Domestic Violence, Sexual Violence, Intimate Partner Violence

This course is designed to assist 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:

1. Define domestic abuse;
2. Identify 5 risk factors for violence against a spouse or significant other;
3. Discuss 3 reasons why victims stay with the  abusive partners;
4. Explain 3 reasons why victims of domestic violence are not identified in the healthcare system; and
5. Formulate a plan to assess a victim of domestic violence. 

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).

The annual costs of domestic violence/intimate partner violence have been estimated to be between $2 and 7$ billion a year (Nelson, et al., 2012).  According to the Bureau of Justice Statistics, domestic violence/intimate partner violence accounts for approximately 17% of all violent crime in the United States (Catalano, 2012). Most victims of domestic violence/intimate partner violence are spouses/significant others, 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 (Catalano, 2012). 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.

50% of domestic violence occurs at or near the victim’s home (US Census Bureau, 2009). 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.  31.1% 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., 2012). It is clear from published studies 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. Motives are different, as well. For women, anger over emotional pain, attempts to gain a partner's attention, jealousy, stress, and self-defense appear to be motivators for becoming violent (Liesring, 2012). Violence is also common in lesbian, gay, bi-sexual, and transgender relationships (Goldberg, et al., 2012). 

Abuse tends to happen 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). Unfortunately, there is evidence that suggest the more severe the violence, the more chronic it is and the more likely it is to worsen over time (Lipsky, et al., 2012). ?

1.     Tension Building

• Tension mounts in the relationship.
• The batterer is irritable, frustrated, and unable to cope with everyday stresses.
• The victim attempts to appease the batterer by becoming compliant, nurturing, or staying out of the way
• The victim often assumes responsibility for controlling the abuser’s anger
• The victim denies the inevitability of the beating and the terror.    
• The batterer fears that the victim will leave and their fears are reinforced by the victim’s coping strategy of withdrawing and avoiding.

2.      The Battering Incident

• The batterer's intent is to teach a lesson, not to inflict injury. In the process, they lose control of their rage
• Only the batterer can end this phase
• The victim needs a safe place during this phase  
• Once over, the victim will deny the incident, injuries and terror

3.       The Calm Respite of "the Honeymoon."

• The batterer is kind and charming, and terrified the victim will leave
• The victim wants to believe that the suffering is over; believing that this "good" side of the abuser’s personality is the person they love; and develops learned helplessness

Then the cycle continues and returns to stage one.

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 hasn't 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 lack of severe consequences, like incarceration or financial penalties (WHO, 2010).  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, 2010).

Risk factors for violence against their spouse or significant other are (Farrell, 2011; Theobald, et al., 2012; WHO, 2010):

• Family history of violence
• Alcohol and drug use
• Emotional dependency, insecure and low self-esteem
• Lack of impulse control
• Antisocial, aggressive, and borderline personality disorders
• Poverty
• Marital discord or conflict

Numerous studies from both industrialized and developing countries produced a consistent list of events triggering spouse or significant other violence. They are (Dobash, et al, 2011):

• not obeying the man;
• arguing back;
• not having food ready on time;
• not caring adequately for the children or home;
• questioning the man about money or girlfriends;
• going somewhere without the man’s permission;
• refusing the man sex;
• the man suspecting the woman of infidelity.

Batterers come from all social classes, races, cultures, religions, backgrounds, and countries (WHO, 2010)). The following behaviors may be warning signs (Farrell, 2011; Theobald, et al, 2012):

• extreme jealousy;
• blames others for their faults and circumstances for their problems;
• unpredictable behavior;
• verbally abusive;
• unable to control their anger;
• always asking for a second chance, saying they’ll change and won’t do it again;
• their family resolves problems with violence;
• plays on your guilt;
• their way is the only way;
• behavior often worsens when using alcohol or drugs; and
• cruelty to animals.

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). 

