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Special Collection: Domestic Violence and Health Care

Table of Contents:





Introduction | Back to top

Health care settings provide an immense opportunity for health care providers to address the problem of domestic violence. Patients who are at risk of abuse, who are being abused, or have been abused are likely to seek services for regular health care, injuries, or chronic health problems related to abuse. In addition, patients who use violence against their partners are also likely to seek health services. This provides opportunities for health care providers to prevent or respond to domestic violence by identifying patients who are using violence or being abused, documenting abuse, guiding patients affected by domestic violence in safety planning, and making referrals to advocates. Health care providers are also in a unique position to engage in primary prevention. This can be done by disseminating information about domestic violence through on-going dialogue with patients about healthy relationships or by educating against domestic violence through posters, pamphlets, and brochures.

This special collection on health care and domestic violence draws heavily from the work of the Futures Without Violence National Health Resource Center on Domestic Violence. The resources included in this special collection are organized into the following five areas: 1) the impact of domestic violence on health; 2) public health approaches to domestic violence prevention; 3) guidelines and issues concerning identification and intervention by health care providers; 4) information about collaboration between health care providers and domestic violence advocates; and 5) training. This special collection also includes a bibliography of related journal articles. For information on federal regulations, state statutes and policies relevant to address­ing domestic violence in health care settings, including information on mandatory reporting laws, please visit the website of the National Health Resource Center on Domestic Violence.

This collection was developed by staff of the Minnesota Center Against Violence and Abuse in consultation with the National Resource Center on Domestic Violence. Comments and content suggestions for this special collection are welcome via VAWnet's Online Contact Form.

Impact of domestic violence on health | Back to top

The health impacts of domestic violence vary and may be physical or psychological, and short or long term. This section includes documents that discuss poor health outcomes of women resulting from domestic violence. The documents included in this section recognize domestic violence as a public health problem and highlight the importance of health care providers in domestic violence prevention, identification, and intervention.

(WHO, 2013)

  • Global and regional estimates of violence against women: Prevalence and health effects of intimate partner violence and non-partner sexual violence | PDF PDF (60 p.)
    by the World Health Organization (2013)
    The report presents the first global systematic review of scientific data on the prevalence of two forms of violence against women: violence by an intimate partner (intimate partner violence) and sexual violence by someone other than a partner (non-partner sexual violence). It shows, for the first time, global and regional estimates of the prevalence of these two forms of violence, using data from around the world.
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In the film, Power and Control: Domestic Violence in America, Jacquelyn Campbell of Johns Hopkins Univeristy discusses "psychosomatic complaints," and the impact of multiple, cumulative injuries and forced sex. See the transcript here.

