counseling a client with domestic violence issues

Crisis Response Portfolio
Intimate partner violence affects clients across the socioeconomic, ethnic, age, and sexual orientation spectrums. Women are nearly twice as likely to experience violence or sexual abuse than men, but statistics should never cloud over the fact that man men are the victims of intimate partner violence or household abuse (Sugg, 2015). While factors like patriarchal norms and gender roles frequently factor into the etiology of intimate partner violence, counselors should be careful to avoid jumping to conclusions or using stereotyped judgments when working with clients like Jamie.
Jamie is a 28 year-old Latino male. Born and raised in Honduras, Jamie could be considered a typical male in a patriarchal society but the case conceptualization reveals a more complex pattern of abuse, especially when viewed through the lenses of systems theory. Focusing on Jamie allows me to provide insight into systemic issues, thereby lending insight into ways all family members can heal. For example, Jamie’s behavior is in part modelled after that of his father based on what the client has revealed about his own childhood. Jamie was himself sexually abused by an uncle, undoubtedly contributing to lingering trauma precipitating the perpetuation of abuse. While Jamie is sometimes the aggressor in his relationship with Maria, Maria has also resorted to violent behavior against Jamie. Rigid concepts of masculinity, male virility, and male sexuality are also contributing factors in this case. Now that Sofia, the eight-year old daughter of Jamie and Maria, is at risk for experiencing sexual abuse, case workers have a responsibility to intervene immediately.
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Part 1: Roles and Responsibilities
Ethical Responsibilities.
Professional counselors working in a crisis situation like that of the Luna household have a direct ethical responsibility to intervene. While counselors are ethically obliged to maintain confidentiality with clients, there are exceptions to the rule especially when “serious and foreseeable harm” may be at stake, as it is in this case (ACA Code of Ethics B.2.a). The ACA also advises all counselors working on the same case to collaborate when making decisions related to confidentiality. The ACA Code of Ethics provision B.4.b also covers ethical behavior when working in a team on family cases. As a counselor working with Jamie, I also need to remain sensitive to the client’s immigration status and that of his wife, keeping such information confidential in accordance with ACA Code of Ethics B.1.c.
Legal Considerations.
As the ACA Code of Ethics, B.2.a mentions, counselors often do have a legal obligation to report behaviors that threaten or jeopardize the safety of another person. The State of Florida also has laws that protect the best interests of each family member, with the emphasis on Jamie’s daughter. For example, state statutes like § 921.0024 require that the counselor alert Jamie about the legal ramifications of exposing Sophie to domestic violence. The counselor is not legally obligated to report violations of American immigration law and absolutely should not in this particular case (Sconyers & Tate, 2016).
State Requirements and Protocols for Emergency Response Team (ERT).
The State of Florida has requirements and protocols for an Emergency Response Team (ERT) that can be used when working with Jamie. The Florida Center for Abuse and Rape Emergencies (CARE) includes an ERT with a crisis center and a transitional housing option in case one of the partners chooses to leave the household (FCADV, 2019). Food and clothing assistance may also be available to Jamie.
Resources
Florida offers an abundance of resources for clients like Jamie. For example, the FCDAV (2019) CARE emergency response operation helps Jamie to receive transitional housing, food, and clothing assistance if the abuse were to escalate. Local resources are also important in this case. For example, Miami-Dade County offers a Domestic Violence Assistance program (https://www8.miamidade.gov/global/service.page?Mduid_service=ser1502483183449106), which offers job assistance during the relocation process as well as legal assistance should the case go to trial.
Part 2: Disaster Response Resources
American Red Cross
The Red Cross provides generalized disaster response resources, but resources are disseminated at the local level. In this case, the local chapter of the American Red Cross is the Greater Miami & The Keys Chapter, which offers clients like Jamie additional options for disaster response.
Local and National Community Resources
An abundance of local, national, and community resources are at Jamie’s disposal, and also for the counselor for providing optimal interventions for the client. Some of the best national resources include the National Domestic Violence Hotline (https://www.thehotline.org/). Miami-Dade County offers resources including shelters and relocation services for the victims of domestic violence (https://www8.miamidade.gov/global/service.page?Mduid_service=ser1502483183449106).
8 Core Actions for Psychological First Aid.
The National Child Traumatic Stress Network (2019) proposes a set of eight core actions for providing psychological first aid. Those eight core actions include contact or engagement, safety and comfort, stabilization, information, practical assistance, social support connections, coping, and linking with collaborative services.
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Part 3: Suicide
Risk Factors
Jamie did not mention suicidal thoughts or behaviors, but the counselor is responsible for inquiring directly.
Suicide Assessment Questions
Some assessment questions that could help the counselor recognize the risk factors or early warning signs would include how often the client has morbid thoughts related to self-harm or self-annihilation, and to what degree the client has envisioned methods of carrying out the act of suicide. The counselor should also ask whether the client has attempted suicide in the past and if the client believes that death would be a relief or way out of problems.
Safety Plan
A safety plan for a suicidal client would be beyond that of a domestic violence client like Jamie and start with a reliable hotline to use such as the Miami Dade County Crisis Intervention resource (http://www.miamidade.gov/assistance/crisis_intervention_hotlines.asp).