1. Lack of resources
   1. Responsibility for dependent children.
   2. Not employed outside of the home.
   3. The victim does not solely own any property.
   4. Lack of access to cash or bank accounts.
   5. Fear of being charged with desertion; therefore, losing children or joint assets.
   6. Fear of a decline in living standards for herself and her children. 
2. Institutional responses
   1. Clergy and secular counselors are often trained to see only the goal of saving the marriage at all costs.
   2. Police officers treat domestic violence as a dispute instead of a crime.
   3. Police may try to dissuade women from filing charges.
   4. Prosecutors are reluctant to prosecute cases and judges are lenient with the sentencing.
   5. Even with a restraining order, there is little to prevent a released abuser from returning and repeating the assault.
   6. There are not enough shelters to keep victims safe. 
3. Traditional ideology
   1. The belief that divorce is not a viable alternative.
   2. The belief that a single parent family is unacceptable, and that even a violent father is better than no father at all.
   3. Many women are socialized to believe that they are responsible for making their marriage work.
   4. The isolation of a victim contributes to a sense that there is nowhere to turn.
   5. Rationalization of their abuser’s behavior by blaming stress, alcohol, problems at work unemployment, or other factors.
   6. Many women feel that their identity and worth are contingent upon getting and keeping a man.
   7. During the non-violent phases, the abuser may fulfill the woman’s dream of romantic love. She believes that he is basically good. 

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).

• Attention deficit/hyperactivity disorder
• Anxiety
• Behavioral problems, e.g., aggression
• Depression
• Eating disorders
• Poor academic performance
• Low self-esteem
• Need for psychotropic medications
• Nightmares
• Physical health complaints
• Self-harming behaviors

Domestic violence/intimate partner violence is also strongly associated with a high incidence of child neglect and maltreatment (Nicklas, et al., 2013). There is also evidence that domestic violence increases the risk of child morbidity and mortality (WHO, 2012).

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. 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.

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).

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:

• Governments and other donors should be encouraged to invest much more in research on violence by intimate partners over the next decade.
• Programs should place greater emphasis on enabling families, circles of friends and community groups, including religious communities, to deal with the problem of partner violence.
• Programs on partner violence should be integrated with other programs, such as those tackling youth violence, teenage pregnancies, substance abuse and other forms of family violence.
• Programs should focus more on the primary prevention of intimate partner violence.

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).  

• Lack of time
• Lack of training
• Lack of resources
• Language barriers
• Cultural barriers
• Emotional discomfort
• Behavior of the victim, e.g., uncooperative, unwilling to accept help

Mental healthcare 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).

Domestic violence is a crime that causes severe health consequences. Healthcare professionals are mandated and morally obligated to identify and offer assistance to victims of domestic violence. Legal and societal changes in the US have reduced the occurrence of Domestic Violence, but the problem is still epidemic. Your efforts can make a difference.

Alabama Coalition Against Domestic Violence
P.O. Box 4762
Montgomery, AL 36101
Phone: 1-800-650-6522 (in state)
Fax: 334-832-4803
TTY: 1-800-787-3224
Another State: 1-800-799-SAFE (7233)
Email: info@acadv.org
Crisis help lines are open 24 hours

Alaska Network on Domestic Violence and Sexual Assault
130 Seward Street, Room 214
Juneau, AK 99801
Phone: 907-586-3650
FAX: 907-463-4493
Hotline: 1-800-799-SAFE (7233)
lbrowne@andvsa.org

Arizona Coalition Against Domestic Violence
301 E. Bethany Home Rd.
Suite C194
Phoenix, AZ 85012
Phone: 602-279-2900
FAX: 602-279-2980
TTY: 602-279-7270
Toll-Free: 1-800-782-6400
E-mail: acadv@azcadv.org
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
FAX: (501)907-5618
Toll Free: (800)269-4668

Coalition to End Family Violence
1030 N. Ventra Rd
Oxnard, CA 93030
Phone: 805-983-6014
FAX: 805-983-6240
24-Hour Hotline: 805-656-1111
Spanish Hotline: 800-300-2181
TDD: 805-656-4439

