SCREENINGANDINTAKEFORMS

For

Non-EmergencyDomesticViolencePrograms

PreparedbyDeadriaBoyland

December2016

AcknowledgementsSpecialthankstoNewHopeDV/SAServices,YWCAYakima,NewBeginningsforBatteredWomenandtheirChildren,KingCounty,LowerValleyCrisis&SupportServices,YakimaCounty,EmergencySupportShelter,CowlitzCounty,LifeWire,KingCounty,YWCAofClarkCounty,YWCAofTacoma/PierceCounty,KoreanWomen’sAssociation,PierceCounty,CrisisSupportNetwork,PacificCounty,DomesticViolenceCenterofGreysHarborCounty,HealthFamiliesofClallamCounty,RoomOne,OkanoganCounty,HumanResponseNetwork,LewisCounty,whokindlymadetheirmaterialsavailabletousandwereuniformlygenerouswiththeirinsight.

Iwouldalsoliketothanktheadvisorygroupwhohelpeddesignthemodelformsanddevelopthequestionsforthescreeningandguidelines:BeckyJackson,NewBeginnings;ErinnGailey;Anne-MarieSchwerin,YWCAWallaWalla;KathrynCohenYWCAClarkCounty,DeidreEvansLifewireKingCounty,DebbieGonzalezNewHopeGrantCounty,AbigailMottYWCAYakima,StephanieBarrYWCAClarkCounty.

Lastbutnotleast,aspecialthankstothestaffattheWashingtonStateCoalitionagainstDomesticViolenceforsharingtheirexpertise.SpecialthankstoJudyChen,LeighHofheimer,BeccaCampbell,ReedForesterandKellyStarr.

ThisprojectwassupportedbythefundingfromtheWashingtonStateDepartmentofSocialandHealthServices.PointsofviewinthisdocumentarethoseoftheauthorsanddonotnecessarilyrepresenttheofficialpositionorpoliciesoftheWashingtonStateofDepartmentofSocialHealthServices.

IntroductionOneofthevaluesofouradvocacyworkistocontinuallyexamineandreevaluateourpracticesand exploreways to improve our services on behalf of survivors. Even though our advocacyprogramsofferaricharrayofservicesforsurvivorsbeyondemergencyshelter,formanypeople,“seekingshelter”isstillahighlyvisibleandcommonlyrecognizedoptionforhelp.Weknowthatshelterisnotenough.Weknowthatsurvivor’sneedsarecomplexandthatweoftendon’thavethecommunityresourcesthatwewant.Andyet,survivorstellusthatgettingthroughourdoorscanbeaconfusingandoverwhelmingexperience.Survivor-centeredadvocacypracticepushesustoquestionhowwearescreeningpeoplewhoareseekinghelpfromourprogramsandasksustothinkaboutthewaysweinadvertentlycreatebarrierstoourservices.Thisreportdescribesour findings and recommendations following an assessment of the screening and intakeprocessesof13domesticviolencesheltersand2community-baseddomesticviolenceprograms.

Thingstokeepinmind

Ø Screeningformsshouldbebrief,includestaffinstructionsandprompts,orframingintroductoryorexplanatorysentencesthathelpthecallerunderstandtheprocess.Additionally,screeningquestionsshouldbelimitedandfocusedon:thesurvivor’spriorities;understandingwhatthesurvivoridentifiesasriskstothemselvesortheirchildren;andthethreatsposedbytheabuserthatimpactsafetyforthecallerortheirchildren.

Ø ShelterScreeningsshouldleadwiththeintentiontoprovidesafetyandadvocacyservicesfor

individualsexperiencingarangeofabusivetacticsfromtheirpartner.

Ø Shelterscreeningsshoulddetermineeligibilitybasedonthesurvivor’sperceptionandunderstandingoftheriskstheyarefacingfromtheirabuser.Determinationofsheltereligibilityshouldgobeyondthelimitedlegaldefinitionsofdomesticviolencefoundinstatute.

Ø Bothshelterscreeningsandintakeformsshouldincludeexplanatoryinstructionsandguidelines

withpromptsthatguidetheadvocateandparticipantthroughtheprocessandexplainthepurposeofthequestions.

Ø Bothshelterscreeningsandintakeformsshouldincludestaffpromptsthatremindadvocatesto:

explainthepurposeofthequestions;describetheiradvocacyservices;provideinformationaboutaccommodations;offertimelyneededservices,offerbreaksduringtheprocessandcheckforunderstandingwiththeparticipant.

Ø Programsprovideongoingtrainingforstaff,volunteersandreliefworkersabouttheshelter

screeningandintaketobuildconsistencyandasharedunderstandingaboutthepurposeoftheseprocesses.

