ProCert has awarded certification in the amount of 1 Continuing Competence Units (CCUs) to this activity. CCUs are a unit of relative value of an activity based on its evaluation against a rigorous and comprehensive set of standards representing the quality of an activity. The CCU determination is a valuation applying many factors including, but not limited to, duration of the activity. No conclusion should be drawn that CCUs correlate to time (e.g. hours).
This course assists the healthcare worker in understanding domestic violence and the mandates about domestic violence that involve healthcare workers. It concludes with strategies for healthcare workers to use in identifying and managing victims of domestic violence.
After completing this course, the learner will be able to:
Domestic violence amongst family members can take many forms. It may include emotional abuse, economic abuse, sexual abuse, threats, using the threat of removing children, using male privilege, intimidation, isolation, and other behaviors used to maintain fear, intimidation, and power. Acts of domestic violence are categorized into psychological battering, physical battering, or sexual abuse (CDC, 2010). The term domestic violence is still used, but more recently physical, psychological, or sexual violence in the context of a relationship is called intimate partner violence. The World Health Organization (WHO) defines intimate partner violence as “any behavior within an intimate relationship that causes physical, psychological or sexual harm to those in the relationship” (Rhodes, 2012)
Psychological Battering causes trauma to the victim by acts, or threats of acts, or coercive behavior. Typical behaviors classified as psychological battering include controlling/dominating behavior, deprivation of economic, healthcare and physical resources, destruction of personal property, embarrassment, excessive possessiveness, harassment, humiliation, isolation from family and friends, stalking, and verbal abuse, (CDC, 2010).
Physical Battering involves intentional physical attacks and aggressive behaviors that have the potential to cause harm, harm that ranges from bruising and pain to murder. It often begins with what is excused as trivial contact and escalates into more frequent and serious attacks (CDC, 2010).
Sexual Abuse is typically divided into three categories: 1) sexual activity that is compelled, forced; 2) sexual activity with someone who cannot, or is incapable of giving consent or understanding the sexual situation, and; 3) sexual activity that is abusive, degrading, or humiliating (CDC 2010). Sexual abuse can take place in many types of relationships. Sexual abuse and sexual violence and violence against women commonly occur together in the context of a relationship of an intimate partner relationship.
Battering is a pattern of behavior that uses fear and intimidation to establish power and control over another person. It is an escalating process. It often begins with threats, name-calling[G2] , and damage to objects or pets. It may escalate into restraining, pushing, slapping, or pinching. Next, the behavior may include punching, kicking, biting, sexual assault, tripping, or throwing. Finally, battering may become life-threatening with serious behaviors like choking, breaking bones, or using weapons (CDC, 2010). Abuse tends to happen in cycles; does not just go away; and tends to get worse over time (CDC, 2010).
According to the Bureau of Justice Statistics, domestic violence accounts for approximately 17% of all violent crime in the United States (Planty, 2016). Most victims of domestic violence are spouses, but children and other family members are often victimized as well. The incidence of child physical abuse and child neglect associated with intimate partner violence has been estimated to be between 30%-60% (Lamers-Winkleman et al., 2012).
Although males are victims, females are the victim in 85% of abuse by a spouse or significant other (Planty, 2016). The lifetime risk for U.S. women of suffering from intimate partner violence has been estimated to be between 22% - 39% (Nelson et al., 2012). Elder abuse, child abuse, and same-sex abuse are also significant problems.
Fifty percent of domestic violence occurs at or near the victim’s home (US Census Bureau, 2013). Simple assault is the most common domestic violence offense, but domestic violence/intimate partner violence can be lethal: approximately 22% of homicides are domestic murders (Wozniak et al., 2010).
There is a strong association between substance abuse and domestic violence/intimate partner violence (Smith et al., 2012). Smith et al., 2012, found that almost 22% of all perpetrators of intimate partner violence had an alcohol abuse problem. About 31% of all the perpetrators had a substance abuse problem (alcohol, illicit drugs), and the use of alcohol in conjunction with incidents of intimate partner violence has been estimated to be between 22-60% (Smith et al., 2012; Taft et al., 2010).
The traditional image of domestic violence/intimate partner violence has been a man abusing a woman. However, women can be the perpetrators of violence in a relationship. There is controversy about how common women-initiated violence is. The reported incidence of abused men varies widely, but in 2010, Black et al. stated in the WHO reports that 1 in 4 men have been abused by their female partner, and this appears to be confirmed by other studies (Walter et al., 2016).
Research demonstrates that violence by women in the context of an intimate relationship is relatively common. But the consequences to the victims and the motives of the female perpetrator do appear to be different. The violence perpetrated by women seems to be less frequent, but any particular incident is likely to be more severe. Violence is also common in lesbian, gay, bi-sexual, and transgender relationships (Goldberg et al., 2012).
