Are you afraid? Identifying victims of domestic abuse. Ask the question but don’t always expect a straightforward answer

The SafeLives Dash is the most commonly used risk assessment tool available to help professionals assess the risk of serious harm and homicide for domestic abuse victims. It has been absolutely invaluable in my work.

When risk assessing women who experienced domestic abuse, I have always asked the question ‘Are you very frightened?’ It is question number two on the DASH. Fairly frequently, they would respond to the question by saying ‘No, I’m not feeling frightened.’

I would continue the assessment. ‘Have you ever been raped?…. Have you ever been strangled?’ They would sometimes reply ‘Yes’ despite having just told me that they were not feeling afraid.

This surprised me somewhat. How can a woman who has been raped and strangled by someone not be feeling frightened?

It’s important when completing a SafeLives Dash to look at it in its entirety and to use professional judgement (experience, knowledge and expertise) to fully assess the situation. It can be useful when completing a full risk assessment to see these discrepancies and to get an understanding of the person’s mindset in relation to their experience.

The question becomes more problematic though when being used by clinicians as an isolated question in settings such as General Practice or an Emergency Department.

Davis et al (2010) explains the response difference in phasic (short-term) and sustained (long-term) fear.

‘Fear is a generally adaptive state of apprehension that begins rapidly and dissipates quickly once the threat is removed (phasic). Anxiety is elicited by less specific and less predictable threats…thus anxiety is a more long-lasting state of apprehension (sustained fear)’

Therefore, perhaps the question which may be more likely to identify abuse could be ‘are you feeling frightened or anxious?’ If your professional judgement tells you that the response given was not the one that you expected to hear then ask more questions….

Research has shown that victims of abuse want to be asked.

© Sarah Blake, 2018