By Gita Mammen
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Additional info for After Abuse
Could you worsen their situation by allowing them to open up troubled aspects of their life? What if they become suicidal? On the other hand, you are also aware that the reverse might be equally true for them—the lack of scope to deal with their complex issues is central to their ongoing despair. Your client feels that exploring abuse matters will actually make them feel better, not worse. You tend to agree. Such a situation is precisely where a risk assessment proves invaluable. It allows you, together with your client, to delineate potential risk.
Regarding depression or substance-use): How will these goals be achieved concurrent to undertaking abuse-specific work? b Abuse-specific goals. 3 Mention priorities allocated within abuse-specific work. 4 Highlight preferred and realistic strategy options. 5 State what you can contribute within your framework and what will need to be sought elsewhere. 6 Reiterate how risk will be monitored. 7 List strategies that will be used to maintain safety during the process. indd 36 16/6/06 10:00:07 AM 37 CHAPTER 4 Preliminary considerations, principles and pitfalls CHAPTER AT A GLANCE Preliminary considerations gender issues process issues Principles underpinning transactions power issues trust issues survivor control of pace foundations first, superstructure later Pitfalls managing risk survivor-related issues worker-related issues The assessment is over.
Assessment appropriate to abuse-specific healthcare has three components: a holistic component, an abusespecific component, and a risk assessment. Depth of detail takes time, so the time taken by each component of the assessment will vary. It is useful, however, to allocate a defined number of hours overall— perhaps about three, in the first instance. More information will emerge as you continue the work. Holistic assessment Even if you have known your client for a while previous to their disclosure of childhood abuse, when they come up with this hugely relevant information it is useful to revisit your earlier intake-assessment to fill in more detail.