Domestic Violence

What to do if a Woman Discloses?

Many practitioners fear disclosure as they do not fell that they have the tools to "treat" the problem. The role here is supportive not curative: the task is to validate the woman's experience and find out what she wishes to do. Try to ascertain her level of risk for serious harm and ensure she knows how to contact the appropriate resources if she does not wish to access them immediately. Follow-up visits should be arranged for ongoing care if the woman wishes.

1. Respond to the disclosure
   • "I'm glad you told me that".
   • "How are you coping?"
   • "How can I help you?"
   • "Have you spoken to anyone about this before?"
   • "Did this happen recently or in the past?"
2. Provide non-judgmental support - whether she returns to her partner or not
3. Remind her that she is not to blame.
4. Name the violence as abuse
5. Assess safety
6. Establish safety of the children
7. Provide clinical care
8. Document findings
9. Help the woman develop a safety plan
10. Provide information on community resources and the options-legal and other that she has.
11. Ask if she would like to speak to a social worker.
12. Refer for ongoing counselling at any time if she wishes.
13. DO NOT refer for couple counselling (Ferris, p.42) AMA says it leads to escalation of violence. (Ibid,p38/
14. Do not share information if both partners are your patients.
15. Instruct your staff not to leave messages with partner or on home answering machine. (Ferris, p.42)

NB: If child abuse is disclosed, health professionals have an obligation to notify child protection authorities.

Find out what your legal obligations are to notify protection agencies when child witnesses to abuse are identified in your province.

Dealing with women who remain in abusive relationships

1. Remain empathic and don't blame the patient for the abuse.
2. Acknowledge your own feelings about caring for a person who is not leaving an abusive situation.. It is important that these feelings don't interfere with you ability to care for the victim.
3. Recognize and acknowledge the violence and express concern for her safety.
4. Time, reinforce the idea that no one deserves to be abused.
5. Give her educational material and information on community resources.
6. Offer her referral for individual counseling and for shelters/community resources.
   Ferris, p.45.

Last Modified: September 5, 2006