Statewide California Coalition for Battered Women
PO Box 19005
Long Beach CA 90807
Toll-Free: 888-SCCBW-52
Phone: 562-981-1202
Fax: 562-981-3202
E-mail: sccbw@sccbw.org

Alternative Horizons
P.O. Box 503
Durango, CO 81302
Phone: 970-247-9619 (24-hour hotline)
E-mail: ah@frontier.net

Colorado Coalition Against Domestic Violence
1120 Lincoln Street, Suite 900
Denver, CO 80203
TOLL-FREE: 888-778-7091
Phone: 303-831-9632
FAX: 303-832-7067
E-mail: ccadv@ccadv.org

D.C. Coalition Against Domestic Violence
5 Thomas Circle, NW
Washington, DC 20005
Phone: 202-299-1181
FAX: 202-299-1193
E-mail: info@dccadv.org
Hours: 8:30am-5-00pm Monday - Friday

SOS Program (A part of DC Coalition)
Domestic Violence Intake Center Satellite Office
Greater Southeast Community Hospital
1328 Southern Ave SE
Room 311
Washington, DC 20032
Phone: 202-561-3095 x12
Fax: 202-561-3093
Hours: 9:00am-5:00pm

My Sister's Place
P.O. Box 29596
Washington, DC 20017
Phone: 202-529-5991 (24-hour hotline)
Administrative Office: 202-529-5261
Fax: 202-529-5984

Delaware Coalition Against Domestic Violence
100 W. 10th Street Suite 703
Wilmington, DE 19801
Phone: 302-658-2958
FAX: 302-658-5049
Hotline: 1-800-799-7233
E-mail: dcadv@dcadv.org

Florida Coalition Against Domestic Violence
425 Office Plaza Dr.
Tallahassee, FL 32301
TOLL-FREE: 800-500-1119
Phone: 850-425-2749
FAX: 850-425-3091
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
TOLL-FREE: 800-334-2836
Phone: 404-524-3847
FAX: 404-524-5959

Hawaii State Coalition Against Domestic Violence
716 Umi St., Unit 210
Honolulu, HI 96819
Phone: 808-832-9316
Fax: 808-841-6028
Email: hscadv@pixi.com

24 Hr Hawaii Shelters by Island:
• Hilo: 959-8864
• Kauai: 245-8404
• Kona: 322-SAFE (7233)
• Maui/Lanai: 579-9581
• Molokai: 567-6888
• Oahu: 841-0822

Iowa Coalition Against Domestic Violence
515 28th St
Suite 104
Des Moines, IA 50312
TOLL-FREE: 800-942-0333
Phone: 515-244-8028
FAX: 515-244-7417
E-mail: admin@icadv.org

Idaho Coalition Against Sexual and Domestic Violence
300 E. Mallard Dr., Suite 130
Boise, ID 83706
TOLL-FREE: 888-293-6118
Phone: 208-384-0419
FAX: 208-331-0687
E-mail: jmatshushita@idvsa.org

Illinois Coalition Against Domestic Violence
801 South 11th Street
Springfield, Illinois 62703
Phone: 217-789-2830
FAX: 217-789-1939
TTY: 217-241-0376
E-mail: ilcadv@springnet1.com

Between Friends
(Formerly The Friends of Battered Women and Their Children)
P. O. Box 608548
Chicago, IL 60660
Phone: 773-274-5232
FAX: 773-262-2543
HOTLINE: 1-800-603-HELP
E-mail:info@afriendsplace.org

Life Span
P.O. Box 1515
Des Plaines IL 60017
24-Hour Crisis Line: 847-824-4454
Phone: 847-824-0382
Fax: 847-824-5311
E-mail: life-span@life-span.org
Special site on Police Domestic Violence

Indiana Coalition Against Domestic Violence
1915 W. 18th Street, Suite B
Indianapolis, IN 46202
TOLL-FREE: 800-538-3393
Phone: 317-917-3685
Fax 317-917-3695
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)
Phone: 785-232-9784
FAX: 785-266-1874

Kentucky Domestic Violence Association
P.O. Box 356
Frankfort, KY 40602
Phone: 502-209-5382
FAX: 502-226-5382
E-mail:info@kdva.org

