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The Role of the Accident Compensation Corporation in the Prevention of Family Violence in Aotearoa New Zealand and promising practices to reduce the incidence and severity of injuries from Family Violence-related assaults.

Free essay example:

Double Dissertation Module


Thames Valley University

Faculty of Health and Human Sciences

Double Dissertation Module

Level 3

The Role of the Accident Compensation Corporation in the Prevention of Family Violence in Aotearoa New Zealand and promising practices to reduce the incidence and severity of injuries from Family Violence-related assaults.

Student Number:


Word Count:


Date Due:

10th June 2005

Date Submitted:

14th May 2005





The Accident Compensation Corporation

Family Violence in Aotearoa New Zealand

The Cost of Family Violence to the Accident Compensation Corporation

Health Promotion

Injury Prevention

Family Violence Prevention

Primary Prevention

Secondary Prevention

Tertiary Prevention

Prevention of Family Violence

Parenting Programmes

Universal Home Visits

Social Marketing

Universal Screening

Education of Children and Young People

Community Development and Action

Working with Witnesses of Family Violence

Working with adult female victims

Working with Perpetrators

Government Legislation and Strategy

Health promotion: An approach to the prevention of family violence.

The Role of ACC in family violence prevention




Family violence has been found to affect families from all cultures, backgrounds and socio-economic situations.  It can occur in all close personal relationships, wherever individuals are part of a family or fulfilling the role of family.  

The Accident Compensation Corporation of Aotearoa New Zealand funds the care and rehabilitation costs of all New Zealanders injured within the confines of Aotearoa New Zealand.  The huge cost of family violence to the Corporation requires ACC to act to reduce the impact of family violence on its claim costs.

Through supporting agencies working to reduce family violence at primary, secondary and tertiary levels, ACC will impact its own costs and thus the levies to its funders while contributing to making Aotearoa New Zealand a safe place for all, in line with the New Zealand Injury Prevention Strategy.

Approaches to reducing family violence include parenting programmes, universal home visits, social marketing, universal screening, education of children and young people, community development and action, working with victims, perpetrators and witnesses of family violence and implementing Government legislation and strategies.

Health promotion theory provides an ideal framework to ensure that family violence is being addressed at every level.  Through identifying effective interventions and placing them with a health promotion framework, recommendations for the Accident Compensation Corporation’s role can be made.


My thanks go to my colleagues at the Accident Compensation Corporation and the members of the Te Rito Advisory Group for their support and advice in preparing and writing this paper.


This paper will examine the role of the Accident Compensation Corporation in reducing the incidence and severity of family violence in Aotearoa New Zealand.  It will also provide an overview of family violence and effective health promotion and injury prevention models to reduce the effect of family violence on society (Ministry of Social Development 2002, Department of Child, Youth and Family Services 2001, Ministry of Health 2001).

I will begin by introducing the New Zealand accident compensation scheme and providing an overview of family violence and its cost to the Corporation.  I will then look at the most common approaches to health promotion and injury prevention in Aotearoa New Zealand before moving on to explore examples of initiatives that have taken place both locally and internationally to prevent family violence, showing how these fit within a health promotion framework and finally, providing recommendations for the Corporation’s future involvement in this field.

The Accident Compensation Corporation

The Accident Compensation Corporation / Te Kaporeihana Äwhina Hunga Whara (ACC) was established on 1st April 1974 to administer a no-fault coverage against injury scheme for every New Zealander (ACC 2004).  The accident compensation scheme administered by the Corporation came into being as a result of a 1967 Royal Commission looking into workers’ compensation; in 1972 Parliament adopted the recommendations of the Royal Commission and passed the Accident Compensation Bill into law.  The original system had three parts:

  • Compensation for work injuries, funded through levies paid by workers and their employers;
  • Compensation for road injuries, funded through levies paid by owners of motor vehicles;
  • Compensation for everyone else, funded through the New Zealand Government.

There have been many changes in the scope and structure of the Accident Compensation Corporation since its inception, primarily as a result of changing legislation.   The scheme is now primarily governed by the Injury Prevention, Rehabilitation and Compensation Act 2001 (IPRC).  The IPRC is essentially a set of regulations governing who is entitled to compensation, what is covered by the scheme, how the scheme is funded and how much can be paid out to claimants.

A major change brought about by the introduction of the IPRC has been an increased focus on injury prevention.  Section three of the Act provides the Corporation with the responsibility “to enhance the public good and reinforce the social contract represented by the first accident compensation scheme by … minimising both the overall incidence of injury in the community, and the impact of injury on the community (including economic, social, and personal costs)” (IPRC 2001).  Section 263 of the IPRC requires that the Corporation undertake injury prevention work if this is likely to result in a cost-effective reduction in either levies or the government contribution to the scheme.  The Corporation is also required to co-ordinate activities with other government agencies to increase the efficiency and effectiveness of its injury prevention activities.