About 22% of murder victims in 2007 were family members. Family members were most likely to kill a young child, while a friend or acquaintance was most likely to murder an older child age 15 to 17. Forty-three percent of murder victims were related to or acquainted with their assailants (Durose et al., 2005). Intimate partners committed 14% of all homicides in the US in 2007, and 64% of all women killed in 2007 were murdered by a family member or an intimate partner (Catalano et al., 2009).
Intimate partner violence is relatively common. Approximately 15% of employees in the workplace suffer the effects of intimate partner violence (Katula, 2012). Women lose roughly 8 million days of work a year due to intimate partner violence (Magnusson et al., 2011), and their emotional and psychological issues and their work absence affect co-workers and the places they work, as well. Intimates (current and former spouses, boyfriends and girlfriends) were identified by the victims as the perpetrators of 1.7% of all workplace violent crime against females and 0.8% of males (US Department of Justice, 2011). About 59% of the female victims of violence in the workplace reported that they knew their offender (US Department of Justice, 2011).
Approximately four out of 10 African American women, American Indian women, and Alaska Native women have experienced physical violence, rape, or stalking in their lifetime by an intimate partner (Black et al., 2010). Mixed race non-Hispanic women experience these crimes at an incidence of 53.8%. The rate for white women is 34.6%, for Hispanic women 37.1%, and 19.6% for Asian and Pacific Islander women (Black et al., 2010).
Abuse tends to occur in cycles. It does not just go away and tends to get worse over time. Domestic violence and intimate partner violence typically, but not always, follows a pattern. There is a period of tension building; there is an episode of violence; and there is a time calm, or a "honeymoon" (Hancock, 2012). Research suggests the more severe the violence, the more chronic it is and the more likely it is to worsen over time (Lipsky et al., 2012).
The cycle of violence is as follows:
There are many theories as to why some people are abusers. However, the reason abusers use this behavior is that violence is an effective method for gaining and keeping control over another person. In a domestic situation, the abuser traditionally has not suffered adverse consequences as a result of violent behavior.
Historically, domestic violence in many cultures and societies has not been treated as a "real" crime. This lack of regard to violence is evident in the absence of severe consequences, like incarceration or financial penalties (WHO, 2016). Some cultures support the man’s right and just cause to punish their spouse by beating, in some circumstances (Waltermaurer, 2012; Uthman et al., 2011; WHO, 2016).
Abusers often display immaturity and are dependent and non-assertive (Saddock, 2015). They tend to suffer from strong feelings of inadequacy, and they use their bullying behavior to humiliate their partner in order to support their own low self-esteem. They sometimes displace aggression provoked by others onto their partner. The psychological dynamics of male abusers include identification with an aggressor (father, boss, brother, etc.), testing behaviors (i.e., “Will she stay with me no matter what I do to her?”), distorted desires to express manhood, and dehumanization of women (Saddock, 2015).
Risk factors for violence against their spouse or significant other are (Farrell, 2011; Theobald et al., 2012; WHO, 2016):
Research from both developed and undeveloped countries has consistently identified the following triggers for domestic violence (Dobash et al., 2011):
Batterers come from all social classes, races, cultures, religions, backgrounds, and countries (WHO, 2016). The following behaviors may be warning signs (Farrell, 2011; Theobald et al., 2012):
There have been assessment tools developed that can help identify someone who has the potential for domestic violence/intimate partner violence. The Spousal Abuse Risk Assessment (SARA) is a validated tool that looks for the presence of 20 behaviors such as a history of assault and/or sexual violence, personality disorder, history of the use of weapons, and emotional denial or minimization of violence (Theobald et al., 2012).
Why do victims stay? All too often that question is answered with a victim-blaming attitude. Victims of abuse often hear that they must like or need abusive treatment, or else they would leave. Sometimes, victims are told that they “love too much" or have low self-esteem. The truth is that no one likes being beaten, regardless of his or her emotional state or self-image. The reasons that a victim stays are many and complex (Kelly, 2011; Panchanadeswaran et al., 2011; Employee Assistance, 2004).
Millions of children witness intimate partner violence at home (Harding et al., 2013). The effect of this exposure has been compared to direct physical abuse of the child (Harding et al., 2013), and these children suffer from a wide range of emotional, physical, and psychological problems listed below (Lamers-Winkleman et al., 2012; Bauer et al., 2013; Nicklas et al., 2013).
Domestic violence/intimate partner violence is also strongly associated with a high incidence of child neglect and maltreatment (Nicklas et al., 2013). Evidence suggests that domestic violence increases the risk of child morbidity and mortality (WHO, 2016).
