CHAPTER 6: assessment

Introduction

 Providing good case management services

rests on conducting a good assessment as
well as having a good relationship with the
survivor
Introduction

 In social work case management, assessment

is defined as the act of gathering
information about a client and using it with
the client to make decisions about the
client’s care.
Introduction

 In GBV case management, this step involves

listening to the survivor to find out what has
happened and what the current situation is,
and giving information and helping the
person identify their needs and problems.
3.1: FACILITATING THE SURVIVOR’S
DISCLOSURE
 Asking the survivor to talk about what
happened to them is likely to feel difficult and
scary for them.
 Some ways you can make the person feel
more at ease during this conversation are:
FACILITATING THE SURVIVOR’S
DISCLOSURE

1. Using an open-ended question to invite the person to begin,

e.g. “Would you like to tell me about what happened?” or
“Can you tell me what brought you here today?”

2. Listening carefully to the story as the person tells it.

3. Watching the person’s body language closely for any signs of

discomfort, such as crying, staring into space, mumbling,
giving one-worded answers, turning away, or changing the
topic.
FACILITATING THE SURVIVOR’S
DISCLOSURE

4. Actively check in with the person along the way—Are

they okay with continuing to talk about this? Do they
need to take a break?
5. If the person verbally or non-verbally expresses that they
are not comfortable answering questions or sharing
information with you, respect their wishes and stop.
Forcing a survivor to tell their story is harmful. You
should not do this under any circumstances.

6. Take notes if needed, but keep your focus on the survivor.

FACILITATING THE SURVIVOR’S
DISCLOSURE

7. As the person tells you what happened, encourage and empathize

through both verbal and non-verbal communication. Phrases such
as “continue”, “go on” or “I am listening” can be helpful.

8. Once the person has disclosed, respond to the disclosure with

compassion, validation and reassurance

9. Ask clarifying questions only after you have let the survivor speak
and have responded to their disclosure. Avoid unnecessary
questions; only ask questions that will give you information to
help the survivor.
FACILITATING THE SURVIVOR’S
DISCLOSURE
 As you begin this step, you will continue to
build trust by fostering a safe environment in
which the person feels listened to, not judged
and not blamed for what happened.
GATHERING BACKGROUND
INFORMATION
 Before you begin your conversation with the
survivor about what happened to her/him,
you may want to gather basic information
about their background. This may help the
person feel more comfortable and safe, and it
gives you more time to build rapport with
them.
GATHERING BACKGROUND
INFORMATION
 Instead of asking a list of questions, begin
with an open question that invites the person
to tell you about her/himself. You can then
ask follow-up questions if necessary.
Information that is helpful to know includes:
GATHERING BACKGROUND
INFORMATION
 The survivor’s age (can be approximate if the
person does not know)
 Current living situation
 Family situation
 Occupation or role in the community.
UNDERSTAND WHAT HAPPENED

 The following information is important for

you to understand about what happened to
the person:
1. Nature of the violence or abuse
2. Who the perpetrator is and what access they have
to the survivor
3. When the last incident took place
4. Frequency
RESPONDING TO A SURVIVOR’S
DISCLOSURE
 After a survivor has shared what has
happened, it is important to communicate
compassion, validation and reassurance.
RESPONDING TO A SURVIVOR’S
DISCLOSURE
 In addition to thanking the person for sharing
something very difficult, there are a few
simple statements you can say that can be
very powerful and supportive for the person
to hear.

 These statements, called Healing

Statements” can be an import part of a
survivor’s healing.
 RESPONDING TO A SURVIVOR’S
DISCLOSURE
1. Validate and empower the survivor by saying, “You were
very brave for sharing that with me.”

2. Continue to build trust by saying, “I believe you.”

3. Express empathy by saying, “I am sorry this happened to

you,” or “I am so sorry you are going through this.”

4. Provide reassurance that what happened was not their

fault by saying “You are not to blame” or “What happened
was not your fault
3.2: ASSESSMENT OF NEEDS

 Assessment of a survivor’s needs begins with

listening. While you may develop a sense of
the person's major concerns through their
recounting of the GBV incident, it is also
important to ask the person directly how
they see the situation and what they want
to happen next.
 This will help you understand their priorities
for help and support.
ASSESSMENT OF NEEDS

 In the immediate aftermath of an incident,

the survivor’s life may be at risk either
because of health complications or threats
to safety.

 In such cases, it is important to prioritize

these areas in your assessment of needs.
ASSESSMENT OF NEEDS

 In addition, caseworkers do not need to carry

out a complete assessment or gather all
demographic information the first time they
meet with a survivor.

 This can and should be done in a phased

manner as appropriate to the survivor’s case,
priority needs and context
ASSESSMENT OF NEEDS

1. SAFETY NEEDS AND STRATEGIES

2. HEALTH NEEDS AND SERVICES
3. PSYCHOSOCIAL NEEDS AND SUPPORT
4. LEGAL RIGHTS
5. OTHER PRACTICAL AND MATERIAL NEEDS
SAFETY NEEDS AND STRATEGIES

 While the person is telling you what

happened, you should listen for situations,
circumstances and people that are
continuing to harm them or put them at risk
of harm. You will also want to discuss
strategies for mitigating those risks.

