1.Todetermineifsomeonehasendureddomesticviolence,lookfor physicalinjuries,especiallypatternsofuntreatedinjuriestotheface, neck,throat,andbreasts.Otherindicatorsmayinclude
•Inconsistentexplanationsforinjuriesandevasiveanswerswhen questionedaboutthem
•Complicationsinpregnancy,includingmiscarriage,prematurebirth, andinfantillnessorbirthdefects
•Stress-relatedillnessesandconditionssuchasheadache,backache, chronicpain,gastrointestinaldistress,sleepdisorders,eating disorders,andfatigue
•Anxiety-related conditions, such as heart palpitations, hyperventilation, andpanicattacks
•Asad,flataffectortalkofsuicide •Historyofrelapseornoncompliancewith
substanceabusetreatmentplans
2.Alwaysinterviewclientsaboutdomestic violenceinprivate.Askaboutviolenceusing concrete examples and hypothetical situations ratherthanvague,conceptualquestions. Screeningquestionsshouldconveytosur- vivorsthatnobatteringisjustifiedandthat substanceabuseisnotanacceptableexcuse forviolentbehavior.
3.Assoonasitisclearthataclienthasbeenor isbeingbattered,domesticviolenceexperts shouldbecontacted.
4.Theprovidershouldcontactaforensics experttodocumentthephysicalevidenceof battering.
5.Referralsshouldbemadewhenever
appropriateforpsychotherapyandspecial- izedcounseling.Stafftrainingindomestic violenceisimportantsothatsubstanceabuse treatmentcounselorscanrespondeffectively toadomesticviolencecrisis.
6.A survivor of domestic violence who relocates toanothercommunityshouldbereferredto theappropriateshelterprogramswithinthat community.
7.Becausebatterersintreatmentfrequently harasstheirpartners(threateningthemby phone,mail,andmessagessentthrough approvedvisitors),telephoneandvisitation privilegesofbatterersandsurvivorsin residentialsubstanceabusetreatment programsshouldbecarefullymonitored. 8.Thediscussionoffamilyrelationships,which
is an element of all substance abuse screening interviews,canbeusedtoidentifydomestic violenceandgaugeitsseverity.
9.Agoodinitialquestiontoinvestigatethe possibilitythataclientisabusingfamily membersis,“Doyouthinkviolenceagainsta partnerisjustifiedinsomesituations?”A third-personexamplemaybeused,followed
byspecific,concretequestionsthatdefine theextentoftheviolence:
•Whathappenswhenyouloseyourtemper? •Whenyouhit(person),wasitaslapora
punch?
•Doyoutakecarkeysaway?Damage
property? Threaten to injure or kill (person)? 10.Onceithasbeenconfirmedthataclienthas
beenabusive-whetherphysically,sexually, orpsychologically—theprovidershould contactadomesticviolenceexpert,either forreferralorconsultation.Treatment providersshouldensurethatthedangerthe battererposesiscarefullyassessed.
11.Theprovidershouldbedirectandcandid, avoidingvagueoreuphemisticlanguage, suchas,“Isyourrelationshipwithyour partnertroubled?”Instead,askabout “violence,”andkeepthefocusonbehavior. 12.Becomefamiliarwithbatterers’rationaliza-
tionandexcusesfortheirbehavior: •Minimizing:“Ionlypushedher.”“She
bruiseseasily.”“Sheexaggerates.” •Claiminggoodintentions:“Whenshegets
hysterical,Ihavetoslaphertocalmher down.”
•Blamingintoxication: “Iwasdrunk.”“I’m notmyselfwhenIdrink.”
•Pleadinglossofcontrol:“Something
snapped.”“Icanonlytakesomuch.”“Iwas soangry,Ididn’tknowwhatIwasdoing.” •Faultingthepartner:“Shedrovemetoit.”
“Shereallyknowshowtogettome.”
•Shiftingblametosomeoneorsomethingelse: “Iwasraisedthatway.”“Myprobation officerisputtingalotofpressureonme.” “I’vebeenoutofwork.”Substanceabuse treatmentprovidersshouldframescreening questionssothattheydonotallowabatterer toblamethepersonbatteredoradrug.
13.Whentreatingaclientwhobatters,
providersshouldtrytoensurethesafetyof thosewhohavebeenormaybebattered (partnersandchildren,usually)duringany crisisthatprecedesoroccursduringthe courseofhistreatment.
14.Treatmentprovidersshouldmandatethat battererssigna“no-violencecontract” statingthattheclientwillrefrainfrom usingviolencein- andoutsidetheprogram. 15.Treatmentprovidersshoulddeterminethe
relationshipbetweenthesubstanceabuse andtheviolentbehavior:
•Whenyoutake/drink(substance),exactly whendoestheviolenceoccur?
•Howmuchofyourviolentbehavioroccurs whileyouaredrinkingoronotherdrugs? •Whatsubstancesleadtoviolence?
•Whatfeelingsdoyouhavebeforeandduring theuseofalcoholorotherdrugs?
•Doyouusesubstancestogetovertheviolent incident?
16.Afteridentifyingthechainofeventsthat precedesortriggersviolentepisodes,the providerandclientshouldformulate strategiesformodifyingthosebehaviors andrecognizingemotionsthatcontributeto violentbehavior.
17.Providersofservicestoclientswhobatter shouldwatchforsignsthattheclientsare misinterpretingthe12-Stepphilosophyto excusecontinuedviolence.Forexample, thefirststepisadmittingpowerlessness overalcohol.Thustheclientmaybeone shortrationalizationawayfromexcusinga violentactwhileintoxicated,whichislater justifiedbecausethesubstance“mademe doit.”Anotherdangeristhatbattererswill calltheirpartners“codependent”toshift blameforbatteringtothepersonharmed. 18.Referralstoself-helpaftercaregroupssuch
asBatterersAnonymousshouldbemade
onlyaftertheclienthascompleteda batterers’interventionprogramandhas remainednonviolentforaspecifiedperiod oftime.