1

Non-EmergencyDVProgramScreening

Date_____/______/_____Advocate:

Thankyouforcallingourprogram.Howcanweassistyoutoday? Pleasedescribeyoursituationandwhatpromptedyoutocallourprogram. Tip:Pleasefamiliarizeyourselfwiththequestionsaheadoftime.ThisisatooltoassistyouinunderstandingtheneedsoftheparticipantsothatyouareequippedtoprovidetheappropriatesupportThankyouforsharingyourstorywithme.I’msorryyouareexperiencingthischallengeinyourlife.Iwouldliketoaskyouafewquestions,sothatIcanprovidethemostappropriateservicestoyou.ParticipantFirst&LastName _______ Areyouinterestedincomingintodayorwouldyoulikeforustosetupanappointmentwithanadvocate?

Assesslevelofdanger

Screen

Screenintoprogram

Provideresources

Call911? Assistcallerincalling911?

Assesslevelofdanger

Screenparticipantintoyourprogram

2

WewanttokeepyourconncetionwithusasconfidentialaspossiblesoIwouldliketogooverthebestwaystoconnectwithyoubyphone.SafePhoneNumberwithAreaCode( ) Isitokaytoleavemessages?qYesqNoIfyes,whatspecificallyshouldthemessagesay? Whoelsemightansweryourphone? ______________ Istheabusivepartnerlivinginthehome?qYesqNoWhatisyourrelationshipwiththepersonwhoishurtingyou?________________________________Isitstillokaytocallthesafenumberprovided?qYesqNoOurprogramprovidesmanydifferentservices.Canyousharewithmewhatservicesyoumightbeinterestedin?(Thisisalsoagreattimetosharemoreinformationaboutyourprogram)□Supportgroups □LegalAdvocacy □MentalHealthsupport□Children’sServices □ChemicalDependencysupport □HousingAdvocacy□OneonOneadvocacyandSupport □other

Wehavechildren’sservices.Willyoubebringinganychildrenwithyou?_________whatareyourchildrensages?________________Ifyes,howmany?____________Whattypeofservicesdoyouthinkmightbesupportivetoyourkidsatthistime?_______________

Emergency&BasicNeedsResources:

• Foodbank• Rentalassistanceprograms• Othershelters/Dayprograms• SexualAssaultservices• Legalassistance• Financialresources• Healthclinics• Localcommunitycenters• Libraries• Otherresources

ProvideResources

3

SafetyPlanningPleasesafetyplanbeforedisconnectingwiththecaller.Oftenfolkswhocontactournon-emergencyprogramsarestillconnectedtotheirabuser.Theymightbetryingtodecideonlifeoptionsandneedtoreachouttoseewhatserviceswillsupporttheirdecisions.Theymaynothaveanyinterestinendingtherelationship.That’sok!Wecanstillhelpthemplantostayassafeaspossible.Caller’sSafetyPlan:

Safetyplanningisanongoingconversationwithasurvivorandmayormaynotbeaformalorwrittenplan.Safetyplanningstrategiesshouldberelevanttothesurvivors’priorities,decisionsandrisks.Theplanningprocessshouldbedynamicandflexibletomeetthesurvivors’changingcircumstances.Davies,J.DomesticViolenceAdvocacy:ComplexLives/DifficultChoices,2,secondedition,2014

Asafetyplanistailoredtoeachindividualandmayneedtoadjustastheirsituationchanges.Calling911:Ontherareoccasionthatyouassistedthecallerincontacting911documentthathere.________________________________________________________________________________________________________________________________________________________________________________Thanksforyourpatiencewithallthesequestions.Nowitisyourturn,doyouhaveanyquestionsforme?________________________________________________________________________________________________

________________________________________________________________________________________________

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Non-EmergencyDVProgramScreeningGuidelines

Asseslevelofd

anger

Date,Advocate’sname Thisisimportantinformationfornotingwhensomeonefirstcontactedyourprogram.

“Thankyouforcallingourprogram.Howcanweassistyoutoday? Pleasedescribeyoursituationandwhatpromptedyoutocallourprogram.”

Thankthecallerforreachingouttoyourprogram.Thisshowsyouareavailableandreadytosupport.

Assesslevelofdanger Whilelisteningtothecalleryoushouldbeabletoassessthelevelofdanger.Forexample;

• Abuserinthebackgroundyelling• Calleriswhisperingorisafraidtotalk• Callerisafraidtostayanylongerinthe

residenceandispackedandreadytogo.

