DOMESTIC VIOLENCE ASSESSMENT TIPS
1. Assess the immediate safety needs of the victim.
Is the domestic violence victim in immediate danger? Where is the perpetra-
tor now? Where will the perpetrator be when the patient is finished with the
medical care? Does the patient want or need security to be notified immedi-
ately?
2. Assess the pattern and history of the abuse.
Assess the perpetrator’s physical, sexual, or psychological tactics, as well
as the economic coercion of the patient.
“How long has the violence been going on? Has your partner forced or
harmed you sexually? Have others been harmed by your partner? Does
your partner control your activities, money, or the children?”
3. Assess the connection between domestic violence and the patient’s
health issues.
Assess the impact of the abuse on the victim’s physical, psychological, and
spiritual well-being: What is the degree of perpetrator’s control over the
victim.
“Have there been other incidents resulting in injuries or medical problems?
How is abusive behavior affecting your current health?”
4. Assess the victim’s current access to advocacy and support resources.
Are there community resources available to this patient? Has the patient
tried to use them in past? If so, what happened? What resources (if any), in
addition to the health care provider, are available now?
5. Assess patient’s safety: Is there future risk of death or significant
injury/harm (lethality) due to the domestic violence?
Ask about the perpetrator’s tactics: use of weapons, escalation in frequency
or severity of the violence, hostage taking or stalking, homicide or suicide
threats, use of alcohol or drugs as well as about the health consequences of
past abuse. If there are children, inquire about the children’s physical
safety.
GANLEY, A. “DOMESTIC VIOLENCE: STRATEGIES FOR SCREENING,
ASSESSMENT, INTERVENTION, AND DOCUMENTATION.” TRAINER’S
MANUAL FOR HEALTH CARE PROVIDERS, FAMILY VIOLENCE
PREVENTION FUND (1998). 1
DOMESTIC VIOLENCE INTERVENTION TIPS
Goals for effectively responding to domestic
violence victims:
➤ increase victim safety and
➤ support victims in protecting themselves and their children by
validating their experiences, providing support, and providing
information about resources/options.
➤ The goal is not to get them to leave their abusers or the “fix” the
situation or the relationship for the patient, but to provide
support and information.
1. Listen to the patient and provide validating messages:
➟ “You don’t deserve this. There is no excuse for domestic violence.
You deserve better.”
➟ “I am concerned. This is harmful to you (and it can be harmful to your
children).”
➟ “This is complicated. Sometimes it takes time to figure this out.”
➟ “You are not alone in figuring this out. There may be some options. I
will support your choices.”
➟ “I care. I am glad you told me. I want to know about domestic
violence so we can work together to keep you safe and healthy.”
2. Listen and respond to safety issues:
a. Encourage victims to make their own safety plan for when a batterer is
present in the medical setting, a victim fears leaving the medical
setting, or a victim is returning to the batterer.
b. See separate handout on safety planning.
Continued…
GANLEY, A. “DOMESTIC VIOLENCE: STRATEGIES FOR SCREENING,
ASSESSMENT, INTERVENTION, AND DOCUMENTATION.” TRAINER’S
MANUAL FOR HEALTH CARE PROVIDERS, FAMILY VIOLENCE
PREVENTION FUND (1998). 2
Continued...
3. Provide information about domestic violence to the patient:
a. Domestic violence is health issue for patient (and children). Violence
can escalate; damage from the abuse escalates over time.
b. Stopping domestic violence is the responsibility of the perpetrator,
not victim.
c. Victims, with assistance and support from others, can increase their
own safety (and their children’s).
d. List whichever supports are available: within the health system; legal
options; community advocacy services, etc.
4. Make referrals to local resources:
a. Advocacy and support systems within the health care setting
b. Advocacy and support services within the community (if any).