Poor health outcomes
  • National Intimate Partner and Sexual Violence Survey: 2010 Summary Report | PDF PDF (124 p.)
    by Michele C. Black, Kathleen C. Basile, Matthew J. Breiding, Sharon G. Smith, Mikel L. Walters, Melissa T. Merrick, Jieru Chen, and Mark R. Stevens for the National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (November 2011)
    Findings from NISVS confirm that sexual violence, stalking, and intimate partner violence are serious public health problems in the United States. Included in the survey report is information on the health consequences for victims of these forms of violence.
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  • New Studies Link the Mental Health Effects of Trauma with Poorer HIV Treatment Access and Outcomes for Women | HTML HTML
    by National Center on Domestic Violence, Trauma & Mental Health (March 2012)
    This page highlights research on the link between past and recent abuse with poorer HIV treatment access and outcomes for women.
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  • Intimate Partner Violence and Healthy People 2010 Fact Sheet | PDF PDF (6 p.)
    by Futures Without Violence
    Draws statistics from a growing body of research that has linked intimate partner violence (IPV) to many of the leading health indicators defined in the federal Healthy People 2010 initiative.
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  • WHO multi-country study on women’s health and domestic violence against women: Initial results on prevalence, health outcomes and women’s responses | HTML HTML (1 p.)
    by Claudia García-Moreno, Henrica A.F.M. Jansen, Mary Ellsberg, Lori Heise & Charlotte Watts, World Health Organization (2005)
    This report presents initial results of a cross-section study carried out in ten countries. Findings document the prevalence of intimate partner violence and its association with women's physical, mental, sexual and reproductive health.
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  • Adverse Health Conditions and Health Risk Behaviors Associated with Intimate Partner Violence - United States, 2005 | HTML HTML (5 p.) PDF PDF (28 p.)
    by Morbidity and Mortality Weekly Report (MMWR), Centers for Disease Control and Prevention (CDC) (February 8, 2008)
    This report indicates that persons who report having experienced IPV during their lifetimes also are more likely to report current adverse health conditions and health risk behaviors, underscoring the need for IPV assessment in health-care settings.
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Physical injuries
Traumatic Brain Injury and Domestic Violence: Understanding the Intersections (Updated July 2012), offers tools to screen for traumatic brain injury within the context of domestic violence as well as presentations, articles, and other relevant resources on this topic. The purpose of this collection is to: 1) increase knowledge and understanding of TBI within the context of domestic violence, 2) provide tools to advocates and other professionals to screen domestic violence survivors for TBI, and 3) highlight best practices.
  • Domestic Violence Clinical Presentation | HTML HTML
    by Lynn Barkley Burnett, Jonathan Adler, Steven A Conrad, Francisco Talavera, Robert Harwood, and John D Halamka for Medscape (November 2011)
    This article provides guidance around what to look for when screening patients for abuse in a clinical setting, including detailed descriptions of characteristic physical injuries.
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  • Traumatic Brain Injury and Domestic Violence: What do professionals need to know? | PDF PDF (18 p.)
    by the New York State Office for the Prevention of Domestic Violencen
    This document provides information and relevant resources for the early detection of TBI among domestic violence survivors. It also offers an analysis of the intersection between brain injury and domestic violence as well as other relevant information.
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  • Maxillofacial Injuries and Violence Against Women | HTML HTML
    by Oneida A. Arosarena, Travis A. Fritsch, Yichung Hsueh, Behrad Aynehchi, and Richard Haug for Archives of Facial Plastic Surgery, Volume 11, Issue 1 (Jan/Feb 2009)
    This study reveals that victims of intimate partner violence are likely to suffer certain types of fractures around the eye or upper face, which differ from facial injuries sustained by other types of assaults or accidents.
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Impact on mental health/chemical dependency
Trauma-Informed Domestic Violence Services (April 2013) is a 3-part VAWnet Special Collection Series reflecting an integrated perspective that incorporates an understanding of the pervasiveness and impact of trauma, supports healing and resiliency, and addresses the root causes of abuse and violence. It provides resources for building collaborations to ensure that survivors and their children have access to culture-, domestic violence- and trauma-informed mental health and substance abuse services.
  • Intimate Partner Violence and Lifetime Trauma | PDF PDF (6 p.)
