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Figure 1. Excerpts from the Domestic Violence Survivor Assessment Form: Issues about the Relationship—Triggers of Abusive Incidents
|Denies and excuses abuse. May accept blame by partner.
Committed to continuing.
|Rejects self-blame. Continues to make excuses to others, but realizes partner chooses to abuse.
Considers change: abuse and options
|Will not tolerate abuse. If left, avoids partner. If together, monitors partner for change.|
Establishes a new life—apart or together.
Source: Jacqueline Dienemann, Visiting Professor, University of North Carolina at Charlotte, Department of Adult Health Nursing, 9201 University City Boulevard, Charlotte, NC 28223; E-mail: firstname.lastname@example.org or email@example.com. Used with permission.
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