Chapter 7: Actions and Prevention of RV
Balbir Gurm
Key Messages
- Although the total cost of relationship violence is difficult to estimate, the yearly cost of domestic violence and child abuse has been estimated as about $15 billion annually for adults and $23 billion for children in Canada.
- A significant way to address this cost is through investments in primary prevention initiatives, including strengthening strategies to prevent childhood exposure to RV, improving young people’s relationship skills, supporting the development of healthy community norms and non-violent environments. On a more macro level, this includes prevention measures in legislation and policy and comprehensive data collection/monitoring systems.
- Action must be evidence-based and the evidence can come from multiple ways of knowing and developed collaboratively from multiple lenses.
- BC models that have had some success are the BC ICAT Model that brings together experts to address high risk clients and the DVU model that houses social workers and support workers with police.
- There are a number of toolkits available to support an evidence-informed response to preventing RV, including The Early Childhood Exposure to Domestic Violence, the Community Champions Toolkit, and a Toolkit for Health Professionals. As well, several screening tools can be found on the NEVR website.
- A range of recommended resources can be found below including links to National Collaborating Centres created by the Public Health Agency of Canada.
Relationship violence is any form of physical, emotional, spiritual and financial abuse, negative social control or coercion that is suffered by anyone that has a bond or relationship with the offender. In the literature, we find words such as intimate partner violence (IPV), neglect, dating violence, family violence, battery, child neglect, child abuse, bullying, seniors or elder abuse, male violence, stalking, cyberbullying, strangulation, technology-facilitated coercive control, honour killing, female genital mutilation gang violence and workplace violence. In couples, violence can be perpetrated by women and men in opposite-sex relationships (Carney et al., 2007), within same-sex relationships (Rollè et al., 2018) and in relationships where the victim is LGBTQ2SAI+ (lesbian, gay, bisexual, transgender, queer, Two-Spirit, intersex and asexual plus ) (The Scottish Trans Alliance, 2010; Rollè, 2018). Relationship violence is a result of multiple impacts such as taken for granted inequalities, policies and practices that accept sexism, racism, ageism, xenophobia and homophobia. It can span the entire age spectrum. It may start in-utero and end with death.
Models and risk factors were presented in chapter 6. This chapter focuses on initiatives to prevent all types of RV.
Actions
Although the total cost of relationship violence is difficult to estimate, the yearly cost of domestic violence and child abuse has been estimated as about $15 billion annually for adults (Neilson, 2013) and $23 billion for children in Canada (Prince Albert Daily Herald, 2018). Many children and adults suffer long-term health and social issues that could be avoided. Watch this video on the neurological impact of trauma (Ference, 2018). A significant way to address this is through primary prevention. Since doing this work over the last three decades, we have learned that there will never be enough resources to address all the abuse that occurs promptly. However, primary prevention addressing factors that increase resiliency and prevent relationship violence from occurring in the first place might be helpful.
Healthy relationships are formed from conception to early adolescence. As well, societal attitudes about women’s work, the role of women, ideas about power and control contribute to relationship violence. Unfortunately, women and young girls continue to be blamed for the violence by such statements as “don’t wear short shorts” and “don’t provoke men.” This misogynistic language not only shows the prevalent rape culture rooted in society, but it indicates the need to provide awareness and literacy about normalized violent behaviours among individuals (Inside Southern, n.d.). It is time to change the culture from one that blames girls and women to one that addresses the root causes of societal attitudes of gender inequality and privilege.
It is also important to engage men because the majority of the offenders may be men (mixed results from studies). Watch this video that discusses the importance of involving men, especially for heterosexual couples in which the male is the offender. It is important to reach men through social marketing and encourage them to attend programs (Learning to End Abuse, 2017). Click here to read a Canadian paper on engaging men in RV (Wells et al., 2013).
We need programs that change societal attitudes and make community members resilient, starting from an early age. Also, we need a whole community approach based on our model (see chapter 6). According to Raphael (2016), the 16 social determinants for Canadian society are:
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- Aboriginal Status
- Early Childhood Development
- Education
- Employment and Working Conditions
- Food Insecurity
- Gender
- Health Care Services
- Housing
- Income and its Distribution
- Social Exclusion
- Social Safety net
- Unemployment and Job Security
- Disability (Ability)
- Geography
- Immigrant status
- Race
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The literature is in silos but we think that actions conceived for domestic violence can be carefully adapted to address all sexual and gender diverse groups dyad or group relationships.