The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) defines standards for healthcare organizations and monitors compliance with those standards. JCAHO mandates that hospitals must develop criteria to identify possible victims of abuse. The criteria must focus on observable evidence and not just on allegations. It must at least address physical assault; rape or other sexual molestation; domestic abuse; and abuse or neglect of elders and children. The criteria should be developed in a way to prevent any action or question that could create false memories of abuse in an individual (Burnett, 2011).
Staff must be trained to apply the criteria. They should question whether abuse might have occurred if a patient's story for his or her injury does not match the actual injury. A hospital must maintain a list of private and public community agencies that provide help for abuse victims. Staff must be able to make appropriate referrals for victims (Burnett, 2011).
For example, a child’s x-rays may show an unexplained broken bone. Staff should observe the behavior of the people who brought the child to the emergency room. Does the child cling to one parent and avoid the other? Staff members should question the child in a non-threatening manner, look for bruises on the body, and listen to explanations to see if there is a balance between the physical evidence and the story.
New York was the first state that requires hospitals to establish protocols to identify and treat domestic violence victims and make referrals to community services. California passed the first state law mandating protocols for hospitals and clinics to detect the presence of violence in the lives of patients.
California further required domestic violence training a part of the licensing and re-certification process for healthcare providers. Connecticut, Florida, Iowa, and Kentucky also require domestic violence training for re-licensure of physicians (Medscape Education, 2012).
WHO (2010) recommends the following actions:
Early identification and intervention with victims of domestic violence can help prevent injuries and save lives (Nelson et al., 2012; Decker et al., 2012). Many victims of domestic violence seek assistance in healthcare settings, often repeatedly, but are only treated for symptoms and injuries. Unfortunately, healthcare professionals often fail to identify victims. Missed cases of intimate partner violence may be due to the screening method: depending on the screening tool that is being used, the rate of detection has been reported to range from 9.2% to 30.5% (Sprague, Madden, Dosanjh, et al., 2012).
Missed cases may also be due to healthcare professionals simply not screening (Sprague, Madden, Simonuvic, et al., 2012), and many nurses are not prepared to provide care to a woman who is a victim of violence from her partner (Sundborg et al., 2012). There are many reasons nurses, physicians, and other healthcare professionals may not screen for intimate partner violence (Beynon et al., 2012).
Mental health providers see victims of domestic violence for suicide attempts, anxiety, and depression. Practitioners who specialize in chronic pain, such as headaches or stomach disorders, also treat victims of abuse. Pediatricians who see abused children may also see abused women because child abuse and spousal abuse frequently co-exist (Harding et al., 2013).
Pregnancy may be a risk factor for battering. Approximately 1 in 12 women in North America who are pregnant experience some form of intimate partner violence (Kramer et al., 2012). Violence during pregnancy increases the incidence of morbidity and mortality. Specifically, victims of violence are more likely to deliver a pre-term or low-birth-weight infant (Kramer et al., 2012), it affects breastfeeding, and these victimized women are more prone to miscarriage, depression, alcohol and drug abuse, and forgoing prenatal care (Hellmuth et al., 2013).
Healthcare providers can help by screening for domestic violence, documenting abuse in the medical record, safeguarding evidence, providing medical advice, referrals, and safety planning, and showing empathy and compassion. Victims of domestic violence/intimate partner violence may not discuss the violence unless they are asked directly (Beynon et al., 2012; Morse et al., 2012). However, many victims of domestic violence/intimate partner violence will talk about the abuse if they are asked in a direct, caring, and non-judgmental manner (Decker et al., 2012).
Abuse victims need referrals to legal and social services. They may need help with finding temporary shelter, advice on how to keep safe should they return home, and affirmation that the abuse is not their fault (Burnett, 2011).
Screening questions should always be asked in a private room, away from the batterer and preceded by assurances of strict confidentiality. The spouse or partner should be separated from the patient if they demand to accompany the patient into the examining room (Hancock, 2011).
It is not the role of the healthcare provider to invoke or foster criminal justice intervention. Calling the police is not always in the best interest of a victim of domestic abuse. Some victims of domestic violence have learned to distrust the police or believe that law enforcement intervention will further endanger them. Immigrant victims may fear that calling the police will lead to deportation. Others are unwilling to use law enforcement intervention until a safety plan is in place.
Each victim should be informed of their legal options and encouraged to make their own choices (Burnett, 2011; Hancock, 2011). The requirements for reporting incidents of domestic violence/intimate partner violence - what must be reported, how it must be reported and to whom, and who is responsible for the reporting – vary from state to state (Family Violence Prevention Fund, 2010).