Louisiana Coalition Against Domestic Violence
P.O. Box 77308
Baton Rouge, LA 70879-7308
Phone: 225-752-1296
FAX: 225-751-8927
HOTLINE: 1-888-411-1333

Maine Coalition to End Domestic Violence
170 Park St.
Bangor, ME 04401
Phone: 207-941-1194
FAX: 207-941-2327
HOTLINE: 866-83-4HELP
Email: info@mcedv.org

Maryland Network Against Domestic Violence
6911 Laurel Bowie Road, Suite 309
Bowie, MD 20715
TOLL-FREE: 800-MD-HELPS
Phone: 301-352-4574
FAX: 301-809-0422
Email: info@mnadv.org

Jane Doe Inc./Massachusetts Coalition Against Sexual Assault and Domestic Violence
14 Beacon Street, Suite 507
Boston, MA 02108
Phone: 617-248-0922
Crisis / Information: 989-686-4551
FAX: 617-248-0902
TTY/TDD: 617-263-2200
Email: info@janedoe.org

Bay County Women's Center
P.O. Box 1458
3411 E. Midland Rd.
Bay City, MI 48706
TOLL-FREE: 800-834-2098
Phone: 517-686-4551
FAX: 517-686-0906
Michigan 24-Hour Crisis Line: 517-265-6776

Minnesota Coalition for Battered Women
590 Park Street North, Suite 410
St. Paul, MN 55103
TOLL-FREE: 800-289-6177
Phone: 651-646-6177
FAX: 651-646-1527
E-mail: mcbw@pclink.com

Missouri Coalition Against Domestic Violence
217 Oscar Dr., Suite A
Jefferson City, MO 65101
Phone: 573-634-4161
FAX: 573-636-6613

Women's Support and Community Services
2165 Hampton Ave
St. Louis, MO 63139
HOTLINE: 314-531-2003
Office: 314-646-7500
Hours: Monday-Thursday 8:00am-7:00pm; Friday 8:00am-1:00pm

Mississippi State Coalition Against Domestic Violence
P.O. Box 4703
Jackson, MS 39296-4703
HOTLINE: 800-898-3234
After Hours HOTLINE: 1-800-799-7233
Phone: 601-981-9196
FAX: 601-981-2501
E-mail: mcadv@misnet.com
Hours: Monday-Friday 8:00am-5:00pm

Crisis Line
P.O. Box 6644
Great Falls, MT 59406
Phone: 406-453-HELP
TOLL-FREE: 1-888-587-0199

Montana Coalition Against Domestic and Sexual Violence
Montana Coalition Against Domestic & Sexual Violence
PO Box 818
Helena MT 59624
Phone: 406.443.7794
TOLL-FREE: 888-404-7794
Fax: 406.443.7818

Nebraska Domestic Violence and Sexual Assault Coalition
1000 "O" Street, Suite 102
Lincoln, NE 68508-2253
TOLL-FREE: 800-876-6238
Phone: 406-443-7794
FAX: 406-443-7818

Nevada Network Against Domestic Violence
220 S. Rock Blvd. Suite. 7
Reno, NV 89502
TOLL-FREE: 800-500-1556
Phone: 775-828-1115
FAX: 775-828-9991

Safe House
921 American Pacific Dr. Suite 300,
Henderson, NV 89014
Phone: 702-451-4203
FAX: 702-451-4302
HOTLINE: 702-564-3227
E-mail: kareng@safehouse.org

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
Phone: 603-224-8893
Fax: 603-228-6096

New Jersey Coalition for Battered Women
1670 Whitehorse/Hamilton Square Road
Trenton, NJ 08690
TOLL-FREE: for Battered Lesbians: 800-224-0211 (in NJ only)
Phone: 609-584-8107
FAX: 609-584-9750
HOTLINE: 1-800-572-7233
TTY: 609-584-0027 (9am-5pm, then into message service)
E-mail: info@njcbw.org

