College of Medicine and Dentistry Study and training Dentistry resources: responding to domestic and sexual violence Trauma Informed approach

Trauma Informed approach

This scenario demonstrates a dentist applying a trauma-informed approach and adapting general dental practices to create a safe environment for a patient who is a victim-survivor of domestic and sexual violence. This covers building rapport and trust with the patient, confidentiality, history taking and screening for domestic violence, identifying triggers and engaging with patients to safely navigate those triggers and to best support them in the clinic.

Objectives of the Scenario

Demonstrate understanding of a trauma-informed approach to working with people who are victim-survivors of domestic and sexual violence.

Demonstrate skills in building rapport and trust with the patient, discussing confidentiality, completing history taking and screening for domestic and sexual violence.

Demonstrate skills in engaging with patients who have experienced domestic and sexual violence in identifying triggers and adapting general dental practices to create a safe environment for the patient.

Video resource

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; Warringu Aboriginal and Torres Strait Islander Corporation; 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, Senior Lecturer, Social Work, James Cook University (JCU); Dr Felicity Croker, Adjunct Associate Professor, Dentistry, JCU; Dr Alex Dancyger, Lecturer, Dentistry, JCU; Simone Dewar, Research Assistant, Social Work, JCU; Dr Vinnitta Mosby, Lecturer, Social Work JCU – First Nations advisor.

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

Dentist: Dr. Hannah Treston
Actor: Michelle George
Dental Staff: Victoria Cushway

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