Counseling an Intimate Partner Violence Victim: Melinda’s Journey Melinda, a 25-year-old,…

Counseling an Intimate Partner Violence Victim: Melinda’s
Journey

Melinda, a 25-year-old, middle-class, African American
female, first came to counseling for depression. During the initial intake
interview, Melinda reported experiencing difficulty sleeping, frequent crying
spells, low self-esteem, and feelings of hopelessness. Melinda’s counselor,
Candace, screened for suicidal ideation, homicidal ideation, and IPV as a
routine part of the initial interview. Melinda denied suicidal and homicidal
ideation and said that she had never been abused by her current boyfriend. At
the end of the
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Counseling an Intimate Partner Violence Victim: Melinda’s
Journey

Melinda, a 25-year-old, middle-class, African American
female, first came to counseling for depression. During the initial intake
interview, Melinda reported experiencing difficulty sleeping, frequent crying
spells, low self-esteem, and feelings of hopelessness. Melinda’s counselor,
Candace, screened for suicidal ideation, homicidal ideation, and IPV as a
routine part of the initial interview. Melinda denied suicidal and homicidal
ideation and said that she had never been abused by her current boyfriend. At
the end of the initial session, Candace provided Melinda with a packet of
materials that she distributes to all new clients, which included a pamphlet on
IPV.

Over the next two sessions, Melinda and Candace developed a
strong rapport. During her third session, Melinda tearfully disclosed that her
live-in boyfriend sometimes pushes or hits her when he has been drinking.
Candace listened empathically to Melinda and let her know that the abuse was
not her fault and that she believed her. After Melinda’s disclosure, Candace
asked for more information about the abuse, including how arguments usually
begin, details of the most recent incident of violence, and Melinda’s history
of experience with IPV. Melinda reported that the last time her boyfriend hit
her was a week ago, when he came home drunk from a party. Melinda sustained a
split lip but did not require stitches.

Candace also completed a lethality assessment and determined
that Melinda’s boyfriend had never threatened to kill her, did not have a
criminal record, and did not have a gun in the house. Melinda stated that she
had never feared for her life when her boyfriend became abusive. She indicated
that she did not want to break up with her boyfriend and that she did not think
the abuse was serious enough to report to the police. Candace respected
Melinda’s autonomy and provided her with additional educational materials about
IPV and information on 24-hour IPV crisis resources that Melinda could use in
case of an emergency. Since Melinda reported that her boyfriend typically drank
every weekend, Candace scheduled another appointment with Melinda before the
upcoming weekend in order to develop a safety plan. Melinda and Candace collaboratively
developed the following safety plan in order to minimize the risk and impact of
IPV:

1. Plan to be away from the house when boyfriend comes home
drunk.

2. If boyfriend comes home drunk unexpectedly, stay away
from the bathroom and kitchen.

3. Pack and hide an emergency bag with clothes, cash, and an
extra set of keys in case of the need to flee the house quickly.

4. Program IPV crisis hotline number into cell phone.

Melinda and Candace also discussed ideas for building coping
resources, including engaging in self-care activities like reading empowerment
books and joining a women’s support group at church.

Over the next several months, Candace and Melinda met once a
week for counseling. They continued to discuss and evaluate Melinda’s safety.
Despite her efforts to avoid physical violence from her boyfriend, the
incidents of abuse became more frequent over time. Melinda had now sustained
several injuries, including a broken arm and a broken rib. A turning point
occurred when Melinda learned that she was 8 weeks pregnant with her first
child. Melinda decided that she did not want to raise a child in an abusive
home. She was ready to leave. Candace and Melinda discussed the risks
associated with leaving an abusive partner and tips for ensuring a safe escape.
Together, they decided that an IPV shelter was the best option, since Melinda
had no trusted family or friends in the area. Candace arranged for
transportation to the shelter straight from her office and waited with Melinda
until help arrived.

Discussion Questions

1. Are there other considerations that will need to be
implemented into Melinda’s treatment?

2. What are some short-term and long-term therapeutic
considerations?

3. What are some case management issues that must be
addressed?

4. What referrals need to be made for Melinda?

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