Wells et al. (2012) in How Public Policy and Legislation Can Support the Prevention of Domestic Violence in Alberta made six recommendations, see below. We believe that further additions can be made to these recommendations, our additions are in brackets. The full report can be accessed here.
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- Prohibit corporal punishment
- Prevent unplanned and teenage pregnancy
- Improve the parenting skills of at-risk parents (all parents)
- (Implement nurse-family partnership program at conception)
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- Introduce mandatory evidence-based anti-bullying and healthy relationships programming in all (pre-schools, schools, including post-secondary)
- Introduce trauma-informed/trauma-sensitive practices and principles into mental health, health, education and child welfare systems
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- Engage men and boys in violence prevention
- Support immigrant, refugee and temporary foreign workers to enhance healthy family and community norms.
- Normalize equity in decision making for all family members
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- Foster healthy, non-violent workplaces
- Limit access to alcohol to reduce rates of violence
- Limit access to drugs
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- Include primary prevention in domestic violence-related legislation and policy frameworks
- Expand the definition of family violence in legislation to include dating relationships, as well as emotional and financial abuse. Instead, use NEVR’s definition of relationship violence
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- Develop a robust data collection system to more accurately track the prevalence of domestic violence (relationship violence)
- Develop an integrated and outcomes-based management and accountability framework that supports research, evaluation and continuous improvement
- Introduce social auditing to assess cultural safety in all organizations (Wells et al., 2013)
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7. Apply social justice lens to all legislation and policy.
Action must be evidence-based and the evidence can come from multiple ways of knowing and developed collaboratively from multiple lenses. We suggest the following broad actions that are consistent with our model.
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- Approach RV as a pandemic issue (similar to COVID-19)
- Create a provincial plan to address RV using a multisectoral/multidisciplinary approach
- Implement a healthy relationship campaign
- Implement cultural safety in all interactions and structures and use social auditing to measure success
- Create hubs of (academics/service providers and community members) to formulate local policies and actions
- Utilize post-secondary faculty and students to create toolkits or synthesize literature (empirical knowing)
- Provide training using interactive learning methods that address the knowing, being and doing (brain, hands, heart) for long-term retention
- Implement programs to increase resilience across the lifespan (ie nurse-family partnership program, healthy relationships, mindfulness-based courses, and other successful courses/programs)
- Implement health hubs (registered nurse, social worker, psychologist) in schools/workplaces/community centres) to screen and provide knowledge and information across the life span
- Provide person-centred services (i.e., counselling, employment training) and housing for all experiencing RV
- Provide adequate resources and structures for the work required
- Evaluate and share programs, so they can be adapted to specific context by others
- Engage the community in learning and addressing RV
- Build on successes
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This approach includes integrating cultural safety into all interactions and organizational structures in order to create equity as well as building on successes. It requires organizations to practice the Human Rights Act and the Human Rights Code of their province.
Rothman et al. (2003) identified 74 international domestic violence intervention programs through snowball sampling. They reviewed various components such as definition, staff training effect on staff and effectiveness. Read the full report here. An excellent website for policy actions for sexualized violence can be accessed here.
Multi-Agency Approach
There is some evidence for actions for a multi-agency approach, screening and school programs. More program evidence can be found in chapters dealing with specific populations.
Benefits for clients for multi-agency working together were improved access to services, through speedier and more appropriate referral, and a greater focus on prevention and early intervention and a holistic approach (Atkinson et al., 2007). It is also the most effective and efficient (NICE, 2018). There was also support for conferences that bring the whole sector together to learn together (Cleaver et al., 2019). In BC, NEVR has some success with two models, see chapter 3.
1. The BC ICAT model brings together service providers from various sectors such as police, victim services, probation, Ministry of Children and Family Development (MCFD), transition houses and others to share information, identify risks and create safety plans for specific high-risk domestic violence cases. ICATs do not involve physically co-locating partners but instead brings a team of subject matter experts together as and when required. ICATs do not involve physically co-locating partners but instead bring a team of subject matter experts together as and when required.(EVABC, 2015).
2. The Domestic Violence Unit (DVU) model brings together social workers and support workers together with police to address high risk offenders.
