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revised September 10, 2012

Arrow BulletCASE STUDY

Ask the question…

“I am a concerned about the chronic headaches you have been suffering and realized that we have never talked about any experiences you may have had with abuse. Women so often experience physical, sexual, or emotional abuse in their relationships, which can lead to negative health experiences for women and their children. Have you ever experienced any form of abuse in your current or previous relationships?”

What if she says YES

What If she says NO

When her response is YES...

1. Validate her disclosure by communicating messages of support, such as:

  • “I’m really sorry that this has happened to you because no-one deserves to be treated this way.”
  • “I hope you understand that you are not to blame for this situation.”
2. Ask additional direct questions to assess when the abuse occurred? such as:
  • “What happened? How were you hurt? Can you tell me about the most recent time?”
  • “Did this happen recently or in the past?”
  • “Have you spoken to anyone else about this before?”
3. Ask questions, which assess safety and risk, such as:
  • “How are you coping?’
  • “Are you currently experiencing abuse?”
  • “Do you feel you or you children are in danger now?”
4. Document disclosure
  • All written documentation should outline the abuse in the patient’s own words
  • If physical symptoms are present, these should also be documented either in written or drawn form
5. Offer referrals or resources in a safe and non-pushy way. Things you could ssssay are:
  • “I understand that it may not be safe for you to take information home with you, but this is a safe place for you to use our phone…there is a 24-hour hotline for women experiencing abuse, if you would like to make a phone-call…”
  • “Would you like me to arrange for you to speak to either a counselor or social worker who can also help to support you through this

Remember, while a disclosure may occur, women may be at different stages of their readiness to accept help and/or leave the abusive situation. Whatever the decision, you need to offer your acceptance and support.

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When her response is NO...

1. Accept her response…she may not feel safe or ready to disclose OR “No” could mean “No”.

2. Use the opportunity to communicate general information about abuse, such as:
  • “Well, I’m glad to hear that because unfortunately that is not the situation for many women in their relationships. And, if you ever feel abuse is an issue for you, I want you to know that this is a safe place for you to talk to me about it and that help is available.”

3. Document verbal response and any signs of abuse that are suspect, if present.

4. Repeat to patient that woman abuse is now a part of your health assessments and that in about a year, you will ‘check in’ again, as situations can sometimes change.

5. Leave resources out in the open, should she want to take pamphlets or other resources available.

Remember, even if abuse is suspected, health care professionals should not have any expectations. The goal is not higher disclosures, but more routine screening of woman for abuse. When ready, women will disclose.

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Revised: September 10, 2012


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