generate satisfaction.

  (Pharmacotherapy)

In light of the pathogenesis data of affection-adaptive disorders described above, in addition to behavioural recovery techniques in relation to morbid entities, the interventions aim at correcting neurological somatic, and vegetative, symptoms.

First, the medication we chose for this group of children generally implies the specific psycho-active therapy plus the form of clinical pathogenesis, the evolution of the disorder, etc.

According to S.Milea, certain rules for the implementation of schemes must be followed in the therapeutic approach:

A clear diagnosis regarding causes, clinical forms, development of the case

• Existence of concomitant co-morbidity;
• The pharmaco-kinetic peculiarities of the drug should be known: half-life period, better tolerance per kg / body in children;
• Specificity of action of pharmaceutical chemicals (anxiolytics, sedatives, narcotics, AE, in relation to new classifications of Kaplan, Sadock, 2001);
• Individualization of therapy in relation to the neurobiology of child age;
• Compliance with secondary reactions of the drugs and with contraindications;

CONCLUSIONS

The phenomenon of “violence” is a real conflicting state in families, regardless of culture, ethnicity, social origin, number of children, etc. This phenomenon has increased in recent years all over the world and imposed:

1. The foundation of certain “Violence in the Family” Emergency Centres “Domestic violence”, well equipped and furnished within the churches, but also independent centres with the help of local administrative bodies, NGOs, whose contribution in functioning is clearly beneficial;
2. These emergency centres work with a multidisciplinary commission constituted ad-hoc, on admission to the centre by professionals from the medical and social care fields, who take immediate action for the whole family by providing a program of care, financial aid, measures to continue schooling, educating children and attendance of rehabilitation institutions for children with various NP dysfunctions;
3. The specialists working at the Centre develop a comprehensive counselling program for parents and set up a school to educate the beneficiaries’ behaviour, stimulating family tolerance and mutual help and education (for family members);
4. The social care service, by completing the survey at each hospital admission informs on:- The type of family (see the categories listed in the paper);
   – Economic situation of families;
   – Cultural level of the parents assessing the educational potential of children;
   – The medical staff assesses the morbidity level in family, disease stages, the effectiveness potential of the treatment and a rehabilitation program is developed as necessary in patients with multiple deficiencies, thus contributing to improved health and emotional homeostasis. Of course, laboratory investigations and imaging input helped us in a number of 7 beneficiaries, representing 3.5% of the total in the diagnosis decision and taking a correct attitude concerning the treatment.

    

5. At family level, taking account of family needs in special cases, the Commission experts require that the children should be urgently institutionalised. This decision must be established with great responsibility.- Temporarily, a small number of beneficiaries was admitted to the centre to perform investigations and surgeries in a monitored manner. In the system of the rehabilitation of behaviours with neuro-psycho-somatic deficit, these children were included in rehabilitation programs in specific institutions of the day care centre type.

    

6. Under these circumstances, mayors of towns, villages have the task to:- find suitable housing to the Family;
   – offer a job to a parent, thus providing a normal emotional homeostasis;
   – Provide a more substantial material aid to families with many children, especially if they go to school;
   – Make sure that people acting as “social workers” inside municipalities, communes in particular, attend training courses and get familiar with social care issues. Then, in the future, they become able to solve problems of families with cases of violence as reported above.
7. The intervention form (see Annex) is completed when performing the interview with the child. In these conditions, the child has some special needs (set out in the paper), being helped accordingly. After leaving the Emergency Centre, for a period of 12 months, families are monitored by the Emergency Centre’s social worker, by DGASPC and by the Social Care Service within the local town halls, and in the end, a final report is made to close the case.

BIBLIOGRAPHY

1. Albert Ellis D.M. – T.C.E.R. (Terapia comportamentala emotiv – raţionala) – Ed.Antel XX, 2006;
2. Beldiceanu Iolanda – „Formator pentru munca de prevenire si interes comunitar în situatia de violenta domestica” – Curs 2009, Brasov;
3. Bradu Ioan Iamandescu – Psihologie medicala, psihoterapie – , Ed.Medica, 2006, Bucuresti;
4. Dan Valentina – „Violenţa în familie” – Rev. Viaţă şi Sănătate, nr. 11, 2011, p. 20;
5. Goleman Daniel – Inteligenţa emoţională – Ed.Cartea Veche, Bucureşti, 2008;
6. Milea Ştefan – „Agresivitatea – un concept complex interactiv eterogen şi deschis” – Rev.SNPCAR nr.3, 2010, p. 71;
7. Neamţu Cristina – Devianţa şcolară – Ed.Polirom, Bucureşti, 2003;
8. Nussbaum Laura – Abilitarea si reabilitarea psihiatrica la copii si adolescenţi – Ed. ArtPress, 2011, Timisoara;
9. Zamfir Elena – Ghid de interventie in caz de violenta in familie – Ministerul Muncii, Agenţia Nationala pentru Protectia Familiei, Bucuresti, 2009.