BRIEF Core Competencies CHECK-UP

Please type in the first your last name followed by your first name. *

What year were you born? *

Today's Date *

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What kinds of DV Treatment Sessions do you do? (Check all that apply) *

A Group In-Person Session.

An Individual In-Person.

A Group Tele-therapy Session.

An Individual Teletherapy Session.

There was no particular Session (i.e., this is a make-up Assignment).

Required

Where do you usually attend Sessions? *

Alamosa

Monte Vista

Trinidad

Walsenburg

About how many DV Group or Individual Sessions Have you Completed Thus Far? (Number does not have to be exact. Just give it your best guess). *

Please Note: The DVOMB Core Competencies are a Mandatory Requirement for persons with DV Offenses in Colorado. The State Agency that manages DV Offender Treatment mandates that every persons with a DV Offense be required to master the following Core Competencies before he or she can be successfully discharged from DV Offender Treatment. PLEASE CAREFULLY READ the Instructions Below:

Whatever you do, DO NOT write "N/A or Not Applicable or None, or Does not Apply to me, or Never did this...." underneath any of these Core Competencies as listed below. What you need to do here is to demonstrate by your answers how each one of these Core Competencies below has been mastered by you, regardless of the nature of your DV-Related Offense; or how your DV Offense relates to the Core Competency.

PLEASE CAREFULLY READ the Instructions Below and answer the question (below) that you will find underneath each Competency. If you have not yet discussed this Competency in Session, please be sure to honestly note this in the space provided:

Question: Please create an original and sincere and statement here that demonstrates that you fully understand this particular core competency how understanding it will help you prevent DV moving forward.

Essentially, you are being asked to prove that you understand what this Competency is talking about and how it relates to your offense, as well as how it can relate to having healthier relationships.

AGAIN: Whatever you do; DO NOT put a check-mark or write "N/A or Not Applicable or None, or Does not Apply to me, or Never did this.... ,or I understand this Competency" on this list below.

These Competencies apply to all persons with DV-Related Offenses.

Please Read Each Core Competency Below and Respond to the questions: *

Yes, I understand these instructions above and I will do my best to complete this assignment truthfully and thoroughly.

Required

_______A. Elimination of Abusive Behavior. _______1. Consumer commits to the elimination of abusive behavior: _______2. Eliminates the use of physical intimidation, psychological cruelty, or coercion toward one’s partner or children.

Question: Please create an original and sincere and statement here that demonstrates that you fully understand this particular core competency how understanding it will help you prevent DV moving forward.

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B. Demonstration of Change

_______1. Consumer demonstrates change by working on the comprehensive personal change plan: _______2. Begins implementing portions of the personal change plan; _______3. Accepts that working on abuse related issues and monitoring them is an ongoing process; _______4. Begins designing an Aftercare Plan; _______5. Completes an Aftercare Plan and is prepared to implement this plan after discharge from treatment.

Question: Please create an original and sincere and statement here that demonstrates that you fully understand this particular core competency how understanding it will help you prevent DV moving forward.

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C. Personal Change Plan

_______1. Consumer completes a comprehensive Personal Change Plan: _______2. Reflects the level of treatment and has been reviewed and approved by the MTT; _______3. Driven by the Consumer’s risk and level of treatment

Question: Please create an original and sincere and statement here that demonstrates that you fully understand this particular core competency how understanding it will help you prevent DV moving forward.

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D. Empathy _______1. Consumer development of empathy: Recognizes and verbalizes the effects of one’s actions on one’s partner/victim; _______2. Recognizes and verbalizes the effects on children and other secondary and tertiary victims such as neighbors, family, friends, and professionals; _______3. Offers helpful, compassionate response to others without turning attention back on self

Question: Please create an original and sincere and statement here that demonstrates that you fully understand this particular core competency how understanding it will help you prevent DV moving forward.

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E. Responsibility _______1. Consumer accepts full responsibility for the offense and abusive history; _______2. Discloses the history of physical and psychological abuse toward the offender’s victim(s) and children; _______3. Overcomes the denial and minimization that accompany abusive behavior; _______4. Makes increasing disclosures over time; _______5. Accepts responsibility for the impact of one’s abusive behavior on secondary, tertiary victims and the community; _______6. Recognizes that abusive behavior is unacceptable (abuse wrong-no excuses or justifications-no blaming)

Question: Please create an original and sincere and statement here that demonstrates that you fully understand this particular core competency how understanding it will help you prevent DV moving forward.

