Psychiatric Mental Health Nursing by Videbeck

11 ABUSE ANDVIOLENCE 231

continued from page 230

relationship, and so forth. Support or therapy

groups are available in many communities,

including groups for battered women (through

shelters or abuse and assault centers), survivors

of child abuse or incest, child abusers (e.g., Par-

ents Anonymous groups), men who are abusive

(men’s groups to prevent violence against

women), and groups for lesbians or gay men in

abusive situations.

Abusive situations engender a variety of feelings

that the client needs to express, including grief

for the loss of an ideal or healthy relationship,

trust, health, hope, plans, financial security, and

home. In addition, victims of abuse often feel

that they deserved abuse, or it would not have

happened. Finally, abuse in a relationship does

not preclude feelings of caring.

The client may not see his or her strengths or

work as valuable and may have suffered abuse

when displaying strengths in the past. Positive

support may help reinforce the client’s efforts and

promote the individual’s growth and self-esteem.

Offering choices to the client conveys that the

client has the right to make choices and is capable

of making them. Achievement at any level is an

opportunity for the client to receive positive

feedback.

The client can try out new or unfamiliar behaviors

in a non-threatening, supportive environment.

The client needs to learn effective skills and

to make his or her own decisions. When the

client makes a decision, he or she can enjoy the

achievement of a successful decision or learn that

he or she can survive a mistake and identify

alternatives.

Development of the client’s strengths and abilities

can increase self-confidence and enable the client

to see and work toward self-sufficiency and

independence from the abusive relationship.

Spend time with the client, and encourage the
client to express his or her feelings through talk-
ing, writing, crying, and so forth. Be accepting of
the client’s feelings, including guilt, anger, fear,
and caring for the abuser.

When interacting with the client, point out and
give support for decision-making, seeking assis-
tance, expressions of strengths, problem-solving,
and successes. Recognize the client’s efforts in
interactions, activities, and the treatment plan.

Give the client choices as much as possible.
Structure some activities at the client’s present
level of accomplishment to provide successful
experiences.

*Use role-playing and group therapy to explore
and reinforce effective behaviors.

Teach the client problem-solving and coping skills.
Support his or her efforts at decision-making; do
not make decisions for the client or give advice.

*Encourage the client to pursue educational,
vocational, or professional avenues as desired.
Refer the client to a vocational rehabilitation or
educational counselor, to a social worker, or to
other mental health professionals as appropriate.

continued on page 232