Treatment should follow these steps (Saddock, 2015):
The first step in treatment is identification of the victim. Many women who are victims of abuse will not voluntarily share this information; however, they will discuss if the provider asks the right question in a compassionate, non-judgmental manner. The healthcare provider might start by asking, “Because violence is common in many people’s lives, I ask every patient the same question. At any point, has your partner harmed or threatened you?” These conversations should always take place in a private setting when the patient is alone.
If the patient answers yes to this question, the healthcare provider should encourage her to talk about it. The healthcare provider should listen nonjudgmentally; this helps begin the healing process and provides information that will help with treatment planning. It is also very important for the healthcare worker to validate the victim's fears because they often think that others won’t believe them or will downplay their experiences. The healthcare provider might say, “You don’t deserve to be treated this way,” and “You are not to blame.”
The healthcare provider must document the patient’s complaints and symptoms. The complaint should be written using the patient’s own words when possible. Also, be sure to detail and describe injuries including their type, size, location, and number. If possible take color photographs and include those in the chart as well.
Next, assess the danger to your patient. Determine whether he or she is safe to leave the healthcare setting. Indicators of escalating danger include an increase in the frequency, duration, or severity of assaults, new threats of homicide or suicide by the partner, threats to children or other loved ones, and the presence or availability of a gun.
Finally, healthcare providers should offer the appropriate referral and support. Start by treating the victim’s injuries. If the victim is determined to be in imminent danger, refer him or her to stay with friends, family, or at a domestic violence shelter. If he or she is not in imminent danger, provide written information about community shelters and resources. Also, be sure to provide him or her with a toll-free domestic violence hotline number.
Chelsea is a 43-year-old Caucasian female living with her second husband. She arrives at the clinic appearing shaky and nervous. During the initial physical assessment, she begins to cry explaining that her husband is aggressive towards her. She describes his various behaviors, which could be classified as emotional, physical, and financial abuse. She has two children, ages three and six who both at the clinic with her.
She denies any current suicidal thoughts and any current drug or alcohol misuse. Assessment of the children does not reveal any evidence of abuse towards them, and Chelsea denies witnessing any aggression towards them in the past. The healthcare worker completes an assessment and explains to Chelsea her legal options. Chelsea agrees to go with her children to a local shelter where she can begin more specialized treatment and receive adequate community resources.
Nitya, a 28-year-old immigrant from India living in the Midwest, left her husband and moved into her friend’s house after three instances of physical abuse. Nitya has obtained a restraining order, but her husband is attempting to retaliate by filing for a modification of custody for their children, citing frivolous allegations and inappropriate parenting. Her lawyer continues to represent her, and she has recently begun seeing a social worker for cognitive-behavioral therapy. This counseling has helped her emotionally process her situation and previous trauma.
Stephanie, a 21-year-old college student, broke up with her violent boyfriend about a month ago; however, he continues to stalk her. He continues to show up on campus and will appear outside her classes, the cafeteria, and the library. He calls and text messages her daily saying threatening and hurtful things. Stephanie is scared and has been considering dropping out of school. She decides to seek help through a legal aid, who documents his stalking behavior and facilitates a meeting with the college dean. Her attorney represents her in a court hearing, and she is able to obtain a protective order so she can continue her education.
Domestic violence is a crime that causes severe health consequences. Healthcare professionals are mandated and obligated to identify and offer assistance to victims of domestic violence. Legal and societal changes in the United States have reduced the occurrence of Domestic Violence, but the problem is still epidemic. Your efforts can make a difference.
National Domestic Violence Hotline
Staffed 24 hours a day by trained counselors who can provide crisis assistance and information about shelters, legal advocacy, health care centers, and counseling.
Rape, Abuse & Incest National Network
The Rape, Abuse & Incest National Network (RAINN) is the nation's largest anti-sexual assault organization. Among its programs, RAINN created and operates the National Sexual Assault Hotline at 1.800.656.HOPE and the National Sexual Assault Online Hotline at rainn.org . This nationwide partnership of more than 1,100 local rape crisis centers provides victims of sexual assault with free, confidential services, 24 hours per day, 7 days per week. These hotlines have helped over 1.3 million people since RAINN's founding in 1994.
