1

INTIMATE PARTNER VIOLENCE

Intimate Partner Violence

Valeria Castillo

University of Texas at Arlington

2
INTIMATE PARTNER VIOLENCE

Introduction

Intimate partner violence is an on-going and serious public health issue across the

world. Sexual and domestic assault, stalking, and psychological abuse are all sub-topics

categorized under intimate partner violence. Data from the CDC’s National Intimate Partner

and Sexual Violence Survey showed that “about 1 in 4 women and nearly 1 in 10 men have

experienced contact sexual violence, physical violence, and/or stalking by an intimate partner

during their lifetime” (CDC, 2020). The causes of intimate partner violence vary between

different relationships, as well at how it looks. The relationship can involve jealousy or lack

of trust, conflict with finances and family, or an “old-school” mentality of gender norms.

Abuse of drugs and alcohol consumption can increase violence in a relationship. Just like

there are multiple causes of intimate partner violence, there are also multiple effects that may

occur. Not every relationship experiences the same effects, but there is a common trend in

most. Effects can vary from individual and societal costs to effects on one’s mental health

and the development of poor health conditions (CDC, 2020).

Although help is available to those experiencing mistreatment from their significant

others, many individuals tend to look the other way or are unaware of the resources available

to them. The purpose of the literature review is to explore the different variables that may

influence an individual from obtaining help. Additionally, the literature review seeks to also

answer the research question, what is the most effective way to increase access and

awareness of resources to those experiencing intimate partner violence? In order to answer

the question, the variables being examined are barriers of screening for intimate partner

violence, safety planning, and ways to bridge resource gaps.

Barriers of Screening for Intimate Partner Violence

To grasp an understanding of barriers to screening for intimate partner violence, a

systematic review was conducted in Amsterdam. Studies were grouped into two separate time
3
INTIMATE PARTNER VIOLENCE

periods to examine the differences in the reported barriers. The five categories of barriers that

were established in the review include personal barriers, resource barriers, perception and

attitudes, fears, and patient related barriers. Patient-related barriers include a language

barriers and patient attitudes on intimate partner violence. Personal barriers consist of

misdiagnosing a patient, neglecting to ask the patient their history of abuse, and personal

discomfort on the topic. Attitudes and perceptions focus on how a woman or man perceives

the matter and whether they blame themselves or know their rights. There is also a fear

instilled in the health care providers with involving the police and whether this could

potentially escalate the issue. Finally lack of resources another barrier in screening for

intimate partner violence. Inadequate follow-ups, procedures, and support all fall under lack

of resources. In the personal barrier results, it was concluded that about 54.5% of reported

personal discomfort as a barrier in discussing intimate partner violence (Sprague et al., 2012).

It was then followed by concern of safety and a misdiagnosis (Sprague et al., 2012). The

highest resource barrier was time constraints, while the highest reported perception was that it

is not the role of a health care provider to provide a screen for intimate partner violence.

Although it is recommended to clinicians to screen for signs of intimate partner abuse,

“only 9%-40% of clinicians routinely screen for IPV” (Paterno & Draugon, 2016). The

journal article, Screening for Intimate Partner Violence, addressed the barriers presented in

the article titled Barriers to Screening for Intimate Partner Violence. It was stated that “ these

barriers can be addressed through proper training and development of a systematic screening

protocol. Certified nurse-midwives and certified midwives, as primary care providers of

women's health, play a crucial role in identifying and responding to IPV” (Paterno &

Draugon, 2016). The systemic approach identifies who will be conducting the screening, the

method of screening, who will responds if the screening results in a positive detection, and

how often to screen. All clinicians should make it a routine to screen women, but before
4
INTIMATE PARTNER VIOLENCE

doing so there must be training involved. Having a set approach with open-minded

communication can create a safe space for the patient and build their comfortability, so they

can share their experience and seek assistance.