Callin

g911

Callersoundsliketheyareinimmediatedanger

Youcanaskifthecallerwouldlikeforyoutoassistthemincalling911.Thiswouldrequireyoutoobtaintheirlocationandotherinformation.

Thisisnotanoptionforeveryone

Pleasebepreparedtodiscussthesomeoftheconsequencesthatcouldresultincalling911.

• Anarrestcouldhappenanditcouldbeyou,yourpartner,orboth

• Concernsaboutdeportation• Whatwillhappentothechildren?•

5

Screen

participan

tintoyourprogram

“Thankyouforsharingyourstorywithme.I’msorryyouareexperiencingthischallengeinyourlife.Iwouldliketoaskyouafewquestions,soIcanprovideyouwiththemostappropriateservices.”

Again,thankthemforsharingtheirstorywithyou.Folksarevulnerableduringthistimeandtheyaretakingariskbysharingpersonalinformationbeforetheyevenknowifyouwillbeabletohelp.

ParticipantFirst&LastName Youmightnotthinkhavingthelastnameoftheparticipantisimportantbutmostnon-emergencyprogramscanservemanypeopleatonce.It’slikelythatmanypeoplewillhavethesamefirstname.

“Areyouinterestedincomingintodayorwouldyoulikeforustosetupanappointmentwithanadvocate?”

Noteveryoneisinanemergencysituationandmightwanttomakeanappointment.Thisalsoallowsyoutheopportunityto:

• safetyplan• discussresourcesinthecommunity• giveanideaofwhattoexpectatan

appointment• getdocumentsreadyifneeded• planforarideorbusdirections• getchildcareifneeded• workaroundtheirworkschedule

“WewanttokeepyourconnectionwithusasconfidentialaspossiblesoIwouldliketogooverthebestwaystoconnectwithyoubyphone.“

Ifthecallersaysit’sokforyoutocallthemit’simportanttodiscusssafetyplanningwhileusingthephone.It’salsoimportanttoknowiftheabuserisstillinthehomeandmayanswerthephone.

SafePhoneNumberwithAreaCode“Isitokaytoleavemessages?”

Makethedistinctionofcallingvs.leavingamessage.Itmightbeoktocallthephonebutnotleaveamessage.Areacodesareimportantwithcellphones.Noteveryoneislocalandyouwillneedtheareacodetocallthemback.

6

Screen

participan

tintoyourprogram

“Ifyes,whatspecificallyshouldthemessagesay?”

Thecallermightwantyoutohaveasecretphraseplanned.Forexample:“HithisisSandyfromAvon;theknittinggrouponPike;orthelocalyogaclass.Iwillcallbacktomorrow.”

“Whoelsemightansweryourphone?” Thecallermightnotthinkthatsomeoneelsewillanswertheirphonesoit’salwaysgoodtogetclarificationandplanforallpossibilities.

“Istheabusivepartnerlivinginthehome?”

Thisquestionwillhelpyouunderstandwhythecallermightbespeakingquietlyand/ornotengagingwithyouatthetimeofyourcall.

“Whatisyourrelationshipwiththeabuser?”

It’shelpfultoknowwhatroletheabusivepersonplaysinthelifeofthecaller.Theabusercouldcontrolwhenthecallerleavesthehouseand/orhowtheygettotheirappointments.Youshouldbepreparedtoprovidesomehelpfultipsandsafetyplanningonhowtogettoyouroffice.

“Isitstillokaytocallthesafenumberprovided?”

Whyaskthisagain?Afterthepreviousquestionsthecallermayhavedecidedthatit’snotagoodideaforyoutocallback.Nowisthetimetotalkaboutasafewaytocommunicate.

“Ourprogramprovidesmanydifferentservices.Canyousharewithmewhatservicesyoumightbeinterestedin?”

Aftersharingwhatservicesyouprovideit’sagoodideatouncoverwhatthecallermightbeinterestedin.Theymightbeabletoconnecttootherresourcesbeforecomingtotheappointment.

“Wehavechildren’sservices,willyoubebringinganychildrenwithyou?”

Sharingthatyouhaveservicesforkidssaysyouareopentonotjustservingthecallerbutthechildrenaswell.

“Whattypeofservicesdoyouthinkmightbesupportivetoyourkidsatthistime?”

Byaskingthisquestionyougetasmallwindowintowhatthechildrenmightneedandwhatyoumightneedtoprovideresourcesfor.

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ProvideRe

sources

Providethecallerwithresourcesinthearea.

• Foodbank• Rentalassistanceprograms• Othershelters/Dayprograms• SexualAssaultservices• Legalassistance

Safetyplanbeforeyoudisconnectwiththecaller.