Strengthen Our Sisters
P.O. Box U
Hewitt, N.J. 07421
HOTLINE: 800-SOS-9470 (800-767-9470)
Office: 973-248-0776
E-mail: info@sosdv.org

New Mexico State Coalition Against Domestic Violence
201 Coal Avenue SW
Albuquerque, NM 87102
TOLL-FREE: 800-773-3645 (in New Mexico Only)
Legal Helpline: 800-209-DVLH
Phone: 505-246-9240
FAX: 505-246-9434
E-mail: info@nmcadv.org

New York State Coalition Against Domestic Violence
350 New Scotland Avenue
Albany New York 12208
Phone: 518-482-5465
English: 1-800-942-6906
English TTY: 1-800-818-0656
Spanish: 1-800-942-6908
Spanish TTY: 1-800-780-7660
Fax: 518-482-3807
Email us at nyscadv@nyscadv.org

North Carolina Coalition Against Domestic Violence
123 W. Main Street, Suite 700
Durham, NC 27701
Phone: 919-956-9124
HOTLINE: 1-888-232-9124
FAX: 919-682-1449
Western Office:
PO Box 17398
Asheville, NC 28816
Phone: 828-505-3708

North Dakota Council on Abused Women's Services
State Networking Office
418 East Rosser Avenue, Suite 320
Bismarck, ND 58501
TOLL-FREE: 888-255-6240 (In ND Only)
Phone: 701-255-6240
FAX: 701-255-1904

Ohio Domestic Violence Network
4807 Evanswood Drive
Suite 201
Columbus, Ohio 43229
Phone: 614-781-9651
TTY: 614 781-9654
HOTLINE: 800-934-9840
Fax: 614 781-9652
E-mail: info@odvn.org

Oklahoma Coalition Against Domestic Violence and Sexual Assault
3815 N. Santa Fe Avenue, Suite 124
Oklahoma City, OK 73118
Telephone: 405-524-0700
Fax: 405-524-0711
E-mail: info@ocadvsa.org
Education Office:
PO Box 135
Poteau, OK 74953
Telephone: 918-647-5814
Fax: 918-649-3772

Oregon Coalition Against Domestic Violence and Sexual Assault
State Office:
380 Spokane St.
Suite 100
Portland, OR 97202
Telephone: 503-230-1951
TTY: 1-800-553-2508
Fax: 503-230-1973
Statewide Crisis Number: 1-888-235-5333

Pennsylvania Coalition Against Domestic Violence/National Resource Center on Domestic Violence
6440 Flank Drive, Suite 1300
Harrisburg, PA 17112-2778
Phone: 717-545-6400
Toll Free: 800-932-4632
TTY: 800-553-2508
FAX: 717-671-8149

Women's Center of Montgomery County
Main Administrative Office:
101 Washington Lane, Ste. WC-1
Jenkintown PA 19046
Toll-free hotline: 1-800-773-2424
Norristown Office:
Women's Advocacy Project
400 Courthouse Plaza, 18 W. Airy St.
Norristown PA 19404
610-279-1548
Pottstown Office:
Women's Advocacy Project
555 High Street, 2nd Floor
Pottstown PA 19464
610-970-7363
Bryn Mawr Office:
610-525-1427
Lansdale Office:
215-853-8060

Laurel House
P.O. Box 764
Norristown, PA 19404
Phone: 610-277-1860
HOTLINE: 1-800-642-3150
Fax: 610-277-64025
E-Mail: LaurelHaus@aol.com

Rhode Island Coalition Against Domestic Violence
422 Post Road, Suite 202
Warwick, RI 02888
HOTLINE: 800-494-8100
Phone: 401-467-9940
FAX: 401-467-9943
ricadv@ricadv.org

South Carolina Coalition Against Domestic Violence & Sexual Assault
P.O. Box 7776
Columbia, SC 29202-7776
TOLL-FREE: 800-260-9293
Phone: 803-256-2900
FAX: 803-256-1030

