Domain – Abuse and violence (guiding topics)

Communication

Identify and Manage Barriers to Communication

• Language Differences: Use interpreters or translation services.
• Cultural Differences: Understand cultural norms and practices.
• Health Literacy: Use simple language and visual aids.
• Hearing or Visual Impairments: Use assistive devices and ensure a quiet environment.
• Emotional Barriers: Build trust and use empathy to create a supportive environment.

Understand Specific Considerations for Aboriginal or Torres Strait Islander Patients

• Cultural Respect: Acknowledge and respect cultural heritage and practices.
• Family and Community Involvement: Include family or community members in discussions if appropriate.
• Communication Style: Use indirect questioning and allow for silence in conversations.
• Trust Building: Spend time building rapport and trust.

Manage Distress

• Active Listening: Show empathy and validate feelings.
• Provide Reassurance: Offer comfort and support.
• Calm Environment: Create a safe and quiet space for discussions.

Use De-Escalation Techniques

• Stay Calm: Maintain a composed demeanor.
• Non-Threatening Body Language: Use open and relaxed posture.
• Clear Communication: Speak slowly and clearly.
• Empathy and Validation: Acknowledge the person’s feelings and concerns.

Apply Appropriate Counselling Techniques for PTSD or CPTSD

• Trauma-Informed Care: Understand the impact of trauma on behavior and responses.
• Safe Environment: Ensure the patient feels safe during sessions.
• Empowerment: Encourage patients to take control of their recovery process.
• Support Systems: Involve family and community support where appropriate.

Identify and Manage Trauma

• Screening: Regularly screen for signs of trauma.
• History and Documentation: Take a detailed history and document findings accurately.
• Safety Planning: Develop a plan to ensure the patient’s safety.
• Referral: Refer to specialized services for further support.

Abuse and Violence in Children and Adolescents

Recognize Symptoms and Signs

• Physical Signs: Unexplained injuries, bruises, or burns.
• Behavioral Changes: Withdrawal, aggression, or anxiety.
• Developmental Delays: Delays in physical or emotional development.

Identify Red Flags

• Inconsistent Explanations: Discrepancies between reported cause of injury and actual injury.
• Reluctance to Go Home: Fear or reluctance to return home.
• Regression: Reverting to earlier developmental stages (e.g., bedwetting).

Conduct and Document Physical Examination

• Thorough Examination: Conduct a head-to-toe physical examination.
• Photographic Documentation: Take photographs of injuries with consent.
• Detailed Records: Maintain detailed and accurate records of findings.

Assess for Exposure at Every Developmental Assessment

• Routine Screening: Include questions about safety and well-being in routine assessments.
• Vaccination Appointments: Use these opportunities to screen for abuse or violence.

Impact of Adverse Childhood Experiences

• Long-Term Effects: Understand the long-term impact on physical and mental health.
• Early Intervention: Prioritize early intervention to mitigate long-term consequences.

Management and Safety Plans

• Individualized Plans: Develop personalized safety and management plans.
• Collaborate with Services: Work with child protection services and other relevant agencies.

Mandatory Reporting Requirements

• Legal Obligation: Understand the legal requirement to report suspected abuse.
• State Differences: Familiarize with specific reporting requirements in your state.

Informed Consent for Sexual Activity

• Essential Elements: Ensure patients understand and voluntarily consent to sexual activity.
• Legal Age: Be aware of the legal age of consent.

Referral to Specialist and Community Services

• Multidisciplinary Approach: Refer to pediatricians, psychologists, and social workers.
• Community Resources: Utilize local support services and resources.

Abuse and Violence in Adults

Screening for Exposure

• Routine Screening: Include questions about safety and well-being in regular check-ups.
• Times of Vulnerability: Pay special attention during pregnancy and other vulnerable periods.

Identify Red Flags

• Physical Injuries: Unexplained bruises, fractures, or burns.
• Behavioral Changes: Anxiety, depression, or withdrawal.

History and Examination

• Comprehensive History: Take a detailed history of any incidents of abuse.
• Thorough Examination: Conduct a full physical examination and document findings.

Roles of Medico-Legal Assessor vs. Advocate

• Medico-Legal Assessor: Objective documentation and evidence collection.
• Advocate: Support and empower the patient.

Legal Requirements

• Request for Information vs. Subpoena: Understand the differences and comply accordingly.
• Privacy Act 1988: Ensure compliance with privacy regulations.

Medico-Legal Report

• Correct Terminology: Use appropriate medical and legal terminology.
• Non-Emotive Language: Maintain objectivity and avoid emotive language.

Trauma-Informed Practice

• Understanding Trauma: Recognize the effects of trauma on behavior.
• Patient-Centered Care: Focus on the patient’s needs and safety.

Initial Assessment After Sexual Assault

• Comprehensive Assessment: Conduct a thorough physical and emotional assessment.
• Post-Exposure Prophylaxis: Consider the need for prophylaxis and emergency contraception.

Impact of Adverse Childhood Events

• Long-Term Effects: Recognize the impact on adult health and behavior.
• Holistic Approach: Address both physical and emotional needs.

Managing PTSD and CPTSD

• Therapeutic Interventions: Use evidence-based therapies to manage symptoms.
• Support Systems: Engage family and community support.

Engaging with Perpetrators of Violence

• Assessment: Conduct a thorough assessment of risk and behavior.
• Management Plan: Develop a plan that includes treatment and support services.

Referral to Specialist Services

• Multidisciplinary Team: Refer to mental health professionals, legal advisors, and support groups.

Abuse and Violence in the Elderly

Identify Red Flags

• Physical Signs: Unexplained injuries, malnutrition, or poor hygiene.
• Behavioral Signs: Withdrawal, anxiety, or fearfulness.

Screening for Exposure

• Routine Screening: Include questions about safety and well-being in regular check-ups.
• Cultural Sensitivity: Approach the topic with cultural sensitivity and respect.

Vicarious Trauma and Self-Care

Recognize Susceptibility

• Awareness: Be aware that all healthcare workers are at risk of vicarious trauma.

Signs and Symptoms

• Emotional Symptoms: Anxiety, depression, or emotional numbness.
• Physical Symptoms: Fatigue, headaches, or sleep disturbances.

Coping Strategies

• Adaptive Coping: Use healthy coping mechanisms like exercise, hobbies, and social support.
• Stress Relief: Engage in activities that reduce stress and promote relaxation.

Practicing Self-Care

• Routine Self-Care: Make self-care a regular part of your routine.
• Supportive Environment: Encourage a supportive work environment where colleagues also practice self-care.

Self-Reflection

• Regular Reflection: Take time to reflect on your experiences and feelings.
• Professional Support: Seek supervision or counseling when needed.