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F. Understanding of offense, pattern of power and control, cultural context _______1. Consumer identifies and progressively reduces pattern of power and control behaviors, beliefs, and attitudes of entitlement: _______2. Recognizes that the violence was made possible by a larger context of the offender’s behaviors and attitudes; _______3. Identifies the specific forms of day-to-day abuse and control, such as isolation that have been utilized, as well as the underlying outlook and excuses that drove those behaviors; _______4. Demonstrate behaviors, attitudes and beliefs congruent with equality and respect in personal relationship

Question: Please create an original and sincere and statement here that demonstrates that you fully understand this particular core competency how understanding it will help you prevent DV moving forward.

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G. Offender Accountability _______1. Accepts responsibility for one’s abusive behaviors, _______2. Accepts the consequences of those abusive behaviors, _______3. Actively works to repair the harm, and prevent future abusive behavior; _______4. Taking corrective actions to foster safety and health for the victim

Question: Please create an original and sincere and statement here that demonstrates that you fully understand this particular core competency how understanding it will help you prevent DV moving forward.

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--- A. Recognizes and eliminates all minimizations of abusive behavior and without prompts identifies one’s own abusive behaviors

Question: Please create an original and sincere and statement here that demonstrates that you fully understand this particular core competency how understanding it will help you prevent DV moving forward.

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--- B. Demonstrates full ownership for his/her actions and accepts the consequences of these actions: The Consumer demonstrates an understanding of patterns for past abusive actions and acknowledges the need to plan for future self-management and further agrees to create the structure that makes accountability possible

Question: Please create an original and sincere and statement here that demonstrates that you fully understand this particular core competency how understanding it will help you prevent DV moving forward.

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--- C. The Consumer accepts that their partner or former partner and their children may continue to challenge them regarding past or current behaviors. Should they behave abusively in the future, they consider it their responsibility to report those behaviors honestly to their friends and relatives, to their probation officer, and to others who will hold them accountable

Question: Please create an original and sincere and statement here that demonstrates that you fully understand this particular core competency how understanding it will help you prevent DV moving forward.

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H. _______ Consequences and Choice _______1. One accepts that one’s behavior has, and should have, consequences; _______2. Identifies the consequences of one’s own behavior and challenges distorted thinking and understands that consequences are a result of one’s actions or choices. _______3. The Consumer makes decisions based on recognition of potential consequences; _______4. Recognizes that the abusive behavior was a choice, intentional and goal-oriented

Question: Please create an original and sincere and statement here that demonstrates that you fully understand this particular core competency how understanding it will help you prevent DV moving forward.

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I. Client participation and cooperation in treatment: _______1. Participates openly in treatment (e.g. processing personal feelings, providing constructive feedback, identifying one’s own abusive patterns, _______2. Completes homework assignments, _______3. Presents letter of accountability, _______4. Demonstrates responsibility by attending treatment as required by the Treatment Plan.

_______ 3. Client needs to be sure that all DV Treatment Fees are paid in order to successfully complete DV Treatment.

Question: Please create an original and sincere and statement here that demonstrates that you fully understand this particular core competency how understanding it will help you prevent DV moving forward.

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J. Offender ability to define types of domestic violence _______1. Defines controlling behavior and all types of domestic violence e.g. (a) physical, b) emotional, c) sexual, d) psychological, e) animal abuse, f) property, g) financial, h) isolation & jealousy, i) male privilege, j) intimidation, & k) coercion and threats. _______2. Identifies in detail the specific types of DV engaged in, and the destructive impact of that behavior on the Consumer’s partner and children; _______3. Demonstrates cognitive understanding of the types of domestic violence as evidenced by giving example and accurately label situations; defines continuum of behavior from healthy to abusive

Question: Please create an original and sincere and statement here that demonstrates that you fully understand this particular core competency how understanding it will help you prevent DV moving forward.