In addition to its interest in assault as a result of the IPRC, the Corporation is a key stakeholder in a number of strategies which impact on family violence.  These include:

  • Te Rito: New Zealand Family Violence Prevention Strategy (Ministry of Social Development 2002);
  • Crime Reduction Strategy: Action Plan to Reduce Community Violence and Sexual Violence (Ministry of Justice 2002A).
  • New Zealand Injury Prevention Strategy (Minister for ACC 2003);
  • Opportunity for All New Zealanders (Office of the Minister for Social Development 2004).

Whilst not a major stakeholder in the area of assault within these strategies, the Corporation as a result of its interest in the prevention of intentional injury has the potential to play a major part in operationalising these strategies.

Family Violence in Aotearoa New Zealand

Family violence is a significant issue in Aotearoa New Zealand; it creates major social and economic costs for our society.  Family violence has been found to affect families from all cultures, backgrounds and socio-economic situations.  It compromises the safety of children, adults and elders and its effects are broad and multi-dimensional.  The need to understand and address family violence is not new, however identifying effective best practice can be problematic.  A broad range of controlling behaviours falls under the banner of family violence.  These typically lead to fear, intimidation and emotional deprivation through psychological, sexual and emotionally abusive behaviours.  Family violence can occur in all close personal relationships, wherever individuals are part of a family or fulfilling the role of family.  Common forms of violence within the family include:

  • Spouse or intimate partner abuse (violence and abuse between adult partners);
  • Child abuse or neglect (abuse and neglect of children by an adult);
  • Elder abuse or neglect (abuse and neglect of people over the age of 65 by a person or persons with whom they have a relationship of trust);
  • Parental abuse (violence perpetrated by a child against a parent);
  • Sibling abuse (violence perpetrated between siblings).

(Ministry of Social Development 2002, Ministry of Health 2001)

Family violence is a major social problem, estimated to cost Aotearoa New Zealand between $1.187 billion and $5.302 billion per year (Snively 1994).  It further contributes to the continuation of the cycle of abuse within families and in society in general (Ministry of Social Development 2002).  The perpetrators of the most severe and lethal cases of family violence are predominantly men; their victims are predominantly women and children.  Tangata whenua[1] are significantly over represented as both victims and perpetrators of family violence.

The best available population-based estimates of partner abuse suggest that 15 - 35 percent of women are hit or forced to have sex by their partners at least once in their lifetime, while seven percent of men report experiencing this type of abuse.  A 1995 study revealed that one in five New Zealand men admitted assaulting their partners in the previous year (Leibrich, Paulin & Ransom1995).

Men assaulting their women partners comprise between 86 percent (New Zealand Police Statistics for 1996/97 operational year, men were the offenders in 86.7 percent of Family violence incidents) and 98 percent (Hamilton Abuse Intervention Project database, 1991-1994).of family violence-related arrests. New Zealand studies found that 35 percent of men reported physically assaulting their partners (Leibrich, Paulin & Ransom1995) and 33 percent of women reported physical or sexual abuse from their male partner (Morris 1996).

According to the Ministry of Health (2001), lifetime estimates of child abuse suggest that between four and ten percent of New Zealand children experience physical abuse and approximately 18 percent experience sexual abuse.  Between 1996 and 1997, 38,000 children were present during the 30,340 family violence incidents attended by New Zealand Police; 28,621 were under 10 years old, and 9,844 were aged between 10 and 16 years (New Zealand Police 1997).  From interviews with children, researchers found that almost all can describe detailed accounts of violent behaviour that their mother or father never realised they had witnessed (Jaffe, Wolf & Wilson 1990).

In the year to June 2000, the Department of Child, Youth & Family Services assessed 6,833 children as abused or neglected (Ministry of Social Policy (now Ministry of Social Development) 2001).  Further, in the four years to 2002, over 1,600 children under the age of 10 years were sexually abused.  Given the nature of this issue, the number of child victims (as with women) is considered grossly underrepresented.

Research indicates that there is considerable overlap between physical, psychological and sexual abuse, and children who are subject to one form of abuse are significantly more likely to suffer other forms of abuse (Briere & Runtz 1990).

There are significant overlaps between male violence against female partners and child abuse and neglect.  A comprehensive review of studies in this area indicates that in 30 to 60 percent of families where either child abuse or partner abuse is found, the other type of abuse occurs also (Edelson 1999).  The likelihood of co-occurrence of child abuse increases with increasing frequency of partner abuse.

Most research estimates that between two and five percent of the older population are victims of elder abuse.  In Aotearoa New Zealand, based on the 1996 census, this means there could be between 8,453 and 21,133 older New Zealanders suffering from some form of abuse and neglect.  Most elder abuse victims are aged 70 to 84 years, with psychological abuse considered the most common type of elder abuse (Age Concern New Zealand 1992).

