Intimate partner violence: Intervention and patient management
- Amy Weil, MD, FACP
Amy Weil, MD, FACP
- Professor of Medicine and Social Medicine
- University of North Carolina School of Medicine
Intimate partner violence (IPV) is a serious, preventable public health problem affecting more than 32 million Americans . 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 .
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".)
INITIAL APPROACH TO THE PATIENT
Futures without Violence has identified four guiding principles of intervention for clinicians :
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- INITIAL APPROACH TO THE PATIENT
- Assessing for safety
- - Risk factors for escalating abuse
- Perpetrator factors
- Victim factors
- Safety plan
- INTERVENTION, COUNSELING, AND REFERRAL
- Effectiveness of intervention
- Counseling the victim
- - Local resources
- Resources in the United States
- Intervention for the perpetrator
- LEGAL ISSUES
- Mandatory reporting
- - Abuse involving children
- Protection order
- MANAGING THE CHALLENGING PATIENT
- CURBING SOCIETAL VIOLENCE