What works? Educate all patients about the connection between IPV and HT and their health and engage them in strategies to promote wellness and safety. The following are evidence-based steps that a multi-disciplinary care team can take to talk to patients on IPV and HT, while also promoting prevention. This approach has also been adapted to use via telehealth during COVID-19.
Evidence-Based Intervention: “CUES”
Know your state’s reporting requirements and share any limits of confidentiality with your patients.
Always see patients alone for part of every visit so that you can
bring up relationship violence safely.
UE: Universal Education + Empowerment
Give each patient two safety cards to start the conversation about
relationships and how they affect health.
Open the card and encourage them to take a look. Make sure
patients know that you’re a safe person for them to talk to.
Though disclosure of violence is not the goal, it will happen --
know how to support someone who discloses.
Make a warm referral to your local domestic/sexual violence
partner agency or national hotlines (on the back of all safety
Offer health promotion strategies and a care plan that takes
surviving abuse into consideration.
FamilyCare Health Center has seen a large increase in IPV disclosures since we’ve implemented universal education with the safety card. Our DV/SA advocacy partner, Branches, was quite full in the month after we held the training on IPV.
— Kat Cadle Adams, PsyD Psychologist, FamilyCare Health Center (Scott Depot, WV)
The terms intimate partner violence (IPV), domestic violence (DV) and domestic violence and sexual assault (DV/SA) will be used interchangeably throughout this toolkit.
Use Universal Education
It is important to use universal education in clinical settings, the strategy used to talk to all adult female-identifying and LGBTQ patients, and adolescent patients about the health consequences of IPV and HT. Even when asked directly by skilled providers, women may not disclose abuse for reasons including distrust and concern for subsequent violence.1,2 Combining universal education on IPV and HT(regardless of a disclosure on any screening tool) with brief trauma-informed harm reduction strategies and warm referrals is beneficial to patients. Following these steps help to increase safety, reduce violence, and improve clinical and social outcomes.
Use the safety card intervention
Universal education is aided by the use of safety cards. The evidence-based safety card tool was developed to help clinicians and DV/SA advocates open conversations about IPV and HT and healthy relationships with their clients. Because survivors may choose not to disclose abuse for a variety of reasons, universal education ensures that patients receive information regardless of disclosure, promoting primary prevention. With the support of FUTURES’ safety cards and other patient education materials, survivors of IPV and HT do not have to disclose abuse in order to receive help.
Tools to Promote Universal Education
- Bair-Merritt MH, et al. Primary care-based interventions for intimate partner violence:. Am J Prev Med 2014;46(2):188-94. McCloskey LA, et al. Assessing intimate partner violence in health care settings leads to women’s receipt of interventions and improved health. Public Health Rep 2006;121(4):435-44.
- Miller E, et al. A family planning clinic partner violence intervention to reduce risk associated with reproductive coercion. Contraception 2011;83(3):274-80. Rhodes KV, et al, Interventions for intimate partner violence against women: clinical applications. JAMA 2003;289(5):601