Introduction
Domestic violence is becoming so popular in the United States. There have been numerous reported cases that indicate the domestic violence where women are the ones who are most affected. The national statistics reflects how wide-spread the issue of domestic violence is and the fact that only a few women are spared from it. Domestic violence is turning to be a social menace that has jeopardized social interactions and community development.
In the practice setting, physicians and psychiatrists have always been the center of help in instances of domestic violence. The physicians have a great role to play where they interview the victim so that they can gather information to be used in provision of diagnosis. Physicians goes to an extent of taking the vital signs and the clinical symptoms that can be used as evidence to really proof an individual was subjected to the violence (Jordan & Franklin, 2011).
On the other hand, domestic violence has created both physical and emotional problems that need to be addressed. In such instances, the psychiatrists have a big role to play so that the victim is assisted in the best way. Since time immemorial, psychiatrists have been in the frontline to offer the best advice to the victims so that they can mitigate the depressions associated with the violence. The individual client system will be successful only when the physicians as well as psychiatrists are involved in the real settings and the victim is interviewed and advised.
Physician and psychiatrists are charged with responsibilities that will be helpful in solving the domestic violence issue. They will always assist the victim to improve their depressed conditions so that they can be back to fitness.
Identification and description of client system
Mary is a married woman aged 31 years who had been tolerating domestic violence for over five years. This has been the reason for the development of an individual client system. This system aims to assess the situation and provide a way forward to solving Mary’s problem. Mary has three children and as a result of the previous domestic violence, she feels that her children will also be hurt if she does not call for help. The client system is basically collecting information about the victim, the situation that victims are in, and to assimilate the information collected into a report that shall be referred to when making decisions or reviews.
There are plenty sources of referral that were exposed to Mary as a means of relieving her agony. Mary used friends, professional contacts, online acquaintances such as those in the social media, and police referral. Mary was able to reach such referral sources that significantly advised her to seek refuge and report the case to the police. She contacted professionals such as psychiatrists and physicians who diagnosed her, analyzed the situation and developed the way forward. The reason why Mary asked for referral is because she knew that she would benefit from professional counseling who could relieve stress due to her welfare situation. Mary has also learned from previous study that many victims of the domestic violence had found referral helpful and of significant effect on their solutions.
Mary’s condition of domestic violence has threatened her life to the extent that she had acquired an involuntary status to seek referrals and report the case to the police. She realized that if she is late in calling for help, there would be a serious deterioration of their marriage condition and she would also suffer from physical harm. She had making long calls explaining her condition to the psychiatrist, friends and physicians in the previous instances of domestic violence.
Some of Mary’s friends who are neighbors have been witnessing her victimization and even the last night she was abused by her husband as the friends watch. Therefore, witnessing has been considered as one of the main source of information. One of the Mary’s children is old enough to explain how the domestic violence has been conducted and he has been considered as an important source of information. Other sources of information involve learning behavior theory that explains the causes of domestic violence. According to this theory, domestic violence is caused by the loss of control. This is applicable in Mary’s case since her husband had been losing control and becomes abusive when he drinks alcohol.
Identification and description of client system
History of the presented problem
Records from the police indicate that 30% of women in the United States are experience domestic violence. Despite the increased social awareness creation among the people and terming the act as unethical and unacceptable, the practice has still been increasing (Reamer, 2006). The condition is more prevalent in cases where the wife and husband come from different tribes and also more predominant in cases where the husband’s economic prowess is far much higher than that of the wife. Everyday, police record approximately 125 cases of domestic violence. Additionally, it is suspected that most of the cases go unreported due to the male antipathy that prevails in many communities within the US. The psychiatrist history shows that domestic violence against women cannot be subjected to clinical assessment of signs and medical symptoms. A well-developed medical diagnosis is completed in a proper manner when only the examination takes place at the exact time of the problem (Reamer, 2006).
Brief summaries of client system challenges and strengths
The client system is where the social worker will put measures that will help in collecting information about the existing problem and offer the best way to enable Mary to successfully go on with life in the women domestic violence shelter. The system is associated with both challenges and strengths. The practitioner meets the client and subdues her to an interview where information surrounding the scenario is gathered. The strengths that are related with the system are elucidated below;
The client system is a good base to collect information that will be very vital in the diagnosis of the patient. The practitioner will interview the client in line with the set criteria and this will avoid any instances that can distort the information from the victim’s mouth. Any existing factual errors will be eliminated in the system and the physician will be in a position to offer the best diagnosis. The client system is also important since it reviews the client information up to date. This will avoid incomplete or missing information that can lead to poor intervention when the diagnosis done by the practitioner (Jordan & Franklin, 2011). The client system is also useful in a way that it uses the medical codes as assigned in the ICD-10. This helps the tool to be applied in improving educational standards when it is used as a teaching tool.
