Standard of Care with Domestic Violence
1. At “first” suspicion or client statement about concern of possible domestic violence:
Give local emergency number of women’s shelter program. Teach client safety plan, i.e. pack small bag/case with extra set of keys, extra set of clothes, money, medications, important papers and anything else deemed important. Have client place bag somewhere outside of house so can grab it quickly, if needed. Tell client not to park her/his car so that car can’t go both ways- forward or backwards. If parked in front of garage, car can only go one way and client would be trapped. Have client either call women’s shelter or a safe friend’s house. I give client a card that Victim Witness provides describing DV and resource numbers. It fits into client’s wallet like a credit card. (I have had both female and male clients that I have done this with. I actually have one male client whose wife was given three years probation and one year batterer’s group therapy.)
2. Assess history of any type of abuse with current partner. Assess current level of potential violence or actual violence. Inform client of Emergency Restraining Order good for 30 days, can be issued on the spot by law enforcement if feel in danger. (Some officers give client a hard time, almost have to have blood and tissue before they will do it.) Officers will not offer it, client has to request it. Tell client to call “911” if feels is in physical danger.
3. Educate client about domestic violence types: intimidation, punching walls, throwing things, trapping so cannot leave, marital rape, cuts off access to any funds, etc. Biblio-therapy. Cycle of violence-tension building-explosion-honeymoon.
4. Educate client that “most” dangerous time for violence is when client decides to leave or when pregnant. Stress the potentiality for lethality at that time.
5. Ask client if any weapons are in the house. If so, either remove or if a gun, get firing pin removed. If fearful of perpetrator’s reaction, client can ask perpetrator to have them held for safety at Sheriff’s Department or mutually agreed upon safe friend who will agree not to release weapons to perpetrator.
6. Refer and connect client with support group at local women’s shelter so won’t feel so alone.
7. Inform client of Temporary Restraining Order Clinic at Center for Alternatives to Domestic Violence. It is free, and held monthly.
8. Couples therapy is contraindicated because unless this couple is violence free for one year, then the couples therapy can increase the potential for violence. This is the current Standard of Care.
9. If client decides to leave the relationship, inform client it would be wise to take different routes to work, shop for groceries at a different store, etc. Remind that if gets restraining order, it is only as good as whether the client consistently uses it. That if perpetrator violates order, client will call police.
10. Explore client’s family-of-origin history of violence. Explain to client that without intervention, the violence only gets worse. Teach boundaries/give assessment “how bad was your abuse.”
11. As therapists, we are not allowed to report domestic violence, unlike our requirement for child abuse. All we can do is give the women’s shelter emergency number, help the client do a safety plan, and increase support.
12. Most individuals in a situation of domestic violence try to leave the relationship several (about seven or eight) times. Often they go back to the perpetrator. Our job is to not shame them, or give up on them, but to normalize the situation. If we don’t, they won’t come back to therapy. These are extremely difficult clients to work with, as we may wonder why they don’t leave and unconsciously give them that message. We just need to continue to provide support for them.