 Listen and assess for:

SAFETY NEEDS AND STRATEGIES

1. The person’s sense of safety in their home

and in the community

2. The person’s existing safety and support

systems and strategies

3. Other resources that may be available or

mobilized
HEALTH NEEDS AND SERVICES

 For a recent GBV incident, it is important to

determine whether a medical referral is
required.

 This is particularly important for incidents of

rape, sexual assault or any form of non-sexual
physical assault that may have resulted in
acute injury, pain or bleeding.
HEALTH NEEDS AND SERVICES

 You can understand a survivor’s health needs

primarily by listening to their story of what
happened and determining the medical
implications.

 You may also have to ask clarifying questions

—the goal of which is to understand:
HEALTH NEEDS AND SERVICES

 Nature of the incident (i.e. if it was a rape or sexual

assault, medical treatment is highly recommended)
 Presence of and/or complaint of pain or injury.
 Date/timing of the last incident (i.e., for sexual assaults
that happened within 72 or 120 hours, lifesaving
treatments can be provided as described below)
 Prevention of HIV
 Prevention of pregnancy
 Medical stabilization/treatment of acute injury or pain:
 Forensic evidence collection
PSYCHOSOCIAL NEEDS AND
SUPPORT
 Experiences of GBV have a great impact on a
person’s emotional well-being, their ability to
keep up with day-to-day tasks, their overall
sense of safety in the world, and their ability to
trust others.
PSYCHOSOCIAL NEEDS AND
SUPPORT
 You can begin to understand the survivor’s
psychosocial state from the very first meeting
with them.

 The person’s emotional state, their facial

expressions, body language and other behavior
can indicate signs of distress. The key
assessments areas for psychosocial needs and
support are:
PSYCHOSOCIAL NEEDS AND
SUPPORT

 Get a basic sense of how the person is feeling

 Observe the person’s appearance and behavior

 Assess changes in the person’s feelings or behavior

 Assess opportunities for education and livelihoods

 Identify protective factors and strengths

LEGAL RIGHTS

 The decision whether to pursue justice is an

important one, and survivors need to have
access to full information to think through such a
decision.

 It is important for you to understand if what

happened to the person is a crime within the
legal framework of your setting, and if so,
whether the person wants to take legal action.
OTHER PRACTICAL AND MATERIAL
NEEDS
 It is likely that survivors will also need
practical and material support. For example,
they may need money, clothes, food, phone
credit, transportation, etc.

 These are likely to be needs that the person

identifies on their own as a priority because
they are critical for survival
3.3 DOCUMENTING INFORMATION
FROM THE ASSESSMENT

 If you have a case management system and

are using forms, you should document the
information from your assessment.

 The most important information to

document is the survivor’s description of
what happened, what the survivor identified
as concerns, and what you identified
together as needs.
3.4 SUICIDE RISK ASSESSMENT AND
SUPPORT
 One of the most serious consequences of
GBV is a survivor’s risk of suicide.

 It can be expected that survivors will have

feelings of wanting to die, end their life or
“disappear.”
3.4 SUICIDE RISK ASSESSMENT AND
SUPPORT
 If a survivor is expressing such feelings, it is
important that a more in-depth assessment
be carried out.

 The main task is to determine whether or not

this is a feeling only, or a feeling with an
intention to act (i.e. the intention to actually
take one’s life).
3.4 SUICIDE RISK ASSESSMENT AND
SUPPORT
 Organizations will need to have clear policies
on how suicide risk cases are handled, which
should be based on the staff’s and
supervisors’ own capacity to carry out suicide
risk assessments including the following
steps:
3.4 SUICIDE RISK ASSESSMENT AND
SUPPORT

Step 1: Assess current/past suicidal thoughts

Step 2: Assess risk: lethality((‫ ا لفتك‬and safety
needs
Step 3: Address feelings and provide support
Step 4: Develop a safety agreement
Step 1: Assess current/past suicidal thoughts

 Explain to the person: “I’m going to ask you

some questions that may be hard for you to
answer, but I am worried about you, so I want
to know that you are going to be ok.”
Step 1: Assess current/past suicidal thoughts

 Ask the person questions that can help you

assess their current and past suicidal thoughts.

 Some examples of questions you can ask are

below. Keep in mind that these will need to be
adapted based on the cultural context
Step 1: Assess current/past suicidal thoughts

SAMPLE SCRIPT
To assess current or past suicidal thoughts you can say:

 That sounds like a lot for one person to take. Are you feeling so bad that
you’re considering suicide to escape?

 Do you think about dying? Or wish you were dead?

 Are you or have you ever thought about hurting or killing yourself?

 Has all that pain you’re going through made you think about hurting yourself?

