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What? You don’t Screen for Domestic Violence?

January 17, 2018

I am gobsmacked.

I posted to my social media (Linked In) and to several of the chat rooms there, about the naivety of counselors who do not screen for domestic violence prior to meeting with couples in counseling and included this blog post: Is It Safe?

In the regular Linked In news feed my post and related article was met very positively, including:

  • Very important issue. We “helpers” tend to believe that going to therapy, mediation, or counselling with us “can’t hurt”. We have to be mindful that when we intervene in the lives of others just the act of intervening itself can have negative effect if we don’t assess appropriateness. The risk of escalated violence is one big example. Sending a child or teenager to be “fixed” when the problem is dysfunction in the family is another. Engaging in a process is not always benign.
  • The trust people place in us when they seek help is humbling. We must remember it and respect it.
  • I have to screen because most of my clients have drug/alcohol issues and i assess immediately if they need more treatment than I can give them such as detox, rehab etc. which can be more life/death situations more than most therapists have to do.
  • Excellent article and so important.
  • Great points Gary. Thank you for being this to the front of mind.

However, in one of the group chat areas specifically for therapists, I was met with defensive replies where counselors defended the practice of not screening, but indicated rely on what transpired during sessions to in a sense, figure out if abuse was occurring within the relationship.

Responses included:

  • I think it’s Ok to set the initial appointment and ask the questions there. Much can be inferred from a face-to-face meeting that may not be as obvious via phone.
  • Marriage and Family Therapists are trained to asked questions in the initial session and assure informed consent. I do not know what is required of a social worker. I disagree with the “naive” statement, believe me after a masters and 3000 hours of supervised work…no naivety is left in regards to informed consent! There may be, however, those who do not think it is necessary to go over the paperwork clients have signed, that would be negligence!
  • Still I do not agree with your statement. Your given reason has not ground. How do you know that other people are not screening enough?  Now in terms of violence in the relation or family focus is not relation at all. If you recognize that. Violence is very different spectrum of self.

My replies included to the defensive comments included:

  • These issues are well recognized in the fields of family mediation and family arbitration. Standards of practice for mediation require screening for domestic violence and power imbalances and in the Province of Ontario for a Family Arbitration to be enforceable through the courts, the couple subject to arbitration must have been screened prior to the arbitration. The standards of practice and Ontario requirements are based on a review of social science literature as it pertains to the risks regarding bringing two people in conflict together where they shared an intimate relationship. I hold dearly to the view that the same or similar risks are present, particularly in the context of couple counseling. When we bring two people together where one may be dangerous and we have no inkling in advance, we can inadvertently increase the risk of harm. From my perspective it remain naivety to think otherwise and contrary to best practices in related fields.
  • Interesting responses. By the time the couple is in the office together, the genie may be out of the bottle and the impact of disclosure in the context of an abusive or dangerous relationship will have already occurred… Similar to the physician’s motto of “do no harm”, I wonder why some therapists may think that screening isn’t of value. It would be interesting to hear your view on this blog post: https://garydirenfeld.wordpress.com/2013/08/29/marital-counseling-look-before-you-leap/
  • While I do believe in the value of clinical wisdom, such as when you say, “believe me” and provide data on your experience, clinical wisdom may still fall short of the social research. Our beliefs, created and reinforced from years of doing things the same way may actually lead to implicit bias as opposed to naivety. As per the research study above, the findings suggest that as many as 79% of counselings at the time of the research conduct pre-screening interviews before counseling begins. It remains an ethical obligation to keep people safe (as possible). I can only hope that other counselors reviewing this post consider their approach.

I want to say without hesitation that while we may never know with certainty if domestic violence is occurring or necessarily the dangerousness with which it may be occurring, we do have a duty to screen before bringing couples into counseling.

If the couple is already with you when the issue of violence or power imbalances emerge, even if the couple appears together and reasonable in the session, it still creates the risk of retaliatory and dangerous behavior when the couple leaves your office and has privacy if one of the couple harbors resentment.

Counseling is not like water. Counseling does carry risks. We should seek to minimize the risks as screening may provide,although appreciating that screening isn’t perfect and we may have false positives and we may have false negatives. This doesn’t mean though that we don’t screen.

Just to add, there is an abundance of research to now support screening for domestic violence. I would only encourage people to review the available literature if there is any shred of uncertainty. After reviewing the literature, then consider training in any of the many available courses.

Here are just a few interesting resources:

12 Reasons Why Couples Counseling Is Not Recommended When Domestic Violence Is Present

Please screen.

I am Gary Direnfeld and I am a social worker. Check out all my services and then call me if you need help with a personal issue, mental health concern, child behavior or relationship, divorce or separation issue or even help growing your practice. I am available in person and by Skype.

https://garydirenfeld.files.wordpress.com/2013/07/gary-feb-12.jpg?w=200&h=301

Gary Direnfeld, MSW, RSW

gary@yoursocialworker.com
www.yoursocialworker.com for counseling and support

www.garydirenfeld.com – to build your successful practice

 

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Gary Direnfeld is a social worker. Courts in Ontario, Canada, consider him an expert in social work, marital and family therapy, child development, parent-child relations and custody and access matters. Gary is the host of the TV reality show, Newlywed, Nearly Dead, parenting columnist for the Hamilton Spectator and author of Marriage Rescue: Overcoming the ten deadly sins in failing relationships. Gary maintains a private practice in Dundas and Georgina Ontario, providing a range of services for people in distress. He speaks at conferences and workshops throughout North America. He consults to mental health professionals as well as to mediators and collaborative law professionals about good practice as well as building their practice.

2 Comments
  1. Gary, I spoke at a workshop to a group of American counselors in a religiously affiliated agency. My topic was Screening for Subtle Control Tactics in Couples Counseling. I was astounded that not a single one of these professionals had ever assessed for it. They seemed stunned, and many were openly hostile that I suggested controlling or psychologically abusive behaviors would be present in *religious* couples. There was a distinct coldness in the room, very few questions were asked, and they all looked like deer in the headlights.

    Dr. Kerin Groves, PhD, LPC-S, NCC, CCMHC http://www.conflictmanagementinc.com

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