College of Medicine and Dentistry Study and training Dentistry resources: responding to domestic and sexual violence Subtle signs of domestic violence with long-term patients

Private practice scenario A: Subtle signs of domestic violence with long-term patients

This scenario demonstrates how the acquisition of specific training on DSV can assist dental professionals to recognise and respond to subtle signs of DSV with long term patients.

Objectives of the scenario

Exemplify knowledge of subtle signs of DSV; including coercive control; collusion; the person using violence defining the narrative of the victim-survivor’s behaviour; behaviour of children potentially mirroring the power and control dynamics in the parental relationship; patterns of behaviour, and changing family dynamics over time
Demonstrate skills in how to recognise and respond to subtle signs of DSV with long term patients; including when the dentist works with both the victim-survivor, and the person using violence
Exhibit a whole-of-practice approach to DSV and trauma-informed care

Video resource

This scenario demonstrates how the acquisition of specific training on DSV can assist dental professionals to recognise and respond to subtle signs of DSV with long term patients.

Print resource

This print resources includes:

Prompts to discuss the content in the video
Critical reflective questions
Links to relevant resources

Download the print resource

The following scripts are examples of how you can communicate with patients who are victim-survivors of DSV:

Screening
Opening the conversation
Risk assessment
Confidentiality
Potentially breaking confidentiality
Documentation
Trauma informed practice (following a disclosure of DSV)

Download the example scripts.

Please note

Each of the following scripts are examples only, and you will need to adapt them so they sound more ‘natural’ to you. Each time you use these scripts with a patient, you need to consider:

the patient’s particular circumstances
organisational policy and procedure
State/Territory legislative requirements
National legislative requirements
Requirements of your professional association.

Points to consider

self-care refers to activities to take care of our mental, emotional, and physiological well-being.
when working with people who have / are experiencing DSV, be attentive to signs of vicarious trauma.
concepts related to vicarious trauma include stress, secondary traumatic stress, compassion fatigue, empathetic distress, and burnout.
see the resources below for detailed information on the indicators of vicarious trauma and associated concepts.
ensure your workplace is enacting strategies to mitigate negative impacts of your work in general, and specifically in relation to vicarious trauma.

Relevant resources

There are many excellent resources on self-care and worker well-being available online or through specific worker training. Here are a few places you can start building your knowledge and skill set in relation to self-care, and mitigating vicarious trauma:

1800RESPECT (1800 737 732):
Wellbeing and self-care
Work-induced stress and vicarious trauma
Vicarious trauma: Looking after yourself at work
Dental Practitioner Support: An anonymous national health and wellbeing support service for dental practitioners
For dental students: contact with your university’s student well-being service
For dentists employed in an organisation: contact the ‘employee assistance program’ connected with your organisation.
For dentists in private practice: contact the ‘Dental Practitioner Support’ service listed previously.
CRANA plus: has a 24 hour ‘Bush’ hotline in addition to online resources:
- Mental health and well-being resources, with a focus on working in rural and remote locations.
- Supporting yourself after a traumatic event
Burnout and self-care in dentistry: an article by Dr Kaejenn Tchia

Acknowledgements

This collaborative project to develop video scenarios and print resources involved many people from dentistry, social work, the domestic and sexual violence sector, and victim-survivors of domestic and sexual violence. We extend our sincere appreciation to:

The following organisations: James Cook University Social Work; James Cook University Dentistry; JCU Dental Clinic; Cairns Regional Domestic Violence Service; Be Conscious; Hudson Films; ADA-Dental Health Foundation.
The dentists who provided expert advice: Adjunct Associate Professor Andrew Lee, JCU; Dr Julee Birch, Australian Dental Health Foundation.
The people and organisations who participated in research that informed, and evaluated, the video scenarios and print resources.
The research team: Dr Ann Carrington, Social Worker, Trauma Specialist, Adjunct Research Fellow, James Cook University (JCU); Dr Felicity Croker, Adjunct Associate Professor, Dentistry, JCU; Dr Alex Dancyger, Lecturer, Dentistry, JCU, Private Practitioner; Simone Dewar, Social Worker, Research Assistant, Social Work, JCU.

We also acknowledge the kindly contributions of the dentist, dental staff, and actor in this video:

Dentist: Dr Yousef Abdalla, Associate Professor Orthodontics, College of Medicine and Dentistry, JCU
Dentist: Dr Mimi Tam, Senior Lecturer in Clinical Dentistry, College of Medicine and Dentistry, JCU
Dental assistant: Erin Dreger, DV Case Manager
Actor: Natalie Taylor, Taylor Films-Theatre

With special thanks to the victim-survivors of domestic and sexual violence who participated in this research, and generously and courageously shared their stories.