Pathways To ChangeRefraining and Responding to Violence against Women Health care Professionals are among the first person to whom a victim of abuse will turn for help. This present a significant opportunity to offer effective, timely interventions that help victims regain a sense of control over their lives. Assessment begins with a patient-centered interview conducted in a place that affords privacy. Regardless of why a woman has stayed in an abusive relationship or whether she has tried to leave, most battered women talk frankly about their predicament in the context of a supportive and confidential interview. Full assessment include: Assessment should differentiate long-standing personality disorder or psychiatric disease from adaptations to the situational stress of a battering relationship. Suicide is also a risk that must be weighed, particularly if there are previous suicide attempts or the women is severely depressed, anxious about the fate of her children and isolated from friends or family, or feels "trapped." Confidentiality in all aspects of working with battered woman is a precondition to implementing a safety plan. The objectives are to review the woman's priorities in relation to available options and resources. Facilitate the implementation of a safety plan for the woman and her children, and plan for ongoing support. Designed for short-term crisis intervention — the battered woman's shelter meets the need for safe housing and can usually offer counseling around violence, housing child care and advocacy with the legal, social service and welfare systems. When serious psychiatric conditions are present, an appropriate discharge plan includes psychiatric evaluation and referral. If mental health professionals and services are unfamiliar with the special issues posed by domestic violence, continued advocacy may be needed, to ensure the patient's safety . Help is available and health care providers can help her contact the services. Help by these three simple steps: AAA — Ask-Assess-Advocate. Interventions around woman battering should not be confused with strategies used to resolve family "conflict" such as couple's counseling or parenting education. The empowerment strategies appropriate with battered women differ markedly from the protective service orientation that characterized intervention with the vulnerable populations of children or the elderly. Planning for safety with battered women often includes women's groups, ongoing physical therapy, changing jobs, continuing education, applying for emergency assistance, counseling for children and working with child and/or adult protective services and programs for the disabled. The success of each stage of the process — identification, assessment, the formulation of a safety plan, and referral, depends on follow up through each stage. Monitoring and feedback, including follow up to determine, what has actually changed in relation to what a woman hopes to gain through each step in her plan. Even if things go badly after discharge, as they may, the sense of control a woman gains from identifying her problem, and developing a plan to mange it, is a significant step toward her recovery. |