For the purposes of this paper, family violence will be assumed to include intimate partner abuse and child abuse or neglect.  The prevention of parental, elder and sibling abuse are beyond the scope of this discussion, primarily due to the lack of clear evidence that these present significant cost to the Accident Compensation Corporation.  It should also be noted that these three areas are not currently being prioritised within either Opportunity for All New Zealanders or Te Rito: New Zealand Family Violence Prevention Strategy.

The Cost of Family Violence to the Accident Compensation Corporation

The costs to ACC of providing treatment and entitlements in respect of assault (excluding sexual abuse) cannot be easily identified, particularly as many claims are processed through the bulk funded emergency departments of public hospitals[2].  Recent estimates of the cost of assault to the Corporation suggested a possible 6,660 cases at a cost of over NZ$21 million (Stephenson, Trotter & Langley 2004).  According to Statistics New Zealand (2001), “male assaults female” (i.e., intimate partner abuse) is the most common type of violent crime recorded by New Zealand Police and thus the most common reported assault.  We can therefore assume that family violence is the most common form of assault, with intimate partner abuse alone accounting for half the cost of assault to the Corporation.

Health Promotion

The Ottawa Charter for Health Promotion defines health promotion as “the process of enabling people to increase control over, and to improve their health” (World Health Organization 1986).  The three strategies for health promotion identified in the charter are advocacy, enabling and mediating, these are explained within the Health Promotion Glossary (World Health Organization 1998) as “advocacy for health to create the essential conditions for health... enabling all people to achieve their full health potential; and mediating between the different interests in society in pursuit of health”.

The three strategies of health promotion are supported by five key areas for action:

  • Building healthy public policy;
  • Creating supportive environments for health;
  • Strengthening community action for health;
  • Developing personal skills; and
  • Reorienting health services.

There are many other models for health promotion and a range of theories to support the different facets of this emerging discipline however, with the exception of its failure to recognise the social contracts of indigenous peoples (Lane & Gardiner 2003), the Ottawa Charter for Health Promotion is sufficient to provide a working definition of health promotion.

Under the IPRC, the Corporation clearly has a role to play in reducing the level of family violence within society and thus reducing its own costs.  Section 263 of the IPRC recognizes that in fulfilling its primary function to reduce personal injury, the Corporation should seek to:

  • Create supportive environments that reduce the incidence and severity of personal injury; and
  • Strengthen community action to prevent personal injury; and
  • Encourage the development of personal skills that prevent personal injury.

Clearly health promotion is a role of the Accident Compensation Corporation.

Injury Prevention

ACC has traditionally involved itself in the prevention of unintentional injury, mostly in the areas of sport, traffic, workplace and falls.  Within these areas, the Corporation has adopted an injury prevention approach.

Injury prevention is a subset of health promotion, using educational, engineering and enforcement approaches to reduce injuries within society.  Whilst injury prevention makes use of the models of health promotion, specific models have also been developed.  The Spectrum of Prevention (Cohen & Swift 1999) provides a framework for delivering comprehensive injury prevention programmes.

Level of Spectrum

Definition of Level

Strengthening Individual Knowledge and Skills

Enhancing an individual’s capability of preventing injury or illness and promoting safety

Promoting Community Education

Reaching groups of people with information and resources to promote health and safety

Educating Providers

Informing providers who transmit skills and knowledge to others

Fostering Coalitions and Networks

Bringing together groups and individuals for broader goals and greater impact

Changing Organizational Practices

Adopting regulations and shaping norms to improve health and safety

Influencing Policy and Legislation

Developing strategies to change laws and policies to influence outcomes

Spectrum of Prevention (Cohen & Swift 1999)

Injuries can be prevented at a primary, secondary or tertiary level.  Primary prevention aims to reduce the risk of injury at a population level, secondary prevention reduces the risk to those in high risk groups whilst tertiary prevention aims to reduce the reoccurrence of injury.

Whilst acknowledging the above and other models of injury prevention as a subset of health promotion, this paper will consider primary, secondary and tertiary injury prevention activities as they fit into the framework for health promotion action proposed by the Ottawa Charter for Health Promotion (World Health Organization 1986).  The various activities will be considered as they fit into a matrix considering healthy public policy, supportive environments for health, community action, personal skills and health services.

Family Violence Prevention

Given the limited access to University facilities provided by the author’s remote location, the internet has been utilized to identify and obtain the literature relating to the prevention of family violence.  Initial searches were undertaken using www.google.com and the key words “family violence” and “primary prevention”, “secondary prevention” or “tertiary prevention”.  The author has also made use of his substantial connections within the family violence sector in Aotearoa New Zealand to gain access to documents and research papers produced by the various government ministries.

Primary Prevention

It is recognised that primary prevention strategies based on risk factors have limited effectiveness; in common with many health promotion programmes it is necessary to use broadly based social programmes (Bethea 1999, Edelson 2000).  Programmes should be focused on society and not individuals.  It should also be noted that whilst much research has been done on the prevalence of family violence within Aotearoa New Zealand and elsewhere, little sound research into the most effective practices is available (Bethea 1999, Family Violence Prevention Fund 2004).

