CONTENTS

About This Course

Table of Contents

1. Introduction to the Issues
2. Understanding Alcohol Abuse
3. Understanding Violence Against Women
4. Alcohol and Domestic Violence
5. Alcohol, Sexual Assault, and Rape
6. Prevention and Early Intervention
7. Screening and Assessment
8. Diagnosis and Treatment
9. Legal and Ethical Issues

Supplements
Fact Sheets
Videos
Resources

Silence Hurts
Alcohol Abuse and Violence Against Women

Module Content Objectives Introduction General Screening For Domestic Violence and Sexual Assault -- Domestic Violence Screening Statements -- Additional Statements of Support Addressing Alcohol Abuse With Domestic Violence Clients -- Screening Instruments for Alcohol Use -- Assessments For Alcohol Use -- Talking About Alcohol Abuse -- Supporting Sobriety Assessing Violence for Women in Alcohol Treatment -- Domestic Violence Screening -- Domestic Violence Assessment Tips Addressing Alcohol Abuse With Men in Treatment For Violence -- Alcohol Screening -- Alcohol Assessment Addressing Domestic Violence With Men in Alcohol Treatment -- Abuse Screening -- Timing for Batterer Intervention/Relapse Prevention Child Maltreatment and Abuse Psychiatric Comorbidities -- Dual Diagnosis Safety Planning Summary of Module References Module 7 Quiz

Introduction

This module explores the screening and assessment process for women and men with abuse and/or alcohol addiction problems. There are many assessment tools that are available for purchase. This tutorial provides those that are available to the public at no charge, with permission from the author.

Health care professionals treat women at every age. Most women regularly see doctors, nurses or mental health professionals for routine check-ups, pregnancy issues, physical injury, or mental health concerns. During these visits, health care providers have the opportunity to do screenings and assessments for domestic abuse and sexual assault, as well as for alcohol abuse. Many of these providers, however, never ask questions or probe beyond the presenting problem to determine the underlying cause of a problem.

Few people are willing to identify themselves as victims.¹ In fact, the American Medical Association found that less than 10 percent of primary care doctors routinely screen for domestic violence among their patients. Many never ask about alcohol intake when examining a person for bruises or other injuries.

Clarification of Terms

For this tutorial, screening and assessment are defined as follows:²

• Screening. This is a brief procedure used to:
  1. Determine the presence of a problem (e.g., mental health disorder, substance abuse)
  2. Substantiate that there is a reason for concern
  3. Identify the need for further evaluation

  Screening is done early in the process of collecting information. It may be done by a questionnaire or checklist. Screening tools are not meant to provide a mental health or substance abuse diagnosis. Instead, they are used to collect initial information that will help in further assessing the problem.

• Assessment. This is a more comprehensive diagnostic and treatment planning process typically based on screening information. A detailed assessment may take hours to complete and should help to prepare a treatment plan. Some goals of assessment are to:³
  1. Examine the scope and/or severity of mental health or substance abuse problems
  2. Identify other possible psychosocial problems that may need to be addressed further
  3. Provide a foundation for treatment
  4. Identify possible strengths of the woman that can become part of the treatment planning process

Screening and assessment should be done by trained professionals with experience in violence or substance abuse issues who use specialized instruments. Health care providers should routinely screen for alcohol and intimate partner violence. The standardization of screening instruments among providers would also enhance the level of screening in these areas.

Abused women report that the one of the most important aspects of their doctor's visit was their ability to talk about the abuse.⁴ Healthcare providers can screen for physical abuse, sexual abuse and psychological abuse by having clients fill out simple questionnaires. The Family Violence Prevention Fund and the American College of Obstetricians and Gynecologists have created general screening policies for all health care providers to use. For more information or detailed recommendations for specific health care settings, please go to www.endabuse.org or www.acog.org.

Health care providers, social workers, psychologists, or any other professionals working with clients are required to follow their profession's rules for confidentiality and mandatory exceptions to confidentiality. Professionals should explain to clients/patients the limits to confidentiality before they begin a screening. For more legal and confidentiality information, see Module 9.