The Role Occupational Therapy Plays in Working with Survivors of Domestic Violence
October is Domestic Violence Awareness month, and that hits close to home for several reasons. Something that you may not know about me is 1. I have a background in trauma informed care and 2. I have also survived a psychologically abusive relationship. So you can see—DVAM hits close to home for me.
Since I’ve returned to school to focus on my PhD, I’ve been able to use some elective credits to take some Social Work courses that have allowed me to further my understanding of the intersection of not just Occupational Therapy and Social Work (because, truly, there is), but specifically how OTs can use their specific skill set to best aid survivors of Domestic Violence in any and all forms. To be clear, survivors of DV are not just intimate partners— in my line of work, I have found myself working with children who reside in homes where DV is present. The burn unit is one example of this; a study by Toon, et al. (2011) found that anywhere between 10-20% of burn presentations are injuries inflicted by the child’s caregiver.
So what knowledge and skills do we as occupational therapists have that enable us to treat these survivors?
1. Our ability to tailor our evaluation, plan of care and treatments to best suit that particular person. With roughly 1.3 million women and 835,000 men being affected by intimate partner violence (IPV) each year in the United States alone (Javaherian-Dysiner et al., 2021), it is imperative that we treat each survivor as an individual and not as a part of a general Morpheus collective. We want to know what matters to you. Activities of Daily Living are of course the building blocks of OT but what we do goes beyond just that. We want to work WITH YOU to construct a plan of care and goals and treatments that make sense to you and for you.
2. Our understanding of the Model of Human Occupation. Helfrich & Aviles (2001) make the argument for the use of the MOHO when working with survivors of IPV. MOHO is intended to be used with any person who is experiencing problems in their occupational life; one would argue that survivors of IPV likely fit this category. As OTs, we are highly equipped to utilize our understanding of the importance of meaningful occupation and how it works to define a person’s role both as they view themselves as an individual and as a part of the human collective.
3. Our roles in the adult, pediatric, and gerontology fields. Elder abuse is also a form of intimate partner violence that is rarely discussed or not talked openly about (AJOT, 2007). Occupational therapists work in so many different fields and are not just mandated reporters but are willing and able to ask the difficult questions that so many aren’t willing to simply by nature of our occupation. We “go there.”
4. We make a damn difference. A 2015 study by Javaherian-Dysinger et al. reviewed OT evaluations from two domestic violence shelters. The researchers found that the most common problem areas were leisure, education, work, child rearing, and health management, and that the most common goals were in the areas of education, work, health management, child rearing, and home management. Retrospective pre- and post-change scores in performance and satisfaction for 25 women were statistically significant.
Sources
1. Christine A. Helfrich PhD OTR/L & Ann Aviles OTR/L (2001) Occupational Therapy's Role with Victims of Domestic Violence, Occupational Therapy in Mental Health, 16:3-4, 53-70, DOI: 10.1300/J004v16n03_04
2. Heather Javaherian-Dysinger, Erika Dalida, Caitlin Maclang, Eunice Cho, Hekanne Simbolon, Marielle Santiago; Intimate Partner Violence and OT: A Systematic Review. Am J Occup Ther August 2021, Vol. 75(Supplement_2), 7512520380p1. doi: https://doi.org/10.5014/ajot.2021.75S2-PO380
3. Javaherian-Dysinger, H., Krpalek, D., Huecker, E., Hewitt, L., Cabrera, M., Brown, C., Francis, J., Rogers, K., & Server, S. (2016). Occupational Needs and Goals of Survivors of Domestic Violence. Occupational therapy in health care, 30(2), 175–186. https://doi.org/10.3109/07380577.2015.1109741
4. Occupational Therapy Services for Individuals Who Have Experienced Domestic Violence (Statement). Am J Occup Ther November/December 2007, Vol. 61(6), 704–709. doi: https://doi.org/10.5014/ajot.61.6.704
5. Toon MH, Maybauer DM, Arceneaux LL, Fraser JF, Meyer W, Runge A, Maybauer MO. Children with burn injuries--assessment of trauma, neglect, violence and abuse. J Inj Violence Res. 2011 Jul;3(2):98-110. doi: 10.5249/jivr.v3i2.91. PMID: 21498973; PMCID: PMC3134932.