5. Follow-up steps for health care practitioners:
a. Schedule future appointments. Ensure the patient will have a
connection to a primary care provider. Ask what happened after the
last visit.
b. Review medical records and asking about past episodes of domestic
violence in order to communicate a concern for patient and a willing-
ness to address this health issue openly.
c. Domestic violence, like other health issues (smoking, poor nutrition,
high blood pressure, etc.), often requires multiple interventions over
time before it is resolved.
GANLEY, A. “DOMESTIC VIOLENCE: STRATEGIES FOR SCREENING,
ASSESSMENT, INTERVENTION, AND DOCUMENTATION.” TRAINER’S
MANUAL FOR HEALTH CARE PROVIDERS, FAMILY VIOLENCE
PREVENTION FUND (1998).
This material was adapted from the publication entitled, “Improving the Health
Care Response to Domestic Violence: A Trainer’s Manual for Health Care Providers,”
Produced by the Family Violence Prevention Fund. The primary author is Anne L.
Ganley, Ph.D., with contributions by John Fazio, R.N, M.S., Ariella Hyman, J.D., Lisa
James, M.A., and Anita Ruiz-Contreras, R.N., M.S.N, C.E.N.
[Link]
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Safety Planning Intervention
When a woman has been screened for domestic abuse and has been identified as a victim
or suspected victim, it is important to speak to her about her immediate and future safety
before she leaves the clinic. The severity of the current injuries or the abuse is not always
an accurate predictor of future violence. Assisting the woman in making a safety plan can
help a victim think through various options, and help the clinician assess the situation and
better support her. The following check-list will help you initiate these important
discussions.
A. If she is planning to leave:
! Does the woman have a friend or supportive family member that lives nearby with
whom she can stay?
! Does she have a friend that will stay with her to minimize the violence in the home?
! Does she want to go to a battered women’s shelter, homeless shelter or use other
housing assistance programs such as hotel vouchers from social services or advocacy
programs?
! Does she want to call the police, obtain an order of protection or an emergency
protective order?
B. If she is not planning to leave:
! Would she call the police if the perpetrator becomes violent? Is she couldn’t get to
the phone, could she work out a signal with a neighbor to call for her and/or teach
her children to call 911?
! What kind of strategies have worked in the past to minimize injuries? Does she think
these strategies would continue to work for her?
! Can she anticipate an escalation of violence and take any precautions?
! Does she have a support network or friends or family that live nearby who could help
her when she needs assistance?
! Are there weapons in the home? Can they be removed or placed in a safe locked
area separate from the ammunition?
C. If the perpetrator has been removed from the home:
! Discuss safety measures such as changing the locks on the doors and windows,
installing a security system, purchasing rope ladders, outdoor lighting sensitive to
movement, smoke detectors and fire extinguisher, if affordable.
! It is important to teach children how to use the phone and make collect calls in case
the perpetrator kidnaps them. Make arrangements with schools and daycare centers
to release children to designated persons.
! Encourage her to tell her neighbors, family and friends that he has left and to call 911
if he is seen around the house.
4
D. Being prepared to get away:
! Discuss the following components of a safety plan with your patient:
! Encourage her to keep in a safe place:
" keys (house and car)
" important papers: social security cards and birth certificates (for parent and
children), photo ID/driver’s license, green cards
" cash, food stamps, credit cards, checkbooks, etc.
" medication for parent and children, children’s immunization records
" spare set of clothes
" important phone numbers and addresses (friends, relatives, police, domestic
violence shelter)
" loose change to make phone calls from pay phones.
! If possible, she should pack a change of clothes for herself and her children, personal
care items, extra glasses, etc.
! Have her plan with her children. Identify a safe place for them: a room with a lock
or a neighbor’s house where they can go, and reassure them that their job is to stay,
not to protect her.
! Encourage her to arrange a signal with a neighbor to let them know when she needs
help.
! Contact the local domestic violence program to find out about laws and community
resources before they are needed.
Dental Providers Against Violence
[Link]
© Copyright, 2004, California Dental Association Foundation, Inc., All Rights Reserved. Research and Presentation
by Kathleen A. Shanel—Hogan, DDS, MA