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Alcohol and Other Drugs professionals


17 NOV 2012

The following case study is a good practice example of how alcohol and other drugs (substance misuse) professionals can help clients who are affected by domestic and family violence.

Casey and Holly

Casey discloses to you that her partner, Shannon, physically and verbally abuses her. He is worse when he uses meth.

Shannon and Casey also both use heroin and alcohol. Shannon supplies Casey’s drugs. She says he tells her she is a useless junkie and no one else would want her. Casey wants to leave Shannon, as she is very fearful for her safety. But she is worried about her access to drugs, his mates’ violence and where she might go to live with her daughter, Holly, who is three years old.

You have identified and discussed with Casey that she has been experiencing domestic family violence, and that Shannon uses emotional and verbal abuse to maintain his power and control over her. You discuss the impacts of domestic and family violence and help Casey identify how it has impacted on her sense of self and contributed to her difficulties, including her drug and alcohol use.

Your service has a domestic and family violence policy with screening protocols, a risk assessment framework and a solid practice in safety planning. You have developed and nurtured solid collaborative practice networks with domestic violence services, police, court support services as well as family support and early intervention child protection services.

In supporting and counselling Casey around her substance misuse, you assess the risk factors – Shannon’s history of severe violence and abuse, drug usage and the potential escalation of risk if Casey leaves. You discuss these with Casey.

You help Casey to understand the interweaving of her substance misuse and the violence she lives with, and explain that you will support her in making choices that help her to heal and make changes. You discuss the likelihood of separation being maintained, in light of Shannon’s role as Casey’s supplier, and the social isolation that has occurred since Casey became involved with Shannon. You link her management of her drug issues with rebuilding a safe and secure life that is free from violence.

In working to rebuild Casey’s self-esteem and positive behaviours and choices, you help to build her understanding of the effects of domestic and family violence and trauma on both her and her daughter. Validating her mixed and confused feelings and normalising them as consequences of domestic and sexual violence helps Casey to move to become more accepting of these feelings, which in turn will help her to inform more safe and protective decisions and choices.

Safety planning

In safety planning with Casey, you discuss how she can stay safe now, whether a protection order would be valuable, and you provide a warm referral to a specialist domestic family violence police officer – one you know is skilled at working with people who have complex needs and are affected by domestic family violence.

You consider any mandatory reporting requirements for Holly. You discuss the risk and safety issues for her with Casey, and the impacts of ongoing exposure to domestic and family violence on her wellbeing, and talk about child protection options under the relevant laws in your state or territory.

Casey suggests that the best safety strategy to protect Holly from further exposure to violence is for Casey and Holly to move in with Casey’s cousin, who lives in a security block.

With Casey’s agreement, you talk to the child protection early intervention or family support service while Casey is with you. You discuss emergency escape plans and provide a warm referral to a domestic and family violence counsellor.

Casey tells you she is happy for you to exchange information about risk factors and safety issues with the domestic and family violence service.

You discuss with the service the physical violence and other risk factors and organise to work with them to develop solid safety plans for Casey and Holly.

You continue to work with Casey as a client of your service, but with each visit, reassess the risk issues and make referrals or update safety plans accordingly. By exploring the links between Casey’s substance misuse, self-esteem and relationship with Shannon, Casey may eventually move towards positive choices for herself and her daughter.