    by Carole Warshaw for the National Center on Domestic Violence, Trauma & Mental Health (May 2011)
    This article reviews available research exploring the link between histories of physical and sexual abuse in childhood and IPV victimization in adulthood.
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  • Prevalence of Intimate Partner Violence and Other Lifetime Trauma among Women Seen in Mental Health Settings | PDF PDF (6 p.)
    by Carole Warshaw for the National Center on Domestic Violence, Trauma & Mental Health (May 2011)
    This document provides a brief review of the available research documenting the prevalence of lifetime abuse among women receiving mental health services.
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  • Addressing the Health Consequences | PDF PDF (6 p.)
    by E. Taliaferro, Keynote Speech Women’s Health Symposium (2003)
    In this keynote, the author emphasizes the critical role of health care providers in responding to intimate partner violence.
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  • Making the Connection: Domestic Violence and Public Health, An Evidence-based Training Tool, Part 3: Mental Health and Substance Abuse | PPT (15 p.)
    by Linda Chamberlain, MPH, PhD (2005)
    This chapter provides information about the impact of domestic violence on physical and mental health and substance abuse.
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  • Substance Abuse and Intimate Partner Violence | PDF PDF (15 p.)
    by Larry Bennett and Patricia Bland, VAWnet: The National Online Resource Center on Violence Against Women (May 2008) This document provides an overview of the research on the relationship between substance abuse and woman battering, covering the victim’s use of substances and the specific needs for domestic violence services for those with substance abuse problems.
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Impact on reproductive health
  • National Women & Girls HIV/AIDS Awareness Day: Safety Strategies for Women at Risk | mp4 ( p.)
    presented by Dr. Michele Decker for the National Resource Center on Domestic Violence (March 10, 2014)
    On this webinar, Dr. Michele Decker discussed the link between dating/domestic violence and women's exposure to HIV. Ways to raise awareness, decrease stigma and increase services for HIV+ women were shared for crisis counselors, domestic violence victim advocates and shelter managers.
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  • Violence During Pregnancy and the Postpartum Period | PDF PDF (15 p.)
    by Sandra L. Martin, Jennet Arcara, and McLean D. Pollock with contributions from Lonna Davis (December 2012)
    This Applied Research paper provides research findings concerning violence against pregnant and postpartum women, discusses some of the strengths and limitations of these studies, and concludes with comments concerning the implications of this work for practice and research.
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  • Sexual Violence Against Women: Impact on High-Risk Health Behaviors and Reproductive Health | PDF PDF (15 p.)
    by Sandra L. Martin and Rebecca J. Macy with contributions from Janice A. Mirabassi (June 2009)
    This Applied Research paper provides a brief overview of research on the impact of sexual violence on females’ high-risk health behaviors and reproductive health, focusing on studies of sexual assault or rape experienced primarily during adulthood.
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  • The Facts on Adolescent Pregnancy, Reproductive Risk and Exposure to Dating and Family Violence | PDF PDF (3 p.)
    by the Family Violence Prevention Fund (February 2010)
    Violence limits young womenís ability to manage their reproductive health and exposes them to sexually transmitted diseases. This fact sheet outlines ways that violence affects reproductive health and impacts risky sexual behaviors.
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  • Interpersonal Violence and Adolescent Pregnancy: Prevalence and Implications for Practice and Policy | PDF PDF (48 p.)
    by S. Leiderman and C. Almo (2001)
    This report shows that adolescents who have experienced interpersonal violence are at a higher risk of teen pregnancy. The report recommends strategies to prevent adolescent pregnancy as well as to support pregnant and parenting adolescents.
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  • Study: Many Victims of Partner Violence Experience Reproductive Coercion | HTML HTML
    by Futures Without Violence
    This page highlights findings from a groundbreaking study examining the relationship between intimate partner violence, reproductive coercion and unintended pregnancy.
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  • 1 in 4 Hotline Callers Report Birth Control Sabotage, Pregnancy Coercion | HTML HTML
    by National Domestic Violence Hotline and Futures Without Violence (February 15, 2011)
    This page highlights findings from the first national survey to measure the extent of reproductive coercion experienced by callers to the National Domestic Violence Hotline.
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Prevention approaches | Back to top

