Safety and Sobriety Manual
Best Practices in Domestic Violence and Substance Abuse
January 2005
Guidelines for Completing Domestic Violence and Substance Abuse Screens
Introduction
In March 2000, four sites in the state of lllinois began integratinglcoordinating domestic violence and substance abuse services for adult women as part of the Substance AbuseIDomestic Violence Initiative, funded by the Illinois Department of Human Services, Office of Alcoholism and Substance Abuse. Part of the Initiative was to conduct substance abuse screenings at the domestic violence agencies and domestic violence screenings at the substance abuse treatment facilities. As a result, screening tools for adult women were developed and modified. Although there are no hard and fast rules regarding the use of the screening tools, the original four sites have put together guidelines they feel should help in the work to best meet clients' needs.
When to complete screen
In DV setting: In many domestic violence shelters there is the initial intake of a client when she first enters shelter. The assessment phase often continues and is a time that staff uses to further determine her appropriatenesslreadiness for life in shelter as well as services that she may need. In many instances this is the time period in which her Service Plan may also be developed. It is best to complete the substance abuse screening during this time period. It is important that she be made aware of all services that are available to her through the domestic violence agency.
The same is often true for non-residential clients seeking domestic violence services. The first several appointments include things such as rapport building, safety planning and service planning. It is recommended that during the service planning phase the substance abuse screening be done along with letting her know what services are available to her through the domestic violence agency.
In the substance abuse setting: Within substance abuse treatment facilities there is a myriad of paperwork to be completed at the time of intake. It is believed that intake is the best time to complete a domestic violence screen also. In some instances this will determine what treatment group is the best fit for a client's needs. Of course, it is unlikely that screening upon intake into detoxification would be productive.
How and Where
Since sobriety greatly impacts a woman's ability to get and stay safe, a screening for alcohol and drug abuse should be done with every client whether she is seeking shelter or non-residential services. It is important to remember when working with victims that her substance abuse may be a very reasonable response to the trauma that she may be dealing with on a daily basis.
In both settings it is imperative that the screening be completed with only the woman present. In some cases the woman may show up for serviceslintake with children or significant others. It is of utmost importance that these people be excused from the room so that the staff member and the woman can talk freely with no potential ramifications for the woman. Children that are able to verbalize what has gone on during the screening could be given headphones to listen to or could be temporarily placed with another staff member so that the screen can be completed in privacy. Pre-verbal children do not pose the same threat to disclosure.
All screens should be completed in privacy. Many facilities have common areas where clients congregate. A screening should never be completed in these areas. They should be completed in a private room with the door closed if the client feels comfortable with that circumstance. If she is uncomfortable with the door closed then she may make the request to keep it open.
All screenings should be completed by trained staff. Under no circumstances should the screening be given to the client to be filled out. Though documentation necessitated having closed ended questions, staff is encouraged to ask the questions in a conversational style starting with the least intrusive. Staff training should consist of a basic understanding of both domestic violence and substance abuse and their intersections as well as an opportunity to discuss and practice the questions to be asked. It should also include reviewing who to contact with questions/concerns, should they arise. Training should be done on an on-going basis.
It is important to remember that the client always has the right to refuse the screen. A woman may have many reasons for not wanting to disclose her history. One reason may be a fear that her disclosure may affect services offered to her. Please remember to remind the client that the screening is being completed only to be better able to help her get the services that would best address her needs.
When to re-screen
As we all know, many of our clients will leave services only to return later. The question then arises as to when to complete another screen. In the case of a domestic violence client who is an admitted drug user the time that would be spent doing a screening for substance abuse may be better spent just talking with her about her most recent use.
In the case of client who has received services in the recent past it is necessary to rescreen. It is imperative that it be determined where the client is at the time of service. Remember, she has gotten services from you in the past so she may be more readylable to discuss her domestic violencelsubstance abuse history.
After Screening
Upon completion the screen should be given to the staff member who is the liaison for the agency that deals with the issue being screened. This person can then make the determination as to whether or not the woman is in need of integrated domestic violence/substance abuse services.
Under no circumstances should the substance abuse screen be included in the domestic violence file. Although the Illinois Domestic Violence Act provides protection for information contained within domestic violence files, the best practice would be to include only subtle documentation of substance abuse. You may wish to document that she is addressing substance abuse issues or that she has been referred for substance abuse groups due to the fact that these services are also offered to meet the needs of family members who are concerned about another's substance abuse issues. Each agency should weigh the value of documenting substance abuse recovery successes in victim files against the risk of stigmatizing the victim.
The domestic violence screening can be included in the substance abuse treatment file. Again, care should be taken to reduce the stigma that may be attached to a client who has experienced domestic violence. Subtle documentation of specifics of her history should be documented only selectively.
(Note: This information can be found on pages 7 & 8 of the Appendix Resource (pdf))
Domestic Violence Screening Tool
(Note: The form can be found on pages 9 & 10 of the Appendix Resource (pdf))
Client Name or ID:
Screen Completed by:
Date:
As part of our interview with everyone who comes to us for help, we always include questions about other issues besides substance abuse. We feel it is really important to help you with as many of your problems as we can. We understand that sometimes in order to help with one problem other problems must also be addressed.
In most homes where there is substance abuse, families have other problems too. I'm going to ask some questions to see whether any of these things have happened to you or your family. If we find that you need help, we will help you take whatever actions are necessary to ensure your safety and recovery, if you wish.
