Interventions to support recovery after domestic and sexual violence in primary care

Abstract

Experiences of domestic and sexual violence are common in patients attending primary care. Most often they are not identified due to barriers to asking by health practitioners and disclosure by patients. Women are more likely than men to experience such violence and present with mental and physical health symptoms to health practitioners. If identified through screening or case finding as experiencing violence they need to be supported to recover from these traumas. This paper draws on systematic reviews published in 2013-2015 and a further literature search undertaken to identify recent intervention studies relevant to recovery from domestic and sexual violence in primary care. There is limited evidence as to what interventions in primary care assist with recovery from domestic violence; however, they can be categorized into the following areas: first line response and referral, psychological treatments, safety planning and advocacy, including through home visitation and peer support programmes, and parenting and mother-child interventions. Sexual violence interventions usually include trauma informed care and models to support recovery. The most promising results have been from nurse home visiting advocacy programmes, mother-child psychotherapeutic interventions, and specific psychological treatments (Cognitive Behaviour Therapy, Trauma informed Cognitive Behaviour Therapy and, for sexual assault, Exposure and Eye Movement Desensitization and Reprocessing Interventions). Holistic healing models have not been formally tested by randomized controlled trials, but show some promise. Further research into what supports women and their children on their trajectory of recovery from domestic and sexual violence is urgently needed.

Panorama científico de la relación entre la violencia intrafamiliar y de género y la resiliencia familiar: posibilidades, retos y límites

“…Adicionalmente, se encontraron estrategias, como la regulación emocional bajo la supresión y la ree-valuación (Hong et al, 2018), al igual que la identificación de estrategias de control para intervenir en el proceso de lesión (Hartney & Barnard, 2015), la intervención en atención primaria (Hegarty, Tarzia, Hooker, & Taft, 2016), el enfoque integrado de cuerpo, mente y espíritu (Liao, 2019), el empoderamiento y el papel de la comunidad (Inman & Rao, 2018;, la comunicación madres e hijos para romper la vif (Insetta et al, 2015), las intervenciones que construyen el capital social y la capacidad de recuperación de los jóvenes (Scorgie, et al, 2017) y la empatía frente a las historias de superhéroes como fuente de intervención en jóvenes (Weschenfelder, Fradkin, & Yunes, 2018).…”

Effectiveness of a brief behavioural intervention on psychological distress among women with a history of gender-based violence in urban Kenya: A randomised clinical trial

“…Social stigma regarding GBV can be so high that affected women are at risk of further violence or abandonment if they disclose the violence [ 5 ], and this can impede women’s seeking of assistance [ 6 ]. Accordingly, multiple agencies recommend integrating care of women who have experienced GBV into general health services to safely reach a maximum number of affected women [ 7 , 8 ].…”

Editorial

“…Before-and-after and pilot studies of cognitive behavioural therapies and advocacy interventions have suggested improved psychological outcomes, but require testing in randomized controlled trials. Hegarty, Tarzia, Hooker, and Taft (2016) report similar challenges with regards to primary care responses to domestic violence and highlight a range of potentially promising advocacy, safety planning, and psychological interventions. INTERNATIONAL REVIEW OF PSYCHIATRY, 2016VOL.…”

“…Previous work has suggested that mental disorder is associated with an increased risk of domestic violence perpetration, although it is unknown whether a causal relationship exists (Oram, Trevillion, Khalifeh, Feder, & Howard, 2014). Yet, and as highlighted by Hegarty et al (2016) and Trevillion et al (2016) with regards to primary and secondary care settings, respectively, there is a critical lack of evidence for interventions to reduce domestic violence perpetration (Hegarty et al, 2016;Trevillion et al, 2016). Easton and Crane (2016) take on this issue in the final paper of the volume.…”