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Departments & Programs,UW Medical Foundation,Patient Resources,Social Work Services Quick Guide,Social Work Manual,Abuse and Neglect,Domestic Abuse

Presentation by Betsy Abramson

Presentation by Betsy Abramson - Departments & Programs, UW Medical Foundation, Patient Resources, Social Work Services Quick Guide, Social Work Manual, Abuse and Neglect, Domestic Abuse

Focus

Domestic Violence: The Role of Health Care Providers

Betsy Abramson, Health Care Project Consultant
Wisconsin Coalition Against Domestic Violence
12/30/2008

Victims’ Voices

The first time physical violence happened I thought it was my fault. I thought there was sin in my life that wasn’t confessed -- Janet

I struggled with the issue of forgiveness. I thought I had to forgive my husband – Delia

Definition of Domestic Violence

Dynamics and Tactics of Abuse

Health Impact on Victims

Indirect Health Impact on Victims

DV General Statistics

Incidence of DV in Health Care Settings – PRIMARY CARE

Incidence of DV in Health Care Settings – EMERGENCY ROOM

WRONG QUESTION!

Why doesn’t she just leave?”

RE-FRAME

What are the barriers to her living free from abuse?”

What can we do to help her reduce and overcome the barriers to her living free from abuse?”

Barriers – General

Add’l Barriers–Rural Settings

RED FLAGS

Medical

Behavioral

Health Care Providers Can

Goals in Asking and Responding

Health Care is Not a Neutral Encounter

Barriers to Screening in Clinic

Role of Health Care Provider

Tips for Asking about Abuse

Screening Questions for DV

Start with opening statement

Then get more specific

DO NOT

DO NOT escalate her danger or increase her entrapment

When “No” is the answer but you suspect...

Always leave the door open and express concern

“I have talked with many women who are embarrassed to tell me they have been hit (hurt), and I understand that. I just want you to know that if you are ever hurt or scared it’s okay to tell me about it. I want you to know that I am a safe person to talk to.”

“Thanks for letting me talk with you about it. If you ever have any questions, I’m always available and I want you to know we have information available as well.”

TOP MESSAGES when patient DISCLOSES ABUSE

Assessment of Domestic Violence

■ Listen ■ Believe ■ Affirm ■ Offer help ■

Help her:

Offer Immediate Assistance

Ask what you could do to help her right now.

Don’t be surprised if her immediate need relates to an errand, child care, banking, the farm, transportation, or something else that appears unrelated to the abuse. Help her.

Interventions for Domestic Violence

Basic Safety Planning for Victims

Discuss safety planning:

Intervention for Domestic Violence

Understand Law Enforcement Role

Defining Success

Domestic Abuse Hotlines

Agency Resources

Resources

Nurses Danger Assessment Tool

Nurse Assessment Tool

Pocket Card Assessment Tool

Patient Safety Card