Public health approaches to domestic violence prevention may be targeted to the general public, or tailored to specific populations, or to high-risk groups. Documents included in this section present various domestic violence prevention strategies. Also included in this section are a variety of domestic violence brochures and pamphlets for both healthcare providers and patients. Materials for providers offer guidance on conducting routine assessment, documenting abuse, and providing appropriate information and referrals. The patient education materials educate people about healthy relationships, help potential victims identify signs of abuse and seek help, and urge perpetrators to stop abuse.

Public health approaches
  • Before It Occurs: Primary Prevention of Intimate Partner Violence and Abuse | PDF PDF (11 p.)
    by L. Cohen, R. Davis and C. Graffunder (2006)
    This document discusses various levels of prevention and focuses on primary prevention polices for intimate partner violence. It also explores health care professional’s role in primary prevention of intimate partner violence.
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  • A Prevention Primer for Domestic Violence: Terminology, Tools, and the Public Health Approach | PDF PDF (10 p.) HTML HTML
    by Linda Chamberlain, VAWnet: The National Online Resource Center on Violence Against Women (March 2008)
    This document provides an introduction to basic prevention concepts by exploring the public health approach, two classification systems, a planning tool used to develop more comprehensive initiatives, and the importance of understanding terminology.
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  • Assessment for Lifetime Exposure to Violence as a Pathway to Prevention | PDF PDF (12 p.)
    by Linda Chamberlain with contributions from Peggy Brown, VAWnet: The National Online Resource Center on Violence Against Women (February 2006)
    This document provides a brief overview of the research on lifetime exposure to violence and the long-term health consequences of violence. It also examines how assessment for lifetime exposure to violence can create a pathway to prevention.
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  • Reducing Inequities in Health and Safety through Prevention | PDF PDF (16 p.)
    by Prevention Institute & The Joint Center for Political and Economic Studies (January 23, 2009)
    This memo offers a suggested strategy for developing a comprehensive, prevention-oriented approach to health equity, starting with the highest levels of the federal government and continuing to states and communities.
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Brochures and pamphlets for providers

To obtain free hard copies or a digital download of the pregnancy wheel or safety card, please visit Futures Without Violence’s online store.

  • Medical Power & Control Wheel | PDF PDF (1 p.)
    by The Domestic Violence Project, Kenosha, WI, adapted from the original wheel by the Domestic Abuse Intervention Project
    This graphic depicts some ways in which healthcare providers may inadvertently contribute to increase the isolation and decrease the safety of victims of domestic violence.
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  • Pregnancy Wheel | PDF PDF (2 p.)
    by Futures Without Violence (2008)
    This pregnancy wheel for OB/GYN and reproductive health settings assists providers in assessing for domestic violence.
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  • Mental Health System Advocacy Wheel | PDF PDF (1 p.)
    by The Domestic Violence Project, Kenosha, WI, adapted from the original wheel by the Domestic Abuse Intervention Project, published by the National Center on Domestic & Sexual Violence (1992)
    This wheel depicts how mental health providers can best respond to victims of domestic violence by respecting victim’s autonomy and confidentiality and promoting access to community services.
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  • Domestic Violence Assessment Guide | PDF PDF (2 p.)
    by Futures Without Violence
    This pocket reference card for health care providers includes guidance on conducting routine assessment for domestic violence.
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Brochures and pamphlets for patients
  • Is Your Relationship Affecting Your Health? | PDF PDF (2 p.)
    by Futures Without Violence (2012)
    This card provides safety planning information and help women recognize how their relationship impacts their health and the health of their children.
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  • How Abuse Might Affect Your Mental Health: Safety and Well-Being Tipsheet Series | PDF PDF (2 p.)
    by the National Center on Domestic Violence, Trauma & Mental Health (November 2011)
    This tip sheet provides information on the ways that experiencing abuse can affect the mental health of survivors. Tips on how to seek support for oneself, or a loved one who is being abused, are also included.
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  • Domestic violence and traumatic brain injuries | PDF PDF (1 p.)
    by Brain Injury Association of Virginia
    This pamphlet provides information about signs and symptoms of traumatic brain injuries that are likely to result from domestic violence. The pamphlet also includes domestic violence screening questions for patients who have traumatic brain injuries.
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  • Safe Homes, Safe Babies: Creating Futures Without Violence | PDF PDF (2 p.)
    by Futures Without Violence (2012)
    This card provides safety resources for women and can be distributed to patients by perinatal health care providers.
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  • Did You Know Your Relationship Affects Your Health? | PDF PDF (1 p.)
    by Futures Without Violence (2012)
    This poster presents information about sexual abuse and coercion in relationships and suggests women who experience sexual violence to talk to their healthcare providers and national hotlines.
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  • Hanging Out or Hooking Up? | PDF PDF (2 p.)
    by Futures Without Violence (2012)
    This safety card for teens is written in gender-neutral language and provides information about healthy relationships.
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  • Your Kids Make Memories Everyday | PDF PDF (1 p.)
    by Futures Without Violence
    This poster informs the perpetrators of domestic violence about the negative effects of domestic violence on children and encourages the perpetrators to stop abuse.
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  • The Coaching Boys into Men Brochure | PDF PDF (2 p.)
    by Futures Without Violence (2005)
    This brochure outlines tips for talking to all of the boys in your life about respect, honor, and responsibility, and why violence against women is wrong.
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  • Developing Healthy Relationships: A Role for Adults | PDF PDF (1 p.)
    by Centers for Disease Control and Prevention
    This brochure provides information about key skills that adults can help develop in teens, so that teens can give and receive respect in any relationships.
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Identification and intervention by health care providers | Back to top

