Introduction of Mental Health Core Competencies for Sexual Assault and Domestic Violence Programs

1. Introduction of Mental Health Core Competencies for Sexual Assault and Domestic Violence Programs ODH, ODVN, OSATF December 2009

2. Welcome to Webinar training • PURPOSE : Training for sexual assault and domestic violence programs on the core competencies and how they might use them in their community and in partnership with local mental health providers. • CONTENTS • History and mission of the MH/SA/DV project • Overview of the Core Competences • Overview Clinician Self-Assessment Tool • Development Plan • Action Plan • Recommendations

3. Mental Health/SA/DV project • During the spring of 2002, the Ohio Sexual Assault Task Force (OSATF) convened five regional public hearings to encourage comments from the community on gaps in sexual assault services. • Around the same time, the Ohio Domestic Violence Network (ODVN)sponsored focus groups with victims of domestic violence. • A key finding for both of these assessments was a lack of adequate mental health services for survivors of sexual assault and domestic violence.

4. Mental Health/SA/DV project • ODH and ODVN partnered to convene an ad-hoc committee on SA/DV Training for Mental Health Professionals to identify strategies to address these issues. • The first meeting of the committee was held in May 2004, with representatives from a wide range of mental health agencies and organizations participating. • After discussion and study, the committee decided to create core competencies in domestic and sexual violence for helping professionals. • The committee created a Core Competencies Self Assessment Tool that SA/DV providers can offer as part of an in-service trainings at mental health facilities - completed in Nov. 2009.

5. Mission The committee created a mission statement: To promote the health, safety and healing of domestic violence and sexual assault survivors.

6. Purposes of Core Competencies • These competencies are intended to indicate pre-requisite awareness and knowledge for all generalist practitioners. • They are to be used as an assessment for both individuals and programs to identify areas of training need. • Individuals may also choose to specialize in working with the issues of sexual assault and domestic violence, which would require additional levels of skill and ability for application of the requisite knowledge. • Promote partnership in the community • Clinicians and Survivors • Advocates and Social Service providers • Criminal justice and Medical professionals

7. Core Competencies Cont. Domestic and Sexual Violence for Helping professionals • Competency A - Regarding ethical and legal considerations. • Competency B - Regarding identification and assessment. • Competency C - Regarding intervention. • Competency D - Regarding prevention and awareness.

8. Competency A, Cont.Regarding ethical and legal considerations • These are listed first because they are integral to all the competencies and should be taken into full consideration at all steps – identification and assessment, intervention, and with regard to prevention and awareness activities • Understands the importance of the survivor’s right to self-determination. • Knows state and national laws, rules and regulations regarding sexual and domestic violence, including mandatory reporting responsibilities. • Knows the laws and ethical principles that apply to confidentiality regarding interviews and records.

9. Competency A, Cont.Regarding ethical and legal considerations 4. Knows appropriate methods of documentation that maximizes confidentiality and safety of clients and providers. • Is aware of warning signs of vicarious trauma in self and colleagues and understands the importance of addressing vicarious trauma to ensure the continued delivery of high-quality services. • Knows strategies for addressing vicarious trauma in self and colleagues. • Is aware of cultural factors that influence the occurrence and patterns of responses to sexual and domestic violence in individuals, families and communities. • Knows how to provide assessments, interventions and prevention programming that are culturally competent and maintain human rights

10. Competency B, Cont.Regarding identification and assessment. • Is aware of the prevalence of domestic and sexual violence in all its forms throughout a lifetime. • Is aware of co-morbidity of domestic and sexual violence, elder abuse, child abuse and neglect and abuse against animals. • Is aware of factors that increase vulnerability to domestic and sexual violence (e.g. disability, age, isolation) while in no way blaming victims/survivors for these vulnerabilities. • Is aware of and able to recognize protective factors used by survivors and how those strategies can be misinterpreted by service providers, family and friends

11. Competency B, Cont.Regarding identification and assessment. 5. Understands societal factors that contribute to domestic and sexual violence including power, patriarchy, oppression and privilege 6. Knows the physical, emotional, sexual, behavioral and environmental indicators of domestic and sexual violence. 7. Understands the importance of routine repeated screenings of all referrals and cases for the presence of domestic and sexual violence. 8. Knows developmentally appropriate questions to be used in repeated screenings in various settings. 9. Is aware of individual, cultural, familial, and societal barriers to disclosing domestic and sexual violence and understands how these barriers impact disclosures.