Oftenfolkswhocontactournon-emergencyprogramsarestillconnectedtotheirabuser.Theymightbetryingtodecideonlifeoptionsandneedtoreachouttoseewhatserviceswillsupporttheirdecisions.Theymaynothaveanyinterestinendingtherelationship.That’sok!Wecanstillhelpthemplantostayassafeaspossible.Safetyplanningisanongoingconversationwithasurvivorandmayormaynotbeaformalorwrittenplan.Safetyplanningstrategiesshouldberelevanttothesurvivors’priorities,decisionsandrisks.Theplanningprocessshouldbedynamicandflexibletomeetthesurvivors’changingcircumstances.Davies,J.DomesticViolenceAdvocacy:ComplexLives/DifficultChoices,2,secondedition,2014

Calling911:Ontherareoccasionthatyouassistedthecallerincontacting911documentthathere.

Thisdoesnothappenoften,howeverifyouassistedthecallerincalling911,documenttheinformationincasethepolicedepartmentcallsyoubackorfollowsupformoreinformation.

QuestionsNOTonthisform:Toomanyquestionscanbeoverwhelming.Ifyoudonotseequestionsonthisformthatyounormallyask,pleaseconsiderputtingthesequestionsonanoptionalformforthemtofilloutandgivebacktoyoulater.

Consideralternativestoaskingalotofquestionsonyourforms.Additionalquestions,liketheonesbelow,canbeonahandoutthatparticipantsfilloutontheirowntimeandreturntoyou.

• Courtorder,policeinvolvement• Veteranormilitarystatus• Additionaldemographicsorneedsof

children(canthisbecollectedwiththechildren’sadvocate?

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Non-EmergencyDVProgramIntake

Name__________________________Date_____________Interpreter__________________CellNumber______________________LastAddress______________________________City______________________State_________________ZipCode:__________________ID# DateofBirth

Tip:PleasefamiliarizeyourselfwiththeIntakequestionsaheadoftime.ThisisatooltoassistyouinunderstandingtheneedsoftheparticipantsothatyouareequippedtoprovidetheappropriatesupportWelcomingstatement:“Ihopewewillbeabletoprovideyouwiththeresourcesyouneedandifnot,guideyouintherightdirection.Ourprogramwelcomeseveryone–andweopenourdoorstoindividualswhoreachouttousfromdifferentcultures,raceandethnicities,fromavarietyofreligiousbackgrounds,folkswithdiversegenderidentitiesandsexualorientations,folkswithhiddenorvisibledisabilities,folkswhohavesubstanceusechallenges,folkswithmoneyornomoney–justliketheworldaroundus.”Tip:Wheneverpossible,beforeyoubeginthepaperwork,taketheparticipants(includingchildren)onatourofyourprogram.Providethemwithanopportunitytogetacquaintedwithanunfamiliarplace.Sharethehighlightsofyourprogrambeforeyougettothepersonalquestionsonyourform.Thisallowsfolktimetogetcomfortableandappreciatethegoalofyourprogram.AccessibilitywithinourFacilitiesDidyounoticeanythingonourtourthatmightpreventyoufromgettingaround?Doyouhaveanyconcernsorhesitationsaboutusingourprogram?Doyouhaveanyaccessneedsthatweshouldknowabout?qNoqYesPleasedescribe:_____________________________________________________

Introductionsandoverviewofyourprogram

Letusgettoknowyoubetter

Wewanttodoourbesttosupportyou

Introductionsandoverviewofyourprogram

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.Tip:Shiftingtheconversation–sharingthestory“Thenextquestionisfocusedonsharingwhatbroughtyoutoourprogram.Pleasetakeyourtimeandfeelfreetostopifyouneedtotakeabreak.Pleasesharewhateveryoufeelcomfortablewith,allyouranswersarevoluntary.Wekeepthisinformationconfidentialandwedon’tshareitwithanyonewithoutyourpermission.Except,ifyoutellusthatyouwanttohurtyourselforsomeoneelse,oryoutellusthatyourchildhasdirectlyexperiencedabuse.”Iknowthisisadifficulttimeforyou,andwhenyoufeelcomfortable,Iamreadytohearabouttheeventsthatledyoutocallourprogram.

