|
Overlaps
Between Abuser Education 
and Therapy
By Laurie VanLoon, LICSW
In this article I speak from my experiences
as a therapist in private practice who tries
to incorporate what I learned as an abuse
educator to help make my counseling work
relevant and effective. I was trained by
Emerge, and co-led groups in the 90's, as
well as supervising Emerge's Latino program
groups. I have been a clinical social
worker for almost 20 years; previously I saw
families and children as well as adults; now
my practice is just with adults.
Those of us therapists who were trained
decades ago rarely discussed domestic abuse
in our training. If trained more recently,
we probably were exposed to new ideas to
support survivors, as well as relevant ideas
about trauma. But very few of us have had
help in learning how to recognize and work
with perpetrators, and many therapists still
struggle with the complexities of working
with survivors. As a result, certain errors
are common when we start out:
-
Physical abuse is often seen as more
serious or more real than other forms of
abuse, which may be assumed to be just
ordinary unpleasant behavior.
-
Not seeing forms of control or abuse
because it's not on our radar screens.
Often we are more attentive to
establishing or maintaining trust in the
therapeutic alliance and less focused on
identifying abuse.
-
Confrontational tactics with abusers
rarely produce positive results.
-
Disempowering survivors by defining
their experiences and urging action is
dangerous and counterproductive.
It is helpful to good counseling practice to
have the kind of comprehensive understanding
of abuse that Emerge provides, alongside
therapeutic skills that focus attention on
the specifics of a relationship. I believe
that much of what therapists have learned
about human functioning can be adapted to
integrate well with abuse education
philosophy once we know to include it in our
work. That integration begins with how we
assess, and assessment by counselors is what
I will focus on in this article.
Assessment is sometimes thought of as what
we do at the beginning of a therapeutic
relationship. But there are no guarantees
that we are given complete information. Many
people are not yet comfortable enough to be
open, or do not wish to reveal certain
behavior or thoughts, or their thinking or
perceptions are distorted. So assessment
is, properly, a continuous process.
Many years ago therapists were often
uncomfortable asking about substance use.
Now this is fairly routine, and most of us
are relaxed and comfortable with it. Most
of us have also become comfortable asking
about sex. Additionally, we're recognizing
how the other (often socially taboo) topics
of money and religion can be useful areas of
inquiry. We are beginning to develop a
similar "it's routine to discuss this"
attitude about gender and sexual
orientation. But while we may ask basic
questions about physical safety or threat of
it in relationships, we often stop there.
Assessment of individuals should include
questions about other forms of abuse, more
subtle behavior, and contexts, as well as
beliefs about relationships.
The assessment tools we use, whether formal
or informal, can be similar for considering
the possibility of either survivor or
perpetrator roles. We look not only at
behavior, but attitudes, history, and
context. Emerge uses some of the following
assessment tools, of which I was able to
play a part in helping to design:
1.
A brainstorming exercise in the form of an
extensive checklist of behavior and
attitudes ranging from the unpleasant to the
potentially lethal;
this can be used for survivors individually
or in groups; it can also be used for
perpetrators assessing themselves or
imagining what their partners might say.
2.
A set of evaluation questions
(at Emerge, we use the Violent and
Controlling Behavior Checklist - ed.)
to help therapists tune in to perpetrator
behavior and beliefs in specific, relevant
ways; these can also be helpful in abuser
education groups. The questions can be used
with survivors to help clarify patterns in
their relationships.
3.
A comprehensive set of question and
guidelines for determining whether specific
actions that clients identify constitute
abusive behavior. Called Defining Domestic
Violence: Three Considerations, a Tool for
Counselors and Therapists [Contact the
Emerge office for more information on these
tools].
Emerge has developed a day-long training for
therapists on the complexities of assessing
for domestic abuse called
"Is It Abuse?".
Although we have no upcoming dates at this
point, please let Emerge know if you might
be interested in this training.
When we assess in therapy we are of course
trying to get a complete picture, including
many areas in addition to the question of
possible domestic abuse. Deciding where to
focus our goal-setting work can be confusing
if there are other pressing concerns too.
In a future article I will address
assessment and treatment dilemmas I have
encountered when working with couples. Next
month, I will share with you some of my own
experiences and dilemmas assessing
individual adults, both survivors and
perpetrators. I will use fabricated case
examples constructed from combinations of
characteristics of my (and other
therapists') clients, and add a few thoughts
about treatment.
|
