Preventing Sexual Violence
An Educational Toolkit for Health Care Professionals

What Is Sexual Violence?
How Do I Prevent It?
Overview of Web version



Sexual Violence Prevention Toolkit
School-age Visit Vignette Script

Focus:  bullying and domestic violence
Scenario:  Well-child visit with 10-year-old boy (Tom) and his mother (Mrs. Ericson)

Green light
Discussion of what’s happening at school, models how parents can talk to their kids.

Dr Stirling:        Boy, Tom’s sure been growing up in the past couple of years.
Mrs. Ericson:    Yeah, he’s been doing pretty well.
Dr:                   You’re in fifth grade now, right?
Tom:                Yeah.
Dr:                   Where do you go to school?
Tom:                Eisenhower.
Dr:                   How’s school going?
Tom:                Fine.
Dr:                   What part of school do you like best?
Tom:                Recess and lunch.
Everyone laughs.
Dr:                   How are your grades?
Tom:                OK.
Dr:                   What part of school is the hardest?  I used to think the class after lunch was hardest because I’d want to fall asleep.
Tom:                Not me.  It’s the end of the day—I just sit and look out the window.  I can’t wait to get out of there!
Dr:                   Why?  What goes on after school?
Tom:                Well, I really like to draw.  (long pause)  And I’m in this art program a couple days a week.
Dr:                   That’s great.  Are any of your friends in the program with you?
Tom:                Yeah, my best friend Justin is.  He goes to a different school, so it’s cool that I get to see him at art class.
Dr:                   Tom, some of the other fifth graders I talk with have trouble with bullies or people that tease others in a hurtful way.  Have you or Justin had any trouble with bullies?
Tom:                Yeah, there’s this older guy, he’s 13, in our art class who says nasty things and tries to steal our art stuff sometimes.
Dr:                   What kinds of things have you tried to get him to stop?
Tom:                Mostly ignoring him, and keeping our stuff close.
Dr:                   Tom, I’m glad you’re talking about this because it’s always good to brainstorm with others about what can be done.  It may be important to let your teacher know or talk to your mom about other ways you can keep this guy away from you and Justin
Mom:               Yes, Tom, I’m glad I know about this.  Maybe we can talk; I have some ideas that might help
Dr:                   Sometimes we think we have the answers or know what’s going on, but if you give Tom a chance to talk while you really listen, you may be surprised. 

Yellow light
Tom and Mrs. Ericson reveal that he was suspended for sexually bullying another boy.

Dr:                   It’s great to hear how well you’re doing.
Mrs. Ericson:    Sarcastically.  Well, it’s not all good, is it, Tom?
Tom scowls.
Dr:                   What’s up?
Mrs. Ericson:    He was suspended last week.
Dr:                   For what?
Tom:                They said I was talking to some kid.
Dr:                   About what?
Mrs. Ericson:    Rolls eyes.  They said he was bullying another kid.  They’re so sensitive these days.  Kids have always called each other names.
Dr:                   So that’s what happened?  You called a kid a name?
Tom:                Yeah.
Dr:                   What did you call him?
Tom:                A homo.
Dr:                   Why did you call him that?
Tom:                I don’t know.  He annoys me.
Dr:                   So what annoys you so much?
Tom:                I don’t know.  He lives next door to a friend of mine, and they’re always hanging out together even though he’s kind of a nerd.  Now she’s not talking to me so much.
Dr:                   Well, what happened when you called him that?
Tom:                He started crying.  And then he told the teacher.
Dr:                   He didn’t like what you said, huh? 
Tom:                Shrugs.  I guess not, but he didn’t need to tell the teacher.
Dr:                   How would you feel if someone called you a name?
Tom:                I guess I wouldn’t like it either.  But I wouldn’t tell.
Dr:                   Well, maybe you wouldn’t tell, but how do you think this girl feels about you when you call her friend names?
Tom:                I guess she might think I’m kind of mean.
Dr:                   That’s possible.  So what might be a better way to get her attention?
Tom:                Well, I guess being nice would be better.  (pause, thinking)  And I think she likes art too, so maybe I could show her some of my drawings.
Dr:                   That sounds like a much better approach to me.