Tip:Oncetrusthasbeenestablished,andbecausewewanttoprovidethebestadvocacyservices,itmaybehelpfultoknowhowapersonidentifiestheirgender.Remindparticipantstosharewhatevertheyfeelcomfortablewith,alltheiranswersarevoluntary.Makeawelcomingspaceforpeopleofallgendersandopenthedoorforadvocacyafterintake.Whatisyourgenderidentity?___________________________________________________qFemaleqMaleqTransgenderqGendernon-conformingqSomethingelseyouwouldliketoshare_________________________________________Canyousharewhatyourrelationshipiswiththepersonwhoisharmingyou?qSpouseqBoyfriend/GirlfriendqEx-Boyfriend/Ex-GirlfriendqPartnerqOtherrelationship________

Letusgettoknowyoubetter

Wewanttodoourbesttosupportyou

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Tip:Timetocheck-inandlettheparticipantknowthatyoubeaskingthemtodescribetheirexperienceoflivingwithabuse.Lettheparticipantknowthatyouarehappytotakeabreakandreturntothisconversation.Canyoudescribeyourexperienceofabuse?EmotionalAbuse:______________________________________________________________ PhysicalAbuse:_______________________________________________________________ SexualAbuse:_________________________________________________________________Othertactics:_________________________________________________________________Wewouldliketogettoknowyourchildren.Canyousharetheirnamesandanyparticularneedsthatwecansupportyouwith?

Name Gender DateofBirth Age

Hasyourpartnereverharmedyourchildren?qNoqYes, Pleasedescribe:___________________________________________________Canyousharehowyourchildrenwereharmed? qNoqYes, Pleasedescribe:___________________________________________________Whatisyourbiggestconcernforyourchildrenrightnow? qNoqYes, Pleasedescribe:___________________________________________________Experiencingabusecanbeextremelydifficulttolivewithandsometimesitcanleadtopeopleharmingthemselvestoeasethepain.Haveyoueverthoughtaboutharmingyourself?qNoqYes Pleasedescribe:_______________________________________________________________Haveyoueverdoneanythingtohurtyourself?qNoqYes Pleasedescribe:_______________________________________________________________Whileyouarewithus,ifyouarefeelinglikeyoumightwanttoharmyourselfwouldbewillingtotalktostaffandsharehowwecansupportyou?_________________________________Manypeopleexperiencingabuseusealcoholorotherdrugstohelpthemcope.Weareheretosupportyouandcanconnectyoutoresourcesthatmatchyourneeds.Isthissomethingthatyouwouldlikehelpwith?qNoqYes,Howcanwesupportyou?____________________________________________

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Thismaynotbeaconcernforyounow,howeverweleteveryoneknowthatwecantalkwithyouaboutarangeofbirthcontroloptionsincludingemergencycontraception.Wouldyoulikemoreinformationaboutthis?qNoqYesPleasedescribe:____________________________________________________Tip:Lettheparticipantknowthatthenextsetofquestionsfocusonwhattheymayneedtobecomfortableinthisspaceandincludessomedemographicquestions.Remindparticipantsthattheanswersarevoluntaryandyoucanreturntothematalatertime.Manypeoplehavebeenprescribedmedicationtotakedaily.Ifyouneedhelpwithrefillingaprescription,wecanassistyouwiththat.Doyouoryourchildrenhaveanyconcernsabouthealthormedicalrelatedissuesthatyouwouldliketoaddress?qNoqYesPleasedescribe:________________________________Doyouhaveanyculturalorreligiousneeds?qNoqYesPleasedescribe:______________________________________________________________Canyousharewhatspecificcultural,ethnicgroupsorcommunitiesyouidentifywith?Race:�AfricanAmerican �Asian �NativeAmerican �AlaskaNative �PacificIslander �White �Multiracial�Other_______ Ethnicity:�Non-Hispanic/Non-Latino �Hispanic/Latino �Other________Canyousharewhatisyourmainsourceofincome?qTANF__________IfnotonTANF,eligible?__________qSSI__________qWorker’sCompensation__________qNoneqUnknown qEmployment__________qVeteran’sDisability__________qGA___________qUnabletoWork____________________qOther:____________HasparticipanteverreceivedinformationonapplyingforTANF?____________*IfNOTonTANFandpossiblyeligible,giveinformationNOWonhowtoapply.

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Ourprogramworkswithinourcommunitytoconnectyoutoservicestosupportyouandyourfamily.Let’sdiscusssomeoftheseprogramsandseeifyoumightbeinterestedintheirservices.qCommunityAdvocacy qEmployment/VocationalCounselingorTraining qDrug/AlcoholCounseling qLegalAdvocacy qFood/ClothingqGroupSupportqCourtAdvocacy qChildcare/RespiteCare qCulturallyAppropriateServicesqInterpreterServices qEducation qOtherqShelter qESL qNoParticipantServicesNeededqHousing qAddressConfidentialityProgramqUnknownqFinancialAssistance qHealthcare/Medication qTransportation qParent-SkillCounselingqDVEducation qMentalHealthCounselingEmergencyContactInformation__________________________________(Incaseofanemergencyisthereanyoneyouwouldlikeforustocontact?) SafetyPlanningSafetyplanningisanongoingconversationwithasurvivorandmayormaynotbeaformalorwrittenplan.Safetyplanningstrategiesshouldberelevanttothesurvivors’priorities,decisionsandrisks.Theplanningprocessshouldbedynamicandflexibletomeetthesurvivors’changingcircumstances.Davies,J.DomesticViolenceAdvocacy:ComplexLives/DifficultChoices,2,secondedition,2014

