Domestic Violence/Intimate Partner Violence: Applying Best Practice Guidelines

Identifying Abuse

Introduction

Defining the Problem

Statistics

Identifying Abuse

Consequences of Violence

Risk Factors for IPV/DV

Dynamics of Abuse

Select Populations and IPV/DV

Barriers to the Identification of Violence

Best Practice Guidelines

Reporting IPV/DV

Documentation & Follow-up

Safety Planning

Conclusion

Resources

References

Appendix A

Appendix B

Appendix C

Appendix D

Appendix E

Test

Exit to Menu



Some signs of abuse are clear: physical injuries, repeated injuries, injuries that are explained in a manner unlikely to occur given the explanation, bilateral injuries, injuries that appear in a pattern left by the object used in the assault.

In addition to the physical injuries, there are behavioral indicators that IPV/DV may be occurring.

 

Case Study 3. Rhoda

 

Rhoda and Jim have been married for 38 years. Rhoda has been suffering from severe headaches for about 10 years. At a recent holiday dinner, Rhoda's niece Hannah notices, once again, how Jim always accuses Rhoda of flirting with one of her 4 brothers-in-law. Inevitably, at every family get together, after a few drinks, Jim starts this behavior. Hannah has always liked her aunt Rhoda, despite not seeing her very often, and her shy, self-effacing manner. But Jim has always been jealous. Hannah knows that he also doesn't allow Rhoda to spend much money. She turns over her paycheck to him and he gives her a small allowance. That is all she's allowed to spend. Jim does all the shopping in the home.

Jim has not allowed Rhoda to go to have the headaches evaluated. Besides work and the occasional family event, Rhoda doesn't really get out much. Hannah is curious and asks Rhoda if she's ok. Rhoda begins to cry and tells Hannah that Jim has been physically abusing her ever since he started drinking-about 10 years ago-after Jim had been laid off from his high level management position with a Fortune 500 company. That was about the same time that her headaches started.

Hannah offers to take Rhoda to see her primary care provider, a nurse practitioner, for her headaches. When the NP screens for IPV/DV, this time, Rhoda admits to the abuse.

 

 

Sometimes it is hard to identify an abusive relationship, or to admit to it. There are clear signs to help in the identification of abuse. Consider IPV/DV when faced with the following (USDHHS, 2008):

  • Monitoring how the partner spends all of her time;
  • Criticism of even little things;
  • Constant accusations of unfaithfulness;
  • Prevention or discouragement of partner seeing friends or family, or going to work or school;
  • Anger when drinking alcohol or using drugs;
  • Controls how any money is spent;
  • Controls the use of needed medicines;
  • Humiliates the partner in front of others;
  • Destroys property or things that the partner cares about;
  • Threatens to hurt the partner, the children, or pets, or does cause hurt (by hitting, beating, pushing, shoving, punching, slapping, kicking, or biting);
  • Uses or threatens to use a weapon against the partner;
  • Forces sex against the partner's will;
  • Blames the partner for his/her own violent outbursts.

Continue on to Consequence of Violence