Common features of effective programmes include (Bethea 1999, Family Violence Prevention Fund 2004):

  • Strengthening family and community connections;
  • Raising awareness of the unacceptability of family violence;
  • Developing networks of agencies and community leaders;
  • Changing the social and community conditions which foster violence;
  • Making services accountable to the needs of families and communities.

Secondary Prevention

The secondary prevention of family violence is largely concerned with the potential victims in homes and families in which family violence is already occurring.  This will include child witnesses of intimate partner violence, siblings of abused children, and so forth.  Initiatives here will focus on:

  • Addressing the needs of the perpetrator to ensure they do not widen the scope of their violence given that there is between a 30 and 60 percent chance of families where either child abuse or partner abuse is found, also experiencing the other form of abuse (Edelson 1999);
  • Working with child and adult witnesses of family violence to develop safety behaviours and to break the cycle of violence, particularly given the strong correlations between witnessing family violence as a child and experiencing family violence in adult intimate relationships (Strauss, Gelles & Steinmetz 1980);
  • Providing key workers with the skills to recognise and respond appropriately to families at high risk of violence.

Tertiary Prevention

There are a range of interventions offered within Aotearoa New Zealand to assist families who have experienced family violence.  These include education programmes for perpetrators and victims delivered by Non-Government Organisations under the Domestic Violence Act, legislation and systems to protect women and children from abuse by family members (i.e., Protection Orders and specific offences relating to family violence) and programmes such as Strategies with Kids, Information for Parents (SKIP), the Ministry of Social Development programme to provide parents with non-violent means of disciplining children along with strategies to raise happy and healthy children.

It is recognised that many initiatives and practices to address family violence will cross all three levels of injury prevention, this was evidenced most recently in the Family Violence Funding Circuit Breaker Project, where attempts to categorise grass root projects to address family violence failed due to linkages between the levels of prevention (Opie 2004).

Prevention of Family Violence

There are a wide range of strategies and programmes operating within Aotearoa New Zealand to prevent or minimise the occurrence of violence within families.  I shall consider those which have been evaluated here.  It should be noted that many potentially effective programme running throughout the world have not been evaluated due to funding limitations.

Parenting Programmes

A huge diversity of parenting programmes are available throughout the world, most programmes within Aotearoa New Zealand operate from a parenting skills development base rather than addressing parenting issues (Dalziel).  Parenting programmes do not fit neatly into a primary, secondary or tertiary prevention model as they vary considerably in scope, some are aimed at all parents, some at high risk parents and some at parents who have already abused their children.  The Triple P – Positive Parenting Programme (Sanders, Turner & Markie-Dodd 2002) is an example of a programme that covers a broad range of familial need, this was the only programme identified that had been evaluated.

The programme reported having a strong theoretical and research base, clear methods for using learning to inform practice, being specific about parenting skills and making use of a wide variety of referral routes.  Weaknesses of the programme included a failure to engage with families in greatest need for the length of a programme and a lack of awareness of gender related power and control issues (Sanders, Turner and Markie-Dodd 2002)

Universal Home Visits

Bethea (1999) reports that of the range of supports offered to parents, including long term home visitation, short term home visitation, early and extended mother/child contact, intensive GP contact, drop-in centres and parenting classes, only long-term visitation has been found to be effective in reducing the incidence of child abuse as measured by hospital admissions.  Results of studies included improved parental attitude towards children, increased interactions between parents and children and reduced incidences of child abuse.  However the high costs associated with a universal home visiting programme have prevented such programmes

Social Marketing

Social marketing is the application of commercial marketing techniques to achieve social change (i.e., to influence social and health behaviours and attitudes).  It is intended to influence how people think and behave (Nutbeam & Harris 1999); examples of social marketing materials include television and radio commercials, advertisements in print media, posters and mailouts.

Many programmes to raise awareness of family violence have been undertaken throughout the world, examples include the Family Violence Prevention Fund There’s No Excuse for Domestic Violence, (Fullwood 2002), Freedom From Fear (Donovan, Francas, Paterson & Zapelli 2000), Aktiv gegen Männergewalt / Active Against Male Violence (Women Against Violence Europe), Zero Tolerance Campaign (Women Against Violence Europe)  These campaigns largely operate from the premise that it is necessary to change social norms that allow family violence to exist.  A range of media have been utilised, including posters, print and broadcast media, information pamphlets, CD ROMs, large scale events and the internet.  The target groups for the campaigns have included the general public (Fullwood 2002, Women Against Violence Europe), adult males (both perpetrators and non-perpetrators) (Donovan, Francas, Paterson & Zapelli 2000), boys and young men (Reid Howie Associates Ltd 2001)

The components that contributed to successful social marketing campaigns included integration of all aspects of the campaign (Donovan, Francas, Paterson & Zapelli 2000, Reid Howie Associates Ltd 2001), the use of research in campaign development, the use of a conceptual framework working with relevant stakeholders throughout the campaign (Donovan, Francas, Paterson & Zapelli 2000), creating critical discussion around the issue of family violence (Reid Howie Associates Ltd 2001, Women Against Violence Europe) and consistent use of appropriate promotional strategies (Donovan, Francas, Paterson & Zapelli 2000).