In the United Kingdom, the MARAC model is the collaboration model being used (Robinson, 2013). Some challenges noted with this multi-agency model that need to be considered are the unclear roles and responsibilities, competing priorities, communication, professional and agency culture and management, including professional silos and hierarchies, and lack of training across the workforce (Atkinson et al., 2001, 2002, 2005; Cleaver et al., 2019; Gasper, 2010; Laming, 2009; O’Carroll et al., 2016; Secker & Hill, 2001; Stevens, 2013; ). Another challenge is that it has changed the culture of work from a feminist framework (power & control analysis) to that of judicial processes and bureaucratic political processes. It has resulted in dominance by the government sector over non-profit serving agencies (Harvie & Manzie, 2011). Governments control funding to non-profit organizations, and it is often men that create laws that further oppress women and the non-profit sector (Harvie & Manzie, 2011). This is consistent with what we hear from NEVR members. They would like to see a multi-agency approach, but with long-term funding, so that they can participate equally without having to worry about funding and spending hours writing grant proposals.
Screening Tools
Early identification of issues allows for more opportunities to address them. With this thought, NEVR created a screening tool for health professionals. Here is a slide presentation that shows why screening for RV is absolutely necessary and how to assess in emergency rooms, dental offices and physicians’ offices (FVPF, n.d.). Here are guidelines developed for registered nurses in Ontario that can be adapted by healthcare systems for use with all genders. Although a little bit old, 2012, it is still applicable today minus some resources that are only applicable to Ontario (RNAO, n.d.). This article in the American Family Physician journal recommends screening and provides some toolkits for screening (Dicola & Spaar, 2016).
School-based programs can be effective but NEVR members representing teachers state they are asked to take on too many social issues and there is no time for different programs. Therefore, we recommend that the teachers offer mindfulness over other programs since a meta-analysis found that these interventions decrease stress and anxiety (Dunning et al., 2018), so mindfulness may assist with improving the overall resilience of children.
Integrated Prevention Interventions
We need to address relationship violence by addressing multiple factors. The lessons for British Columbia are that we need to be aware of what works, adapt it to our context, consistently evaluate outcomes and work toward eliminating the challenges of intersectoral work. We need to focus on integrated prevention interventions that start at conception right through to death.
The following are based on many years of our own work with the service providers in BC:
a) Increase offender accountability by establishing programs and paths that must be taken to change offender behaviour
b) Use cultural safety and intersectionality approaches in all programs and by all service providers in education, health and in the justice system
c) Require collaboration and integration of services across all agencies
d) Develop a National Plan with the integration of provincial and local services in order to avoid duplication and increase efficiency
e) Require evaluation of all government-funded programs and open access to programs and evaluations through a central website
f) Implement a national media strategy to normalize gender/race equality and equitable decision making
g) Require all health care provider and teacher training to include relationship violence screening
h) Require all primary health care providers to screen for relationship violence
i) Improve housing services, so emergency shelters are available when needed
j) Develop a national help-line for relationship violence similar to 911 that is currently used for emergency services
k) Fund only evidence-based programs
l) Provide timely interpretation services by encouraging a larger bank of interpreters
m) Change the judicial system so that survivors are not re-victimized
n) Allow other models of reporting and reconciliation
o) Fund psychologists, counsellors and social workers to work with all family members who are impacted by relationship violence even if they do not press charges
p) Encourage organizations to link to this platform in order to create a useful living document that provides working knowledge.
Table 7.1 – Programs in Canada
| Agency | Program | Summary |
| Simon Fraser University | Children’s Health Policy Centre at SFU | A program developed in the United States on Nurse-Family partnerships that have been implemented in several countries has data to support that it can decrease intimate partner violence. In BC, the Nurse-Family Partnership Program is being implemented in 5 regional health authorities (Fraser Health, Interior Health, Island Health, Northern Health & Vancouver Coastal Health). |
| NEVR – Network to Eliminate Relationship Violence | Community Champion | A program that helps recognize abuse, intervene safely and get survivors to resources. It can be downloaded in English, Cantonese, Farsi and Punjabi languages. It is a bystander program based on theoretical underpinnings. It is delivered as an interactive workshop. You can obtain the PPT and scenarios by writing to NEVR@ kpu.ca. Please, use the evaluation forms for the workshops. This program is being evaluated |
| The Canadian Centre for Gender+Sexual Diversity | LGBTQ2S+ Intimate Partner Prevention Program workshop | It can be booked for free, and it will be delivered by qualified individuals. |
| Western Centre for School Mental Health | Primary Prevention of Violence Against Women and Girls | This resource contains a list of programs available for Elementary and Secondary Schools to support the prevention of violence.
