The clinic of abuse: The gift paradigm and public policy

Casagrande, Alice

The clinic of abuse: The gift paradigm and public policy - 2022.


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A multidisciplinary team providing home care for older people suffering from psychiatric disorders were confronted with family conflicts and situations of mistreatment during their work. But this process did not make the resolution of these situations any easier. This led practitioners to use the contextual approach to try to guide families toward new resources and solutions to end abusive situations. Linking this clinical, intersubjective method to public policy is no easy matter, as the two spheres seem hardly compatible at first. However, the Anti-Abuse and Person-Centred Care Commission deliberately used a consensus-building approach aiming to establish a shared definition of abuse with this clinical concern. To this end, the article was written in two voices. First, the commission gathered all stakeholders and took great care in working through all forms of contradictions and conflicts during the consensus-building process. Second, the commission included, at all steps of the process, the voice and concerns of persons who, in a situation of vulnerability, were most likely to suffer from abuse, or who had experienced it. This led to a definition of abuse which, far from erasing the necessity of clinical multidimensional analysis when a situation of abuse is identified, gives it a solid basis, a common set of definitions, that facilitates shared knowledge which always proves extremely useful in the fight against abuse against older persons.

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