South Dakota Coalition Against Domestic Violence and Sexual Assault
P.O. Box 141
Pierre, SD 57501
HOTLINE: 800-430-7233
Phone: 605-945-0869
FAX: 605-945-0870
PO Box 1402
Sioux Falls, SD 57101
(605) 271-3171 Phone
(605) 271-3172 Fax
1-877-317-3096
(Info/Referral only)
Email: siouxfalls@sdcadvsa.org

Safe Harbor
PO Box 41
310 S. Kline St.
Aberdeen, SD 57402-0041
Phone: 605 226-1212
Toll Free: 888-290-2935
Fax: 650-226-2430
Email (general information only): safeharbor@safeharbor.ws

Tennessee Task Force Against Domestic Violence
2 International Plaza Dr., Suite 425
Nashville, TN 37217
TOLL-FREE: 800-289-9018
Phone: 615-386-9406
FAX: 615-383-2967
Email: webmistress@tcadsv.org

Texas Council on Family Violence
P.O. Box 161810
Austin, TX 78716
TOLL-FREE: 800-525-1978
Phone: 512-794-1133
FAX: 512-794-1199

Families In Crisis, Inc.
P.O. Box 25
Killeen, Texas 76540
Phone: 254-773-7765
Fax: 254-526-6111
HOTLINE: 888-799-SAFE

Domestic Violence Advisory Council
205 North 400 West
Salt Lake City, UT 84103
Phone: 801-521-5544
FAX: 801-521-5548

Women Helping Battered Women
PO BOX 1535
Burlington, VT
Phone: 802-658-3131
HOTLINE: 802-658-1996
TTY: 802-658-1996
Toll-free: 1-800-228-7395
E-mail: whbw@whbw.org

Women's Rape Crisis Center; Vermont
24 Hour HOTLINE: 802-863-1236
Statewide HOTLINE: 800-489-7273

Vermont Network Against Domestic Violence and Sexual Assault
P.O. Box 405
Montpelier, VT 05601
Phone: 802-223-1302
TTY: 800-223-1115
24 Hour HOTLINE: 1 800 228 7395
FAX: 802-223-6943
E-mail: info@vtnetwork.org

Virginians Family Violence and Sexual Assault Hotline
Charlottesville, VA
302 Hickman Rd
Suite 101
Charlottesville, VA 22911
Phone: 434-979-9002
Fax: 434-979-9003
Richmond, VA
5008 Monument Ave.
Suite A
Richmond, VA 23230
Phone: 804-377-0335
Fax: 804-377-0339
E-mail: info@vsdvalliance.org

Washington State Coalition Against Domestic Violence
WSCADV- Olympia Office
711 Capitol Way, Suite 702
Olympia, WA 98501
Phone: 360-586-1022
Fax: 360-586-1024
TTY: 360-586-1029
WSCADV - Seattle Office
1402 - 3rd Ave, Suite 406
Seattle WA 98101
206-389-2515
206-389-2520 FAX
206- 389-2900 TTY
E-mail: wscadv@wscadv.org

Washington State Domestic Violence Hotline
Tel: 800-562-6025
E-mail: csn@willapabay.org

West Virginia Coalition Against Domestic Violence
Elk Office Center
5004 Elk River Road,
Elkview, WV 25071
Phone: 304-965-3552
FAX: 304-965-3572

Manitowoc County Domestic Violence Center
1127 S. 22nd. St,
Manitowoc, WI 54220
Phone: 920-684-5770
HOTLINE: 877-275-6888
Fax: 920-684-6344
E-mail: dvc@sbcglobal.net

Wisconsin Coalition Against Domestic Violence
307 S. Paterson St. #1
Madison, WI 53703
Phone: 608-255-0539
Fax: 608-255-3560

Wyoming Coalition Against Domestic Violence and Sexual Assault
P.O. Box 236
Laramie, WY 82073
TOLL-FREE: 800-990-3877
Phone: 307-755-5481
Legal Staff: 307-755-0992
Fax: 307-755-5482
E-mail: msholtywcadvsa@yahoo.com