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| Ending Violence Association of Canada | Ending Violence Association of Canada | A non-profit organization that has a few toolkits and links to where to get help and shelter support across Canada (Ending Violence Association of Canada, n.d.). |
| McMaster University | EDUCATE – The Centre for Evidence-Based Orthopaedics | This resources has toolkits and scoping reviews on IPV for health professionals, including program reviews |
In BC, we have the FREDA Centre for research on domestic violence against women and children (n.d.). Their report on prevention describes current practices in BC and it recommends prevention initiatives. A large scale study in the US, the Adverse Childhood Experiences Study (ACES) found that resilience against all childhood abuse and neglect and household dysfunction may just require one stable adult (Centers for Disease Control and Prevention [CDC], 2020). Engage with Dr. Nadine Burke Harris TED talk on ACES about outcomes of childhood trauma (Harris, 2014).
The development of a program whereby nurses are attached to schools to screen children is recommended. For children, nurses are a safe adult as there is no stigma attached to their role. Nurses would work with the same schools throughout so that a relationship can be established with the children, that way they can become a stable adult in a child’s life.
As nurses screen and realize that assistance is needed, they could refer to other healthcare team members such as counsellors and or social workers that need to be attached to schools. We are aware that high schools have counsellors but they are usually not trained in counselling for mental health, they mostly advise on educational matters.
Globally, there are a number of programs for children that show evidence to be effective including school-based programs. They cannot just be an hour or two long assemblies but need to be part of a comprehensive program. The parameters are outlined in What works in prevention. These programs can be duplicated/adapted around the province (Nation et al., 2003). As well, in Canada, we have a centre that addresses bullying and healthy relationship resources (toolkits, videos, books) that can be found here (PREVNet, n.d.).
Another promising practice is the emergence of Foundry Centres as one-stop shops for youth ages 12-24. Foundry is a province-wide initiative supported by the Government of British Columbia, Graham Boeckh Foundation, Michael Smith Foundation for Health Research, Providence Health Care and St. Paul’s Foundation.
There are eight Foundry Centres in British Columbia, with 11 more on the way, each providing unique resources for young people, and their families and caregivers to learn more about health and wellness. They can also access tools to manage and prevent challenges from getting in the way of their daily life. Through a team of healthcare professionals, counsellors, social workers and peer supporters, Foundry works with young people to match the support they receive to their need, whether it is for their mental or physical health, a substance use concern, or help to look for a job.
Working with over 140 partners from across British Columbia, Foundry Centres are operated locally by community organizations and are designed by young people for young people. Foundry’s vision is to provide inclusive and easily accessible services for young people, their families and caregivers by simply coming through the doors of a Foundry Centre, or by exploring their services online.
While centres such as Foundry are a good first step, supports need to wrap around young people. Students need to be screened in schools and referrals made using a well-documented tool such as the ACES questionnaire (NCJFCJ, n.d.). The higher the score, the greater the risk for substance abuse, obesity, mental health issues, missed workdays, heart disease, cancer, stroke, COPD and broken bones. Since the estimated cost of childhood abuse is almost $6 billion in Canada, we cannot afford not to act.
Pregnancy
Violence can start or be exacerbated during pregnancy. A place to begin prevention is at the time of conception. Programs for women at risk of abuse are essential. As well, interventions are necessary during the life span. In order to identify women at risk, it is key for healthcare providers to create an environment of trust and confidentiality with their patients. Tools for risk assessment are less important than creating a culturally safe environment. A health practitioner simply needs to screen and refer. Dr. Elaine Alpert, Director of Interpersonal Violence Programs, UBC states all family physicians have a responsibility to address relationship violence with their patients. They can simply use RADAR to remember.
R: Remember to ask
A: Ask directly
D: Document findings
A: Assess for safety
R: Review options, refer
F: Follow up
Dr. Alpert’s full presentation is available.
Other Resources and Programs
Trauma is experienced by individuals and by communities, affecting health and economics. The Prevention Institute (n.d.) provides a framework for protecting against community trauma that includes the need to “improve community health and wellness and resist the pressures of gentrification and dislocation“ (p. 7) by providing education and access for all people. For details, read the complete report summary.