____________________________________________________________________________________________________________________________________________________________Thanksforyourpatiencewithallthesequestions.Nowitisyourturn,doyouhaveanyquestionsforme?_____________________________________________________________________________________________________________________________________________

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Non-EmergencyDVProgramIntakeGuidelines

Introd

uctio

nsand

overviewofy

ourp

rogram

ParticipantFirst&LastName,ProgramID#,DateofBirth.

Youmightnotthinkhavingthelastnameoftheparticipantisimportantbutmostnon-emergencyprogramscanservemanypeopleatonce.It’slikelythatmanypeoplewillhavethesamefirstname.

Tip:Pleasefamiliarizeyourselfwiththeintakequestionsaheadoftime.Thisisatooltoassistyouinunderstandingtheneedsoftheparticipantsothatyouareequippedtoprovidetheappropriatesupport.Welcomingstatement:Createastatementthatworksforyourprogram

“Ihopewewillbeabletoprovideyouwiththeresourcesyouneedandifnot,guideyouintherightdirection.Ourprogramwelcomeseveryone–andweopenourdoorstoindividualswhoreachouttousfromdifferentcultures,raceandethnicities,fromavarietyofreligiousbackgrounds,folkswithdiversegenderidentitiesandsexualorientations,folkswithhiddenorvisibledisabilities,folkswhohavesubstanceusechallenges,folkswithmoneyornomoney–justliketheworldaroundus.”

Tip:Wheneverpossible,beforeyoubeginthepaperwork,taketheparticipants(includingchildren)onatourofyourprogram.Providethemwithanopportunitytogetacquaintedwithanunfamiliarplace.Sharethehighlightsofyourprogrambeforeyougettothepersonalquestionsonyourform.Thisallowsfolktimetogetcomfortableandappreciatethegoalofyourprogram.Explainthegoalofyourprogramandhowyouplantosupporttheparticipant(caution:toomuchorganizationaldetailmaybeunnecessaryatthistime).Shareifyouprovide24-houradvocacycoverage,legaladvocacyservices,and/orhousingspecialists.Doyouallowsmokingaroundthefacility?Canfamilymembersvisit?Thinkaboutthemostimportantthingssomeoneneedstoknowupfront.Advocatecangainalotbyjustlisteningtosomeonesharingtheirstory.Accessibility Thinkhowpeopleusethespace–whatdopeople

needtofunctionsuccessfullyinyourfacility.Providingatouroftheprogramgivesyoutheopportunitytoengagewiththeparticipantwhilewalkingaround.Makesuretoinquireaboutthechildrenandtheirabilitytogetaroundoranyotheraccessneed.

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Letu

sgetto

kno

wyou

better

Tip:Shiftingtheconversation–sharingthestory“Thenextquestionisfocusedonsharingwhatbroughtyoutoourprogram.Pleasetakeyourtimeandfeelfreetostopifyouneedtotakeabreak.Pleasesharewhateveryoufeelcomfortablewith,allyouranswersarevoluntary.Wekeepthisinformationconfidentialandwedon’tshareitwithanyonewithoutyourpermission.Except,ifyoutellusthatyouwanttohurtyourselforsomeoneelse,oryoutellusthatyourchildhasdirectlyexperiencedabuse.”Byusingthislanguage,youaresharing:1. Thetransitiontoanewsetofquestions.2. Acknowledgmentthatitisokayforparticipantstotakecareofthemselves,and3. Theparticipantisguidingtheconversation.“Iknowthisisadifficulttimeforyou,andwhenyoufeelcomfortable,Iamreadytohearabouttheeventsthatledyoutocallourprogram

Thewayyouaskthisquestionisimportanttobuildingaconnectionandtrustwiththeparticipant.Invitingtheparticipant“toshare”ratherthanmakingthemfeelliketheyhavenochoice.Usephraseslike:“canyoushare”or“whenyoufeelcomfortable,let’sbegin.”Avoidingphraseslike“tellmewhathappenedwhenyouwereabused”or“tellmethedetailsabouttherecentincident.”