Alabama Coalition Against Domestic Violence
P.O. Box 4762
Montgomery, AL 36101
Phone: 1-800-650-6522 (in state)
Another State: 1-800-799-SAFE (7233)
Crisis help lines are open 24 hours
Alaska Network on Domestic Violence and Sexual Assault
130 Seward Street, Room 214
Juneau, AK 99801
Hotline: 1-800-799-SAFE (7233)
Arizona Coalition Against Domestic Violence
301 E. Bethany Home Rd.
Phoenix, AZ 85012
Hours: 8:30am-5-00pm Monday - Friday
Arkansas Coalition Against Domestic Violence
1401 West Capitol Ave, Suite 170
Little Rock AR 72201
Phone: (501) 907-5612
Coalition to End Family Violence
1030 N. Ventra Rd
Oxnard, CA 93030
24-Hour Hotline: 805-656-1111
Spanish Hotline: 800-300-2181
SOS Program (A part of DC Coalition)
Domestic Violence Intake Center Satellite Office
Greater Southeast Community Hospital
1328 Southern Ave SE
Washington, DC 20032
Phone: 202-561-3095 x12
Florida Coalition Against Domestic Violence
425 Office Plaza Dr.
Tallahassee, FL 32301
FL Domestic Violence Hotline: 1-800-500-1119
FL Domestic Violence Hotline TTY: 1-800-621-4202
Georgia Advocates for Battered Women and Children
250 Georgia Avenue, S.E., Suite 308
Atlanta, GA 30312
24 Hr Hawaii Shelters by Island:
Idaho Coalition Against Sexual and Domestic Violence
300 E. Mallard Dr., Suite 130
Boise, ID 83706
(Formerly The Friends of Battered Women and Their Children)
P. O. Box 608548
Chicago, IL 60660
Indiana Coalition Against Domestic Violence
1915 W. 18th Street, Suite B
Indianapolis, IN 46202
Crisis Line: 1-800-332-7385
Kansas Coalition Against Sexual and Domestic Violence
634 SW Harrison
Topeka, KS 66603
TOLL-FREE: 888-END-ABUSE (Kansas state-wide hotline)
Jane Doe Inc./Massachusetts Coalition Against Sexual Assault and Domestic Violence
14 Beacon Street, Suite 507
Boston, MA 02108
Crisis / Information: 989-686-4551
Missouri Coalition Against Domestic and Sexual Violence
217 Oscar Dr., Suite A
Jefferson City, MO 65101
Mississippi State Coalition Against Domestic Violence
P.O. Box 4703
Jackson, MS 39296-4703
After Hours HOTLINE: 1-800-799-7233
Hours: Monday-Friday 8:00am-5:00pm
Montana Coalition Against Domestic and Sexual Violence
Montana Coalition Against Domestic & Sexual Violence
PO Box 818
Helena MT 59624
Nebraska Coalition To End Sexual and Domestic Violence
245 S. 84th Street, Ste 200
Lincoln, NE 68510
Nebraska Spanish Helpline: 1-877-215-0167
Nevada Coalition to end Domestic and Sexual Violence
250 South Rock Blvd, Ste 116
Reno, NV 89502
3275 E. Warm Springs Road
Las Vegas, NV 89120
New Hampshire Coalition Against Domestic and Sexual Violence
P.O. Box 353
Concord, NH 03302-0353
TOLL-FREE For Domestic Violence: 866-644-3574
TOLL-FREE For Sexual Assault: 1-800-277-5570
New Jersey Coalition to End Domestic Violence
1670 Whitehorse/Hamilton Square Road
Trenton, NJ 08690
TOLL-FREE: for Battered Lesbians: 800-224-0211 (in NJ only)
TTY: 609-584-0027 (9am-5pm, then into message service)
New Mexico State Coalition Against Domestic Violence
1210 Luisa Street, Ste 7
Santa Fe, NM 87505
TOLL-FREE: 800-773-3645 (in New Mexico Only)
Legal Helpline: 800-209-DVLH
New York State Coalition Against Domestic Violence
119 Washington Avenue,
Albany, NY 12210
Email us at firstname.lastname@example.org
North Carolina Coalition Against Domestic Violence
3710 University Drive, Ste 140
Durham, NC 27707
North Dakota Council on Abused Women's Services
521 E. Main Avenue, Ste 250
Bismarck, ND 58501
TOLL-FREE: 888-255-6240 (In ND Only)
Oklahoma Coalition Against Domestic Violence and Sexual Assault
3815 N. Santa Fe
Oklahoma City, OK 73118
Oklahoma Safeline: 1-800-522-7233
Oregon Coalition Against Domestic Violence and Sexual Assault
9570 SW Barbur Blvd, Ste 214
Portland, OR 97219
Statewide Crisis Number: 1-888-235-5333
Pennsylvania Coalition Against Domestic Violence
3605 Vartan Way, Ste 101
Harrisburg, PA 17110
Women's Center of Montgomery County
Main Administrative Office:
8080 Old York Road, Ste 200
Elkins Park, PA 19027
Toll-free hotline: 1-800-773-2424
Women's Advocacy Project
107 East Main Street, Ste 307
Norristown PA 19404
Women's Advocacy Project
1800 East High Street, Ste 350
Pottstown PA 19464
Bryn Mawr Office:
14 S. Bryn Mawr Avenue, Ste 207
Bryn Mawr, PA 19010
100 Medical Campus Drive
Lansdale, PA 19446
South Carolina Coalition Against Domestic Violence & Sexual Assault
P.O. Box 7776
Columbia, SC 29202-7776
South Dakota Coalition Ending Domestic & Sexual Violence
122 E. Sioux Ave, Ste B
Pierre, SD 57501
NATIONAL HOTLINE: 800-430-7233
INFO/REFERRAL Only: 1-800-572-9196
Tennessee Coalition to End Domestic & Sexual Violence
2 International Plaza Dr., Suite 425
Nashville, TN 37217
Families In Crisis, Inc.