Safety Planning

Safety is a major concern for victims of intimate partner violence. There are resources

available for victims to guide their escape from the risk of future mistreatment. An

intervention known as safety planning has been utilized by case managers and counselors to

increase the safety of victims of intimate partner violence. Safety planning also focuses on

enhancing a victim’s safety with their everyday life, whether they are still involved in an

abusive relationship, having plans to flee an abusive relationship, or have already fled. Safety

planning can also be provided through domestic and sexual violence hotlines, online chats,

therapy clinics, and women’s shelters. The process of safety planning includes “the gathering

of information, evaluation of the existing situation, decision-making for the type of advocacy

and resources needed and the identification of future strategies on how to respond effectively

to violence” (Kahramen & Bell, 2017). The safety plan is decided and agreed upon between

the victim and a professional. It has been said that "the victim is considered to be the best

expert of her experience, given that many victims show a deep understanding of their

abuser’s behavioral patterns” (Kahramen & Bell, 2017). Safety planning can help the victim

recognize the amount of power they have in controlling what goes on in their personal lives,

as well any additional victims involved such as their children.

After reviewing the article, Safety Planning: A Vital Preliminary Step for

Professionals Working With Intimate Partner Violence Victims, there were a few gaps in the

research that was conducted by the authors. The authors Kahramen and Bell failed to address

how clinicians and those in the public health field can play a role in safety planning. This

piece of information would be significant, because it would demonstrate the importance of

5
INTIMATE PARTNER VIOLENCE

collaboration between various professionals in helping in the detection of intimate partner

violence and those seeking help. With the appropriate training, the professionals can direct

the victims on where to seek additional support and services.

Ways to Bridge Resource Gaps

Web-interventions have become an alternative method to receiving one-on-one

counselling and support services. The idea is that the victim can access support services

anywhere and at any time that works for them, virtually and privately. This makes it very

convenient for the victim involved in intimate partner violence. Instead of calling a hotline,

where the abuser may over hear the phone call. An individual can use an online chat and

receive support virtually. This method is much more discrete. Safety plans can be created

virtually, instead of having the individual visit an domestic and sexual assault organization in

person. The victim can also receive additional insight on where to access resources and go

into hiding.

In an article titled, An Online Healthy Relationship Tool and Safety Decision Aid for

Women Experiencing Intimate Partner Violence, assessed the effectiveness of “an online

interactive healthy relationship tool and safety decision aid (I-DECIDE)” and how it will help

in increasing a “women’s self-efficacy and improve depressive symptoms compared with an

intimate partner violence information website” (Hegarty et al., 2019). In order determine the

effectiveness, a randomized controlled trial was conducted between two groups. One group

utilized the intervention website, while the other group used the control website. The

difference between both of the websites is that the intervention website contains educational

modules and action plans about intimate partner violence, while the control website provides

general information. Although the idea of having online interventions sounds very effective

and efficient, the findings indicated that there is still a need for doing additional research to

provide the best possible information. Another idea is to include a virtual counselling session
6
INTIMATE PARTNER VIOLENCE

in the module to provide an opportunity for victims to ask any additional questions or bring

up their concerns. This would also be a method of providing feedback to improve the

intervention. Several of the women who used the intervention website found the online tool

very helpful in increasing their motivation and feeling supported (Hegarty et al., 2019). If this

approach is implemented more, it can be very impactful and help many people going through

similar experiences.

Another way to bridge resource gaps is through a collaboration of public health

professionals. The article, Coordinated Public Health Initiatives to Address Violence Against

Women and Adolescents, “suggests that partnerships with domestic violence experts are

critical in order to provide training, develop referral protocols, and to link IPV victims to

advocacy services” (Dutton et al., 2015). Creating a plan where a diagnosis is taken as part of

the routine, such as during physicals and checkups, will give the victim an opportunity to

receive help sooner rather than later. If there is a detection of intimate partner violence, the

health professionals will know what the next step is. That is where partnerships with a

domestic and sexual violence organization will play a significant role in the patient. The

patients will be referred and followed up by the intimate partner violence organization. A

recommended suggested in the article was to take it to the next level by creating a “long-

term collaboration between governments and civil society at all levels of the ecological

framework” (Dutton et al., 2015). This will strengthen the seriousness of the issue, but also

help to enforce collaboration with public health professionals by creating the most effective

interventions, resources, and services available for the victims.