Red light
Discussion with Mrs. Ericson alone reveals domestic violence in home.

Dr:                   Have you gotten in trouble like this before?
Tom shrugs.
Mrs. Ericson:    He’s been having problems off and on for 6 months.  But it’s all just little stuff like this.
Dr:                   OK, Tom, I’d like to talk to your mom a little bit.  How about if you go wait in the waiting room?  I think we have some good magazines out there.
Doctor escorts Tom to the door.
Dr:                   I wanted to talk to you a little bit privately.  A lot of times when kids start acting out like what you’re describing, it’s because they’re under stress.  Is Tom under stress?
Mrs. Ericson:    Who isn’t?  Pause.  We’re always under stress.
Dr:                   In what way?
Mrs. Ericson:    I don’t know.  It’s just life, I guess.
Dr:                   Has anyone died or left the family?  Have there been any big changes at home?
Mrs. Ericson:    No, nothing like that.
Dr:                   Now, I remember that you’re married and have two kids.  You’re a stay-at-home mom, right?
Mrs. Ericson:    Yeah.
Dr:                   What does your husband think about Tom getting suspended?
Mrs. Ericson:    He doesn’t know about it, but I don’t think it would bother him.
Dr:                   Why not?
Mrs. Ericson:    He’s just not really the touchy-feely type.  And he says worse stuff than what Tom said all the time.
Dr:                   Who does he say this stuff to?
Mrs. Ericson:    You know, me, the kids, whoever.
Dr:                   That sounds harsh.
Mrs. Ericson:    You don’t know the half of it.
Dr:                   Is it rough for you?
Mrs. Ericson:    Pauses.  Yeah.
Dr:                   Do things ever get violent around the house?
Mrs. Ericson:    Pauses.  Yeah.
Dr:                   Does it ever involve the kids?
Mrs. Ericson:    Not really.  Just spanking sometimes.
Dr:                   With what?
Mrs. Ericson:    Oh, he just uses his hand and hits them on the butt.
Dr:                   Do you ever get hit?
Mrs. Ericson:    Sometimes.  But in general, he’s a really good father.  He works really hard.
Dr:                   You know, a lot of people have problems like this.  Why don’t you tell me a little bit more about what happens at home?
Mrs. Ericson:    It’s just that Frank is so tired when he gets home.  And sometimes I guess he takes it out on me.  I know he doesn’t mean to.  And he always feels really bad about it.
Dr:                   Well, have you tried to get any help?
Mrs. Ericson:    No.
Dr:                   Well, who do you turn to when things get really tough?  Is there someone you can talk to?
Mrs. Ericson:    My mom.
Dr:                   And what does she say?
Mrs. Ericson:    She thinks I should leave him.
Dr:                   Have you thought about it.
Mrs. Ericson:    Pretty much everyday.  But it’s just too hard.  I don’t have a job, and I know he’d try to take the kids from me.
Dr:                   A lot of people are in similar situations and often we can really learn from each other how to handle them.  Let me give you the number for the local YWCA.  They have counselors and other people you can talk to who understand exactly what you’re going through.
Mrs. Ericson:  Hmm…
Dr:                   I’m a little worried about the effect of this behavior on the kids.  How about you?
Mrs. Ericson:    Sometimes.
Dr:                   Do you think what’s going on at home might have something to do with how Tom has been behaving?
Mrs. Ericson:    I guess I could see that.
Dr:                   Yeah, there’s a really high correlation between bullying and violence in the home.  Kids who see their parents abusing each other, either verbally or physically, learn that hitting is the way to handle problems.  We know Tom is already mimicking the name calling he hears at home; we don’t want him to start hitting other kids too.
Mrs. Ericson:    Definitely not.  I guess I can try calling the counselors.  Thanks.