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Practice blog

Why review regularly? Domestic abuse and good case management

As an assessor on the Leading Lights programme, I visit services all around the country to see how they work. It’s a real privilege to be welcomed into organisations, to speak to staff, and to look in detail at the work they do every day to help clients stay safe and recover from abuse. Everywhere I go I see innovative ideas, meet dedicated staff and read about the experiences of clients and the intensive support they receive.

A key area that we assess as part of Leading Lights is the use of risk assessment, and it is in this area that I have recently started to notice patterns in how services implement the risk-led model. At SafeLives we talk a lot about this risk-led response, but how should you use it in practice?

Worth the hassle?

The Leading Lights standard asks you to assess risk with the client during the intake process using an evidence-based tool (This might be the SafeLives Dash or Acpo Dash, Merit etc). We then recommend that you review risk every 6-8 weeks, as well as when circumstances change and at closure. Some services also use the severity of abuse grid to provide context to the risk score, but we recommend that this is in addition to the full Dash, not instead of it.

I do get feedback from front line workers questioning whether it’s always worth reviewing the risk formally. They highlight the fact that - due to historical risk factors - the review Dash may not show a reduction in risk even though all safety planning options have been put in place. Some also feel that completing a full review of the Dash is not helpful for the client and that clients themselves are resistant to it.

So, why do we recommend a full review is completed with the client?

  • New risks can be identified and fed into the support & safety plan e.g. access to weapons, recent incidents, recent separation, pregnancy etc.
  • To identify where risk has reduced and help with case management
  • To provide evidence of defensible decision making in terms of scaling down support or case closure.
  • It creates a dialogue with the client and helps them to understand the risk posed to them by the perpetrator.
  • It will undoubtedly bring up other information that may otherwise be missed if those questions are not asked directly.

In cases where the service has tried to review the Dash but couldn’t contact the client or they declined, it should record this clearly on the case file and keep trying to make contact - but I have found that clients very rarely decline to answer the questions. Workers I have interviewed also say that a full review of the risk assessment empowers the client and allows them to feel in control of the risk they face. Where it can be shown that risk has reduced, it also helps them to see how far they have come on their journey.

Your client's safety - and yours

So what about those cases that some argue will always remain high-risk due to the static risk factors? Where the review still shows that the case is high-risk, even though all safety measures have been put in place?

In these cases, it is still important to have that information – and this is where the severity of abuse grid can help to provide context to the score. In cases where a client is ready for a longer term service but their risk assessment still shows they are high-risk, you can still refer them on. But you need to make clear on your case file the reasons for referral and tell the other agency what has been put in place to reduce the risk.

Sometimes workers tell me that they are constantly assessing risk on a daily basis and there is no need to formally review it. But if it is all in your head and not on your file, it is unsafe for you and unsafe for your client. We have to lead by example – if we want our midwives and police officers to be asking and acting, it is important that we are also comfortable to ask the questions.

It is worth noting that workers who feel most comfortable repeating the Dash have usually developed their own ways of conducting the assessment that are also comfortable for the client. For some the tool forms part of a wider conversation, whereas others find the direct approach works best for them – the appropriate technique to use will vary from client to client.

The final thing to remember in terms of risk assessment is that the checklist forms part of a whole risk-led response. What I love to see when I open a file is regular formal review of risk cross referenced in clear case notes, backed up by regular and robust case management with a supervisor and support plans that are SMART and kept up to date as the case progresses. Those three things a happy Leading Lights assessor makes.

Blink and you’ll miss it: innovative ways to help victims disclose abuse and seek help

One quality an effective independent domestic violence advisor (Idva) needs is the ability to think creatively about the support they offer their clients. They need to offer victims a range of opportunities to take that crucial first step towards help, and towards building a safer future that’s both sustainable and full of hope.

