Universal Screening for Intimate Partner Violence: A Systematic Review

Abstract

Intimate partner violence (IPV) is known to be prevalent among therapy-seeking populations. Yet, despite a growing understanding of the dynamics of IPV and of the acceptability of screening, universal screening practices have not been systematically adopted in family therapy settings. A rapidly growing body of research data-almost entirely conducted in medical settings-has investigated attitudes and practices regarding universal screening for IPV. This article is a systematic review of the IPV universal screening research literature. The review summarizes literature related to IPV screening rates and practices, factors associated with provider screening practice, the role of training and institutional support on screening practice, impact of screening on disclosure rates, client beliefs and preferences for screening, and key safety considerations and screening competencies. Implications for family therapy and recommendations for further inquiry and screening model development are provided.

Health care professionals' role in preventing child homicides in the context of domestic violence

“…There is much debate over the effectiveness of universal screening and fear of unintended consequences (40,41). Yet, research has indicated that screening increases disclosures of violence among patients and that most women and victims of DV endorse screening when it is conducted in a nonjudgmental and supportive environment that provides informed consent and ensures privacy (41).…”

“…Yet, research has indicated that screening increases disclosures of violence among patients and that most women and victims of DV endorse screening when it is conducted in a nonjudgmental and supportive environment that provides informed consent and ensures privacy (41). Physicians in states that have legislation that requires mandatory reporting of DV may be afraid of liability issues and/ or are concerned that patients who disclose violence may be forced into the legal process where they may be revictimized (40); however arresting and charging the abuser may be the only way to ensure the safety of the victim and her children.…”

“…Professional associations need to develop protocols for effectively intervening, specifically with the victim and her children, and managing offender risk (17). Research has indicated that professionals are more likely to conduct routine screening when they have institutional support and supervision, such as standardized protocols for interventions (41). Victims should be referred to commu-nity services that will help provide ongoing support for herself and her children.…”

“…Many of the issues around universal screening can be addressed with enhanced professional training. Research has indicated that training and education can increase a professional's comfort with providing interventions and referrals and therefore can increase the frequency of screening patients (41). Furthermore, training and education on how to talk to victims of DV and explain any limits to confidentiality can ensure that professionals, who are mandated to report violence, avoid liability issues and prepare their patients for the legal process that may follow (40).…”

“…Specifically, professionals should receive enhanced training on the dynamics of DV and the risk for lethality and professional associations should develop protocols for routine screening and intervention that not only considers the risk and safety of the victim but also her children. Over the past 15 years, health care professionals have increasingly recognized the impact of DV on families and several professional associations (e.g., the American Medical Association; the American College of Obstetricians and Gynecologists; the American Academy of Family Physicians) have made recommenda-tions around the need for universal screening (40,41). However, screening rates in several health care settings remain low due to specific attitudes and beliefs among service providers (e.g., screening could be harmful; patients could be offended; it is not the responsibility of the service provider; it is not a problem within the specific health care setting) and the lack of comfort and confidence in intervening with individuals experiencing DV (41).…”