Revised 02/2001; 4/2004; Revised 06/2005, 3’08; Reviewed 09/2007, Revised 10/2009, 6/13, Reviewed 10/10, 10/11
ECHO Community Health Care, Inc.
Policy and Procedure
DOMESTIC VIOLENCE – Protocol for Family/Intimate Partner Violence
PURPOSE: To establish guidelines which provide individuals experiencing domestic violence with education regarding the resources available within the community, assistance with utilizing those services, and assistance notifying the authorities upon request of the patient.
POLICY: It is the policy of ECHC to provide comprehensive primary health care and case management services to individuals who are experiencing domestic violence.
DEFINITION:
Domestic Violence – A pattern of coercive, manipulative behavior used for the purpose of gaining power and/or control over an intimate partner. Physical abuse, verbal abuse, sexual assault, and emotional abuse are types of domestic violence. Individuals from all income levels and cultural backgrounds may experience domestic violence. Domestic violence is rarely a single, isolated incident.
CHARACTERISTICS OF VICTIMS OF DOMESTIC VIOLENCE
§ Unexplained injuries
§ Frequently ‘sick’
§ Fear of intimate partner
§ Feels that he/she does not deserve better
§ Blames self for abuse
§ Accepts responsibility for partner’s actions
§ Accepts responsibility for maintaining the relationship despite the perpetrator’s actions
§ Spends much energy trying not to anger partner
§ Is secretive about the problems in the relationship
§ Relationships with family and friends are lost
§ Continually hopes that things will get better and that partner will change
§ Feels guilty, depressed, angry, and worthless due to partner’s actions
§ Has to constantly account for every action to partner
§ Children either cling to him/her or treat him/her disrespectfully
§ The abusing partner speaks for the victim, hovers, and might not want to leave the partner alone with a health care provider.
GUIDELINES FOR INTERVIEWING VICTIMS OF DOMESTIC VIOLENCE
§ Do not ask about the suspected domestic violence in the suspected perpetrator’s presence
§ Actively listen
§ Ask direct questions
§ Believe him/her
§ Don’t be judgmental
§ Assess for injuries and safety
§ Help dispel myths about abuse
§ Validate the patient’s feelings
§ Don’t tell the patient what to do
§ Ask the patient what he/she wants
§ Provide referrals to police, shelters
§ Help develop safety plan
§ Empower the patient by respecting his/her choices
§ Don’t try to persuade the suspected perpetrator to be nonviolent
§ Do not intervene in a violent episode
PROCEDURE:
A. ECHC provider reviews the history of the patient and provides treatment for injuries and illnesses as necessary. If domestic violence is suspected, a social work referral is made. Ensure patient’s safety within the clinic.
B. Patient is referred to social worker for assessment. Supportive counseling is provided, as necessary.
C. If patient is a minor or an endangered adult, the social worker makes appropriate APS/CPS report.
D. If the patient is neither a child nor an endangered adult, the social worker explains the importance of documenting the abuse allegation with the police department. The social worker then assists the patient in notifying the police upon the consent of the patient.
E. Social worker reviews community resources and counseling options for victims of domestic violence.
F. Social worker facilitates domestic violence shelter placement or counseling appointment as needed.
G. Social worker reviews safety planning and the importance of it.
H. Patient to follow up with the social worker as needed.
LOCAL RESOURCES
Both of these agencies provide a 24 hour crisis line, emergency shelter, counseling, support groups, legal advocacy, and community education.
Albion Fellows Bacon Center 422-5622
YWCA 422-1191
SAFETY PLANNING
SAFETY PLANNING IS NOT MANDATORY. In order for safety planning to be effective, a suspected victim must be genuinely interested in learning how to manage his/her fear and anger in order to protect him/herself and his/her children from violence.
SAFETY PLANNING DOES NOT MAKE ENCOUNTERS WITH THE PERPETRATOR SAFE. Safety plans may reduce risks and may empower individuals to effectively act for themselves. Safety planning is no guarantee of safety; therefore, any failure of a safety plan is not the fault of the person who designed the plan. All violence is solely and exclusively the choice of the violent individual and no one can anticipate every choice the batterer may make.
SAFETY PLANNING REQUIRES CONSTANT EVALUATION AND REVISION. Safety plans must be continually redesigned as circumstances change or when any part of the plan fails.
SAFETY PLANS FOCUS ON WHAT A PERSON IS ABLE TO DO TO STAY SAFE. Only the person can decide what might work for him or her. The victim is the only one who knows his/her capabilities and circumstances. What works for one individual may not work for another.
SAFETY PLANS MIGHT INCLUDE:
§ How to avoid the batterer at home, school, work, at the store, in the car, etc.
§ A telephone list of safe people to call, on speed dial if possible
§ Sharing a ‘code word’ with others which alerts them to your need for help
§ Having a ‘code word’ with children for what they should do
§ How to reach 911 – location of pay phones, change or calling card, etc.
§ Group safety when children are involved
§ Escape routes, including unlocked doors and windows
§ Methods for keeping yourself between your escape routes and the batterer
§ Keeping a cordless telephone near you
§ Hiding what you may need in an accessible location outside your home
§ Providing copies of important papers to a friend or neighbor
§ Keeping car keys accessible at all times, in more than one location
§ Removing all weapons or potential weapons from the home if possible
§ Calming techniques for dealing with an intoxicated or ‘high’ batterer
Are YOU in an Abusive Relationship?
ARE YOU…
q Sometimes frightened by your partner’s behavior?
q Afraid to disagree with your partner?
q Afraid to leave your partner or break up with him/her?
DO YOU…
q Feel you must justify your actions to avoid your partner’s anger?
q Avoid social gatherings because you are afraid of how your partner will act?
q Apologize for your partner’s behavior towards you?
q Feel like your relationship is on a ‘roller-coaster’ of tension followed by anger or meanness, followed by romance or apologies?
HAS YOUR PARTNER…
q Made you feel like things are your fault, no matter what you do?
q Discouraged you from seeing family or friends?
q Acted jealous or suspicious for no reason?
q Put you down or insulted you repeatedly, in private or to others?
q Scared you or threatened you or those you care about?
q Purposely frightened you when he was driving?
q Ever purposely destroyed, or threatened to destroy, objects you love?
q Shown a totally different personality to others than he shows to you?
q Hit, kicked, shoved, choked, grabbed, or thrown things at you?
q Insisted or forced you to perform sexual acts against your wishes?
If you have answered yes to ANY of these questions, it is time to
check your relationship. If you have any issues of concern please
discuss this matter with your provider or ask to see a social worker.
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Section 4-6