There have been a number of news stories recently about different initiatives to encourage victims to speak out – some more successful than others.  It got us thinking about the best examples we’ve seen and we’ve listed them below, in no particular order. Whether big or small, these are all inspiring.

But first, a disclaimer. What might be the ideal way to reach out to one client could be totally unsuitable for another.  A responsibility comes with identifying victims and, as the expert, it’s up to you to determine which approach is best. The victim’s safety is paramount and any potential risks should be considered at all times.

The Red Light app

A member of the SafeLives team here described this as “the best I’ve seen”. Vodaphone has developed an app for smartphones in Turkey which, when shaken, sends an SOS to three trusted contacts. But the app only works if kept secret, so the app’s developers hid information about it in the most ingenious ways. They chose places where the average man would never look – in female toilets, lingerie labels and deep inside video tutorials for hair and make-up.

While ideal for young people, clearly this is an app that plays on gender stereotypes and wouldn’t be suitable for those in LGBT relationships, nor those who don’t own a smartphone. But the ingenious methods the developers used to communicate the app – even changing their approach after 10 months to prevent it becoming too widely known – are truly inspiring and we think earns the app a place on the list.

Business cards

Having an inconspicuous way of giving people your service’s contact details is essential. Something as innocuous as a (fake) business card is less likely to raise the suspicions of the perpetrator.

This works best when services think carefully about the client group they support. The cards need to be believable – what type of organisation is a perpetrator least likely to call? This might be different for older clients, for those who identify as LGBT, or for men in abusive relationships. The benefit of business cards is that they’re relatively inexpensive to print, but you could also provide contact details on pens, membership cards, or even lip balm. A member of the team (who shall remain anonymous) said they used to print Avon calling cards! Not sure how Avon would feel about this though…

Barcodes

Similarly, we’ve seen lots of examples of services creating ‘barcode’ stickers. These replace the usual jumble of numbers with the phone number for their helpline. Clients can then stick the barcode to any item they might normally keep in their handbag – make up, a book,  hairbrush, a bottle of water – and discreetly retrieve it whenever they need to get in touch. Unlike a business card, this would also be accessible to clients for who don’t speak English as their first language.

Emoji

If a picture’s worth a thousand words, it’s no wonder the world’s gone mad for emoji. In a recent survey by TalkTalk Mobile, 72% of 18-25 year olds said they found it easier to express their feelings in emoji symbols than text.

Earlier this year, a Swedish children’s charity launched a set of ‘abused emoji’ to help children and young people living with domestic abuse to seek help. With emoji being such a huge part of the way young people communicate, the app’s creators believe the icons could offer a first step to talking about their problems.

So that’s our top 4 examples of innovative ways of reaching out to victims and encouraging them to take their first brave step towards help. Perhaps you know of others?  We’d love to hear about them.

Why Citizens Advice is asking everyone to ‘Talk about abuse’

Rachel Burr, Campaigns Officer at Citizens Advice, shares details of the charity’s latest campaign to get the nation to open up about domestic abuse.

I don’t need to tell you the stats. But it’s pretty shocking to think that, according to the Crime Survey of England and Wales, last year one in every fifteen women, and one in every 33 men experienced domestic abuse at the hands of their partner or former partner. And that’s just the tip of the iceberg.

Specialist services do some amazing work, but sadly most victims never get specialist help. We know victims are more likely to talk to friends and family than the police or specialist services. Friends and family may be able to support victims where others might not be able to, but at the moment they don’t always feel confident in doing so.

That’s why, today, Citizens Advice launches the ‘Talk about abuse’ campaign.

We want to empower everyone to recognise abuse, to talk about it safely and to enable victims to make the right decisions for themselves. We’ll be directing friends and family members to our online guidance, which has been written with help from specialists such as SafeLives, and gives people tips on how to start a conversation, while signposting to further support.

We’re launching the campaign with an event in parliament, where we’re delighted to have Diana Barran, Chief Executive of SafeLives, speaking. We’ll also be kicking off an online Twitter chat about the signs of domestic abuse, at 1pm. Follow @CABaction and #talkaboutabuse to take part.