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Wewan

ttodo

ourbesttosupp

orty

ou

Tip:Oncetrusthasbeenestablished,andbecausewewanttoprovidethebestadvocacyservices,itmaybehelpfultoknowhowapersonidentifiestheirgender.Remindparticipantstosharewhatevertheyfeelcomfortablewith,alltheiranswersarevoluntary.

Gender–Whatisyourgenderidentity?• Female• Male• Transgender• Gendernon-conforming• Somethingelseyouwouldliketo

share?

Don’tassumeyouknowthegenderoftheprogramparticipant.Oriftheyidentifywithagenderthatistheoneyouthink.

Canyousharewhatyourrelationshipiswiththepersonharmingyou?• Spouse• Girlfriendor(Ex)• Boyfriendor(Ex)• Partner• Otherrelationship?

Noticehowtheparticipantdescribestheirrelationship,usethesamelanguage.Refrainfromcallingtheirpartner“yourabuser,yourbattererortheperpetrator.”

Tip:Timetocheck-inandlettheparticipantknowthatyoubeaskingthemtodescribetheirexperienceoflivingwithabuse.Lettheparticipantknowthatyouarehappytotakeabreakandreturntothisconversation.Canyoudescribeyourexperienceofabuse?• Emotionalabuse• Physicalabuse• SexualAbuse• Othertactics

Mostpeoplelivingwithabusehaveexperienceddifferenttypesofbehaviorslike:threats,putdownsphysicalorsexualabuse,restrictingaccesstomoney,usingadisabilityagainstyou,usingthechildrenagainstyou,interferingwithbirthcontrolanddecisionsaroundfamilyplanning

Wewouldliketogettoknowyourchildren.Canyousharetheirnamesandanyparticularneedsthatwecansupportyouwith?• Hasyourpartnereverharmedyour

children?• Canyousharehowyourchildrenwere

harmed?• Whatisyourbiggestconcernforthe

childrenrightnow?

Theintentofthesequestionsaretolaythefoundationforworkingwiththeparticipantonhowtobestsupportthechild(ren).Weknowthatremovingachild(ren)fromafamiliarspacetoanunfamiliarplaceandchangingroutinesisoftenconfusingandupsetting.

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Experiencingdomesticviolencecanbeextremelydifficulttolivewithandsometimesitcanleadtopeopleharmingthemselvestoeasethepain.• Haveyoueverthoughtaboutharming

yourself?• Haveyoueverdoneanythingtohurt

yourself?• “Whileyouarewithus,ifyouare

feelinglikeyoumightwanttoharmyourselfwouldbewillingtotalktostaff?Couldyoufindastaffpersonandsharehowwecansupportyou?”

“Experiencingdomesticviolencecanbeextremelydifficulttolivewithandsometimesitcanleadtopeopleharmingthemselvestoeasethepain.”“Whileyouarewithus,ifyouarefeelinglikeyoumightwanttoharmyourselfwouldbewillingtotalktostaff?”ForinformationcheckoutthiswebinarontheWSCADVwebsite--SuicideAssessmentandInterventionWebinarbySueEastgard.https://wscadv.org/resources/suicide-assessment-and-intervention-webinar/

Manypeopleexperiencingdomesticviolenceusealcoholorotherdrugstohelpthemcope.Weareheretosupportyouandcanconnectyoutoresourcesthatmatchyourneeds.Issomethingthatyouwouldlikehelpwith?

Theintenthereistooffersupportifneeded,nottopunishpeopleormakethemfeelbadaboutusing.Usingsubstancesshouldnotbeareasontoasksomeonetoleaveyourprogram.

Thismaynotbeaconcernforyounow,howeverweleteveryoneknowthatwecantalkwithyouaboutarangeofbirthcontroloptionsincludingemergencycontraception.Wouldyoulikemoreinformationaboutthis?

Thereareoptionsforfolkswhothinktheymightbepregnantandaretryingtodecideaboutthislifechangingdecision.EmergencyContraceptionworksbestwithinthreedaysofintercourseandcanpreventpregnancy.(Somefolkshavethisonsiteifnot,PlanBisavailableonstoreshelvesortheinternetatAfterpill.com.Weknowthatmanysurvivorstalkaboutthewaystheirpartnerinterferedwiththeirbirthcontrolordidn’trespecttheirdecisionsaroundfamilyplanning.TheWSCADVwebsite’sReproductiveJusticepagehasinformationaboutbasicformsofbirthcontrolthatarelesslikelytobefeltbyapartner.InformationaboutteenrightsaroundaccesstobirthcontrolandparentalnotificationinWA.Informationabouthowemergencycontraceptionworksandwhereyoucangetit(ifyourprogramdoesnothaveitasaresource).