12. Competency B, Cont.Regarding identification and assessment. 10. Is aware of individual, cultural, familial, and societal strengths and resiliencies that facilitate disclosing and recovering from sexual and domestic violence. 11. Understands the significant physical and mental health impact of current, on-going and prior domestic and/or sexual violence to survivors, their families and friends. • Understands how personal reactions, biases and values regarding domestic and sexual violence can impact professional interactions. • Knows how to assess for risk and danger to both the client and practitioner in specific domestic and sexual violence situations.

13. Competency C, Cont.Regarding intervention • Can communicate non judgmentally and compassionately with survivors of domestic and sexual violence, their families and friends. • Is aware of the importance of communicating to survivors of domestic and sexual violence and their families and friends that they are not alone and that there are resources available to them. • Understands control tactics used by perpetrators. • Understands protective strategies used by survivors and how those strategies can be misinterpreted by service providers, their family and friends. • Understands how some interventions (couple counseling, mediation, family counseling or other interventions) can increase risk to the survivors of domestic and sexual violence and knows how to work with survivors without compromising safety.

14. Competency C, Cont.Regarding intervention • Understands and uses evidence-based best practices and interventions specific to the survivor population and investigates new interventions that appear promising. • Understands critical elements of effective batterer intervention programs that hold batterers accountable while striving to change behavior in order to be able to make appropriate referrals to batterer intervention services. • Understands critical elements of effective sex offender treatment programs in order to be able to make appropriate referrals. • Knows how to work collaboratively with various disciplines and service systems and how to access supportive and preventive services to survivors of domestic and sexual violence, their families and friends. • Can make appropriate linkages to local, state and national domestic and sexual violence referral resources, including domestic violence shelters and programs, rape crisis services and offender interventions.

15. Competency C, Cont. Regarding intervention • Can make appropriate linkages to other community-based resources meeting the unique needs of survivors, their families and friends. Examples include: • Mental health services • Alcohol and other drugs • Health care • Other social and legal service • Peer support, including survivor support groups, trauma informed peer support, and peer advocacy. • Knows how to help survivors think through safety needs of themselves, their families, other household members and friends. • Is aware of cultural, familial, and societal barriers that affect survivors of domestic and sexual violence and understands how these barriers impact service delivery and safety planning.

16. Competency D, Cont. Regarding prevention and awareness • Knows how to integrate basic strategies to increase awareness of sexual and domestic violence and basic facts related to both in all areas of practice, and does so in ways which are culturally appropriate. • Is aware of the values and ethical principles regarding social justice and their role in pursuing social change. • Is aware of local, state and national prevention resources.

17. Clinician Self Assessment Tool PURPOSE • Identify training and educational needs of mental health practitioners who are working with clients who may also have experienced traumatizing events such as sexual and/or domestic violence. • This assessment tool is intended to assess the exposure professionals currently have to specific training and education on working with adults who are survivors of domestic and sexual violence.

18. Clinician Self Assessment Tool OVERVIEW I • The assessment is made up of 95 questions • Each question is based directly from the Core Competency Areas (A-D) previously explained • Ideally supervisors and clinicians would complete the assessment together, but it can be done individually • Clinicians will score each question using a ranking scale of 0-5 • Scoring Key 0- I have never heard of and/or do not understand this concept. 1- I have heard of this concept. 2- I have novice training on this concept. (e.g. have seen a presentation). 3- I have advanced training on this concept. (e.g. workshop, CEU class) 4- I have integrated this concept into my practice. 5- I could train others on this concept.