YWCA Battered Women Task Force-Topeka
225 SW 12th St.
Topeka, KS 66612
Daytime: 785-354-7927
Evening and Weekend: 785-234-3300
24 Hour HOTLINE: 1-888-822-2983
Hours: Monday, Wednesday, Thursday and Friday: 8:00am-4:30pm; Tuesday 10:30am-4:30pm

Family Violence Prevention Fund
383 Rhode Island Street, Suite 304
San Francisco, CA 94103-5133
Phone: 415-252-8900
TTY: 800-595-4889
FAX: 415-252-8991
E-mail: info@endabuse.org
Washington, DC Office
1101 14th Street, NW #300
Washington DC 20005
Phone: 202-682-1212
Fax: 202-682-4662
Boston Office
67 Newbury Street, Mezzanine Level
Boston, MA 02116
Phone: 617-262-5900
Fax: 617-262-5901

National Coalition Against Domestic Violence
Main Office: 1120
Lincoln Street
Suite 1603
Denver, CO 80203
Phone: 303 839 1852
TTY: (303) 839-8459
Fax: (303) 831-9251
E-mail: mainoffice@ncadv.org
Public Policy Office
1633 Q Street NW, Suite 210
Washington, DC 20009
Phone: (202) 745-1211
TTY: (202) 745-2042
Fax: (202) 745-0088
E-mail: publicpolicy@ncadv.org
National Battered Women's Law Project
275 7th Avenue, Suite 1206
New York, NY 10001
Phone: 212-741-9480
FAX: 212-741-6438

Safe Horizons
2 Lafayette Street, 3rd Floor
New York, NY 10007
Crime Victims HOTLINE: 800-621-4673
Rape and Sexual Assult & Incest HOTLINE: 212-227-3000
TYY (for all HOTLINES) 866-604-5350
Fax: 212-577-3897
E-mail: help@safehorizons.org

Domestic Violence Shelter Tour
2 Lafayette Street 3rd Floor
New York, NY 10007
Phone: 212-577-7700
Fax: 212-385-0331
24-hour hotline: 800-621-HOPE (4673)

National Resource Center on Domestic Violence
Pennsylvania Coalition Against Domestic Violence
6400 Flank Drive, Suite 1300
Harrisburg, PA 17112
Phone: 800-537-2238
Fax: 717-545-9456
Legal Office:
Phone: 717-545-6400
TOLL FREE: 800-932-4632
TTY: 800-533-2508
Fax: 717-671-5542
National Recourse Center on Domestic Violence
Phone: 800-537-2238
TTY: 888-Rx-ABUSE; 800- 595 -4889
Fax: 717-545-9456

Health Resource Center on Domestic Violence
Family Violence Prevention Fund
383 Rhode Island Street, Suite 304
San Francisco, CA 94103-5133
Phone: 800-313-1310
FAX: 415-252-8991

Battered Women's Justice Project
Minnesota Program Development, Inc
1801 Nicollet Ave, Suite 102
Minneapolis, MN 55403
Phone: 800-903-0111, ext.1
Phone: 612-824-8768
Fax: 612-824-8965

Resource Center on Domestic Violence, Child Protection, and Custody
NCJFCJ
P.O. Box 8970
Reno, NV 89507
Office: 775-784-6012
Phone: 800-527-3223
Fax: 775-784-6628
Email: staff@ncjfcj.org
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
Phone: 215-351-0010
FAX: 215-351-0779
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.

National Clearinghouse on Marital and Date Rape
2325 Oak Street
Berkeley, CA 94708
Phone: 510-524-1582

Faith Trust Institute
(Formerly Center for the Prevention of Sexual and Domestic Violence)
2400 N. 45th Street #10
Seattle, WA 98103
Phone: 206-634-1903, ext. 10
Fax: 206-634-0115
Email: info@faithtrustinstitute.org

National Network to End Domestic Violence
2001 S Street NW, Suite 400
Washington, DC 20009
Phone: 202-543-5566
HOTLINE: 800-799-SAFE (7233)
TTY: 800-787-3224
FAX: 202-543-5626

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