P.O. Box 25
Killeen, Texas 76540
Vermont Network Against Domestic and Sexual Violence
P.O. Box 405
Montpelier, VT 05601
24 Hour HOTLINE: 1 800 228 7395
Virginia Sexual & Domestic Violence Action Alliance
1118 W. Main Street
Richmond, VA 23220
LGBTQ Hotline: 1-866-356-6998
Washington State Coalition Against Domestic Violence
WSCADV- Olympia Office
711 Capitol Way, Suite 702
Olympia, WA 98501
WSCADV - Seattle Office
1511 Third Avenue, Ste 433
Seattle WA 98101
206- 389-2900 TTY
Washington State Domestic Violence Hotline
Manitowoc County Domestic Violence Center/In-Courage
300 E. Reed Avenue
Manitowoc, WI 54220
24/7 Crisis Line: 920-684-5770
Wyoming Coalition Against Domestic Violence and Sexual Assault
P.O. Box 236
Laramie, WY 82073
Legal Staff: 307-755-0992
Washington, DC Office
1320 19th St NW, Ste 401
Washington DC 20036
50 Milk Street, 16th Floor
Boston, MA 02109
Public Policy Office
1633 Q Street NW, Suite 210
Washington, DC 20009
Phone: (202) 745-1211
TTY: (202) 745-2042
Fax: (202) 745-0088
National Battered Women's Law Project
275 7th Avenue, Suite 1206
New York, NY 10001
2 Lafayette Street, 3rd Floor
New York, NY 10007
Domestic Violence Victims: 800-621-4673
Rape and Sexual Assult & Incest HOTLINE: 212-227-3000
For Victims of Crime and their Families: 1-866-689-4357
Domestic Violence Shelters Information
National Resource Center on Domestic Violence
6041 Linglestown Road
Harrisburg, PA 17112
1101 Vermont Avenue, Ste 400
Washington, DC 20005
3605 Vartan Way, Ste 101
Harrisburg, PA 17110
National Recourse Center on Domestic Violence
National Council of Juvenile and Family Court Judges
P.O. Box 8970
Reno, NV 89507
They are only a resource center for professionals and agencies.
Battered Women's Justice Project
c/o National Clearinghouse for the Defense of Battered Women
125 South 9th Street, Suite 302
Philadelphia, PA 19107
TOLL-FREE: 800-903-0111 ext. 3
National Clearinghouse is a national resource and advocacy center providing assistance to women defendants, their defense attorneys, and other members of their defense teams in an effort to insure justice for battered women charged with crimes.
Faith Trust Institute
(Formerly Center for the Prevention of Sexual and Domestic Violence)
2414 SW Andover Street, Ste D208
Seattle, WA 98106
Phone: 206-634-1903, ext. 10
National Network to End Domestic Violence
1325 Massachusetts Avenue NW, 7th Floor
Washington, DC 20005
HOTLINE: 800-799-SAFE (7233)
Alsaker K, Morken T, Baste V, Campos-Serna J, Moen BE. Sexual assault and other types of violence in intimate partner relationships. Acta Obstet Gynecol Scand. 2012 Mar;91(3):301-7. doi: 10.1111/j.1600-0412.2011.01336.
Bauer NS, Gilbert AL, Carroll AE, Downs SM. Associations of early exposure to intimate partner violence and parental depression with subsequent mental health outcomes. JAMA Pediatr. 2013 Apr;167(4):341-7. doi: 10.1001/jamapediatrics.2013.780.
Beynon CE, Gutmanis IA, Tutty LM, Wathen CN, MacMillan HL. Why physicians and nurses ask (or don't) about partner violence: a qualitative analysis. BMC Public Health. 2012 Jun 21;12:473. doi: 10.1186/1471-2458-12-473.
Burnett LB. Domestic violence management & treatment. eMedicine website. (Visit Source). Nov 28, 2011. Accessed April 15, 2017.
Catalano S. Intimate Partner Violence: Attributes of Victimization, 1993–2011. The Bureau of Justice Statistics. (Visit Source). Updated November 2013. Accessed September 9, 2017.
