3: Recognising abuse in adults

Chapter 3: 
Recognising abuse in adults

Aim of the chapter

1. To describe forms of abuse and indicators of same
2. To provide specific cultural and faith-based considerations

Good safeguarding practice means that our denomination must ensure that all staff and volunteers understand how to recognise abuse, and how to pass on any safeguarding concerns to the relevant people.

This does not mean that Kirk Sessions, staff or volunteers are responsible for deciding whether or not abuse has occurred, but they do have a responsibility to be alert to the signs, actions and/or behaviour by adults that suggests that something may be wrong.

A broad look at abuse

Abuse is a ‘single or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust, which causes harm or distress to another individual or violates their human or civil rights’ (Action on Elder Abuse: Definition of abuse 1993, which can be accessed at https://www.nice.org.uk/guidance/ph50/evidence/report-5-elder-abuse-pdf-430409341

Abuse is the misuse of power and control that one person has over another. It can involve direct and indirect contact and can include online abuse.

Abuse is described in regional policies under the following terms:

  P   Physical

  P   Psychological

  F   Financial

  I   Institutional

  N   Neglect

  E   Exploitation

  S   Sexual 

Additionally, there are three related definitions (each have their own separate safeguarding procedures in place):

• Domestic violence/abuse
• Human trafficking/modern slavery
• Hate crime

Abuse can happen anywhere – for example, in someone’s own home, within day care, residential care, nursing care or other institutional settings, at work or in educational settings, in church property at church organisations, or in public.

Anyone can be an abuser – Kirk Sessions, staff and volunteers must be aware that those who cause harm come from all sections of society, all professions and all races and can be male or female, of any age. 

As painful as it may be, we must remain open to the fact that people may join our congregations and become trusted parts of our church communities in order to get easier access to abuse people. In our situation we must remain aware that abusers can also be, for example, those in positions of leadership and trust including Elders, Presbyterian Women (PW) leaders or any others. 

A focused look at definitions of abuse

Physical abuse

Physical abuse is physical force or mistreatment of one person by another, which might or might not cause physical injury. This type of abuse includes:

• hitting
• pushing
• rough handling
• exposure to heat or cold
• force feeding
• improper administration of medication
• denial of treatment
• misuse or illegal use of restraint
• not being allowed to go where you wish, when you wish

Signs of physical abuse are:

• fractures
• bruising
• burns
• pain
• marks
• not wanting to be touched

Psychological (or emotional) abuse

Psychological or emotional abuse is harmful behaviour that can cause mental distress. It can involve both verbal and non-verbal abuse, which can scare, humiliate and isolate a person. 

This may include:

• threats
• humiliation or ridicule
• provoking fear of violence
• shouting, yelling and swearing
• blaming
• controlling
• intimidation
• coercion

Signs of psychological abuse are:

• being withdrawn
• being too eager to do everything that they are asked
• showing compulsive behaviour
• not being able to do things they used to
• not being able to concentrate or focus

Financial abuse

Financial abuse happens if someone tries to steal, steals or defrauds you of your money, goods or property. This includes:

• exploitation
• embezzlement
• withholding pension or benefits
• exerting pressure around wills, property or inheritance

Signs of financial abuse are:

• having unusual difficulty with finances
• not having enough money
• being too protective of money and things they own
• not paying bills
• not having normal home comforts

Institutional abuse

Institutional abuse is the mistreatment or neglect of an adult at risk by a regime or individuals. It takes place within settings and services that adults at risk live in or use, including any organisation, in or outside the Health and Social Care sector.

Institutional abuse may occur:

• when routines, systems and regimes result in poor standards of care
• when poor practice and behaviours are in place
• within strict regimes and rigid routines that violate the dignity and human rights of the adults and place them at risk of harm
• within a culture that denies, restricts or curtails privacy, dignity, choice and independence

Possible signs are:

• the person has no personal clothing or belongings
• there is no care plan for them
• they are admitted often to hospital
• professionals having treated them badly or unsatisfactorily or acting in a way that cause harm to the person

Neglect

Neglect occurs when a person deliberately withholds, or fails to provide, suitable and adequate care and support needed by another adult. It may be through a lack of knowledge or awareness, or through a decision not to act when they know the adult in their care needs help. It may impair the health or well-being of an adult.

Possible signs are:

• having pain or discomfort
• being very hungry, thirsty or untidy
• failing health

Exploitation

Exploitation is the deliberate maltreatment, manipulation or abuse of power and control over another person. It is taking advantage of another person or situation usually, but not always, for personal gain.

Exploitation comes in many forms, including:

• slavery
• being controlled by a person or a group
• forced labour
• domestic violence and abuse
• sexual violence and abuse
• human trafficking

Recognising signs of harm or abuse

You might become aware that an adult is at risk of harm when:

• you see or hear something
• they tell you about abuse, exploitation or neglect happening to them
• a friend, family member or somebody tells you something that causes you concern
• you notice injuries or physical signs that cause you concern
• you notice the victim or abuser behaving in a way that alerts you to thinking something may be wrong

Sexual Abuse

Sexual abuse is unwanted sexual activity or sexual behaviour that happens without consent or understanding.