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Tip:Lettheparticipantknowthatthenextsetofquestionsfocusonwhattheymayneedtobecomfortableinthisspaceandincludessomedemographicquestions.Remindparticipantsthattheanswersarevoluntaryandyoucanreturntothematalatertime.

Manypeoplehavebeenprescribedmedicationtotakedaily.Ifyouneedhelpwithrefillingaprescription,wecanassistyouwiththat.Doyouoryourchildrenhaveanyconcernsabouthealthormedicalrelatedissuesthatyouwouldliketoaddress?

• Areyouoryourchildrenonanymedicationthatstaffshouldbeawareof?

Askingaboutgeneralhealthconcernshelpsyouidentifythesupportthataparticipantortheirchild(ren)mightneed.

Askingaboutprescriptionsisnotanopportunityforyoutodeterminewhatmedicationtheyaretaking;butrather,iftheyhaveenoughtolastforseveraldays.Doesyourprogramprovideapersonallockboxforthemtousewhileintheprogram?Canyourefillmedsquicklyifneeded?

Doyouhaveanyculturalorreligiousneeds?

Canyousharewhatspecificcultural,ethnicgroupsorcommunitiesyouidentifywith?

Participantsappreciateyoureffortstoidentifytheirculturalorreligiousneedswhichwillhelpthemhaveapositiveexperienceinyourprogram.Supportingaparticipant’sculturalandreligiousneedssendsamessagethatyourprogramiswelcomingtoall.Ifpossible,knowingthisinformationaheadoftimecanhelpyoupreparefortheirarrivalandincreaseaparticipant’scomfort.

“Financialstabilityisanimportantpartofsurvival.Ourprogramcanreferyoutofinancialresourcesintheareaifneeded.Canyousharewhatisthemainsourceofyourincome?“

Weknowthathavingasourceofincomeiscritical.Weaskthisquestionsothatifyouneedassistancewecanprovideyouwithinformation.

Ourprogramworkswithinourcommunitytoconnectyoutoservicestosupportyouandyourfamily.Let’sdiscusssomeoftheseprogramsandseeifyoumightbeinterestedintheirservices.

Thisisagreatwaytouncovertheservicestheparticipantmayhavealreadytappedintoandprovideefficientcoordinationandcollaboratewithexistingsupports.And,theparticipantmaywantadditionalinformationorclarificationabouthowtoaccessotherresources.

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EmergencyContactInformation Thisinformationshouldonlybeusedinextremeemergenciesandwiththeparticipant’spermission.Theparticipantgetstodecidewhatconstitutesanemergency.Thisinformationisnottobeusedtotrytolocatesomeoneiftheydonotreturntoyourprogramafterafewdays.Wearenotdetectivesandparticipationinourprogramisvoluntary!

SafetyPlanning Safetyplanningisanongoingconversationwithasurvivorandmayormaynotbeaformalorwrittenplan.Safetyplanningstrategiesshouldberelevanttothesurvivors’priorities,decisionsandrisks.Theplanningprocessshouldbedynamicandflexibletomeetthesurvivors’changingcircumstances.Davies,J.DomesticViolenceAdvocacy:ComplexLives/DifficultChoices,2,secondedition,2014.

Thanksforyourpatiencewithallthesequestions.Nowitisyourturn,doyouhaveanyquestionsforme?

Thisisatimetolistencloselytotheparticipant’sneedsandquestions.Listenforwhytheneeds,questionsandrequestsareimportanttotheparticipant.

QuestionsNOTonthisfrom:Toomanyquestionscanbeoverwhelming.Ifyoudonotseeanumberofquestionsonthisformthatyounormallyaskpleaseconsiderputtingthesequestionsonanoptionalformfortheparticipanttofilloutandreturntoyou.Or,considernotaskingthequestionsandaskyourself–isthisreallynecessary–orareyouaskingthequestionbecauseyouhavealwaysaskedthisquestionandnoonerememberswhy,ortellsyou“wehavealwaysdoneitthisway.”

Consideralternativestoaskingmanyquestionsonyourforms.Additionalquestionscanbeonahandoutthatcouldbefilloutontheirownandreturnedtoyou.

• Courtorder• WerethePoliceinvolved• Veteranormilitarystatus• Otheradditionaldemographics• Additionalneedsofchildren(canthisbecollected

withthechildren’sadvocate?• Areyouduplicatingyourquestionsbetween

differentadvocatepositions?• Couldtherebebettercoordinationbetweenforms

andreducetheduplicativedatacollection?Bottomline:Participantsshouldnothavetoanswerthesamequestionoverandoveragain.