Overview

In addition to the medical assessment conducted in a healthcare setting, it is important to assess for risk of violence, abuse, and/or sexual and reproductive coercion.  Obtaining an accurate and thorough history (to include physical, psychological, social, and sexual health) will help the hospital professional identify potential risks and stressors.  Taking this history also creates opportunities for helping the woman identify available supports.

Celia is coping with several complex issues.  In addition to facing an unplanned/unintended pregnancy, she appears to have an abusive and controlling husband and is giving birth to a child with Spina Bifida.  Women facing multiple complex issues may need help setting priorities.  The healthcare professional can help Celia set priorities by asking Celia to decide which issue is most pressing in her life.  Based on Celia’s response, Elaine can involve the social worker to help and/or make appropriate referrals.

Here are some examples of questions you might ask Celia:

▶       A lot of things are going on in your life.  What do you think is most important to work on first?

▶       We have a social worker on staff that is really good at helping people connect with the resources they need.  Would you like to talk with her?

Elaine will need to prepare Celia to meet and work with Joni, the team social worker.  She can do this by describing Joni’s role and the types of help she can offer to Celia.  Elaine can help Celia identify her needs and then suggest that she meet with Joni, who can help her meet those needs.

Elaine appears to be having difficulty keeping her personal feelings and values from interfering in her interactions with Celia.  She seems aware of her difficulty and seeks out a team member to discuss the case with so that her exchanges with Celia can remain nonjudgmental.  Finding supports to help when you recognize personal values and feelings may be clouding your judgement include: 

▶       Informal meetings with colleagues or other team members can be a good outlet for Elaine to work through her difficulties.

▶       Support groups or peer review groups that meet on a regular basis can be helpful in working through difficult cases.

It is also appropriate to bring in other team members when they have special skills or knowledge that will be helpful.  Techniques to involve additional team members with clients include:

▶       With the client’s permission, discuss the case with your colleague and ask if they have resources to offer.

▶       Discuss the client’s needs with them and then recommend that additional colleagues become involved to help meet these needs.

Issues around maintaining confidentiality must always be addressed.  It is a good idea to get a client’s permission to discuss their case with a colleague at the same agency, but no formal release of information is needed.  For colleagues in other agencies a written release of information must be obtained.