Knowing about successful programs is useful, and evaluations are a great way to check if a program brings positive, negative or even no results to the community to which it has been applied. Among many programs, we bring an overview of four programs assessed, two in Canada and two in the United States. You can see the results in the link program evaluation full report. Three (Fourth R, Safe Dates and Youth Relationships) of the four programs were successful in decreasing physical dating violence. “All three significantly reduced physical violence, while Safe Dates also significantly reduced sexual violence and emotional abuse. Only Ending Violence failed to reduce dating violence perpetration” (Children’s Health Policy Centre (2013).
British Columbia government and a number of agencies have also created a toolkit for childhood exposure to relationship violence in the early years, 0-5. It covers statistics, legislation and reporting abuse and leaving an abusive relationship.
A number of toolkits have been created by NEVR for prevention. Using the whole community response model, the Community Champions Toolkit (NEVR, n.d.) provides statistics and explains the scope of the issue and how to identify, respond and get individuals to resources. This is a secondary prevention toolkit because you identify someone who is being abused and implement strategies for further prevention. The Network to Eliminate Violence in Relationships (NEVR) created a toolkit for health professionals (Etheridge et al., 2014). As well, several screening tools can be found on the NEVR website.
NEVR has also created a theory based toolkit: Peer to Peer Manual: Healthy Relationships, Sexual Health, Drug Abuse, and Internet Safety (Sahota et al., n.d.). KPU nursing students worked with Safe Schools in Surrey staff Nancy Smith and KPU Nursing Faculty Balbir Gurm to create and test the toolkit. It was tested with the girls for ease of use and is currently being implemented in a Surrey School by leadership students. Evaluation data for long-term effectiveness is pending.
In addition, NEVR member Stroh Health Care in collaboration with the Ministry of Public Safety and Solicitor General and the Ministry of Education created resources called Respectful Futures based on the Respectful Relationships program. It is a BC Corrections, Ministry of Public Safety and Solicitor General program that has had success with male perpetrators of RV. Just like the Peer to Peer Manual above, the evaluation data is pending. They can be accessed at Respectful Futures (n.d.).
A network of NGOs, trade unions and independent experts have created a blueprint to create a national strategy (Canadian Network of Women’s Shelters & Transition Houses, n.d.).
It is recommended that everyone advocate for a national plan and a national media prevention strategy.
Table 7.2 – Governmental Relationship Violence Resources in Canada
| Agency | Resources | Summary |
| Funded by Public Health Agency of Canada, located at McMaster University) | National Collaborating Centre for Tools and Methods | Health EvidenceTM – It has systematic reviews on various health topics including RV across the lifespan.
Evidence-Informed Public Health – It has the best available evidence-based on research, context and experience to inform practice and policy. |
| Funded by the Public Health Agency of Canada, located at the University of Northern BC | National Collaborating Centre for Indigenous Health | It has the best available evidence for Indigenous health. It has many resources in print and multimedia formats. |
| Funded by the Public Health Agency of Canada | National Collaborating Centre for Determinants of Health | It has resources on promising practices for creating equity in health. It also has public health training for equitable systems change |
| Government of Canada | For help dealing with family violence | This site has how to recognize abuse, get help for others or yourself, and how to plan for safety and find services in your area (Government of Canada, 2014a). |
| Government of Canada | Family Violence Initiative | Defines family violence and provides statistics, impact and tools to address RV. Thirteen agencies/departments within the federal government work together on this initiative. It is a website with links to other websites. (Government of Canada, 2014b). |
| Government of Canada | Resources for professionals | Has several brochures in different types of violence (Government of Canada, 2018a). |
| Government of Canada | Promoting safe relationships | Information on effective programs (Government of Canada, 2017a). |
| Government of Canada | Funding opportunities | Current funding opportunities on RV (Government of Canada, 2018b). |
| Government of Canada | What provinces and territories are doing | Plans that each province has for addressing RV Government of Canada, 2017b). |
Table 7.3 – Resources to Address Relationship Violence outside Canada
| World Health Organization | School-Based Violence Prevention Program: A practical handbook | This handbook provides a step by step approach on whole school-based programs and identifies ways to address implementation barriers. |
| World Health Organization | INSPIRE: Seven Strategies for Ending Violence Against Children | Developed by the World Health Organization (WHO) with multiple other agencies using the best available evidence to address violence for 0-17. It outlines 7 strategies to prevent violence against children. |