For social marketing campaigns to have maximum effect, they must be supported by other initiatives able to create and sustain dialogue within communities, peer groups and families (Women Against Violence Europe).  The evaluations of the programmes discussed above have all claimed increases in knowledge however few gains have been identified relating to long term attitudinal and behavioural change.  Public awareness campaigns often increase awareness of services and thus referrals (Hall & Stannard 1997), a useful result but often not the purpose of these campaigns.  Mass media campaigns are of little use in isolation but rather make up an important component of a comprehensive strategy to address family violence (Women Against Violence Europe).

Universal Screening

Universal screening of families for family violence has been common in many countries for some years now, whilst it is only now being introduced to Aotearoa New Zealand thanks to the recently developed Ministry of Health Family Violence Intervention Guidelines (Ministry of Health 2002) and associated workforce development.  Evaluations of health care professional training in the USA (Edelson 2000) have shown that universal screening does increase the identification of adult-female victims of intimate partner abuse.  Edelson does however caution on the lack of knowledge of the effects of this screening on those who are not exposed to family violence and the lack of clear evidence of behaviour change as a result of these interventions

Education of Children and Young People

Edelson (2000) suggests that it is in the area of school-based prevention programmes that the greatest primary prevention activities relating to family violence have occurred.  Many programmes have been evaluated and results indicate that young people participating in these programmes have greater knowledge of family violence and hold more desirable attitudes to violence in general.  However, it must be noted that the longest follow-up period for any programme has been 16 months and, as such, it is not possible to comment on any long-term behavioural or attitudinal changes.

The lack of any long term follow up of education programmes noted above makes it difficult to assess whether programmes within schools and other education settings are successfully reducing the acceptability of violence and, ultimately, the levels of family violence within society.  Programmes addressing child abuse, young people’s intimate relationships and family violence as a whole are being delivered in many territories throughout the world however the lack of long term outcome evaluations makes it impossible to identify the factors that create successful projects.  The projects discussed here report some gains and attempt to identify factors that contribute to their success however; the short-term nature of any attached research is problematic.

The school activities contained within the Aktiv gegen Männergewalt (Women Against Violence Europe) campaign were deemed successful in that they initiated ongoing activities within schools however, the campaign did note the considerable support required for teachers at implementation, this need for support and training was also reported by the Zero Tolerance Young Person’s Campaign (Reid Howie Associates Ltd 2001).  

The Australian YouthSafe Peer Support Programme (Partnerships Against Domestic Violence 2000), consisting of one-day awareness raising sessions within schools  and other learning institutions reported increased awareness of pertinent issues amongst young people, including the nature and extent of family violence, alternatives to violence within relationships and assistance available to young people in the community.  Factors considered important in the success of this project included community involvement, staff training and development, level and quality of planning work and the support available to staff delivering the project.

Evaluation of the New Zealand Police Keeping Ourselves Safe programme reported that teaching staff believed it to be an “excellent programme” (Briggs 2002).  The programme reported an increase in the number of children reporting abuse of themselves or their peers, with parents reporting that students who had participated in the programme successfully stopping incidents of sexual abuse and reporting it to their caregivers.  Important factors in the success of this programme have been identified as Police Education Officers working with teachers around the more sensitive issues, parallel information sessions for parents and strong links to the relevant curriculum documents.

Community Development and Action

Community development is “is a process of enabling communities to develop their capacity to address the issues that they identify. Core components of community development are self-help, mutual support, community integration, capacity development, problem solving and self-representation and the promotion of collective action” (Antric 2005) whilst “community action is a process involving the linking of groups and individuals to develop collective action to tackle an identified issue (Antric 2005).  Both are valid approaches to addressing the prevention of family violence and have been utilised in many communities.

The Aotearoa New Zealand Sure Start programme is based on a British model aimed at “improving health and emotional development for young children” (Sure Start 2005).  This model is described as community development although given that it is implemented in Government defined areas with core services including outreach and home-visiting, support services for families and children, quality childcare and children’s facilities, community healthcare, and support for children with special needs, it can more accurately be called community action.  Given that local governance bodies, including parents and community leaders, exist to guide the local priorities (Davies, Wood & Stephens 2002).

Campaigns to mobilise communities to address family violence issues have been undertaken in many communities.  Core strategies have included raising awareness of family violence, connecting those at high risk to support services, developing community leaders able to advocate for healthy families, changing the conditions that support family violence and making services accountable to their communities (Fullwood 2002).  Additionally campaigns have sought to ensure community ownership at the most local level (Maciak, Guzman, Santiago, Villiabob & Israel 1999).

