In the previous two practice questions, we explored our mandated reporting requirements for child, elder, and dependent abuse. This week, we move away from this subject and shift our focus to the topic of domestic violence. While there may be times that the circumstances of domestic violence lead to the reporting of child, elder, or dependent abuse, this will not be the focus of this week’s blog. Instead, we are going to focus on self-determination and safety planning.
As a coach for the MFT licensing exams, I am frequently asked questions about the most appropriate interventions to use when working with victims of domestic violence. This can often be complicated by a therapist’s desire to protect their client and the client’s right to self-determination. All relationships are complex, and relationships with the presence of domestic violence are no different. There are many reasons victims of domestic violence may choose to stay in their relationship, and it will always be important for the therapist to balance their client’s right to self-determination with managing their safety. This can be a hard balancing act for therapists, and addressing feelings of countertransference is paramount.
Let’s take a look at a sample question and determine which answer is most appropriate.
A therapist has been working with a 54-year-old woman who has two grown children from two separate marriages. The woman was referred for therapy through a domestic violence support group. Her second husband, whom she still lives with, struggles with alcohol abuse and has a history of being physically aggressive when under the influence. After ending up in the hospital as a result of a physical assault perpetrated by the husband, the woman spent several weeks in a shelter. She has since returned back to the house and tells the therapist that she wants to make it work with him and is hopeful he will change, though she acknowledges he continues to drink. What actions should the therapist take in this case?
A. Direct the client to return to the shelter since the husband is continuing to abuse alcohol.B.Acknowledge the client’s desire to make the relationship work and collaborate with client on safety planning.
C. Acknowledge the client’s desire to make the relationship work and provide education about the cycle of violence.
D. Inform the client of safety concerns and encourage her to return to domestic violence shelter.
A key aspect of domestic violence is power and control. The perpetrator will often use physical or emotional violence as a way to maintain power and control over their victim. With this in mind, it will always be important to empower clients rather than impose the therapist’s own agenda, even if this means the client makes decisions that are considered unwise or unsafe. To do otherwise would put the therapist at risk of re-victimizing the client. Based on the information provided, which answer would you choose?
The best answer to this question is B. The question is asking what action we should take in this case, and based on legal and ethical obligations, we would look for the answer that manages the client’s safety while also respecting their right to self-determination. Answer B allows us to meet the client where she is at—that she is hopeful things will get better—but also allows us to collaboratively a safety plan with her should the husband become violent again. Answer A does not take into account the client’s desire to stay in the relationship and will likely make the client feel disempowered. Answer C, while acceptable, is not as strong as B. If you must choose between psycho-education on the cycle of violence and safety planning, you would generally choose the latter. Answer D is better than A, but it is wrong because it ignores the client’s stated desire to stay in the relationship and is pushing the therapist’s will onto the client.
Which answer did you choose? Does the rationale fit with your understanding of domestic violence and how you would work in the clinical setting? Or did you learn something new with this scenario? If you have any further questions feel free to check in with a TDC coach or check out our MFT Law and ethics exam prep program. We are here to support you all along the way. And if you came up with the same answer-great job! You are right on the right track to getting licensed.
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