State Commitment Procedures
In the State of Florida, a person can be involuntarily committed if there is “substantial likelihood that in the near future he or she will inflict serious bodily harm on himself or herself or another person, as evidenced by recent behavior causing, attempting, or threatening such harm,” (Mental Illness Policy, 2019).
Resources
Suicidal clients and their family members can access resources in the State of Florida and also in Miami-Dade County. For example, the National Alliance on Mental Illness (https://namimiami.org/crisis-info/) lists several hotlines that can be used by Jamie and other members of the Luna Household.
Part 4: Sexual Assault and Violence
Safety Plan
A safety plan is individualized for Jamie, with other members of the family counseling team providing safety plans for Maria and Sofia. In Jamie’s case, the safety plan will include features like what to do in case Maria does suddenly leave the relationship and especially if she takes Sofia with her. The safety plan also includes provisions in case Sofia were to run away, but also resources that Jamie can use if he were to decide to leave the relationship and seek social assistance. Jamie’s safety plan takes into account the sensitive nature of his immigration status and that of his wife.
Step One: Safety During a Violent Incident
If an argument escalates, I will first try to leave the room or the house.
If I decide to leave, I will use the front door and make sure I have all my identification on me.
I will call a trusted friend, who has agreed in advance to house my daughter and me in case of an emergency.
Step Two: Safety When Preparing to Leave
I can leave another set of keys, clothing, and some emergency cash with my friend, as well as necessary medication I need or that Sofia needs.
I practice my emergency plan with Sofia, with whom I share the details of the plan by practicing the strategy for leaving the house peacefully.
Step Three: Safety in My Own Residence
If an incident escalates suddenly, I can all my friend.
If necessary, I know how to change the locks.
I have a list of trustworthy people who can take care of Sofia in case of an emergency. I never place my daughter in danger.
I alert neighbors about the situation if I decide to leave the house or if Maria leaves and I believe her to be a threat to the family. If Maria has demonstrated violence towards me or to Sofia, I change the locks and tell the neighbors that she is not to be allowed in until the situation has settled.
Step Four: Safety with an Order of Protection
Because of my precarious immigration and legal status, I cannot fully rely on law enforcement services in my area for support in case of an emergency.
Therefore, I will inform my closest friends, my boss, my priest, and any other relatives that I need an informal order of protection that shall be invoked in the case of a violent incident in which my life or my daughter’s life is in danger.
Step Five: Safety on the Job and In Public
Given my boss is aware of my legal status, I share with my boss the fact that I may need physical protection and psychological solace during this difficult time.
If my boss seems reluctant to help or unreceptive to my needs, my backup support system includes the social workers who help me on my case.
I also ask friends and relatives for support, especially if I need to leave my job during the crisis. The Miami-Dade County offers job search assistance to people like me, and I learn about my legal rights if a crisis should arise.
I have reasonable assurance that my boss and my coworkers will not tell the authorities about my immigration status.
Resources
In addition to the local and state resources for persons experiencing domestic violence, Jamie would benefit from the Florida Immigrant Coalition (https://floridaimmigrant.org/). The Florida Immigrant Coalition helps people like Jaime to understand their legal rights, how to access federal and state resources, and also how to carefully utilize social services in ways that prevent detention or deportation.
Jamie should also be made aware of the domestic violence resources available to him in Miami-Dade County, in the State of Florida, and through national organizations too. For example, the National Domestic Violence hotline can provide some assistance in an emergency or crisis situation. Likewise, the Miami-Dade Advocates for Victims (also known as Safespace) can provide Jamie with help (https://www.fcadv.org/centers/miami-dade). The Florida Department of Children and Families https://www.myflfamilies.com/service-programs/domestic-violence/) also provides essential services to the victims of domestic violence. Other local services can be located using the FCADV (2019) online tool (https://www.fcadv.org/local-center-services).
References
ACA Code of Ethics (2014). https://www.counseling.org/resources/aca-code-of-ethics.pdf
The Center for Relationship Abuse Awareness (2019). Develop a safety plan. http://stoprelationshipabuse.org/help/develop-a-safety-plan/
Domestic Violence Resource Center (2019). Safety planning. https://www.dvrc-or.org/safety-planning/
FCADV (2019). Center for abuse and rape emergencies. https://www.fcadv.org/centers/charlotte
James, R. K., & Gilliland, B. E. (2017). Crisis intervention strategies (8th ed.). Boston, MA: Cengage Learning.
McFarlane, J.M., Groff, J.Y., O’Brien, J.A., et al. (2006). Secondary prevention of intimate partner violence. Nursing Research 55(1): 52-61.
Mental Illness Policy (2019). Standards for involuntary committment. https://mentalillnesspolicy.org/national-studies/state-standards-involuntary-treatment.html
National Child Traumatic Stress Network (2019). About PFA. https://www.nctsn.org/treatments-and-practices/psychological-first-aid-and-skills-for-psychological-recovery/about-pfa
National Domestic Violence Hotline (2019). https://www.thehotline.org/help/path-to-safety/
Sconyers, J. & Tate, T. (2016). How should clinicians treat patients who might be undocumented? https://journalofethics.ama-assn.org/article/how-should-clinicians-treat-patients-who-might-be-undocumented/2016-03
Sugg, N. (2015). Intimate Partner Violence. Medical Clinics of North America, 99(3), 629–649. doi:10.1016/j.mcna.2015.01.012