Decker MR, Frattaroli S, McCaw B, et al. Transforming the healthcare response to intimate partner violence and taking best practices to scale. J Womens Health (Larchmt). 2012 Dec;21(12):1222-9. doi: 10.1089/jwh.2012.4058.
Dobash RE, Dobash RP. What were they thinking? Men who murder an intimate partner. Violence Against Women. 2011 Jan;17(1):111-34. doi: 10.1177/1077801210391219.
Domestic Abuse and Sexual Assault. Employee Assistance Program website. (Visit Source) Updated February 24, 2017. Accessed September 9, 2017.
Domestic Violence Facts. National Coalition Against Domestic Violence website. (Visit Source). Updated 2015. Accessed September 9, 2017.
Durose MR, Harlow CW, Langan PA, et al. Bureau of Justice Statistics website. Family Violence Prevention Fund. Compendium of state statutes and policies on domestic policies and healthcare. (Visit Source) Updated 2010. Accessed September 9, 2017.
Farrell HD. Batterers: A review of violence and risk assessment tools. J Am Acad Psychiatry Law. 2011;39(4):562-74.
Feminist Majority Foundation. Domestic Violence Hotlines and Resources. http://feminist.org/911/crisis.html. Updated August 2, 2017. Accessed September 9, 2017.
Ford CL, Slavin T, Hilton KL, Holt SL. Intimate partner violence prevention services and resources in Los Angeles: issues, needs, and challenges for assisting lesbian, gay, bisexual, and transgender clients. Health Promot Pract. 2013 Nov;14(6):841-9. doi: 10.1177/1524839912467645.
Goldberg NG, Meyer IH. Sexual orientation disparities in history of intimate partner violence: results from the California health interview survey. J Interpers Violence. 2013 Mar;28(5):1109-18. doi: 10.1177/0886260512459384
Hancock, M. Intimate partner violence and abuse. In: Tintinalli JE, Stapczynski S, Cline DM, Ma OJ, Cydulka RK, Meckler, GD, eds. Tintinailli’s Emergency Medicine. 7th ed. New York, NY: Mc-Graw-Hill; 2011.
Harding HG, Morelen D, Thomassin K, Bradbury L, Shaffer A. Exposure to maternal and paternal-perpetuated intimate partner violence, emotion regulation, and child outcomes. Journal of Family Violence. 2013;28:63-72.
Harrell E. Workplace Violence, 1993-2009. The Bureau of Justice Statistics. (Visit Source). Updated March 2011. Accessed September 9, 2017.
Hellmuth JC, Gordon KC, Stuart GL, Moore TM. Risk factors for intimate partner violence during pregnancy and postpartum. Archives of Women’s Mental Health. 2013;16(1):19-27.
Hester, M. Portrayal of women as intimate partner domestic violence perpetrators. Violence Against Women. 2012 Sep;18(9):1067-82. doi: 10.1177/1077801212461428.
(Visit Source). Updated June 12, 2005. Accessed April 15, 2017.
Intimate partner violence: Definitions. Centers for Disease Control and Prevention website. (Visit Source). Updated August 22, 2017. Accessed September 9, 2017.
Kelly, UA. Theories of intimate partner violence: from blaming the victim to acting against injustice: intersectionality as an analytic framework. ANS: Advances in Nursing Science, 2011, 34(3), E29-E51.
Kramer A, Nosbusch JN, Rice J. Safe mom, safe baby: A collaborative model of care for pregnant women experiencing intimate partner violence. Journal of Perinatal & Neonatal Nursing. 2012;26(4):307-316.
Lamers-Winkleman F, De Schipper JC, Oosterman M. Children’s physical health complaints after exposure to intimate partner violence. British Journal of Health Psychology. 2012;17(4): 771-784.
Liesring PA. Physical and emotional abuse in romantic relationships: Motivation for perpetration among college women. J Interpers Violence. 2013 May;28(7):1437-54. doi: 10.1177/0886260512468236.
Lipsky S, Cristofalo M, Reed S, Caetano R, Roy-Byrne P. Racial and ethnic disparities in police-reported intimate partner violence perpetration: a mixed methods approach. Journal of Interpersonal Violence. 2012;27(11):2144-2162.
Magnussen L, Shoultz J, Richardson K, et al. Responding to the needs of culturally diverse women who experience intimate partner violence. Hawaii Med J. 2011 Jan;70(1):9-15.
Morse DS, Lafleur R, Fogarty CT, Mittal M, Cerulli C. "They told me to leave": how health care providers address intimate partner violence. J Am Board Fam Med. 2012 May-Jun;25(3):333-42. doi: 10.3122/jabfm.2012.03.110193.
Nelson HD, Bougatsos C, Blazina I. Screening women for intimate partner violence: A systematic review to update the U.S. Preventive Task Force recommendation. Annals of Internal Medicine. 2012;156(11):796-808.