The adverse health consequences associated with domestic violence often bring patients who are abused in contact with health care professionals. Patients who use violence against their partners are also likely to seek health services. Patients may seek health care services for problems, such as physical injuries, anxiety, depression, and post-traumatic stress that are triggered by domestic violence. Facial injuries caused by domestic violence can be identified in dental settings. Primary care, reproductive health, and child health care providers are also positioned to identify and prevent domestic violence. This section includes guidelines for screening, documenting, and responding to domestic violence.

Health Cares About IPV: Intimate Partner Violence Screening and Counseling Toolkit
This toolkit from The National Health Resource Center on Domestic Violence offers health care providers and advocates for victims the tools to prepare a clinical practice to address domestic and sexual violence, including screening instruments, sample scripts for providers, patient and provider education resources. It also offers strategies for forging partnerships between health care and domestic and sexual violence programs.
  • Responding to intimate partner violence and sexual violence against women: WHO clinical and policy guidelines | PDF PDF (68 p.)
    by the World Health Organization (2013)
    These guidelines aim to provide evidence-based guidance to health-care providers on the appropriate responses to intimate partner violence and sexual violence against women, including clinical interventions and emotional support.
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Primary care providers
  • Intimate Partner Violence: Encouraging Disclosure and Referral in the Primary Care Setting | PDF PDF (10 p.)
    by The New York City Department of Health and Mental Hygiene (2007)
    This article discusses the critical role of primary care providers in identifying intimate partner violence and facilitating referrals through routine inquiry, on-going dialogue and by establishing patient trust.
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  • Healing Shattered Lives: Assessment of Selected Domestic Violence Programs in Primary Health Care Settings | PDF PDF (82 p.)
    by Health Resources and Services Administration (2002)
    This report presents domestic violence programs and protocols of nine community-based primary health care centers that are funded by the Bureau of Primary Health Care.
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Reproductive health care providers
  • National Women & Girls HIV/AIDS Awareness Day: Safety Strategies for Women at Risk | mp4 ( p.)
    presented by Dr. Michele Decker for the National Resource Center on Domestic Violence (March 10, 2014)
    On this webinar, Dr. Michele Decker discussed the link between dating/domestic violence and women's exposure to HIV. Ways to raise awareness, decrease stigma and increase services for HIV+ women were shared for crisis counselors, domestic violence victim advocates and shelter managers.
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  • Reproductive Health and Partner Violence Guidelines: An Integrated Response to Intimate Partner Violence and Reproductive Coercion | PPT (52 p.)
    by Linda Chamberlain and Rebecca Levenson for Futures Without Violence (2010)
    This guide focuses on the transformative role of the reproductive health care provider in identifying and addressing intimate partner violence and reproductive coercion.
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  • Intimate Partner Violence During Pregnancy: A Guide for Clinicians | PPT (44 p.)
    by American College of Obstetricians and Gynecologists (ACOG)/Centers for Disease Control and Preventio (2006)
    This presentation provides supplementary information for prenatal health care providers on screening pregnant women for domestic violence and responding to intimate partner violence.
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  • Making the Connection: Intimate Partner Violence and Public Health, Chapter 5: Intimate Partner Violence (IPV) and Family Planning, Birth Control Sabotage, Pregnancy Pressure, and Unintended Pregnancy | PPT (40 p.)
    by Linda Chamberlain for Futures Without Violence (Revised 2010)
    This chapter provides information about the impact of domestic violence on reproductive health.
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  • Making the Connection: Intimate Partner Violence and Public Health, Chapter 7: Intimate Partner Violence (IPV) and Perinatal Programs | PPT (38 p.)