An Australian project aimed at mobilising schools and communities to address family violence highlights a number of key considerations to be addressed in this area (Sidey 2001, Ridge & McLeod 1997).  First and foremost any definition of violence must be negotiated locally and must include a local definition of the problem, including race, gender, ability and sexuality issues.  Preventative action should make use of a positive, strengths-based community development approach and should be aligned with policy, education, community networking and environmental changes where possible.

Working with Witnesses of Family Violence

As will be appreciated by the reader, children have active emotional and psychological lives from the moment of birth and providing children with the opportunity to talk about any negative experiences will support their present and future health (Kelly, Anderson & Dawson 2003).  Any intervention undertaken with child witnesses should be appropriate to the children’s gender, culture, ethnicity, spirituality, ability, etc.  Programmes undertaken with child witnesses of family violence will deal with both the short term needs of the children and breaking the pattern of aggressive behaviour associated with the cycle of abuse (Bennett, Coggan, Fill & Lee 2004).

Many programmes to address the needs of child witnesses of family violence are run in Aotearoa New Zealand under the Domestic Violence Programmes regulations administered by the Department for Courts.  These programmes aim to assist “children to deal with the effects of domestic violence” (Ministry of Justice 2004A), they are provided for the general population and for Tangata whenua; Tangata whenua programmes incorporate indigenous models of health (i.e., Te Whare Tapa Whā (Durie 1994)) and Whakawhanaungatanga (i.e., indigenous concepts around family and relationships).  

Three of the Ministry of Justice approved programmes for children were evaluated (Ministry of Justice 2002B), the evaluations found that the programmes assisted children to manage with the effects of domestic violence through an effective educational programme, and that programmes helped children to express their feelings about family violence and develop strategies to protect themselves.

The uptake of Protection Orders has declined in recent years (Jacobson 2005) and whilst the Ministries of Justice and Women’s Affairs are undertaking research regarding this, any results are not yet available.  Alongside the low uptake of Protection Orders has been low uptake of Ministry of Justice approved programmes (Jacobson 2005).  This results from both the low use of Protection Orders and a lack of awareness by parents of the effects of witnessing family violence on children (Bennett, Coggan, Fill & Lee 2004).  

A programme to raise awareness of the effects of witnessing family violence, the benefits of Protection Orders and the available services to families has been undertaken by Preventing Violence in the Home, formerly the Auckland Domestic Violence Centre (Bennett, Coggan, Fill & Lee 2004).  Evaluation of this project indicates that completion of the programme leads to reports of increased wellness from child participants, the development and implementation of safety plans by children and an increased awareness by parents of the effect of witnessing family violence on children.  Further research is being undertaken to determine whether this and similar projects have a significant effect on the uptake of Protection Orders and Ministry of Justice approved programmes although anecdotal evidence suggests that participation in the Domestic Violence Centre programme quadruples the likelihood of children attending Ministry of Justice approved education programmes.

Working with adult female victims

In Aotearoa New Zealand, education programmes to meet the needs of adult victims of family violence are provided under Section 28 of the Domestic Violence Act to promote the protection of victims of domestic violence through education, information and support (Ministry of Justice 2004B).  The programmes are delivered either in groups or with individuals depending on personal circumstances.  The preferred means of delivery is in groups however, where the victim is male, gay, bisexual or has other special needs, individual programmes are often used.

The Ministry of Justice has produced research to establish “whether programmes for adult protected persons contribute to the protection of victims of family violence” (Maxwell, Anderson & Olsen 2001).  Maxwell et al found that the programmes produced significant gains for participants with 88 percent of women reporting that they had learned how to keep themselves safe, 92 percent reporting that they had learnt how to keep their children safe and 91 percent reporting that they had a safety plan in place for themselves and their children.  The participants in the research also reported a significant reduction in the reporting of abuse during the programme when compared with previous experiences of abuse.  Participants in the programmes “believed that the programme had actively contributed to them feeling safer and being more able to keep children safe” (Maxwell, Anderson & Olsen 2001).

The study by Maxwell, Anderson and Olsen (2001) attempted to identify best practice, although it should be noted that this was not done by comparing the programmes but based on feedback from participants.  The most effective programmes met the needs of women to understand family violence, were culturally responsive and appropriate, had appropriate staffing and were delivered by organisations with effective infrastructures.  Weaknesses of programmes included not being able to meet the broader needs of participants (i.e, if a woman did not have secure accommodation for herself and her family she would be unlikely to prioritise attending the programme), referral to the programme via the Family Court was considered inadequate and further support in accessing the programme was required, and accessing programmes was also difficult in some areas.