Nicklas E, MacKenzie MJ. Intimate partner violence and risk for child neglect during early childhood in a community sample of fragile families. Journal of family Violence. 2013;28:17-29.
Panchanadeswaran S, McCloskey LA. Predicting the timing of women’s departure from abusive relationships. Journal of Interpersonal Violence. 2007;22(1):50-65.
Planty M, Langton L, Krebs C, Cerzofsky M, Smiley-McDonald H. Female Victims of Sexual Violence, 1994-2010. U.S. Department of Justice. 2016. (Visit Source). Accessed September 9, 2017.
Rhodes KV. Taking a fresh look at routine screening for intimate partner violence: What can we do about what we know? Mayo Clinic Proceedings. 2012;87(5):419-423.
Sadock BJ, Sadock, VA, Ruiz, P. Synopsis of Psychiatry. 11 th ed. Philadelphia, PA: Wolter’s Kluwer; 2015.
Smith PH, Homish GG, Leonard KE. Intimate partner violence and specific substance abuse disorders: Findings from the National Epidemiologic Survey on Alcohol and Related Condition. Psychology of Addictive Behaviors. 2012;26(2):236-245.
Smith SG, ChenJ, Basile KC, et al. The National Intimate Partner and Sexual Violence Survey (NISVS): 2010-2012 State Report. 2017. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention.
Sprague S, Madden M, Dosanjh, S, Petrisor B, Schemitsch EH, Bandhari M. Screening for intimate partner violence in orthopedic patients: A comparison of three screening tools. Journal of Interpersonal Violence. 2012;27(5):881-898.
Sprague S, Madden M, Simonuvic N, et al. Barriers to screening for intimate partner violence. Women & Health. 2012;52(6):587-605.
Sundborg E.M, Saleh-Stattin, N, Wädell P, Törnkvist L. Nurses’ preparedness to care for women exposed to intimate partner violence: A quantitative study in primary healthcare. BMC Nursing. 2012;11:1-2.
Taft CT, O’Farrell TJ, Doron-Lamarca S, et al. Longitudinal risk factors for intimate partner violence among men in treatment for alcohol use disorders. Journal of Consulting and Clinical Psychology. 2010;78(6):924-935.
Taft, CT, Murphy CM, Creech SK. Trauma-Informed Treatment and Prevention of Intimate Partner Violence. 2016. American Psychological Association: Washington, DC.
Theobald D, Farrington DP. Child and adolescent predictors of intimate partner violence. Journal of Child Psychology and Psychiatry. 2012;53(12):1242-1249.
Uthman OA, Moradi T, Lawoko S. Are individual and community acceptance and witnessing of intimate partner violence related to its occurrence? Multilevel structural equation model. PLoS One. 2011;6(12):e27738. doi: 10.1371/journal.pone.0027738.
Violence Against Women. Fact Sheet: Intimate Partner and Sexual Violence Against Women. World Health Organization website. (Visit Source). Updated November 2016. Accessed September 9, 2017.
Violence against women: Domestic and intimate partner violence. Women’s Health website. (Visit Source) Updated September 30 2015. Accessed September 9, 2017. from
Walter MW, Iritani BJ, Flewelling RL, Christ SL, Halpern CT, Moracco KE. Violence victimization of young men in heterosexual relationships: does alcohol outlet density influence outcomes? Violence and Victims. 2012;27(4):527-547.
Waltermaurer, E. Public justification of intimate partner violence: A review of the literature. Trauma, Violence & Abuse. 2012;13(3):167-175.
World Health Organization/London School of Hygiene and Tropical Medicine. Preventing intimate partner and sexual violence against women: taking action and gathering evidence. World Health Organization website. (Visit Source). Updated 2010. Accessed September 9, 2017.
Wozniak JA, McCloskey KA. Fact or fiction? Gender issues related to newspaper reports of intimate partner homicide. Violence Against Women. 2010;16(8):934-952.
This course is applicable for the following professions:
Advanced Registered Nurse Practitioner (ARNP), Athletic Trainer (AT/AL), Certified Nursing Assistant (CNA), Certified Registered Nurse Anesthetist (CRNA), Clinical Nurse Specialist (CNS), Dietetic Technicians, Registered (DTR), Dietitian/Nutritionalist (RDN), Home Health Aid (HHA), Licensed Practical Nurse (LPN), Licensed Vocational Nurses (LVN), Midwife (MW), Physical Therapist (PT/PTA), Registered Nurse (RN), Respiratory Therapist (RT)
CPD: Practice Effectively, CPD: Preserve Safety, Domestic Violence, Florida Requirements, Kentucky Requirements