    by Linda Chamberlain for Futures Without Violence (Revised 2010)
    This chapter provides information about physical and sexual abuse during pregnancy.
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  • Addressing Intimate Partner Violence, Reproductive and Sexual Coercion: A Guide for Obstetric, Gynecologic, and Reproductive Health Care Settings, Second Edition | PDF PDF (60 p.)
    by Linda Chamberlain and Rebecca Levenson for Futures Without Violence (2012)
    This guide provides information and strategies for addressing reproductive and sexual coercion with patients seeking reproductive health care services.
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Child health care providers
  • Identifying and Responding to Domestic Violence: Consensus Recommendations for Child and Adolescent Health | PDF PDF (94 p.)
    by Futures Without Violence's National Health Resource Center on Domestic Violence (Revised August 2004)
    This document highlights the need for child health care providers to become actively involved in domestic violence prevention and provides recommendations for regular and universal screening for domestic violence in child health care settings.
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  • Pediatricians Should Screen Moms for Domestic Violence | HTML HTML (1 p.)
    by T. Neale, MedPage Today (April 2008)
    This news article discusses a recent study by Bair-Merritt (2008). Findings of the study underscore the need for pediatricians to screen mothers for domestic violence.
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Mental health care providers
  • Responding to Domestic Violence: Tools for Mental Health Providers | HTML HTML (33 p.)
    by National Center on Domestic Violence, Trauma & Mental Health (2004)
    This material provides tools and information for mental health providers on screening and assessing for domestic violence.
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  • Guidelines for Mental Health Professionals | HTML HTML (1 p.)
    by New York State Office for the Prevention of Domestic Violence
    This document presents good practice tips for health care professionals working with patients who have been abused. The guidelines provide screening tips, highlight the negative effect of couples counseling, and present safety planning tips.
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  • Mental Health and Domestic Violence: Collaborative Initiatives, Service Models, and Curricula | PDF PDF (77 p.)
    by Carole Warshaw, M.D. and Gabriela Moroney, M.A., The Domestic Violence and Mental Health Policy Initiative (September 2002)
    Describes concerns of state domestic violence coalitions and mental health providers and/or agencies and provides model initiatives and programs that have begun the work of responding to the mental health needs of battered women and their children.
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Dental health care providers
  • Family Violence: An Intervention Model for Dental Professionals | PDF PDF (11 p.)
    by K. Littel (2004)
    This bulletin notes the higher probability of identifying abuse during routine dental visits, as victims of domestic violence are likely to suffer facial injury.
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  • The Role of the Dental Team in Responding to Domestic Violence | PDF PDF (4 p.)
    by P. Coulthard and A. L. Warburton (2007)
    This article discusses the role of dental care professionals in identifying domestic violence and responding to patients who have facial injuries that are a result of domestic violence.
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  • Enhancing Dental Professional’s Response to Domestic Violence | PDF PDF (6 p.)
    by Futures Without Violence
    This folio notes that seventy-five percent of domestic violence-related physical injuries are concentrated around the head, neck, and mouth, and provides specialized tools for dental professionals on screening and responding to domestic violence.
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Guidelines for screening and interventions
One of our challenges is not only to have policies in place that say that nurses and physicians need to routinely assess for domestic violence, but how they do it. If they’ve got a checklist and they say, “you’re not abused are you?” or ask it in a way that’s not engaging, that’s clearly uncomfortable. - Jackie Campbell from Power and Control: Domestic Violence in America (2012)