| World Health Organization | INSPIRE Handbook Action | Developed by WHO (2016) for implementing the seven strategies for ending violence against children based on the best available evidence. |
| Hazelden Betty Ford Foundation | Safe Dates | A free program that prevents dating violence. This program is available in many states California, Minnesota, Oregon, Illinois, New York, Florida, Massachusetts, Colorado and Washington. |
| National Institute of Justice | Shifting Boundaries | A program designed for 10 to 15 years old to reduce dating violence and harassment. It is free of charge and has at least one random controlled trial that shows effectiveness. |
| National Institute of Justice | Bringing in the Bystander | Aims at changing attitudes and having individuals. It is similar to Community Champion. |
| Committee for Children | Second Step Social-Emotional Learning | Social-emotional learning program for preschool to middle school with evidence to help create healthy relationships and successful students. It has a cost. It also has bullying prevention programs. |
| Coaching Boys into Men | Coaching Boys into Men | A free program that uses coaches to influence the thoughts and actions of young boys. |
| Prevention Innovations Research Center | UsafeUS | An app that can be used by the university so the students can have resources on their phones. |
| Prevention Institute | The Adverse Community Experiences Framework | It provides an understanding of how structural and community violence that impacts relationship violence can be addressed. The symptoms of community trauma are present in the social, physical and economic environment and need to be addressed. In the socio-cultural domain, it builds on community assets and needs to create connections between youth and adults. This builds resilience and prevents relationship violence. In the physical/environment domain, there is a need to create positive spaces and transportation for community members to interact. |
Indigenous People
One vulnerable group to experience RV is Indigenous peoples. As well as a National Collaborating Centre for Indigenous health, there is the National Aboriginal Circle Against Family Violence (see below). Governments are starting to address this population and a number of resources have been funded. You can read more about Indigenous populations and RV in chapter 19.
The National Aboriginal Circle Against Family Violence (Canada) has created a number of resources, find the link and description from their website:
ANANGOSH: Legal Information Manual for Shelter Workers
This manual is designed to help Indigenous women and service providers address key aspects of violence, as well as understand Indigenous women’s legal rights on matters related to leaving a violent relationship. It discusses legal tools for women’s safety and provides information about relevant legal protections. The manual begins with an explanation of the rights-based framework to addressing violence against Indigenous women, and of the historical and social context that impacts Indigenous women in Canada.
Resources for Shelter Workers Providing Services to First Nations Women
This document is intended for the use of shelter workers who provide services to First Nations women in Canada. The document details legal services, provincial/territorial government services, INAC regional branches, provincial/territorial Human Rights commissions, and general resources.
Ending Violence In Aboriginal Communities:
Best Practices In Aboriginal Shelters and Communities
A summary report based on consultations with twelve on-reserve women’s’ shelters from across the country. In addition to best practices, the report also considers barriers and challenges, shelter profiles, observations and conclusions.
Addressing Funding Policy Issues:
INAC Funded Women’s Shelters
A study that explores how funding flows to on-reserve women’s shelters, and the challenge that directors and staff face in accessing all of the funding that is designated for the shelter.
Responses from Aboriginal Women in Seven INAC-Funded Shelters
Regarding Matrimonial Real Property (MRP)
Findings and recommendations on the complex issue of the equitable division of Matrimonial Real Property (MRP) during a marital break-up, based on consultations with 42 participants (staff and clients) from 7 INAC funded women’s shelters.
Policies and Procedures – Guidelines for Shelters
A reference guide to assist shelters to develop a Policies and Procedures Manual to facilitate the development, design, planning and delivery of services to women and their families. Includes examples and suggestions for operations policy, human resources, financial procedures, safety issues and other issues that might be faced in the work environment.
Financial Skills and Literacy (Draft)
A draft workbook designed to assist Aboriginal women in shelters to learn the tools they need to become financially self-sufficient. It approaches financial topics in a culturally appropriate manner, ranging from the very basics (e.g., opening a bank account, using a debit card) to budgeting and setting financial goals (Note: Publication not available as a download. Please contact NACAFV to order a copy.).
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Ference, J. (2018, January 15). The neurological impact of trauma. The Ending Violence Association of BC. [Video]. YouTube. https://www.youtube.com/watch?v=hrp1uNWZWbY
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