 Do you ever wish you could go to sleep and just not wake up? How often?
Since when?
Step 1: Assess current/past suicidal thoughts

 Based on the person’s responses, you may or may not need to

continue with the suicide risk assessment.

a. If the person answers “no”, and there are no signs that they intend
to harm or kill themselves, it is likely the risk of suicide or self-
harm is low. In this case, you can likely discontinue the
assessment. Again, this is determined on a case-by-case basis and
depending upon whether there are other signs that the person
may be suicidal.

b. If the person answers “yes” to either of the questions, say to the

survivor, “Please tell me more about these thoughts”, and then
proceed to the next step.
STEP 2: ASSESS RISK: LETHALITY AND SAFETY NEEDS

 You will next need to understand if the

person has a plan. You should also assess past
suicide attempts because they signal higher
risk. Examples of questions you can ask to
assess these risks are below.
 If the person is unable to explain a plan for
how they would take their own life and/or has
no history of attempts, the risk is less
immediate.
STEP 2: ASSESS RISK: LETHALITY AND SAFETY NEEDS

 At this point, you should support the person

by exploring strategies for coping with
difficult feelings and thoughts, and if needed,
develop a safety agreement with the survivor
(see Step 4 of the suicide risk assessment).
 If the survivor is able to explain a plan and/or
indicates they have already attempted
suicide, the risk is more immediate. You
should continue to the next step.
STEP 2: ASSESS RISK: LETHALITY AND SAFETY NEEDS

 SAMPLE SCRIPT
 To assess if the person has a plan, you can
say:
 “Tell me about how you would end your life.
[Allow survivor to answer]. What would you
do? When did you think you would do it? Where
did you think you would do it? Are
(guns/pills/other methods) (at home/easy to
get)?”
STEP 2: ASSESS RISK: LETHALITY AND SAFETY NEEDS

 To assess past suicide attempts you can say:

 “Have you ever started to do something to end your life but
changed your mind? Or have you ever started to do
something to end your life but someone stopped you or
interrupted you? What happened? When was that? Tell me
how many times that happened.”

 As with any part of the assessment, be sure to give the

survivor time to answer and pause before asking another
question. Always take your cue from the person as to
whether they need to go more slowly or take a break.
STEP 3: ADDRESS FEELINGS AND PROVIDE SUPPORT

 It is critical that you stay calm if the person expresses suicidal

thoughts and a plan. It may be the opposite of your instinct,
but do not try to talk the person out of it nor offer advice about
what they should do.

 The feeling they have is serving a purpose for them—it is their

last attempt to feel that they are in control of something.

 Instead, you should validate their feelings and acknowledge

the courage it took for them to share such information with
you and communicate your concern for their safety and well-
being.
STEP 3: ADDRESS FEELINGS AND PROVIDE SUPPORT

 SAMPLE SCRIPT
 To address feelings and provide immediate emotional
support, you can say:

 “I understand that you are feeling this way and I am sorry. I

know that it was hard for you to share that. You are very
brave for telling me.

 It is very important to me that you do not hurt yourself.

And I would like us to come up with a plan together for
how we can help you to not do this. Is this okay with you?”
STEP 4: DEVELOP A SAFETY AGREEMENT

 Developing a safety agreement with the

survivor is a way for you to help them identify
their own mitigation and prevention
strategies. In this step, you will explain the
purpose of the agreement. Then you will help
the person identify:
 Warning signs
 Strategies to feel better
 A safety person
STEP 4: DEVELOP A SAFETY AGREEMENT

 First help the person identify warning signs:

 Ask the person to describe their experience “Tell me
what happens when you start to think about killing
yourself or wanting to hurt yourself? What do you
feel? What do you think about? How will you know
when you are going to need to use these strategies?”

 Identify the warning signs (thoughts, images,

thinking processes, mood and/or behaviors) using
the survivor’s own words
STEP 4: DEVELOP A SAFETY AGREEMENT

 Next help the person identify strategies to feel better:

 Explain to the survivor, that you want to find other things
the person can do to make themselves feel better.

 “When you have thought about killing yourself before,

what prevented you from doing it?”

 “Tell me some things you can do to help yourself feel better

when you start to think about hurting yourself or wanting
to end your life. What has helped you feel better in the
past? Is there someone you can talk to or go to?”
STEP 4: DEVELOP A SAFETY AGREEMENT

 Identify a safety person:

 Explain to the person that in addition to the strategies
they have identified, a friend or another family member
must be notified to act as a “safety person” for the
survivor.

 This should be someone who can be with the person all

the time for at least the following 24 hours. You will need
to try to get in touch with this person, explain to them
what is happening and arrange for them to come meet
the survivor or for you to bring the survivor to them.
STEP 4: DEVELOP A SAFETY AGREEMENT

 SAMPLE SCRIPT
 To help the survivor identify a safety
person, you can say:
 “I want to help you stay safe. Can you think of
someone in your family or a friend who could
stay by your side? Can we work together to get
that person to agree to stay by your side in
order to keep you safe?”
 Questions and answers

The end
Thank you for your
good listening