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Recognizing signs of domestic abuse in clients

Date: January 27, 2017

Domestic violence is, regrettably, a ubiquitous problem in the U.S. and across the world. According to statistics from the National Coalition Against Domestic Violence, every year, on average, some 10 million adults across the U.S. experience some form of physical abuse from an intimate partner. Incidence rates suggest that as many as one in three women and one in four men will experience intimate partner abuse at some point in their lives. In addition to domestic violence, other forms of abuse are prevalent in intimate relationships — verbal abuse, emotional abuse, sexual abuse and financial abuse are some of the most common.

Although domestic abuse is common among intimate partners, it is by no means the only context in which abuse can occur. Abuse also can occur between adults and children, between caregivers and the elderly, and caregivers and people with disabilities.

Given the prevalence of domestic abuse, it is necessary for counselors to be able to recognize signs of the problem in clients. This ability is crucial particularly because, as Susan H. Robinson commented in a column found in Counseling Today (a publication of the American Counseling Association), not all counselors have specific training for helping clients navigate abuse. In such scenarios, therefore, it is important that counselors are able to notice potential abuse in order to connect clients with other resources that can offer more effective help and guidance.

Most important, in jurisdictions across the country, counselors are mandated reporters of abuse that targets minors and the elderly. Counselors are expected to file reports with the proper authorities. Their reports must be factual and devoid of editorial and subjective comments.

For a counselor to be able to recognize signs of domestic abuse, it is important to first take a closer look at what leads to domestic abuse and the varying forms that it can take.

What is domestic abuse?

Issues of domestic abuse between the elderly and caregivers and children and adults are nuanced and necessitate scrutiny within separate articles. This article will focus solely on domestic abuse that occurs between intimate partners.

According to the American Academy of Experts in Traumatic Stress (AAETS), domestic abuse typically is correlated by the need of one partner to assert power and control over another. The aggressors in abusive relationships are more often men than women — the AAETS reported that 92 percent of the time, domestic violence cases are committed by men — although women also can be perpetrators. The source stressed that it is important not to overlook the fact that domestic abuse also is observed in same-sex relationships.

The most typical forms of abuse in intimate relationships include physical violence, verbal abuse and sexual abuse.

Counselors should be cognizant of common incidents and actions that fall under the categorization of general domestic abuse — the umbrella term for physical, sexual and verbal violence. The Mayo Clinic provides examples that include:

● Punching, kicking, slapping, biting and any other form of physical violence.
● Threats of violence.
● Extreme anger, particularly after consumption of drugs and/or alcohol.
● Attempts to control the behavior of a partner, especially as it pertains to money, physical appearance, friendships, family and so on.
● Forced sexual activity of any kind.
● Name-calling, insults or other psychological abuse.

Screening clients for domestic abuse

With a comprehensive understanding of what domestic abuse is, counselors are in a better position to recognize signs of potential abuse in intimate relationships.

Susan H. Robinson explained in Counseling Today that it is fairly typical for clients to open up about domestic abuse, whether it is physical, emotional, verbal or sexual. In such situations, counselors should be sure to provide clients with as much help as they request. This helping posture may involve setting up a referral to a psychiatrist, helping the client contact law enforcement or helping the client develop strategies for leaving the relationship in as safe a way as possible. The main goal is to re-establish a safe environment. Without a safe environment, clients may not be able to fully engage in counseling and other wellness-enhancing strategies.

If a client is not forthcoming about intimate partner abuse, counselors can implement several important strategies to screen for it.

1. Look for defensiveness or denial
Robinson noted it is common for clients to not explicitly discuss intimate partner abuse. Indeed, it is often the case that a client may not understand that his or her relationship is abusive. That is why counselors should ask clients questions about their romantic relationships and then use those responses to gauge whether or not abuse is in play. If a client explicitly recounts behaviors and incidents that could be considered abusive but is quick to defend the behavior of his or her partner, or deny the gravity of the situation, there is a possibility that the client is in an abusive relationship but is unwilling to leave or unaware that leaving is a viable option. Upon evidence of abuse, the counselor educates the client about what constitutes abuse and offers to connect him or her with important resources that can help.

2. Keep in mind important questions
If a counselor suspects abuse but needs more information to effectively assess the situation, there are useful questions that can be asked to get a fuller picture. According to the AAETS, examples of questions that can help reveal abusive behavior in a relationship include, but are by no means limited to, the following:

- Do you worry about your partner’s temper?
- Have you ever feared for your safety around your partner?
- Do you worry excessively about keeping your partner happy?
- Do you change things about your appearance or personality to please your partner?
- Are you worried that your partner could seriously injure or kill you?
- Does your partner ever become verbally abusive?
- Has your partner ever coerced you into sexual activity that you didn’t wish to engage in?

3. Look for signs of physical abuse
If clients present with signs that could indicate physical abuse — for example, bruising, sprains and so on — it is important that counselors ask how the injuries were sustained, particularly if there is already suspicion that abuse is occurring. Furthermore, the American Medical Association (AMA) identified that an important indication of abuse can be found in a client’s response to questions pertaining to the injuries: If the client in question is hesitant in his or her response or offers an explanation that seems unlikely or far-fetched, then there is a notable chance that domestic abuse is the cause. This reaction should be a major red flag that all counselors must recognize.

4. Look for emotional signs of abuse
Domestic abuse — whether physical, psychological or both — can have repercussions for a client’s mental health. Consequently, the AMA recommends it is crucial that counselors keep in mind that a client presenting with certain mental health problems could, in fact, be in an abusive relationship and that the relationship could be a significant factor contributing to these presenting problems, even if the client doesn’t explicitly say so. The AMA elaborated that abusive relationships may accompany any one or more of the following mental health concerns: depression, anxiety and extreme stress, as well as abuse of alcohol, drugs or prescription medication. Additionally, clients should be aware that the emotional toll of abuse actually can manifest itself physically. For example, gastrointestinal problems, insomnia, chronic pain and fatigue all can be correlated to stress that may further accompany an abusive relationship.

In summation

Domestic abuse, particularly in intimate partner relationships, is unfortunately rather common. As such, there is high chance that counselors will come across clients experiencing this problem. Even though not all counselors may be trained to help clients experiencing domestic abuse directly, it is important that they keep in mind important signs that could indicate abuse in order to help clients connect with the resources they need.

If you are interested in helping clients facing an array of problems, including domestic violence, consider applying to Bradley University’s online Master of Arts in Counseling program — it could be the first step on your path to a successful counseling career. To learn more, click here.

Sources

http://ct.counseling.org/2011/10/screening-for-possible-domestic-abuse/

http://www.aaets.org/article144.htm

http://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/domestic-violence-against-men/art-20045149

http://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/domestic-violence/art-20048397

http://www.goodtherapy.org/blog/seen-heard-felt-hidden-recognizing-domestic-violence-signs

http://ncadv.org/learn-more/statistics

http://www.ncdsv.org/images/AMA_Diag&TreatGuideDV_3-1992.pdf

http://onlinedegrees.bradley.edu/counseling/masters/

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