Working with Perpetrators

In Aotearoa New Zealand, programmes for perpetrators of family violence are one facet of the array of legal responses to family violence.  The primary objective of these programmes is the “stopping or preventing domestic violence on the part of the respondent” (Ministry of Justice 2004C).  The Department of Corrections evaluated four approved community-based family violence prevention programmes for perpetrators in Porirua, Takapuna, Wanganui and Wellington (Ministry of Justice 2004D).  The evaluation reported a number of positive results.  The participants in the programmes reported a reduced frequency of violence and abusive behaviour, a reduction in their involvement in the criminal justice sector, and significant improvement in their wellbeing.  The partners of the men also reported a reduction in the frequency and nature of physical abuse although no similar reduction in emotional abuse and controlling behaviour was reported.  It should be noted that behaviour change was only monitored for a maximum of 13 weeks following completion of the programmes and even here there was some decline in participants’ sense of wellbeing and further follow up may find that any behaviour change was not maintained (Ministry of Justice 2004D).

The evaluation undertaken by the Department of Corrections identified a number of issues which impacted on the effectiveness of the programmes; these included a failure to meet the cultural needs of men from backgrounds other than Tangata Whenua or Pākehā[3] and a completion rate of approximately half (Ministry of Justice 2004D).  Research into the effectiveness of these programmes indicates that 70 to 80 percent of men who complete the programmes do not return to using physical violence.  This compares to a success rate of around half reported overseas (Gondolf 1998 cited in Ministry of Justice 2004D) however given that Aotearoa New Zealand studies have not been undertaken over a longer period it may be that the rate of non-violence fall over the longer term.

Government Legislation and Strategy

The legislation relating to family violence within Aotearoa New Zealand is largely encompassed within the Domestic Violence Act 1995(DVA)and the Children, Young Persons, and Their Families Act 1989 (CYPFA).  These acts provide for the safety of victims of family violence, support to at-risk families and the prosecution and treatment of perpetrators of family violence.  The major weakness of these Acts is their failure to provide for the mandatory reporting of family violence.

The two key government strategies relating to family violence are Te Rito: New Zealand Injury Prevention Strategy and Opportunity for All New Zealanders.  The former represents the New Zealand Government’s response to family violence prevention while the latter identifies violence within families as one of five priority areas for government.  Te Rito identifies the key areas for action in preventing family violence whilst Opportunity for All represents the largest ever commitment from the New Zealand Government towards the eradication of family violence.  As noted earlier, family violence is also addressed through the New Zealand Injury Prevention Strategy and the Crime Reduction Strategy.

Health promotion: An approach to the prevention of family violence.

I have outlined a number of key areas in the prevention of family violence:

  • Parenting programmes;
  • Universal home visits;
  • Social marketing;
  • Universal screening;
  • Education of children and young people;
  • Community development and action;
  • Working with witnesses of family violence;
  • Working with adult victims of family violence;
  • Working with perpetrators; and
  • Government legislation and strategy.

There are many other areas which will impact on the prevalence of family violence in our society and reductions in the frequency and intensity of that violence however, these are either too broad to consider in a targeted approach or lie too far beyond the scope of ACC to be considered in this paper.  The following table considers how these approaches to the prevention of family violence fit within the health promotion framework provided by the Ottawa Charter.

Ottawa Charter Area for Action

Family violence prevention activities

Building healthy public policy

  • Government legislation and strategy;
  • Education of children and young people (school policies);
  • Universal screening (organisational policies).

Creating supportive environments for health

  • Parenting programmes;
  • Universal home visits;
  • Education of children and young people;
  • Community development and action.

Strengthening community action for health

  • Parenting programmes;
  • Social marketing;
  • Education of children and young people;
  • Community development and action.

Developing personal skills

  • Parenting programmes;
  • Universal home visits;
  • Education of children and young people;
  • Community development and action;
  • Working with witnesses of family violence;
  • Working with adult victims of family violence;
  • Working with perpetrators.

Reorienting health services

  • Parenting programmes;
  • Universal home visits;
  • Universal screening;
  • Working with witnesses of family violence;
  • Working with adult victims of family violence;
  • Working with perpetrators.

Prevention of family violence and the Ottawa Charter

Clearly all the family violence prevention activities outlined in this paper fit within the health promotion framework provided by the Ottawa Charter.  Family violence prevention is most clearly health promotion but what is the role of the Accident Compensation Corporation within this area?

The Role of ACC in family violence prevention

As stated above, ACC has a requirement to undertake health promotion work if this is likely to result in a cost-effective reduction in either levies or the government contribution to the accident compensation scheme.  Conservative estimates place the cost of family violence to ACC as approximately NZ$7 million per annum although according to research conducted by the Injury Prevention Research Unit, this may be as high three times this figure (Stephenson, Trotter & Langley 2004).  Preventing injuries as a result of family violence will result in savings for the Corporation and its funders.

Whilst secondary and tertiary prevention of family violence presents the Corporation with opportunities to reduce immediate costs through preventing re-victimisation of women and children and increasing the safety of at-risk families, it is in primary prevention that the greatest long-term gains can be made.  Challenging the acceptance of family violence at an individual, family, whānau[4], community and societal level, and supporting the development of a violence free society will see the greatest gain for ACC.

