Staff Perspective: Military Response to Domestic Abuse - What Providers Need to Know
Domestic abuse is an issue that impacts both military and civilian families. All behavioral health providers should, at a minimum, know how to safely ask clients about it and be aware of the resources available for use when abuse is disclosed. However, many clinical providers, working both on and off military installations, report knowing very little about this topic.
Here at the Center for Deployment Psychology, we offer a two-hour training on assessment and response to domestic abuse in the military. As one of the trainers for that webinar, I have found that unless people have previously worked in the domestic abuse field, it’s not uncommon for participants to indicate having had little training on the issue and a lack of comfort addressing it with their clients. In this blog, I will offer some information and suggestions to hopefully increase knowledge about this critical issue.
Domestic Abuse and the Family Advocacy Program
While domestic abuse is not a uniquely military challenge, the military offers a wide range of services designed to specifically target abuse as well as to address circumstances that increase risk of abuse. The Family Advocacy Program (FAP) is the Department of Defense’s congressionally mandated program to prevent and respond to domestic abuse. (FAP also provides prevention and response to child abuse and problematic sexual behaviors in children and youth.) FAP not only provides treatment intervention services to victims and abusers, but they also publish data on abuse in the military and engage in awareness campaigns to increase visibility about this issue.
When first established, FAP worked only with married partners. However, over the years, they have expanded services to “intimate partners” of service members as well. With the recently published DoDI 6400.06, an “intimate partner” is now defined as a former spouse, someone who shares a child in common with a service member, someone who lives with a service member or someone who is in a dating or other intimate relationship with a service member. Assessment, treatment, and appropriate referrals are offered to all impacted partners.
Screening for Domestic Abuse
Many organizations who study the issue of violence in intimate relationships, such as the US Preventive Services Task Force and Futures without Violence, encourage using safe screening procedures including asking people about abuse in private settings where a disclosure would not put them in increased danger. When working with couples, it is particularly important to screen partners separately as opposed to asking about abuse when both partners are present. Reporting incidents of abuse in the presence of an abuser can significantly increase risk to victims. To avoid this, clinicians should consider incorporating individual meetings into assessments with all couples. By normalizing this process, it can reduce risk to victims and provide an opportunity for safe disclosure.
Like many sensitive and potentially stigmatizing issues, clients may not report abuse even when asked. It may take time to develop a relationship before abuse is disclosed. If you are looking for guidance regarding how to ask about domestic abuse, Stanford Medicine has a website with helpful suggestions: https://domesticabuse.stanford.edu/screening/how.html.
Clients will also need to know what will happen with the information if it is shared. Ethical guidelines dictate that clinical providers understand and clearly communicate privacy and confidentiality limits. In the military, there are different reporting options available. When seeking assistance from FAP, victims may choose to make either a restricted or unrestricted report. In restricted reports, victims may receive services including victim advocacy, safety planning, and counseling without concurrent notification of a military command or law enforcement. In unrestricted reports, victims receive all the same services, but military commands and law enforcement are also notified, and investigations of the incident are initiated. Empowering victims with information and choices allows them to make informed decisions.
Resources
Regardless of work setting, clinical providers working with military-connected victims should be aware of resources available and safely offer them when appropriate:
- Family Advocacy Program information: This page provides information about the services FAP provides. https://www.militaryonesource.mil/family-relationships/family-life/preventing-abuse-neglect/family-advocacy-program-the-essentials/
- Military OneSource (MOS) Victim Advocate Locator: MOS has a number of resources for service members, spouses and intimate partners experiencing abuse. At the top of the home page there is a link to a Victim Advocate Locator listing military and civilian resources. It can be searched by state or military installation. https://www.militaryonesource.mil/leaders-service-providers/child-abuse-and-domestic-abuse/victim-advocate-locator/
- National Domestic Abuse Hotline: Victims can access help for domestic/intimate partner abuse by calling (1-800-799-7233), chatting (https://thehotline.org), or texting (88788) with trained hotline staff. Also, the website offers additional information including signs of abuse and safety planning templates. This resource is for anyone and is not limited to those with a military connection.
Hopefully by asking screening questions and learning about available resources, clinical providers will be able to offer needed help and support for domestic abuse victims when they most need it.
The opinions in CDP Staff Perspective blogs are solely those of the author and do not necessarily reflect the opinion of the Uniformed Services University of the Health Science or the Department of Defense.
April Thompson, LCSW, is the Assistant Director of Special Projects at the CDP at the Uniformed Services University of Health Sciences (USU) in Bethesda, Maryland.