Answer YES or NO for each of the questions as it applies.
- Are you currently experiencing conflicts with your family or partner that cause you stress?
Current Rel. YES / NO Past Hist YES / NO
- Are you currently experiencing, or have you ever experienced any of the following in your relationships with your family or partner?
- being called names, being put down, told you are worthless
Current Rel. YES / NO Past History YES / NO
- pushing, grabbing, shoving, hitting or restraining
Current Rel. YES / NO Past History YES / NO
- being kept away from family and friends, prevented from leaving your home, or going where you wanted to go
Current Rel. YES / NO Past History YES / NO
- receiving threats that your partner is going to hurt you, your children, other family members or pets
Current Rel. YES / NO Past History YES / NO
- belongings being broken or destroyed
Current Rel. YES / NO Past History YES / NO
- throwing things, punching walls
Current Rel. YES / NO Past History YES / NO
- feeling intimated or afraid to leave home
Current Rel. YES / NO Past History YES / NO
- controlling access to money or not being allowed access to your money
Current Rel. YES / NO Past History YES / NO
- being threatened with lost custody or a DCFS case in regard to your children
Current Rel. YES / NO Past History YES / NO
- have your children witnessed any abuse
Current Rel. YES / NO Past History YES / NO
- having sex in ways that made you uncomfortable or afraid
Current Rel. YES / NO Past History YES / NO
- have you ever obtained or tried to obtain an Order of Protection
Current Rel. YES / NO Past History YES / NO
- Is this person still involved with you?
Current Rel. YES / NO Past History YES / NO
- In what way is this person still involved with you?
- When was the last time any of the above incidents happened?
- Have the police ever been called to your home because of an argument?
Current Rel. YES / NO Past History YES / NO
- Are you or have you ever been afraid of your partner?
Current Rel. YES / NO Past History YES / NO
- Have you ever sought help for any health problems related to stress in the past?
Current Rel. YES / NO Past History YES / NO
- IF YES, Has your partner been supportive of past recovery efforts from any of these problems?
Current Rel. YES / NO Past History YES / NO
- Do you believe your partner will be supportive of your present treatment?
Current Rel. YES / NO Past History YES / NO
- Do you have any concerns or fears of physical harm?
Current Rel. YES / NO Past History YES / NO
- IF YES, Can you give me an example?
- Do you believe that the abuser will be at the treatment facility or in the area of the facility during your treatment?
Current Rel. YES / NO Past History YES / NO
- IF YES, please give his name and description:
Suggestion:
Reason:
Client Agreeable: YES / NO / MAYBE
Comments and/or observations of client.
Substance Abuse Screening Tool
(Note: The form can be found on pages 11 & 12 of the Appendix Resource (pdf))
Client Name or ID:
Screen Completed by:
Date:
As part of our interview with everyone who comes to us for help, we include questions about other issues besides domestic violence. We feel it is really important to help you with as many of your problems as we can. We understand that sometimes in order to help with one problem, other problems must also be addressed.
Many of the victims/survivors who come to us also have problems with alcohol or drugs. We have a program that is especially designed to help women who are dealing with domestic violence and substance abuse. Of course, we encourage you to stop using and to possibly enter a substance abuse treatment program. Be assured that all of your answers will be kept confidential.
Answer YES or NO for each of the questions as it applies.
- Do you feel any of your family members (including the abuser) have/had alcohol or drug problems?
YES / NO
IF YES, please Explain:
- Does your abuser's violence become more dangerous when he is under the influence of drugs or alcohol?
YES / NO
- Tell me about your alcohol/drug use:
-
| DRUG TYPE/NAME |
AGE STARTED |
HOW MUCH & OFTEN |
EFFECT OF USE |
DATE LAST USED |
Alcohol
(whiskey, gin, wine, beer) |
|
|
|
|
Marijuana/Hash
(pot, weed, grass) |
|
|
|
|
Cocaine
(snow, crack, rock, coke) |
|
|
|
|
Stimulants
(speed, amphetamines, uppers) |
|
|
|
|
Narcotics
(heroin, morphine, codeine, Demerol) |
|
|
|
|
Sedatives, barbiturates, tranquilizers
(valium, librium, qualudes, sleepeze) |
|
|
|
|
Hallucinogens
(PCP, LSD, mushrooms, peyote) |
|
|
|
|
Inhalants
(glue, paint, gasoline) |
|
|
|
|
- Have you ever used alcohol or drugs to cope with fear, stress, physical or emotional pain?
YES / NO
- Do you drink or use drugs more than you intended to at times?
YES / NO
- Do you ever feel bad or guilty about drinking or using drugs?
YES / NO
- Has anyone ever expressed concern about your substance use?
YES / NO
- Has your substance use ever caused you any legal trouble (i.e.-disorderly conduct, DUI, etc.)?
YES / NO
- Have you ever attended 12 step groups such as AA, NA, CA, ALANON?
YES / NO
- Have you ever had treatment for alcohol or drug problem?
YES / NO
IF YES, please explain
Suggestion:
Reason:
Client Agreeable: YES / NO / MAYBE
Other observations or comments:
- Smell of alcohol
- Signs of IV drug use (i.e. tracks)
- Unusual or extreme behavior (nodding off, overly alert, slurred speech)
- Staggering
- Tremors
- Glassy eyed/pupils dilated
- Unkempt appearance
- Poor hygiene
- Argumentative, defensive or angry at questions about substance abuse
