Understanding Domestic Violence ______________________________________________________________
In healthcare settings, screening for domestic violence should be culturally sensitive, considering the client’s cultural back- ground and environment. Interviewers need to be well-versed in the social norms of their clients’ groups and trained to avoid cultural stereotypes and specialized terminology. Effective screening for domestic violence often involves provid- ing concrete examples and hypothetical scenarios rather than vague, abstract questions. Focusing questions on the behavior of the client’s partner can help alleviate any discomfort they may have in discussing themself directly. However, interviewers should be cautious not to disparage or criticize the perpetrator, as this could lead the abused client to defend them and inad- vertently take on the role of their ally (Center for Substance Abuse Treatment, 1997). The setting in which sensitive questions about home life are asked is crucial. Privacy, trust, and respect are essential for obtaining candid responses to screening questions, especially since survivors may feel unable to disclose the full extent of their abuse for various reasons. It is imperative for treatment staff to recognize that question- ing a client about domestic violence should always be done in private, regardless of whether the client requests the presence of another person. This is because batterers may manipulate friends or family members into relaying information heard during the interview, putting the client at risk of harm. Ques- tioning the client in the presence of the abuser can pose seri- ous danger and hinder accurate information gathering from the survivor (Center for Substance Abuse Treatment, 1997). EDUCATION AND TRAINING Initiating intervention involves grasping the intricacies of power dynamics and coercive control within abusive relation- ships. Training sessions facilitated by specialists and advo- cates offer valuable insights for effective intervention. Such educational initiatives enhance practitioners’ proficiency in screening and intervening. Furthermore, ongoing medical education (CME) focuses on IPV serves as a complementary resource to training efforts (American Medical Women’s Association, 2023). SCREENING AND ASSESSMENT Incorporate straightforward procedures into practice to screen every patient for domestic violence. These may entail utilizing evidence-based questionnaires and routinely posing open-ended inquiries. Presently, the United States Preventive Services Task Force (USPSTF) advises screening for women of reproductive age, with additional consideration for older or vulnerable adults, women not of reproductive age, and men. Alarmingly, a study discovered that over 60 percent of clini- cians never broached the subject of abuse with older adults.
USPSTF is currently revising this guidance, underscoring the necessity for further research. If utilizing written questionnaires, it’s imperative not to distrib- ute them to the patient’s home or display them in the waiting room, where potential abusers may be present. Practitioners can directly inquire whether patients feel safe or threatened by their partner or subtly pose questions that may unveil personal circumstances. If there’s a possibility that the person accom- panying the patient could be the perpetrator, practitioners should separate the patient to conduct screening inquiries. These questions might delve into the patient’s feelings about personal relationships and any stressors they may face at home or work (American Medical Women’s Association, 2023). Consider utilizing such tools to determine when and how to intervene. Risk assessment aids the healthcare team in deter- mining whether immediate action is necessary or if long-term, consistent follow-up is warranted. Risk assessment tools like the Danger Assessment help gauge the immediate danger faced by the patient. Healthcare professionals may face time constraints, which could impede or prevent screening and risk assessment. In such cases, involving other staff members to assist in these processes can prove invaluable. PATIENT EDUCATION Utilize waiting room resources and restroom signage to dis- seminate information about hotlines and access to support services. Recommend that patients store resource information under a pseudonym, such as a doctor or a friend, enabling them to seek help on their own terms. This approach ensures that patients who are not yet ready to disclose IPV) to a practitioner or their team can still access resources discreetly (American Medical Women’s Association, 2023). Create a Safe Environment Establish a nonjudgmental environment where patients feel safe sharing their experiences of domestic violence, and ensure your staff is trained accordingly. Provide the necessary time, space, and silence for patients to feel comfortable being vulnerable and disclosing whatever information they choose. Avoid pressuring them to leave their relationship or disclose details they’re not ready to share. Instead, focus on listening, validating their experiences, and supporting their decisions to take action or not. It’s crucial that intervention is led by the survivor, as they are best equipped to assess their level of danger, and respecting their autonomy is paramount to their protection. Unless mandated by law, refrain from reporting to law enforcement without the survivor’s consent (American Medical Women’s Association, 2023).
68
EliteLearning.com/Psychology
Powered by FlippingBook