Official reprint from UpToDate®
www.uptodate.com ©2016 UpToDate®

Intimate partner violence: Intervention and patient management

Amy Weil, MD, FACP
Section Editor
Joann G Elmore, MD, MPH
Deputy Editor
H Nancy Sokol, MD


Intimate partner violence (IPV) is a serious, preventable public health problem affecting more than 32 million Americans [1]. Although IPV affects all people, more women than men experience IPV. Lifetime estimates for IPV involving women in the United States range from 22 to 39 percent [2,3]. In countries around the world, 10 to 69 percent of women report physical assault by an intimate partner at some time in their life [4].

The term "intimate partner violence" describes actual or threatened psychological, physical, or sexual harm by a current or former partner or spouse. IPV can occur among people of all gender identities and sexual preferences and does not require sexual intimacy.

Care of the person experiencing IPV requires a team approach involving medical, institutional, and community resources. The clinician's role is to make the diagnosis, provide ongoing medical care and emotional support, assess patient safety, counsel the patient about the nature and course of domestic violence, educate the patient about the range of available support services, document findings, make appropriate referrals, and assure follow-up.

This topic will discuss the clinician's role in managing the patient in whom IPV has been identified. The clinical manifestations of IPV and the screening and diagnosis of IPV are discussed separately. (See "Intimate partner violence: Diagnosis and screening" and "Intimate partner violence: Epidemiology and health consequences".)


Futures without Violence has identified four guiding principles of intervention for clinicians [5]:


Subscribers log in here

To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information or to purchase a personal subscription, click below on the option that best describes you:
Literature review current through: Sep 2016. | This topic last updated: Jun 1, 2016.
The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2016 UpToDate, Inc.
  1. Tjaden P, Thoennes N. Extent, nature, and consequences of intimate partner violence: findings from the National Violence Against Women Survey. Publication No. NCJ-181867, US Department of Justice, Washington, DC 2000.
  2. Nelson HD, Bougatsos C, Blazina I. Screening women for intimate partner violence: a systematic review to update the U.S. Preventive Services Task Force recommendation. Ann Intern Med 2012; 156:796.
  3. Centers for Disease Control and Prevention (CDC). Adverse health conditions and health risk behaviors associated with intimate partner violence--United States, 2005. MMWR Morb Mortal Wkly Rep 2008; 57:113.
  4. The World Health Organization. World report on violence and health. Chapter 4. Violence by intimate partners. http://www.who.int/violence_injury_prevention/violence/global_campaign/en/chap4.pdf (Accessed on August 07, 2011).
  5. Warshaw C, Ganley AL. Improving the health care response to domestic violence: A resource manual for health care providers. The Family Violence Prevention Fund. 1996. http://www.futureswithoutviolence.org/userfiles/file/HealthCare/improving_healthcare_manual_intro.pdf.
  6. Responding to intimate partner violence and sexual violence against women. WHO clinical and policy guidelines. 2013. http://www.who.int/reproductivehealth/publications/violence/9789241548595/en/ (Accessed on August 29, 2013).
  7. Feder G, Wathen CN, MacMillan HL. An evidence-based response to intimate partner violence: WHO guidelines. JAMA 2013; 310:479.
  8. Liebschutz JM, Rothman EF. Intimate-partner violence--what physicians can do. N Engl J Med 2012; 367:2071.
  9. Campbell JC, Webster DW, Glass N. The danger assessment: validation of a lethality risk assessment instrument for intimate partner femicide. J Interpers Violence 2009; 24:653.
  10. www.healthycal.org/archives/14636 (Accessed on May 13, 2014).
  11. Ellsberg M, Arango DJ, Morton M, et al. Prevention of violence against women and girls: what does the evidence say? Lancet 2015; 385:1555.
  12. Rivas C, Ramsay J, Sadowski L, et al. Advocacy interventions to reduce or eliminate violence and promote the physical and psychosocial well-being of women who experience intimate partner abuse. Cochrane Database Syst Rev 2015; :CD005043.
  13. Jahanfar S, Howard LM, Medley N. Interventions for preventing or reducing domestic violence against pregnant women. Cochrane Database Syst Rev 2014; :CD009414.
  14. World Heatlh Organization. Violence by intimate partners. Available at: http://www.who.int/violence_injury_prevention/violence/global_campaign/en/chap4.pdf (Accessed on April 20, 2010).
  15. Nicolaidis C, Curry MA, Ulrich Y, et al. Could we have known? A qualitative analysis of data from women who survived an attempted homicide by an intimate partner. J Gen Intern Med 2003; 18:788.
  16. Archer J, Bower P, Gilbody S, et al. Collaborative care for depression and anxiety problems. Cochrane Database Syst Rev 2012; 10:CD006525.
  17. Babcock JC, Green CE, Robie C. Does batterers' treatment work? A meta-analytic review of domestic violence treatment. Clin Psychol Rev 2004; 23:1023.
  18. Alexander PC, Morris E, Tracy A, Frye A. Stages of change and the group treatment of batterers: a randomized clinical trial. Violence Vict 2010; 25:571.
  19. Bennett L and Williams Ol. Contrroversies and recent studies of batterer intervention programs.National Online Resource Center on Violence Against Women, August 2001 http://www.vawnet.org/summary.php?doc_id=373&find_type=web_desc_AR (Accessed on August 22, 2012).
  20. Stuart GL, Temple JR, Moore TM. Improving batterer intervention programs through theory-based research. JAMA 2007; 298:560.
  21. National Institute of Justice and American Bar Association. Legal interventions in family violence: research findings and policy implications. United States Department of Justice, Washington, DC 1998.
  22. Grau J, Fagan J, Wexler S. Restraining orders for battered women: issues of access and efficacy. Women and Politics 1984; 4:13.
  23. Holt VL, Kernic MA, Lumley T, et al. Civil protection orders and risk of subsequent police-reported violence. JAMA 2002; 288:589.
  24. Felitti VJ, Anda RF, Nordenberg D, et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study. Am J Prev Med 1998; 14:245.
  25. Intimate Partner Violence in Practical Gynecology: A Guide for the Primary Care Physician, 2nd ed, Ryden J, Blumenthal PD, Charney P (Eds), American College of Physicans, 2009.
  26. Michau L, Horn J, Bank A, et al. Prevention of violence against women and girls: lessons from practice. Lancet 2015; 385:1672.
  27. García-Moreno C, Zimmerman C, Morris-Gehring A, et al. Addressing violence against women: a call to action. Lancet 2015; 385:1685.
  28. International Violence Against Women Act )I-VAWA) http://passivawa.org/aboutIVAWA.html (Accessed on June 25, 2012).
  29. http://www.state.gov/r/pa/prs/ps/2012/08/196342.htm (Accessed on September 05, 2012).