Services for victims and perpetrators of family violence in Aotearoa New Zealand are already provided by the Department of Child, Youth and Family, Ministry of Justice and various Non-Government Organisations.  These include comprehensive services for persons covered by a Protection Order (i.e., respondents and their families), services for at-risk children and education programmes for perpetrators of family violence.  As has already been identified, uptake of Ministry of Justice programmes for children who witness family violence has been low.  This may be due to the lack of awareness of these services, the lack of understanding of the effects of witnessing family violence and the barriers to accessing Protection Orders.  Research is currently underway to explore this.  Given this situation, ACC should explore the means by which the Corporation can support families in crisis to take out Protection Orders, access Ministry of Justice approved programmes and increase caregivers understanding of the effects of children witnessing violence.  This will provide a cost effective means of increasing the support for families given that Ministry of Justice funding for programmes is uncapped and relies only on a Protection Order being in place.  Thus the Corporation can ensure that child witnesses and adult victims of family violence are better supported and that the cycle of violence is broken.

There is insufficient evidence of the effectiveness of education programmes for perpetrators to justify ACC’s investment in this area.

ACC does not involve itself in home visits or in working with families however, as a provider of rehabilitation and care services for people with injuries it does have significant contact with up to 1.6 million New Zealanders each year (ACC 2004) through the Corporation’s staff and external contractors.  ACC should therefore develop policies and procedures to ensure that the claimants it, and its agents, have contact with are screened appropriately to identify families experiencing, or at risk of, family violence.  The Corporation should also explore funding major Non-Government Organisations with significant contact with families (e.g., Royal New Zealand Plunket Society, Barnados New Zealand, etc.) to undertake similar policy and procedure development.

Through identifying families at-risk of family violence and supporting access to programmes to break the cycle of violence in families, ACC will see a reduction in the severity and incidence of family violence.  However, these strategies need to be reinforced with population based initiatives to challenge social norms relating to violence.

Major national social marketing campaigns have been launched in various territories throughout the world, including Aotearoa New Zealand.  For these to be effective they need to be sustained over a long period of time and to combine with local awareness raising and community action.  The Corporation should therefore develop a primary prevention programme that includes national and local social marketing along with community action.  It is recommended that ACC work with the lead stakeholders in the area to develop messages and social marketing collateral whilst using its unique knowledge of communities and community action to draw together the many initiatives addressing family violence at a local level and to develop a toolbox for communities to use to strengthen awareness and action around family violence.  

Social marketing and community action will begin to make changes in the diverse communities of Aotearoa New Zealand.  However, this needs to be reinforced through work with children and young people.  Changing the attitudes and expectations of the young whilst working to target the whole population will effectively impact the acceptance of family violence in our society.  It is recommended that ACC support the further expansion of the New Zealand Police Keeping Ourselves Safe programme to reach all early childhood education centres, primary and intermediate schools and colleges.  This will ensure that the same messages are received throughout a child’s scholastic career and that the reputation of the existing programme can be used to roll out a more comprehensive family violence prevention initiative.

ACC must also maintain its involvement in the various national strategies relating to family violence. The Corporation is the largest employer of health promotion / injury prevention staff in Aotearoa New Zealand and has substantial opportunity to reduce its costs relating to family violence through supporting the New Zealand Government to create a society in which everyone can live free from violence.


ACC has a role to play in the reduction of the severity and incidence of family violence in Aotearoa New Zealand.  The Corporation should take a role in supporting the key Government agencies addressing family violence and its prevention (i.e., Ministry of Social Development, Ministry of Health, Department of Child, Youth and Family Services, Ministry of Justice and New Zealand Police) through identifying opportunities to support the work of these agencies and to improve access to existing services.  ACC is required to reduce its costs associated with family violence related assault in a cost effective manner, the Corporation is unable to compete with the considerable Government funding available and as such must seek avenues to add value.  The recommendations made above such as increasing access to Ministry of Justice education programmes, using the Corporation’s considerable expertise in social marketing to support the lead agencies in developing social marketing campaigns and supporting the expansion of existing programmes all provide opportunities for ACC to make considerable gain with a relatively low investment.

Through supporting the activities outlined above and aligning its strategies with the key stakeholders in the sector, ACC can fulfil its obligations under the IPRC and the relevant Government strategies, undertake appropriate health promotion action, achieve substantial savings, reductions in levies and government contributions to injury treatment and rehabilitation and thus contribute to a safer and healthier environment for all New Zealanders.


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Thames Valley University

Page  of

14 May 2005

BSc (Hons) Health Promotion Programme

[1] Whilst the term Māori is more commonly used to refer to the indigenous peoples of Aotearoa New Zealand, the author uses the term Tangata Whenua as this is a term used by these peoples as opposed to the term Māori, introduced by the European colonisers of this land.

[2] Public hospital acute services (i.e., emergency departments) within Aotearoa New Zealand are funded by a bulk payment from ACC to the New Zealand Government.  The Ministry of Health is then funded by the Crown to purchase these services from the District Health Boards on behalf of ACC.

[3] New Zealand European

[4] Extended family, the basic unit of indigenous society within Aotearoa.

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