There should also be more educational programs in place to raise awareness and

educate audiences on intimate partner violence. These educational programs can be provided

to adolescents, and don’t have to only be addressed towards adults. When intimate partner

violence occurs to an individual in their adolescence, it is referred to as teen dating violence.

7
INTIMATE PARTNER VIOLENCE

Teen dating violence is a huge issue and affects millions of teens each year. “About 11

million women and 5 million men who reported experiencing contact sexual violence,

physical violence, or stalking by an intimate partner in their lifetime said that they first

experienced these forms of violence before the age of 18” (CDC, 2020). Collaborating with

intimate partner violence organizations to create educational programs, seminars, paneling

events, or presentations aimed at adolescents can be very impactful to how they view this

issue and the steps they will take if they ever find themselves in a similar experience. It is

imperative for the adolescent’s health, knowledge, and safety that the education system

increases awareness of sexual and domestic violence. This will also create a safe place for the

victims to access resource and for any other individuals who may have questions or concerns

regarding the topic.

Conclusion

To answer the research question, the most effective methods to increasing access and

awareness of resources to those experiencing intimate partner violence requires training

clinicians to detect for signs of intimate partner violence and presenting patients with

information on the topic or where to seek help; addressing the importance of safety and

presenting solutions, such as safety planning; introducing web-interventions as an alternative

for in-person assistance; collaborating between public health professionals, the government,

and intimate partner violence organizations; and incorporating an education program into the

education system. All of the articles presented in the literature review emphasized the need to

conduct more research about intimate partner violence in order to create effective

interventions, solidify steps of domestic and sexual violence detection in various health-

related settings, and addressing gaps to accessing resources. Future researchers should

continuing researching, but also consider the methods addressed above to be effective when

creating and presenting solutions.

8
INTIMATE PARTNER VIOLENCE

References

CDC. (2020, October 09). Preventing Intimate Partner Violence. Retrieved February 04,

2021, from

https://www.cdc.gov/violenceprevention/intimatepartnerviolence/fastfact.html

Dutton, M. A., James, L., Langhorne, A., & Kelley, M. (2015). Coordinated public health

initiatives to address violence against women and adolescents. Journal of women's

health (2002), 24(1), 80–85. https://doi.org/10.1089/jwh.2014.4884

Hegarty, K., Tarzia, L., Valpied, J., Murray, E., Humphreys, C., Taft, A., . . . Glass, N. (2019,

May 30). An online healthy relationship tool and safety decision aid for women

experiencing intimate partner violence (i-decide): A randomised controlled trial.

Retrieved February 04, 2021, from

https://www.sciencedirect.com/science/article/pii/S2468266719300799

Kahraman, Melis & Bell, Kathryn. (2017). Safety Planning: A Vital Preliminary Step for

Professionals Working With Intimate Partner Violence Victims. Journal of Cognitive-

Behavioral Psychotherapy and Research. 6. 10.5455/JCBPR.247567.

Sheila Sprague PhD , Kim Madden MSc , Nicole Simunovic MSc , Katelyn

Godin BSc , Ngan K. Pham BSc , Mohit Bhandari MD PhD FRCSC & J. C. Goslings

MD PhD (2012) Barriers to Screening for Intimate Partner Violence, Women &

Health, 52:6, 587-605, DOI: 10.1080/03630242.2012.690840

Paterno, M. T., & Draughon, J. E. (2016). Screening for Intimate Partner Violence. Journal

of midwifery & women's health, 61(3), 370–375. https://doi.org/10.1111/jmwh.12443