What if medicine is trained to see bruises and fractures—but misses the injuries that leave no visible mark?

In this episode of Partnered with a Survivor, David and Ruth speak with Dr. Norell Rosado, child abuse pediatrician at the University of Wisconsin School of Medicine and Public Health, about the limits of how child maltreatment is identified in medical settings. While bruises and broken bones often drive diagnosis, neglect remains the most common form of maltreatment—and many serious harms leave no outward sign.

Together, they explore how time pressure, fear of court involvement, bias, and incident-based thinking create dangerous blind spots. We discuss shifting to a pattern-based approach that looks beyond single events to identify ongoing harm—including domestic abuse and coercive control that disrupt a child’s health, development, and safety.

Dr. Rosado unpacks how perpetrators interfere with children’s care: undermining medical advice, disrupting therapy, restricting access to food or transportation, and sabotaging a protective parent’s ability to follow through. We ask a question rarely built into clinical assessments: Is anyone interfering with this child’s care?

From traumatic brain injuries without bruising to emerging research on epigenetics, this episode reframes child maltreatment as more than a clinical issue—it is a multigenerational public health emergency.

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Now available! Mapping the Perpetrator’s Pattern: A Practitioner’s Tool for Improving Assessment, Intervention, and Outcomes The web-based Perpetrator Pattern Mapping Tool is a virtual practice tool for improving assessment, intervention, and outcomes through a perpetrator pattern-based approach. The tool allows practitioners to apply the Model’s critical concepts and principles to their current case load in real

Check out David Mandel's new book Stop Blaming Mothers and Ignoring Fathers: How to Transform the Way We Keep Children Safe from Domestic Violence.

Visit the Safe & Together Institute website.

Start taking Safe & Together Institute courses.

Check out Safe & Together Institute upcoming events.

We start with a snow-bright morning and end with a sharper lens. We sit down with advocate and system analyst Valerie Frost to explore how systems built to protect families can become tools of coercive control—and how to change that trajectory with better listening, precise language, and survivor-centered practice. Valerie traces the everyday realities of child welfare, family court, schools, and law enforcement, showing where checklists fail, how jargon shuts doors, and why knowledge inequity forces survivors to learn a foreign language just to get help.

We dig into visible versus invisible harm and why non-physical abuse or coercive control often gets dismissed or misread, leaving anxiety and hypervigilance weaponized against the survivor. From “customer service” logic for public systems to the risks of records, we examine how police calls and protection orders can be turned against survivors, and how both over-engagement with systems and system hesitancy get blamed. The conversation moves from critique to action: validating protective parenting, centering context over compliance, and anchoring assessments in the perpetrator’s pattern rather than the survivor’s reactions.

Valerie shares practical tools—build a dated log, control your narrative with consistent documentation, protect your basics like sleep and hydration—and argues for policy shifts that mandate recognition of coercive control, limit unnecessary information sharing, and reward restraint over surveillance. We also talk about showing up whole: professionals who are survivors, survivors who lead, and creating rooms where the end user defines engagement.

The takeaway is simple and demanding: Systems don’t need more policies as much as they need better listening; survivors have already mapped where harm happens.

If this conversation resonates, subscribe, share it with a colleague or friend, and leave a review so more people can find survivor-centered guidance that actually helps.

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Now available! Mapping the Perpetrator’s Pattern: A Practitioner’s Tool for Improving Assessment, Intervention, and Outcomes The web-based Perpetrator Pattern Mapping Tool is a virtual practice tool for improving assessment, intervention, and outcomes through a perpetrator pattern-based approach. The tool allows practitioners to apply the Model’s critical concepts and principles to their current case load in real

Check out David Mandel's new book Stop Blaming Mothers and Ignoring Fathers: How to Transform the Way We Keep Children Safe from Domestic Violence.

Visit the Safe & Together Institute website.

Start taking Safe & Together Institute courses.

Check out Safe & Together Institute upcoming events.

What happens when David turns the tables on Ruth and interviews her—seven years into their shared body of work?

In this special anniversary episode, David marks seven years since Ruth joined the Safe & Together Institute by stepping into the interviewer role. This is a founder-level conversation about vision, values, the hard work of scaling, and how systems actually change when lived experience is treated as critical professional expertise—not an add-on.

Ruth traces her journey from working with medical practitioners to helping transform Safe & Together from a training organization into a systems-change engine. She shares the deeper vision behind that shift: embedding domestic abuse–informed, trauma-informed, child-centered practice into the real operating conditions of systems through values-aligned leadership, business rigor, and strong operations. A central theme is supporting frontline workers—how poor practice, rigid forms, siloed communication, and unrealistic mandates make ethical work harder, and how better systems design can reduce moral injury and make good practice more sustainable.

Ruth also introduces the Credible Expert approach, embedding diverse, system-literate survivors as compensated contributors to design, strategy, and decision-making. Together, they offer an unflinching critique of “reduce removals” initiatives and explain what meaningful reform actually requires.

Looking ahead, they introduce SafetyNexus, a technology platform designed to coach practitioners, map perpetrator patterns, strengthen documentation, and streamline workflows—without replacing professional judgment—while centering survivor governance from the start.

This episode is both a milestone and an invitation to keep building systems that save lives and save money.

Please follow us, share this episode, and send us your comments.

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Now available! Mapping the Perpetrator’s Pattern: A Practitioner’s Tool for Improving Assessment, Intervention, and Outcomes The web-based Perpetrator Pattern Mapping Tool is a virtual practice tool for improving assessment, intervention, and outcomes through a perpetrator pattern-based approach. The tool allows practitioners to apply the Model’s critical concepts and principles to their current case load in real

Check out David Mandel's new book Stop Blaming Mothers and Ignoring Fathers: How to Transform the Way We Keep Children Safe from Domestic Violence.

Visit the Safe & Together Institute website.

Start taking Safe & Together Institute courses.

Check out Safe & Together Institute upcoming events.