Get involved

The success of this campaign depends on getting the message out as widely as possible. We want to start thousands of conversations in our communities, to get the country talking about domestic abuse.

You can get involved by publicising the campaign on social media, putting posters and leaflets in as many locations as possible, and by letting clients and colleagues know about our online guidance.

For more information, contact rachel.burr@citizensadvice.org.uk.

Why it’s good to be selfish: self-care tips for Idvas

Are you struggling to switch off? Don’t worry, you’re not alone.

As a trainer and assessor for SafeLives, I get to meet Idvas from all over the UK. Whilst there are many local issues that affect practice, there are some things I hear over and over – no matter where I go.

One Idva I spoke to recently summed it up nicely. “I’ve been an Idva for 4 years and I love this job,” she explained. “But it’s hard and it feels like it’s getting harder. Other services are being cut, so referrals are shooting up. Resources are short and long-term contracts are few and far between. There’s no real feeling of security.”

On top of all this, Idvas hear about the abuse and trauma experienced by others, day after day. They see the aftermath of the very worst of human behaviour. So it’s no wonder they find it hard to leave their work stresses at the office.

Often, Idvas will describe themselves as being ‘burnt out’.

Whilst this may well be the case, sometimes what they‘re experiencing is something called vicarious trauma. Vicarious trauma results from repeated exposure to the trauma of others. It impacts on our physical and mental health and alters our view of the world. We stop feeling safe.

If you’ve ever been on a plane, you’ll remember the cabin crew giving you a safety demonstration before take-off (or perhaps you were browsing the duty-free catalogue at that point?). Anyway, they talk about oxygen masks coming down from the ceiling and remind everyone to put on their own mask before helping others with theirs. We often use this analogy during training when talking about self-care. Sometimes we need a reminder that, in order to give others the best support possible, we first have to take care of ourselves.

Of course services have a responsibility to look after their staff – in our Idva training we make recommendations about the support Idvas need to manage the impact their work has on their wellbeing. But is there anything else you can do to look after yourself and minimise the impact of vicarious trauma?

Here are my top tips, based on conversations with Idvas and other professionals.

Some of them might seem basic and some might just sound like wishful thinking. But start with one and then build on it, and you’ll see how quickly new habits can develop.

  1. Have clear boundaries. Be clear where your role begin and ends. Ensure that clients and other professionals understand the limitations of your support. Idvas are not an emergency service.
     
  2. Take lunch breaks and if possible, get away from your desk. Even a walk round the block will give your eyes a rest from that computer screen and give you space to breathe.
     
  3. Book (and take!) your annual leave and any time owing. Having regular breaks from work in your diary will ensure that you maintain work/life balance and don’t get burnt out.
     
  4. Get some exercise. I know this is predictable, but exercise boosts endorphins and allows our brains and bodies to deal with stress and anxiety much better. You don’t have to take up triathlons (unless you want to), a walk at lunchtime or at the end of the day is a great start.
     
  5. Eat well. It is tempting to reach for your comfort food of choice when things get stressful, but unfortunately we tend to crave things that do not give our bodies what they need and often send our blood sugar levels all over the place (I am looking at you, chocolate doughnut). Try to keep a balance and give yourself the right fuel to get through the day feeling good.
     
  6. Ask for help. If you are struggling with something, tell someone. You are not a superhero. Make use of supervision opportunities, formal or informal. It might be hard to prioritise this when you have a to-do list as long as your arm, but busy times are when you need it most.
     
  7. Do things you enjoy. Whatever they may be. Reading, baking, running, knitting, dancing to the radio, hula hooping, or watching kittens on the internet. Anything that quiets your mind and lowers your blood pressure. If it involves exercise of some sort, then that’s two birds with one stone!
     