Domestic abuse is an issue that impacts both military and civilian families. All behavioral health providers should, at a minimum, know how to safely ask clients about it and be aware of the resources available for use when abuse is disclosed. However, many clinical providers, working both on and off military installations, report knowing very little about this topic.
Here at the Center for Deployment Psychology, we offer a two-hour training on assessment and response to domestic abuse in the military. As one of the trainers for that webinar, I have found that unless people have previously worked in the domestic abuse field, it’s not uncommon for participants to indicate having had little training on the issue and a lack of comfort addressing it with their clients. In this blog, I will offer some information and suggestions to hopefully increase knowledge about this critical issue.
Domestic Abuse and the Family Advocacy Program
While domestic abuse is not a uniquely military challenge, the military offers a wide range of services designed to specifically target abuse as well as to address circumstances that increase risk of abuse. The Family Advocacy Program (FAP) is the Department of Defense’s congressionally mandated program to prevent and respond to domestic abuse. (FAP also provides prevention and response to child abuse and problematic sexual behaviors in children and youth.) FAP not only provides treatment intervention services to victims and abusers, but they also publish data on abuse in the military and engage in awareness campaigns to increase visibility about this issue.
When first established, FAP worked only with married partners. However, over the years, they have expanded services to “intimate partners” of service members as well. With the recently published DoDI 6400.06, an “intimate partner” is now defined as a former spouse, someone who shares a child in common with a service member, someone who lives with a service member or someone who is in a dating or other intimate relationship with a service member. Assessment, treatment, and appropriate referrals are offered to all impacted partners.
Screening for Domestic Abuse
Many organizations who study the issue of violence in intimate relationships, such as the US Preventive Services Task Force and Futures without Violence, encourage using safe screening procedures including asking people about abuse in private settings where a disclosure would not put them in increased danger. When working with couples, it is particularly important to screen partners separately as opposed to asking about abuse when both partners are present. Reporting incidents of abuse in the presence of an abuser can significantly increase risk to victims. To avoid this, clinicians should consider incorporating individual meetings into assessments with all couples. By normalizing this process, it can reduce risk to victims and provide an opportunity for safe disclosure.
Like many sensitive and potentially stigmatizing issues, clients may not report abuse even when asked. It may take time to develop a relationship before abuse is disclosed. If you are looking for guidance regarding how to ask about domestic abuse, Stanford Medicine has a website with helpful suggestions: https://domesticabuse.stanford.edu/screening/how.html.
Clients will also need to know what will happen with the information if it is shared. Ethical guidelines dictate that clinical providers understand and clearly communicate privacy and confidentiality limits. In the military, there are different reporting options available. When seeking assistance from FAP, victims may choose to make either a restricted or unrestricted report. In restricted reports, victims may receive services including victim advocacy, safety planning, and counseling without concurrent notification of a military command or law enforcement. In unrestricted reports, victims receive all the same services, but military commands and law enforcement are also notified, and investigations of the incident are initiated. Empowering victims with information and choices allows them to make informed decisions.
Resources
Regardless of work setting, clinical providers working with military-connected victims should be aware of resources available and safely offer them when appropriate:
- Family Advocacy Program information: This page provides information about the services FAP provides. https://www.militaryonesource.mil/family-relationships/family-life/preventing-abuse-neglect/family-advocacy-program-the-essentials/
- Military OneSource (MOS) Victim Advocate Locator: MOS has a number of resources for service members, spouses and intimate partners experiencing abuse. At the top of the home page there is a link to a Victim Advocate Locator listing military and civilian resources. It can be searched by state or military installation. https://www.militaryonesource.mil/leaders-service-providers/child-abuse-and-domestic-abuse/victim-advocate-locator/
- National Domestic Abuse Hotline: Victims can access help for domestic/intimate partner abuse by calling (1-800-799-7233), chatting (https://thehotline.org), or texting (88788) with trained hotline staff. Also, the website offers additional information including signs of abuse and safety planning templates. This resource is for anyone and is not limited to those with a military connection.
Hopefully by asking screening questions and learning about available resources, clinical providers will be able to offer needed help and support for domestic abuse victims when they most need it.
The opinions in CDP Staff Perspective blogs are solely those of the author and do not necessarily reflect the opinion of the Uniformed Services University of the Health Science or the Department of Defense.
April Thompson, LCSW, is the Assistant Director of Special Projects at the CDP at the Uniformed Services University of Health Sciences (USU) in Bethesda, Maryland.