19. Clinician Self Assessment Tool OVERVIEW II • After answering all of the questions please use the scoring sheet at the end of the assessment to list all areas specific to each area of competency that scored at 2 or below in the space provided • On own or with supervisor/supervision team, identify top three priorities for improvement • Create an individual Development Plan using template • Work with community partnership to identify resources for completion of plan • SA/DV provider can offer in-service at mental health facility.(possible in-service exchange) • If possible, have staff complete and return the self-assessment tool • Work with site administrators to use the results to complete an Action Plan and create a multi-year plan to address gaps

20. Clinician Self Assessment Tool • This assessment can be used in a number of different ways: • By individuals – to identify personal achievement in each competency; to identify areas warranting further training • By agencies – to indentify staff strengths and training needs • By supervisors – to assess staff and as a basis for developing training plans • By community partners – to establish minimum expectations for inclusion of practitioners as referral sources to provide mental health services for sexual or domestic violence survivors

21. Clinician Self Assessment Tool Case studies The following three case study examples were developed to help illustrate how the attached competencies and Self-Assessment Tool for sexual and domestic violence could be used by various professionals or organizations in the Mental Health field. I. Individual Practitioner. II. Organizational Assessment III. Performance Evaluations and Personal Developmental Plans.

22. Case study OneIndividual Practitioner • Dr. Eli was approached by the local domestic violence program to see if she was interested in being placed on their referral sheet. In addition to her education, accreditation, and licensure information. The program asked her to review the list of Core Competencies Regarding Sexual and Domestic Violence to assess her level of knowledge and understanding concerning ethical and legal considerations, identification and assessment, intervention and prevention and awareness of sexual and domestic violence. After reading the list, Dr. Eli admitted to needing to know more about ways to document records that will maximize safety and confidentiality. The program referred her to several websites that provided her the information she needed. After reading several of the articles, both Dr. Eli and the program were comfortable adding her to their referral list.

23. Case Study TwoOrganizational Assessment • Walden County Community Mental Health Association recently joined forces with several community organizations to form a local community Sexual and Domestic Violence Coalition. In an effort to better serve their community, they committed to enhancing the knowledge and skill of their staff regarding sexual and domestic violence. As a first step, each unit supervisor was asked to use the Core Competencies Regarding Sexual and Domestic Violence as an assessment tool to determine the training needs of their staff. When data was analyzed, three main areas were identified – elements of effective batterer’s intervention programs; understanding societal factors that contribute to sexual and domestic violence; and cultural factors that influence the occurrence and patterns of response to sexual and domestic violence. Other coalition members helped identify various training opportunities.

24. Case Study ThreePerformance Evaluations and Personal Developmental Plans • After attending training on sexual and domestic violence, Lynn a supervisor at the Oxford Counseling Center, is committed to making sure her staff are competent in the pre-requisite competencies identified in the Core Competencies Regarding Sexual and Domestic Violence. She reviewed the competencies during a recent staff meeting and asked that staff assess their level of knowledge. Areas needing to be enhanced will be added to staff’s personal developmental plans and reviewed annually during performance evaluations. Lynn contacted the community rape crisis center and domestic violence shelter for suggestions regarding training and other learning opportunities for her staff.

25. Development Plan

26. Action Plan

27. Community Response to SA/DV • Education Opportunities • In-house training within agencies • Shared opportunities – cross training • Local speakers/programs • Statewide conferences/events • Computer based training • Reading/articles • Resources • Local Expert Personnel • Trainers within the state – other local communities; state organizations • Community referral information

28. Contact Information • Debra Seltzer The Ohio Department of Health Debra.Seltzer@odh.ohio.gov 614-728-2176 • Beth Malchus The Ohio Department of Health Beth.Malchus@odh.ohio.gov 614-466-8960 • Amanda Suttle The Ohio Department of Health Amanda.Suttle@odh.ohio.gov 614-644-7618