Why Telehealth Is a Complicated Option for Domestic Violence Survivors

Domestic violence counselors are facing a range of challenges in using telehealth services to stay in touch with survivors who may be stuck with their abusers during COVID-19 lockdown.

[Photo: An illustration of a person sitting on a couch. They're holding an tablet and a phone as they video conference with a therapist.]
Eldridge is concerned about how lonely her clients seem to be. Some have told her they feel isolated, and have requested their calls be increased to twice a week. Shutterstock

As a social worker for domestic violence survivors in New York, Sara Eldridge gets daily glimpses into the experiences of survivors trapped inside with their abusers.

Eldridge, who works for Barrier Free Living, helps survivors brainstorm de-escalation strategies or make emergency plans. Other clients are navigating the complex aftermath of intimate partner violence, including concerns about being separated from children quarantined with the abuser.

In mid-March, Eldridge started working from home, a two-bedroom she shares with her husband. When it’s time to speak to her clients, she retreats to the bedroom, turns on a white noise machine, and plugs in her headphones. Until recently, telehealth was an abstract concept for Eldridge. But stay-home orders mean it’s now the only way she can reach clients.

Social workers who address domestic violence expected the virus outbreak to affect their work. Studies have shown that domestic violence reports increase after catastrophic events, and the COVID-19 pandemic is no exception. Portland, Oregon, had a 27 percent increase in domestic violence arrests from March 12 to 23 compared to last year, according to a CNN report. Domestic assault and battery reports to Boston police jumped 22 percent, and domestic violence reports in Seattle increased 21 percent during the same period.

In one county of China’s Hubei province, where COVID-19 first broke out, domestic violence incidents reported to police more than tripled in February, according to the Guardian.

For Eldridge, the transition to using digital platforms to contact clients has been relatively easy. But she misses in-person therapy, where she can comfort clients by resting a hand on an arm or offering a hug.

Eldridge is concerned about how lonely her clients seem to be. Some have told her they feel isolated, and have requested their calls be increased to twice a week. Eldridge said they are “feeling like if something happened, who would know, or care? You know, who’s checking in on me?”

Social workers worry that survivors will lack access to their services during the pandemic. In New York, for instance, some domestic violence hotlines have gotten eerily quiet.

“If you’re in your home with your abuser, you might not be able to safely call us,” said Kimberlina Kavern, senior director of Safe Horizon’s crime victim assistance program. Although Safe Horizon, which answers around 80,000 calls a year on its domestic violence hotline, has a safe chat feature on its website, Kavern suspects few victims are aware of it yet.

Some advocates think some platforms may be erecting more barriers for survivors. Cynthia Amodeo, chief program officer at Barrier Free Living, said that while video platforms facilitate the face-to-face contact that often makes therapy feel meaningful, clients may not have the devices necessary.

For providers, keeping in touch with longer-term clients has also been difficult. Jocelyn Veliz, a counselor advocate at the Violence Intervention Program, said reaching out right now could backfire. “In some cases, a client’s abusive partner may have access to their mobile device,” Veliz said. “Sometimes simply talking on the phone can trigger an abusive partner to lash out.”

Exercising extreme caution, the advocates still call. Veliz said she has not heard from some clients since the start of the pandemic. “That’s always concerning,” Veliz told Rewire.News.

Rachel Gibson, a technology safety specialist at the National Network to End Domestic Violence—an organization assisting domestic violence services across the United States—is supporting providers who are shifting to digital services. Her goal is to help them understand platforms for reaching clients in need of crisis support or resources during the pandemic.

Gibson also directs providers—many of whom have found themselves spending money on trainings or programs—to resources like Tech Soup, a website that helps nonprofits and charities finance their technological needs.

“No platform out there is going to meet your entire need,” Gibson told Rewire.News. For instance, some are expensive but protect user privacy well. Others programs may be affordable but have to be downloaded, leaving technological traces that abusers can exploit.

Whether digitization is temporary or long-term, Gibson tries to help nonprofits make choices that are aligned with the principles of domestic violence social work, no matter how stressful the conditions are under COVID-19. “It’s the same values, same core, just done a little differently,” Gibson said.

Some providers see potential in telehealth as a complement to in-person therapy. Jayna Jones, a social worker with HELP R.O.A.D.S., a domestic violence nonprofit, has mainly talked to her clients on the phone since the outbreak. While she recognizes the confidentiality concerns, she also thinks telehealth may be able to keep certain clients engaged who otherwise might not be able to make it to appointments.

“If we have clients that are presenting with more physical disabilities, or just an inability to travel,” said Jones, “[these platforms] then broaden our ability to communicate.”

She hopes some of the changes in her workflow are permanent. “Unfortunately, it’s taken a pandemic,” said Jones, “to realize that we need to be utilizing these types of services more.”

If you or someone you know is in immediate danger, call 911. For confidential help, contact the National Domestic Violence Hotline at 1-800-799-SAFE (7233). You can also find a safe chat and more resources on their website.