Screening and Intervention
HEALTH CARE PROVIDER SCREENING AND INTERVENTION
Related to Domestic Violence
•Demonstrate that you recognize that violence against women is a health care issue. Show that your health care setting understands that violence against women is a health care issue. Hang posters. Display brochures and tear-off sheets with numbers of national and local resources.
•Screen patients. Private, universal screening is the best way to identify abuse. Never screen with another person present. As part of routine care, screen all patients for abuse, whether signs, symptoms or behaviors suggesting the presence of abuse are present or absent. Simply asking about abuse is an intervention. Even if a patient does not disclose abuse, she will know that the provider is concerned and the hospital or clinic is a safe place to access assistance should she need it in the future.
•Acknowledge and validate the patient’s disclosure. An abused person experiences isolation and shame. The first step in responding to a disclosure of abuse or assault should be to validate the person’s experience and concerns. Tell the patient: “It’s not your fault.” “No one deserves to be hurt.” “I’m so sorry.” “I want you (and your children) to be safe.” and “I’d really like to help you.”
•Respond to the medical consequences of the abuse. Assess the effects of abuse on the patient physically and mentally. Examine current and past injuries and treat injuries and other medical complaints as indicated.
•Assess immediate or present threat. Determine if the abuser is present in the hospital or medical office and whether the abuser is aware that the patient is seeking medical care or support services. Obtain information about the abuser, including name, prior incidents, drug use, types of weapons used and types of weapons in the home. Ask about abuser’s threats to harm or kill the patient, whether she feels safe in the office, safe to go home or concerns that she or her loved ones are in immediate danger. Follow security procedures.
•Develop a safety plan. Review the plan and ask about the patient’s ability to access support and services. Ask if the patient has a plan if the violence or abuse escalates. Always refer the patient to a social worker and/or domestic violence/sexual assault program to assist the patient in developing a safety plan.
•Use hospital and community resources. Contact a social worker for questions about intervention or documentation and for consultation. Be aware of the contact information for local community domestic violence and sexual assault programs in your area.
•Document findings in the medical record. Discrete, careful, objective documentation is critical for continuity of care, legal evidence collection, improved understanding of the impact of domestic violence, justification for specific clinical recommendations, reimbursement for services, strong risk management, and justification for funding and policy reform.
A Guide to Screening and Intervention
Screening Made Practical
What Health Care Providers can do about Domestic Violence
Interventions with Patients who Disclose Abuse
What Health and Mental Health Care Systems Can Do
NCADV Safety Plan
AARDVARC Safety Plan
Safety and DC Plan Instructions
National Recommendations for Education and Training
Brigham and Women’s Hospital
Family Violence Prevention Fund
National Coalition Against Domestic Violence
National Criminal Justice Reference Center
Pennsylvania Medical Society
The National Online Resource Center on Violence Against Women
Vermont Medical Society
Wisconsin Coalition Against Domestic Violence