Family members may not quietly and peacefully accept what has happened...Family members have no choice--they must cooperate with the media, the police and sometimes the courts.
E.K. Rynearson, MD Virginia Mason Medial Center
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Co-victims of Homicide: Special Needs
by Connie Saindon, MA, MFCC, CTS
"No one understands the magnitude of this." "You end up a body with no life in it." --Co-Victim of Homicide, 1998
As traumatic as homicide is, the aftermath is often worse. Even though the actual number of homicides is down, Co-victims of homicide are an under-served group. The violent death of one of its members leaves a family in emotional and social turmoil. Homicide can impact individuals as well as communities such as schools, neighborhoods and workplaces. The trauma and grief experienced by survivors can cause emotional scars that last a lifetime. Of the three causes of violent death (homicide, suicide, or accident), homicide often has the most intense impact.
There is abundant clinical evidence indicating that following a homicidal death, family members are at risk for developing sustained and dysfunctional psychological reactions. And since the nearly 30,000 homicides annually in the United States affect between 120,000 and 240,000 relatives and other survivors, the magnitude of these numbers suggests that homicidal bereavement represents a major public health problem.
"Our society wants to pretend that murder and drunk driving don't happen." Says Sam Knott at a recent tree planting ceremony in honor of his daughter Cara who was murdered by a California Highway Patrol office in 1988.
Rates reported in Death: Current Perspective, by E. Shneidman, Ph.D. match national reports of 25% of all murders are familial homicides and 50% more are boyfriend/girlfriend/acquaintance homicides. These are similar to the findings for rape, that only about 25% of all rapes and homicides are committed by strangers. This is contrary to popular beliefs cautioning us to be wary of strangers.
Conceptual models of bereavement have not included explanatory or predictive principles specifically associated with homicide. Finally, many co-victims of homicide are alienated and distrustful of government and law enforcement personnel. This can lead them to feeling confused and increasingly paralyzed. A critical lack of sensitive and appropriate services only exacerbates their difficulties in dealing with this horrific event.
Responses to this event include (1) PTSD with experiences of intrusive reenactment and avoidance (2) victimization and (3) compulsive inquiry. Families face shifting roles and responsibilities and change patterns of functioning by increasing their closeness or distance with each other.
The need for specialized services is increasingly more evident in both prevention and treatment. Specialized services are needed to provide assistance to families in the aftermath of a homicide to lessen the long-term psychological impact for survivors. In addition, services are needed to help family and friends of homicide victims cope with their grief and devastation in ways that foster their resilience while healing wounds. Information from both private and public groups needs to be shared to find more efficient ways to assist this fragile population.
The treatment model consists of comprehensive screening and two time-limited 10-week groups following the model in Seattle and materials from the Philadelphia model. Adjunct counseling as well as partnering with area services from both public and private sectors add to the response to the needs of co=victims of homicide.
The first intervention is a 10-session group that deals with the "nuts and bolts" (legal terms, how the criminal justice system works, Victim assistance services, dealing with the media, etc.). Meetings are once per week with definite goals and a clear agenda (as distinct from open-ended groups which may tend to bog down).
The second 10-week group intervention deals more with the intrusive imagery, dreams, flashback, grief, loss and trauma. It too follows a structured format.
A Pre and post-screening is conducted to determine treatment effectiveness and provide findings for a National research effort. Instruments include Impact of Event Scale, Alcohol Screening, Death Imagery, Beck Depression, and a "New" Traumatic Grief Instrument.
Community Collaboration is essential with law enforcement agencies, businesses, social service agencies and private mental health providers to ease survivors access, reduce duplication of services and provide the "best" care for this under-served population.
Rynearson, MD (1994) Psychotherapy of bereavement after homicide. Journal of Psychotherapy Practice and Research, 3(4), 341-347. Spungen, D, (1998). Homicide: The hidden victims- a guide for professionals. Thousand Oaks, CA:Sage Publications, Inc.