Sexual violence and abuse can be physical contact or non-contact sexual activities, such as:

• indecent exposure
• stalking
• grooming
• forced to look at or be involved in producing sexually abusive material
• forced to watch sexual activities

Possible signs are:

• genital itching, soreness or having a sexually transmitted disease
• using bad language
• not wanting to be touched
• behaving in a sexually inappropriate way
• changes in appearance

Domestic abuse

Domestic abuse isn’t always physical. Coercive control is at the heart of domestic abuse. It is a pattern of controlling behaviours and acts that may include threats, humiliation and intimidation, assaults or other abuse, which is used to harm, punish or frighten their victim (Women’s Aid NI). This controlling behaviour is designed to make a person dependent on their abuser by isolating them from family, friends and support services, exploiting them, humiliating and degrading them and regulating their everyday behaviour. It can be a gradual process that over time can lead to a total loss of confidence and sense of self.

Examples of coercive behaviour include:

• Love bombing, e.g., being showered with gifts and compliments, wanting the person’s undivided attention, calling and texting frequently, or getting upset when boundaries and limits are put up. Abusers lavish the person with attention or affection, in order to influence or manipulate them
• Gaslighting, e.g., lying to the person, discrediting them, minimising their thoughts and feelings, shifting the blame or an abuser retelling stories/events in ways that are in their favour
• Isolating from friends and family
• Depriving the person of basic needs
• Monitoring the person’s time
• Monitoring via online communication tools or spyware
• Taking control over aspects of everyday life, such as where the person can go, who they can see, what they can wear and when they can sleep
• Depriving the person of access to support services
• Repeated put downs, humiliating, degrading or dehumanising the person
• Controlling finances
• Threats and intimidation

Hate Crime

Any incident that constitutes a criminal offence perceived by the victim or any other person as being motivated by prejudice, discrimination or hate towards a person’s actual or perceived race, religious belief, sexual orientation, disability, political opinion or gender identity.

Human Trafficking

Human trafficking involves the acquisition and movement of people by improper means, such as force, threat or deception, for the purposes of exploiting them. It can take many forms, such as domestic servitude, forced criminality, forced labour, sexual exploitation and organ harvesting. Victims of human trafficking can come from all walks of life; they can be male or female, children or adults, and they may come from migrant or indigenous communities.

Related Definitions

Female genital mutilation (FGM) involves procedures that include the partial or total removal of the external female genital organs for cultural or other non-therapeutic reasons. The practice is medically unnecessary, extremely painful and has serious health consequences, both at the time when the mutilation is carried out and in later life. FGM is a criminal offence in Northern Ireland. 

Forced marriage is marriage conducted without the valid consent of one or both parties and where duress is a factor. Forced marriage is a criminal offence in Northern Ireland.

Honour based violence (HBV) is the term used to refer to a range of violent practices used to control behaviour within families or other social groups to sustain or promote perceived cultural and religious beliefs and/or honour. Such violence can occur when perpetrators perceive that a relative or another has shamed, or may shame, the family and/or community by breaking their ‘honour code’. The punishment can include assault, abduction, restrictions of liberty, confinement, threats and murder. 

Online abuse can happen on any device connected to the web. Adults, like children, often use text messaging, email, apps, online chats and gaming sites regularly to communicate, and abuse can occur via any of these means. It can include adults being persuaded or forced to send sexually explicit images of themselves, or take part in sexual activities or conversations. It also includes exposing or showing pornography to another person. 

Cultural and faith-based considerations

There are a number of additional risk factors that must be considered in recognising abuse in a faith context, like ours.

These risks can cause barriers to disclosure or reporting and include but are not limited to:

• strong beliefs can prevent adults from reporting concerns
• a sense of honour or shame can prevent adults from seeking help or reporting concerns
• strong cultural or religious belief in the sanctity of marriage may dissuade adults from reporting concerns
• opinions expressed by faith communities around young adults especially, regarding sex outside marriage, can cause a barrier for people to speak up about abuse
• social isolation can occur if an individual or family are seen to have acted outside of the community of faith in some manner
• religion or faith can be used as an explanation for abusive behaviours or can be used as a distraction, for example, used to accuse professionals of discrimination
• some professionals lack knowledge about specific cultures and religions and do not feel confident in challenging harmful practices.
• professionals want to be respectful of families’ cultural and religious practices but the desire to be culturally sensitive can result in professionals accepting lower standards of care (Culture and faith: learning from case reviews, June 2014, NSPCC)
• some extreme cases mean people who are seen as ‘disobedient’ or ‘different’ are believed to be possessed by a spirit controlling their behaviour. Individuals can be physically and emotionally abused in an effort to ‘exorcise’ the spirit
• harmful or unhealthy cultures or ministry practices can be created around the character and personality of a charismatic leader, giving opportunity to abuse a position of trust
• individuals can believe the reputation of the church is the most significant risk so do not respond appropriately to knowledge of abuse

CHAPTER END