Prevention

Office Strategies

With limited office time, creative and realistic options for addressing family abuse prevention can include:
  • waiting room questionnaires
  • awareness training for staff to be alert for patient and family red flags
  • manager training re: staff personal domestic abuse issues
  • chart prompts
  • brief education, discussion, follow up at staff meetings
  • posters/brochures/pocket cards available throughout office
  • group parent classes
  • newsletters
  • easily accessible and restocked patient handouts and materials, such as:
  • office website educational areas
  • instructional videos
  • having someone in the office (or social worker) have a working knowledge of community resources (respite care, parent support groups, home health services), parenting classes and counselors for referral
  • defined office protocols about assessment, intervention, documentation, reporting, confidentiality, office security

Clinical Encounter Strategies

During the office visit, model the behavior you would like the parent to use while interacting with the child.
At each well child visit, provide "anticipatory guidance", to help parents understand
  • developmental abilities and limits, so that they are not frustrated in what they expect the child to be able to do
  • safety challenges, and methods to help protect against accidental injury
  • behavioral challenges, with anticipated methods of handling discipline and limit setting
  • anticipated behavioral and physical course for children with medical conditions
Screen parents for domestic abuse, and observe for depression, anxiety, feeling overwhelmed, drug or alcohol use, and general family stresses; particularly ask how these parents cope with childcare demands
  • Educate parents about effects of family abuse on the child
  • Emphasize the importance of consistent love, acceptance and attention
  • Emphasize family strengths
  • Provide detailed written care plan for medical conditions, to prevent inadvertent neglect
  • Monitor children's development, behavior and school performance
  • Educate parents of children with disabilities who encounter multiple caregivers about signs of abuse

For teens

  • educate about healthy relationships
  • monitor social development and communication with parents
  • encourage teen to feel your office is a safe place to discuss difficult topics
  • help teen identify extended family, friends and community social support

Educate children

  • about appropriate touching
  • who they can talk to with concerns
  • consider giving out Child Safety Rules word, courtesy of National Center for Missing and Exploited Children.