ATrain Education


Continuing Education for Health Professionals

Kentucky: Domestic Violence

Module 11

Screening and Assessment for Domestic Violence

The number of medical personnel treating injuries annually is in the millions. To better meet the needs of IPV victims, medical professionals should receive training in screening and assessment, learn to recognize the physical consequences of intimate partner violence, and initiate appropriate medical intervention strategies.

Clinicians have an opportunity to identify and intervene on behalf of abused women and men and to assist in breaking the intergenerational cycle that could affect their children. Whenever possible, at the point of detection, clinicians should communicate with the family’s other healthcare providers, such as pediatricians. Clinicians should also be aware of and follow state reporting requirements related to domestic violence or child abuse and neglect (CDC, 2006).

Training in the use of efficient assessment methods can increase the percentage of providers that screen for intimate partner violence. When providers are asked why they do not screen for violence, they commonly indicate four major barriers:

  • Time constraints
  • Discomfort with the topic
  • Fear of offending the patient or partner
  • Perceived powerlessness to change the problem (CDC, 2006)

Health care organizations and individual providers can increase competency in and commitment to screening for violence. One such screening and intervention method can be summarized in the acronym RADAR, which was developed by the Massachusetts Medical Society (CDC, 2006).

Use Your RADAR:

  • Routinely screen every patient
  • Ask directly, kindly, non-judgmentally
  • Document your findings
  • Assess the patient's safety
  • Review options and provide referrals (CDC, 2006)

The first step in the RADAR process is to routinely screen for violence. Assume that all patients are at risk for violence and ask every patient as part of his or her routine health assessment. Screening requires that the provider ask directly for information at multiple visits. In cases where violence is identified, document your findings in the patient’s chart. Assess your patient’s safety—is the patient or are his or her children in immediate danger? Finally, review the patient’s options and provide him or her with referrals (CDC, 2006).

A woman’s behavior during office visits can provide warning signs for possible intimate partner violence. Abused women may present with a flat affect or as frightened, depressed, or anxious. Severe cases may be characterized by symptoms of post-traumatic stress disorder (PTSD), such as dissociation, psychic numbing, or startle responses to touch. Abused women may appear overly compliant. Most patients have a number of questions, but an abused woman may have “learned” not to question authority. Conversely, an abused woman may exhibit excessive distrust of healthcare providers, possibly because of the fear and shame associated with the abuse and the possibility of its detection (CDC, 2006).

Possible Signs of IPV in Women

  • Flat affect
  • Fright, depression, anxiety
  • Post-traumatic stress disorder (PTSD) symptoms (dissociation, psychic numbing, startle responses to touch)
  • Over-compliance
  • Excessive distrust

Source: (CDC, 2006).

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