The challenges surrounding the client system include the following: the client may feel uncomfortable to provide information that may appear shameful. The system does not also maintain high levels of confidentiality since crucial information can easily spread because of the delicacy of the problem.
The clinical formulation pointed out clearly that the client was a victim of domestic violence. Her husband has been subjecting her to domestic violence for a long period. Mary has undergone depression and anxiety but this time she decided to report to the police. The police handle the case in a proper manner so that a proper diagnosis can be offered. The main thing needed is a practitioner to carry out an investigation by interviewing the client so that the signs and symptoms given can be used for the best diagnosis.
Technique utilized
Among targeted diagnosis and screening, attention to reproductive coercion, crisis intervention and longer term individual and family therapy. The reproductive coercions that were considered include the deliberate sabotage, sexual assault, battery beginning or intensifying during pregnancy and pressure to abort (Reamer, 2006). To be effective, the skill that was used in this field includes integrating valuation for the reproductive coercion into domestic violence screening.
In the crisis intervention technique, the skills that were used involve providing a safe place for Mary to ventilate intense emotions and deal productively with any risks of homicide or suicide. The physician used this technique to assist Mary to bond with community means such as law enforcement, food pantries and shelters. The physicians were also able to help Mary to create safety plans for herself, as well as her three children. On the other hand, the longer term individual and family therapy assisted the physician to critically and carefully think whether to involve Mary’s partner in the treatment. This might be crucial because the partner might be abusive and this can result into a counterproductive and unsafe treatment. However, it was noted advisable to include mother and her children in the same progression of therapy.
The cultural issues and competences used to address the technique utilized include tradition and religious observances (Hepworth et al., 2013). In some communities and religions, men are allowed to apply violence as a way of disciplining their wives. However, some cultures like in US do not guarantee such rights. These two factors were considered when analyzing the victimization of Mary.
The skills that were used to interview the client include confidence, non-verbal skills, and interview etiquette. During the interview, the interview was able to believe in himself and his strength and was committed to provide positive and strong responses. The interviewer did not overlook the use of body language as an added advantage of interview skills.
Recommendations
In order to help the worsening situation of Mary, the physicians should continuously screen her for domestic violence. Despite the fact that the US Domestic Task Force views that the evidence against or for particular domestic violence instruments insufficient, it is significant to question the victim about the physical abuse (Reamer, 2006). This questions should be developed on some specific grounds, such as the potential value of the information acquired in assisting such patient, high popularity of undetected abuse among women patients, and the low risk and low cost of screening.
The care of Mary requires a multidisciplinary team program that involves community and institutional services. The literature proposes that when a victim of abuse is recognized in a formal way, a primary care physician can develop and improve result by taking care of acute injuries, making appropriate referrals, making regular call to enquire conditions, and offering support.
The physician can improve the client’s safety by several practices as described below.
- Assessment of the immediate risks: The client should be asked whether the severity or the frequency for the previous years. Whether Mary’s partner has threatened to hurt her three children, whether there are dangerous weapons in the house, and whether the partner knows her plan.
- Discussing safety behaviors; this procedure should involve advice on self-protection such as removing the weapons that might be presence in home, and plan to leave safely in a dangerous situation (Reamer, 2006).
The effective treatment in the Mary’s situation were based on various guidelines such as community-based advocacy intervention programs, civil protection order, safety intervention protocols, emphasizing potential for fatal result and assessing immediate safety, and contacting with the community resources on domestic violence. Staying in women domestic violence shelter can only be a short term solution to Mary’s situation. However, in the meant time, the women domestic violence shelter program can offer support, knowledge or skills and resources required for her to live a life that is free from all forms of domestic violence.
The mission of Blue Water Safe Horizons is to partner with the community to provide the resources, support and education necessary for every individual to become empowered and live a life free from domestic violence, sexual assault and homelessness.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.) (DSM-5). Washington, D.C.: Author.
Hepworth, D., Rooney, R.H., Rooney, G.D., Strom-Gottfried, K., & Larsen, J. (2013). Direct social work practice: Theory and skills. (9th ed.). Belmont, CA: Brooks/Cole. ISBN: 978-0-8400-2864-8
Jordan, C., & Franklin, C. (2011). Clinical assessment for social workers. (3rd ed.) Chicago: Lyceum. ISBN: 9781933478807
Meenaghan, T., Gibbons, W.E., & McNutt, J.G. (2005). Generalist practice in larger settings. (2nd ed.). Chicago, IL: Lyceum. ISBN: 9780925065858
Reamer, F. G. (2006). Ethical standards in social work (2nd ed.). Washington, D.C.: NASW Press. ISBN: 9780871013711