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K. Consumer understanding, identification and management of one’s personal pattern of violence _______1. Acknowledges past/present violent/controlling/abusive behavior; _______2. Explores motivations; _______3. Understands learned pattern of violence and can explain it to others; _______4. Disrupts pattern of violence prior to occurrence of behavior

Question: Please create an original and sincere and statement here that demonstrates that you fully understand this particular core competency how understanding it will help you prevent DV moving forward.

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L. Consumer understanding of intergenerational effects of violence; _______1. Identifies and recognizes past victimization, its origin, its type and impact; _______2. Recognizes the impact of witnessed violence; acknowledges that one’s upbringing has influenced current behaviors; _______3. Develops and implements as a plan to distance oneself from violent traditional tendencies, as well as cultural roles. (Examples: Homework assignments such as the Genogram, violence autobiography and timeline.

Question: Please create an original and sincere and statement here that demonstrates that you fully understand this particular core competency how understanding it will help you prevent DV moving forward.

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M. Consumer understanding and use of appropriate communication skills: _______1. Demonstrates non-abusive communication skills that include how to respond respectfully to the offender’s partner’s grievances _______2. How to initiate and treat one’s partner as an equal; _______3. Demonstrates an understanding of the difference between assertive, passive, passive aggressive, and aggressive communication, _______4. Makes appropriate choices in expressing emotions; _______5. Demonstrates appropriate active listening skills

Question: Please create an original and sincere and statement here that demonstrates that you fully understand this particular core competency how understanding it will help you prevent DV moving forward.

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N. Consumer understanding and use of “time-outs” and Stop-Breathe-Focus _______1. Recognizes the need for “time-outs” and/or other appropriate self-management skills; _______2. Understands and practices all components of the time-out; _______3. Demonstrates and is open to feedback regarding the use of time-outs in therapy

Question: Please create an original and sincere and statement here that demonstrates that you fully understand this particular core competency how understanding it will help you prevent DV moving forward.

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O. Consumer recognition of financial abuse and management of financial responsibility _______1. Consistently meets financial responsibilities such as treatment fees, child support, maintenance, court fees, and restitution; the MTT may choose to require the offender to provide documentation that demonstrates financial responsibilities are being met; _______2. Maintains legitimate employment, unless verifiably or medically unable to work

Question: Please create an original and sincere and statement here that demonstrates that you fully understand this particular core competency how understanding it will help you prevent DV moving forward.

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P. Violence and Abuse _______1. Consumer eliminates all forms of violence and abuse _______2. The offender does not engage in further acts of abuse and commits no new DV offenses or violent offenses against persons or animals.

Question: Please create an original and sincere and statement here that demonstrates that you fully understand this particular core competency how understanding it will help you prevent DV moving forward.

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Q. Weapons _______1. Consumer is prohibited from purchasing, possessing, or using firearms or ammunition: _______2. An exception may be made if there is a specific court order allowing this – must provide written proof – treatment provider must address safety plan/storage etc.

Question: Please create an original and sincere and statement here that demonstrates that you fully understand this particular core competency how understanding it will help you prevent DV moving forward.

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R. Identification and challenge of cognitive distortions _______1. Consumer identifies and challenges cognitive distortions that play a role in the offender’s violence _______2. Offender demonstrates an understanding of distorted view of self, others, and relationships (e.g. gender role stereotyping, misattribution of power and responsibility, sexual entitlement

Question: Please create an original and sincere and statement here that demonstrates that you fully understand this particular core competency how understanding it will help you prevent DV moving forward.

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S. Consumer understanding and demonstration of responsible parenting: _______1. Consistently fulfills all applicable parenting responsibilities such as cooperating with the child/children’s other parent regarding issues related to parenting, _______2. follows established parenting plan and appropriately uses parenting time including the safety and care of the child/children; _______3. Demonstrates an understanding that abuse during pregnancy may present a higher risk to the victim and unborn child. _______4. The offender demonstrates sensitivity to the victim’s needs (physical, emotional, psychological, medical, financial, sexual, social, during pregnancy; _______5. Demonstrates appropriate interaction with the children and partner in a co-parenting or step-parenting situation

Question: Please create an original and sincere and statement here that demonstrates that you fully understand this particular core competency how understanding it will help you prevent DV moving forward.