  8. Relax. Yes, I know it’s not always that simple. Yoga, meditation and mindfulness can all help you remember how to switch off. There are some great apps for getting started. Patchouli oil optional.
     
  9. Get enough sleep. If you work on numbers 4 and 8, hopefully this one will be easier.
     
  10. Block time out for admin. It will help keep your head clear for your next client.
     
  11. Look out for each other. Peer support is really important. Be aware if one of the team is having a hard time. Targets and cuts can all too often force us to focus on the negatives. Build a culture of recognising and celebrating achievements too, the big and the small.

So those are my suggestions. I know it sounds like a lot and you are really busy but if you only change one thing, here’s what you should do: take time for you. Because you are important. And in order to be able to support others, we have to look after ourselves first.

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Supporting B&ME victims – what the data shows

Last month saw the first national Day of Memory to commemorate victims of “honour”-based violence and abuse. Karma Nirvana, the charity behind the event, reports that at least 12 women a year are known to have been killed as a result of “honour”-based violence in the UK, although the true number is thought to be much higher.

Whilst B&ME women are disproportionately impacted by specific forms of violence against women and girls – such as forced marriage and “honour”-based violence – their experiences of violence are often intersecting and overlapping (Thiara, 2012). In other words, a B&ME woman could experience “honour”-based violence in the context of domestic abuse. Despite being just as likely to experience abuse as any other ethnic group, research shows that the level of disclosure for Black and minority ethnic (B&ME) victims of domestic abuse is far lower than that of the general population (Walby & Allen, 2004). From our own national dataset of 42,000 cases, we know that victims from B&ME communities typically suffer abuse for 1.5 times longer before getting help than those who identify as White, British or Irish.  

I started looking more closely at the data to see why this might be. A third of B&ME clients are at risk of “honour”-based violence, and they’re three times more likely to be abused by multiple perpetrators. A quarter of B&ME victims say that they need the aid of an interpreter to communicate effectively. And 1 in 5 has no recourse to public funds. This combination of more limited access to legal and other services, language barriers, abuse from extended family members and the wider community, and simply not knowing your rights means it’s no surprise that many B&ME victims feel unable to speak out about the abuse they’re experiencing.

Telling someone you’re being abused by an intimate partner or family member is an incredibly tough step to take. But the more I read, the more I realised how much this is compounded for B&ME women. I spoke to Mollin Delve, service manager at the Phoebe Centre in Ipswich – one of the specialist B&ME services using our Insights data analysis and outcome measurement service. She explained the problems her clients face: “Being from a migrant B&ME background means that the majority of our clients don’t have secure legal status in this country and are dependent on others, particularly the perpetrator, for their stay in the UK.”

It can also mean they lack knowledge about UK systems and laws. “This adds to the abusers’ control over them. Victims are often enslaved in their homes, as a result of an inability to voice their experiences. They don’t always speak English and are not allowed to learn or make friends. Many have no entitlement to public funds unless an advocate (like ourselves) helps them to access support,” Mollin reflected.

Specialist services like the Phoebe Centre, which are led and delivered by B&ME women, are essential for advocating on behalf of B&ME victims of abuse to get the support they need. But understanding the unique challenges these women face is essential if we’re ever to increase the number getting help – and this is something we all have a responsibility for, particularly as specialist  services have been drastically reduced in the past 10 years.

Some useful resources for working with B&ME clients

For more information about domestic violence and B&ME victims, including support and training options, visit Imkaan’s website.

The Home Office has published “Three steps to escaping domestic violence” – a leaflet aimed specifically at women in Black and minority ethnic communities. The leaflet is available in 12 languages and can be downloaded from the Gov.uk website.

Did you know that the Dash risk checklist is available to download in 13 community languages? You can also find tips and advice on supporting young people at risk of forced marriage in our forced marriage practice briefing.

Thank you to the Big Lottery Fund for its continued support of Insights – helping services understand how to better support families in their local area.