A woman comes into your practice reporting depression and chronic illness. Her arm is mapped with finger-mark bruises and when her cellphone went off a look of panic swept over her face. Clearly, it appears this young lady has something devious going on behind the scenes in her life. But, how do you open up a dialogue about domestic abuse?
About 25% of women report a time of domestic abuse being inflicted upon them during their lifetime. And, even though it is more common for a partner to abuse a woman; men are also susceptible to receiving this treatment. As embarrassing as it is for the sufferers of domestic abuse to seek out help, it is more common than you would think. And, sometimes we think of domestic abuse as solely physical assaults but there are many forms. Any controlling, manipulative, hurtful, and dangerous behavior from a loved one can escalate quickly into abuse. Mental turmoil can be harder to heal than bruises. Additionally, economic abuse and controlling someone by managing their resources, makes it terrifying for some people to admit the problem or seek help. How do you go about discussing this matter with patients though? Some feel that it is better to keep quiet about the issue and avoid shame on the patient’s end by throwing around accusations. However; whether you hunches are correct or not, it is the duty of a healthcare professional to discuss it with patients and offer a lending hand.
Domestic abuse knows no race, class, or cultural background. It doesn’t matter where you come from and it can happen to people in any walk of life. It’s important to tell this to your visitors so that they feel less ashamed about their particular predicament.
It is crucial as a member of the medical community to care for the overall well-being of their patients. When you consider that 2 million injuries and 1,300 deaths are caused each year as a result of domestic violence, it becomes a medical necessity to inquire about possible situations of foul play at home. There are several ways for a physician to ask about domestic abuse. There’s subtle approaches, straight-forward methods, oral communication, and even written questions. Its important to evaluate the best way to bring up the topic because everyone is different and some ways work for one while the other may not. The level of timidness a patient expresses can help judge the best methodology for handling the serious talk about domestic abuse. The following is a couple ways of handling the topic in an emotionally compassionate manner.
*Also, it should be noted that if a patient is accompanied by their significant other, to ask that they step out of the room before asking.*
Ways to ask about abuse:
- Frame the question. Try asking in an indirect way surrounded by verbiage that makes them feel less insecure about answering the question. For example, “A lot of my patients have reported health issues from domestic abuse, has this ever happened to you? I started asking all my patients now.” When things are worded in certain context, it can really change the impact of the words. You don’t want to make the victim feel anymore singled-out by making it seem like you are asking them a private issue. Putting it in a way like that makes them feel like they are not alone. After all, if they truly are a victim of some kind of domestic abuse, they truly aren’t alone. It’s very common. You’re more likely to get an honest response if they know that others struggle with the same thing.
- Have them answer in writing. Prepare some simple health questions such as “do you feel safe in your relationship?” Follow-up by asking more in-depth questions. Approach it like this, “I see that you said you don’t feel safe in your relationship. Do you have anything you are concerned about that I can help with? It’s safe and confidential.” Some find it easier to begin confessing problems when they are in writing as opposed to face to face.
- Ask questions that are indirect. Sometimes the act of small-talk can be useful in gathering knowledge about a patient’s lifestyle. Asking them about how their relationship was, how their levels of stress were, and how things were at home.
- Ask directly. Some people have a difficult time lying and will open up if asked. Just flat out ask if they have ever been pushed by a partner, if they felt safe in their relationship, etc.
Admitting to being engaged in a violent or abusive relationship. Therefore, be sure to applaud the bravery of disclosure and point them in the right direction. According to a survey conducted by Allstate Insurance, 74% of Americans personally know someone who is or has been abused. If you or someone you know if suffering from domestic violence or abuse, there’s ways to seek help. Helpguide.org can help you learn some ways to rectify the problem.