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T. Offender identification of pro-social and/or community support and demonstration of the ability to utilize the support in an appropriate manner (sponsor, support person, etc. not the victim)

Question: Please create an original and sincere and statement here that demonstrates that you fully understand this particular core competency how understanding it will help you prevent DV moving forward.

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Consumer's consistent compliance with any psychiatric and medical recommendations for medication that may enhance the offender’s ability to benefit from treatment and/or reduce the offender’s risk of re-offense.

Question: Please create an original and sincere and statement here that demonstrates that you fully understand this particular core competency how understanding it will help you prevent DV moving forward.

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V. Consumer’s consistent compliance with any alcohol or substance abuse evaluation and treatment that may enhance the offender’s ability to benefit from treatment and/or reduce the offender’s risk of re-offense

Question: Please create an original and sincere and statement here that demonstrates that you fully understand this particular core competency how understanding it will help you prevent DV moving forward.

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_______ DV Autobiography

Question: Please create an original and sincere and statement here that demonstrates that you fully understand this particular core competency how understanding it will help you prevent DV moving forward.

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_______ Personal Change Plan

Question: Please create an original and sincere and statement here that demonstrates that you fully understand this particular core competency how understanding it will help you prevent DV moving forward.

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_______ Aftercare Plan

Question: Please create an original and sincere and statement here that demonstrates that you fully understand this particular core competency how understanding it will help you prevent DV moving forward.

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_______Statement of Responsibility

Question: Please create an original and sincere and statement here that demonstrates that you fully understand this particular core competency how understanding it will help you prevent DV moving forward.

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_______ Personal Mission Statement

Question: Please create an original and sincere and statement here that demonstrates that you fully understand this particular core competency how understanding it will help you prevent DV moving forward.

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_______ Commitment Statement/Elimination of Abusive Behavior

Question: Please create an original and sincere and statement here that demonstrates that you fully understand this particular core competency how understanding it will help you prevent DV moving forward.

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$$$ _______ I understand that in order to successfully complete DV Treatment, I must pay off all of the Balance that I owe for my Treatment that has not already been covered by Vouchers.

Question: Please create an original and sincere and statement here that demonstrates that you fully understand this particular core competency how understanding it will help you prevent DV moving forward.

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How Helpful is Learning about the DVOMB Core Competencies going to be for you in your efforts to prevent DV in your life? *

Not very helpful at all.

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Very helpful.

How Negatively or Positively has this DV Treatment impacted your Life? *

A Lot More Negatively than Positively Impacted.

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A Lot More Positively than Negatively Impacted

Assistance for Emergencies and Crises and Disclaimer:

Please acknowledge below that you understand that your responses to Dr. B's Online Surveys, Questionnaires, and/or Worksheets are NOT Monitored on a daily or a consistent basis and that if you have a Mental Health-Related or DV-Related Emergency or Crisis; or if you need to communicate with Dr. B. in a timely fashion, that this Online form is NOT the way to do it and Dr. B. cannot be responsible for receiving any timely communications via this platform.

If you are having a Medical Emergency, please dial 911, and/or go to the nearest Emergency Room.

If you are having a Mental Health Emergency or Crisis, please dial the Suicide Crisis Lifeline at 988.

Or, you can contact their CHAT Service at Lifeline Chat.

Or, if needed, you may Text HOME to 741741 free 24/7, to contact the Crisis Text Line for any Crisis so that you can Text with a Trained Crisis Counselor.

If you are a client of Dr. B's and you are in Crisis, please call him at 719-671-7793 (24/7).

Otherwise, If you feel a need to communicate something to Dr. B. that is not a Crisis or an Emergency, please feel free to email him at nepeht@gmail.com. Or you may Text Dr. B. at 719-671-7793.

Please acknowledge below that you have received this information and that you understand its contents.

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*** I understand and agree to the above statement and that I will appropriately use the information in this Item above.

Please describe how helpful this exercise was for you? *

Be sure to Click on the "SUBMIT" Button so your work will go to Dr. B. Thank you for completing this form. After submitting this form, click on the X at the top right corner of your screen. Have a nice day? This Worksheet (c. 2021, Dr. W. T. Beverly).