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Therapist Self-Care Compassion Fatigue & Secondary Traumatic Stress
Domestic Violence continuing education addiction counselor CEUs

Section 7
Practitioners’ Experiences of Client Violence

CEU Question 7 | CE Test | Table of Contents | Domestic Violence
Psychologist CEs, Social Worker CEUs, Counselor CEUs, MFT CEUs

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In the last track we discussed law enforcement issues regarding domestic violence by looking at the landmark cases of Thurman and Watson.

In this track we will focus not on the victim, but on the batterer. We will discuss strategies for ensuring a therapist's physical safety when working with a battering client, as well as the burn-out that results from a therapist's fear for safety.

At what level have you felt that your safety was threatened while working with a battering client? How did you react to this feeling? Did you find it more difficult to maintain your emotional distance and perspective when you felt your safety was at risk? Did you do anything in the future to avoid a similar situation? As you know, simply avoiding a client population that is threatening, such as battering men, is not the only way to maintain feelings of personal safety.

Many therapists believe that when a batterer seeks treatment, he is genuinely looking for help, and harming his partner is not on his mind. However, as you well know, violence can get out of control. How do you structure your environment for safety before the threat of violence becomes dangerous? I have found that I can strategically use both my environment and self to ensure my personal safety when working with battering clients. Here's some basics you may be currently overlooking that could decrease your stress.

4 Strategies for the Use of the Environment
As you are probably aware, the placement of furniture and people can prevent the escalation of danger in a therapeutic setting. Here is a checklist for you.

Environment Strategy 1: Easy Exit.
Does your office design enable an easy exit for you, should you need it during treatment. This easy exit and pathway to a door should never be blocked from you. When you and your co-leader conduct an anger-management group, where is your chair positioned in relation to the exit door? Do you need to reconsider repositioning your chair?

Environment Strategy 2: Telephone Access.
Aside from an emergency escape path, a telephone within easy reach with an uncomplicated method for calling for help is also a great stress-reliever for myself in creating personal safety. Once, when co-leading an anger management group and a client starts to become agitated, I envision myself walking over to the phone and dialing 911 as sort of a safety valve for myself to relieve my stress, knowing I have a course of action. To date, I nor my co-leader has had to resort to calling emergency.

Environmental Strategy 3: Setting Limits.
Obviously, prior to a client outburst, rules are initially set that clients will not be allowed to attend a group if they are under the influence of alcohol or drugs. Also, rules regarding communication and acceptable group behaviors are set.

Environment Strategy 4: Distance.
A therapist can use the environment to ensure personal safety from a battering client by sitting far enough away so the client cannot reach the therapist without taking several steps. I have found a desk or coffee table between the client and therapist can serve as a barrier. Also, chairs set in a large circle serve the same purpose.

Do you already use these four environment strategies of an easy exit, telephone access, setting limits, and distance, to create a safe personal environment when treating a batterer? Perhaps you can consider implementing a strategy we have overlooked during your next session. One or more of these environment issues may be preying on your unconscious, creating stress and adding to your burn-out level.

Strategic use of Self

In addition to using environmental strategies, I have also found strategic use of self to be helpful in creating personal safety. I can diffuse the situation by telling the batterer how his expression of anger is making me feel. I stated to an angry battering client in a session, "The way you are expressing your anger makes it hard for me to understand you. Can you calm down? I want to understand." As you can see in this example, I gave honest feedback to show respect for the battering client and to make clear that I as the therapist had his best interests in mind.

This CD has covered Secondary Traumatic Stress, Perceived Inadequacies, the Therapist's Shield, Client Resistance, Therapist Trap of Arrogance, the Thurman and Watson's Landmark cases, and Strategic Use of Self with Batterers.

I hope you have found the information to be both practical and beneficial. We appreciate that you've chosen the Healthcare Training Institute as a means for receiving your continuing education credit. I wish you the best of luck in your practice. Thank you.

Peer-Reviewed Journal Article References:
Bocian, B. (2020). Fear, self-support, and “good introjects”. The Humanistic Psychologist, 48(4), 363–368.

Geller, S. M., & Porges, S. W. (2014). Therapeutic presence: Neurophysiological mechanisms mediating feeling safe in therapeutic relationships. Journal of Psychotherapy Integration, 24(3), 178–192.

Jussab, F., & Murphy, H. (2015). “I just can’t, I am frightened for my safety, I don’t know how to work with her”: Practitioners’ experiences of client violence and recommendations for future practice. Professional Psychology: Research and Practice, 46(4), 287–297. 

Peluso, P. R., & Freund, R. R. (2018). Therapist and client emotional expression and psychotherapy outcomes: A meta-analysis. Psychotherapy, 55(4), 461–472.

Semiatin, J. N., Murphy, C. M., & Elliott, J. D. (2013). Observed behavior during group treatment for partner-violent men: Acceptance of responsibility and promotion of change. Psychology of Violence, 3(2), 126–139. 

Sprang, G., Ford, J., Kerig, P., & Bride, B. (2019). Defining secondary traumatic stress and developing targeted assessments and interventions: Lessons learned from research and leading experts. Traumatology, 25(2), 72–81.

Online Continuing Education QUESTION 7
What are four environmental strategies that a therapist can use to ensure personal safety when working with a battering client? To select and enter your answer go to CE Test.

Author - OnlineCEUcredit.com team. See Instructors page for details.

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