"To Intervene or Not to Intervene…..That Is The Question"

Patti Tebow, LMHC, BCIA and Leslie Freeman, LMHC

While the explanation of how she fell fit her medical injuries, something didn't appear right about the situation, particularly when her husband walked into the examining room. An astute medical assistant notice that when the patient saw her husband enter the room, the patient's eyes took on a look of fear followed by deadness, her voice changed from nervous energy to stillness, and her attitude changed from observant interest to despair and helplessness. What was going on?

It would be quite easy to only look at the medical aspect of this woman's injuries, treat them, and send her on her way, rather than proactively explore other treatment options which could contribute to making this person healthier. Some comments on why you would want to take the option to intervene. The behavioral, nonverbal, and attitudinal signs of this woman are loud and clear. She is emotionally hurt, very frightened, and defeated. Frequently victims, such as this patient, are unable to adequately express how they feel or what behaviors are occurring in their home. Often they have learned that it's better not to speak up, for to do so could mean further physical or emotional injuries. Over time victims learn to perceive their current life experiences as normal and common place to such an extent that they no longer discern if or when they are in harm's way. They might not even realize there are ways for this hurtful lifestyle to end. The victim, in this case a woman, may not realize how serious the situation is, particularly when there are threats to harm or kill. To allow this person to return to her environment without intervention and support could literally allow her to be killed.

The dynamics of relationships dominated by abusive power and control will not change without strong and clear cut intervention, which almost always includes law enforcement and legal accountability. Therefore, attention from external community resources who have the power to intervene with appropriate responses, accountability, and who can require change to occur within the family dynamics is essential.

The medical community is on the "front line" of response to families involved in the cycle of domestic violence and abuse. The steps taken at this juncture could literally save lives. Screening tools are invaluable in helping medical personnel gain information regarding the frequency, duration, and severity of the abuse. Dr. Lenore Walker, psychologist, has developed a series of pragmatic self-assessment screening tools that are behaviorally oriented to assist patients in assessing the level of abuse in their relationships. Using these tools will not only allow you to better evaluate and refer patients to appropriate resources, but can empower victims to make valuable step towards changing and saving their lives.