“I hate this piece of paper.”

My client spoke the words calmly, but her body language conveyed another message — head down, shoulders pulled forward, muscles tense. She had said out-loud what other clients think, but don’t say, about the one-page document called the Danger Assessment. Containing twenty yes or no questions, answered in mere minutes, the Danger Assessment had shown my client that she was at risk of being killed by her abusive partner.

Unless a domestic violence survivor comes into contact with a trained first responder or victim advocate, she likely will not hear about the Danger Assessment. Most domestic violence survivors are not aware that a particular pattern of assaults and threats can signal that her life is in danger. Has he strangled her? Threatened her with a weapon? Does he threaten to kill her or her children? Has she left him? Does she think he might try to kill her? If a domestic violence survivor answers “yes” to these and a handful of other questions, she is presented with incontrovertible evidence that her situation is dire.

The Danger Assessment is based on 25 years of research by Dr. Jacquelyn Campbell of The Johns Hopkins University School of Nursing. Campbell’s research identified the distinguishing factors that indicate increasing levels of danger for domestic violence survivors. Campbell’s 20 questions are listed below, and a weighted, online assessment is also available.

1. Has the physical violence increased in severity or frequency over the past year?
2. Does he own a gun?
3. Have you left him after living together during the past year?
4. Is he unemployed?
5. Has he ever used a weapon against you or threatened you with a lethal weapon?
6. Does he threaten to kill you?
7. Has he avoided being arrested for domestic violence?
8. Do you have a child that is not his?
9. Has he ever forced you to have sex when you did not wish to do so?
10. Does he ever try to choke [i.e. strangle] you?
11. Does he use illegal drugs? By drugs, I mean “uppers” or amphetamines, meth, speed, angel dust, cocaine, “crack”, street drugs or mixtures.
12. Is he an alcoholic or problem drinker?
13. Does he control most or all of your daily activities? For instance, does he tell you who you can be friends with, when you can see your family, how much money you can use or when you can take the car?
14. Is he violently and constantly jealous of you? For instance, does he say, “If I can’t have you, no one can.”
15. Have you ever been beaten by him while you were pregnant?
16. Has he ever threatened or tried to commit suicide?
17. Does he threaten to harm your children?
18. Do you believe he is capable of killing you?
19. Does he follow or spy on you, leave threatening notes or messages, destroy your property, or call you when you don’t want him to?
20. Have you ever threatened or tried to commit suicide?

My client hated her Danger Assessment results — an understandable response. First, there are the traumatic memories that are stirred up as she answers the questions. There is also the fear and sadness that comes with realizing her partner is likely to seriously injure or kill her. That can be compounded by fear for her children: Are they safe? Who will protect them if she is gone?

Oftentimes, there is additional frustration and regret over not having this information sooner. Through the years, she has sought help from various authorities, but none of them knew about the Danger Assessment. She will never know what her life might have been like if she had known sooner what she knows now.

My role as her therapist is to acknowledge and validate her feelings, but we don’t stop there. Genesis places the highest value on clients’ safety, so we don’t shy away from providing information that is hard for clients to hear. Coupled with that, however, is our message that this knowledge gives them power: Power to realistically assess their level of danger, power to make safety plans that can mean the difference between life and death, and power to advocate for themselves with authorities who may not understand their life-threatening situations.

Dr. Campbell’s research revealed that most (96%) domestic-violence murder victims never received services from a domestic violence program. This is why domestic violence agencies and police departments across the country are teaming up to institute Lethality Assessment Programs. Officers are trained to provide every domestic violence victim they encounter with a Lethality Assessment (a shortened version of Campbell’s 20-question assessment). If the victim answers “yes” to certain questions, the officer immediately helps her contact a domestic violence agency like Genesis Women’s Shelter.

Genesis is committed to helping domestic violence survivors access tools like the Danger Assessment, and our clients show tremendous courage in confronting the harsh realities of risks. In doing so, they are often taking a crucial step toward safety and life.

Written by R.H., a Women’s and Children’s Therapist at Genesis Women’s Shelter & Support.