Violence against Women, Domestic Abuse and Sexual Violence (Wales) Act 2015

1. Violence against Women, Domestic Abuse and Sexual Violence (Wales) Act 2015 “Ask & Act” Group 2 training

2. Housekeeping • Toilets • Breaks • Mobile phones • Taking care of yourself and each other

3. Introductions • Name • Job title • One thing you’d like to learn today

4. Ground rules • Confidentiality • Do you need support? • Respect Any others?

5. Violence against Women, Domestic Abuse and Sexual Violence (Wales) Act 2015 What does the Act do? The Violence against Women, Domestic Abuse and Sexual Violence (Wales) Act 2015 centres on the PREVENTION of these issues, the PROTECTION of victims and SUPPORT for those affected by these issues. This is a unique and ground-breaking piece of legislation.

6. The language we are using: • Abuse; • Domestic abuse; • Gender-based violence; • Sexual violence; • Violence against women; • Victim/survivor; • Client/service user; • Ask; • Act.

7. What are these sessions about? • How to recognise the signs and symptoms of violence against women, domestic abuse and sexual violence; • Understand the purpose of and demonstrate an ability to undertake targeted enquiry; • Demonstrate knowledge around data protection and the duty of confidentiality; • Understand the purpose of risk identification in relation to some forms of violence against women, domestic abuse and sexual violence; • Be able to implement the targeted enquiry care pathway.

8. Benefits of “Ask and Act” • Increased identification of those experiencing violence against women, domestic abuse and sexual violence by using targeted enquiry; • Increased referrals to specialist services for those identified; • An improved culture across the Welsh Public Service where identification of violence against women, domestic abuse and sexual violence is an accepted area of business and where disclosure is supported, accepted and facilitated. Earlier identification ensures support services are available at the earliest opportunity, rather than just at the point of crisis!

9. Targeted enquiry – why? • Victims want to be asked • Early intervention can reduce impacts – including death • Helps to reduce stigma and isolation • Signals service as somewhere that help can be gained • Child protection • Good clinical practice • Silence is not neutral

10. Who does it happen to? • Domestic abuse • Sexual violence • Violence against women

11. True or false? • Although violence against women crosses all social classes, it is more common in working class families • Men who hit their female partners were usually abused themselves as children • Most domestic violence is alcohol related • Women who are abused tend to go from one abusive relationship to another • There are no services for male victims • The extent of domestic abuse is exaggerated by including emotional abuse. I mean, all couples row… • Violence against women is a result of inequality • Extended families can perpetrate violence against women.

12. Prevalence of domestic abuse and other forms of violence against women. See handout.

15. Entrapment Process Conditioning Normalisation Entrapment

16. What is at the heart of VAWDASV? https://www.youtube.com/watch?v=NLlXXt6WNsM

17. Coercive Control Underpins domestic abuse. Most victims of abuse experience coercive control rather than isolated physical assaults alone. Victims often state that the coercive control is far more devastating than physical assaults. Instils fear, dependence, compliance and shame.

18. Group activity: • Get into groups to respond to two questions: • What might be some of the barriers for professionals to make a targeted enquiry about VAWDASV? • What might be some of the barriers for service users/clients/patients to make a disclosure about VAWDASV?

19. Survivors said they want… • To be treated with dignity and respect; • To be believed; • To be given help to get themselves and their children safe; • For professionals to know that abuse is universal; is more than physical assaults; is about power and control and affects the whole family and how hard it is to disclose.

20. How might you encourage disclosure? Think about… • Indicators • The environment/creating a supportive environment • What the client may be feeling • What barriers the worker may create

21. Build rapport • Use the person’s name where possible • Be polite and sympathetic • Use active listening • Agree with them to encourage talking • Do not tell them what to do • Let them know they are doing the right thing by telling you • Let them know you are taking them seriously • Do not act shocked or appear as if you do not believe them

22. Key indicators? • In your department/area of work what would you identify as the key indicators?

23. Key indicators (NICE, 2014) • Depression, anxiety, sleep disorders; • Suicidal tendencies or self-harming; • Alcohol or other substance misuse; • Unexplained reproductive symptoms, including pelvic pain and sexual dysfunction; • Adverse pregnancy outcomes, i.e. multiple unintended pregnancies or terminations, miscarriage, pre-term labour and stillbirth; • Frequent bladder or kidney infections; • Vaginal bleeding or sexually transmitted infections; • Chronic pain (unexplained); • Traumatic injury, particularly if repeated with vague or implausible explanations • Headaches, cognitive problems, hearing loss;

24. Key indicators (NICE, 2014) • Repeated health consultations with no clear diagnosis; • Appointments missed or frequently rescheduled; • Intrusive “other person” in consultations – this can be partner, parent, grandparent or an adult child (abuse of the older person); • Partner or other person’s behaviour: aggressive, overly dominant, doesn’t let their partner/family member speak for themselves.

25. Video clip…. • How to ask and respond…. https://www.youtube.com/watch?v=_uEwNg0pFAI

26. Questions that work • ‘How…’ • ‘Do you ever…’ • ‘Has anyone…’ • ‘Has your partner…’ • ‘I can see…’ • ‘We know that…’ In pairs – think about questions you might ask…. now think of a follow-up question.

27. Responding to disclosures • ‘Thank you for telling me…’  • ‘I believe you…’ • ‘What you have described is not uncommon…’ • ‘You are not to blame for the violence or abuse…’ • ‘Your safety and wellbeing is my priority…’ • ‘You have the right to be safe and get support…’  • ‘You have the right to feel the way you do and to talk about it…’ • ‘You are the expert on what you need…’ • ‘There is help available…’ • For many survivors, just having someone listen to them, is all they need.

28. Do not behave like the abuser. This means do not: • Judge • Deny • Blame • Disbelieve • Tell them what to do • Act without client knowledge (and preferably, do not act without consent)

29. Identify risk: • What do we mean by risk? • Why is it important to identify risk? • Based on the brief video clip – what are some important questions to ask? • What are some of the most significant risk factors associated with cases of serious harm or death in relation to domestic abuse?

30. Additional resources available: YOU ARE NOT EXPECTED TO DO RISK ASSESSMENTS – ASK FOR SUPPORT AND ADVICE. • Refer to an IDVA (add local details); • Refer to Welsh Women’s Aid / local specialists (handout with local information); • Refer to Safeguarding Lead; • Ensure they have the national helpline (give out cards/pamphlets). • Key issues for survivors + safety, housing, money & children – you might need to link into other agencies (refer to handout). Not expecting you to be experts….Group 3.

31. National helpline: • Live Fear Free Helpline: 0808 8010 800 (professionals can also call the helpline for advice). • AVAILABLE TWENTY FOUR HOURS A DAY, SEVEN DAYS A WEEK – FREE OF CHARGE.

32. Local Referral Pathway (handout)

33. Case studies • You will all be assigned a role: Client , Worker or Observer. • You will receive the information for your individual role. • You’ll have 5-7 minutes to work through the case study. • Fill in the form/check the pathway….

34. ASK consistently and ACT confidently; • Get as much information as you can about what services and support are available; • Seek help and support from colleagues, Safeguarding Leads, VAWDASV Leads, workplace champions, specialist sector – there is a lot of support; • Leaving is very dangerous so ensure expert advice is accessed.

35. Recap: • What did you take away? • Any questions? Concerns?

36. Diolch yn fawr - Thank you