Colleen Moore of Mercy Medical Center discusses hospital domestic violence screening protocols and the types of questions that are asked of patients. See the transcript here.

  • The National Consensus Guidelines on Identifying and Responding to Domestic Violence Victimization in Health Care Settings, Second Edition | PDF PDF (98 p.)
    by Futures Without Violence's National Health Resource Center on Domestic Violence (Revised February 2004)
    The guidelines are designed to assist health care providers from multiple settings and in various professional disciplines in addressing domestic violence victimization, including assessment, documentation, intervention and referral information.
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  • Intimate Partner Violence and Sexual Violence Victimization Assessment Instruments for Use in Healthcare Settings, Version 1.0 | PDF PDF (114 p.)
    by Kathleen C. Basile, Marci Hertz, and Sudie Black, Centers for Disease Control and Prevention, National Center for Injury Prevention and Control (2007)
    This compilation provides practitioners and clinicians with an inventory of existing assessment tools for determining intimate partner violence and/or sexual violence victimization in clinical/healthcare settings.
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  • Screening for Sexual Violence: Gaps in Research and Recommendations for Change | PDF PDF (15 p.)
    by Lynne Stevens with contributions from Barbara Sheaffer (December 2007)
    This Applied Research paper provides a review of the current literature on screening women for sexual violence in health care facilities, and discusses the reasoning and rationale behind screening women for sexual violence.
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  • Guidelines for Physicians on the Abuse of Women with Disabilities | HTML HTML (1 p.)
    by M. Nosek, Center for Research on Women with Disabilities (1995)
    This screening guide provides information about the prevalence of abuse among women with disabilities and presents guidelines for health care practitioners for identifying and responding to patents with signs of abuse.
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  • What Do You Say When She Says “Yes?” | HTML HTML [1:53:51]
    by the Washington State Coalition Against Domestic Violence (WSCADV) (May 2010)
    This webinar provides strategies for healthcare professionals when working with patients who disclose domestic violence.
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  • Guidelines for Integrating Domestic Violence Screening into HIV Counseling, Testing, Referral & Partner Notification | HTML HTML
    by the New York State Department of Health (Revised January 2002)
    This resource provides guidelines for screening for domestic violence during HIV counseling and testing.
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Culturally competent screening and interventions
  • Addressing Domestic Violence in a Clinical Setting | PDF PDF (59 p.)
    by Migrant Clinicians Network
    This manual is designed for health professionals and addresses domestic violence from the clinical perspective, with a focus on assisting migrant and immigrant survivors of abuse.
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  • Perinatal Domestic Violence Identification Services: A Guide Toward Culturally Relevant Care in Health Clinics | PDF PDF (144 p.)
    by Washington State Department of Health (2004)
    This document addresses the issue of screening for domestic violence among patients from diverse cultures. It provides guidelines for culturally competent practices in community health clinics.
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  • Medical Providers’ Guide to Managing the Care of Domestic Violence Patients within a Cultural Context | PDF PDF (82 p.)
    by City of New York (2004)
    This manual recognizes the impact of culture on patient-doctor communication, particularly when discussing domestic violence. The manual provides guidelines for health care providers to effectively screen culturally diverse patients for domestic violence.
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  • Intersecting Inequalities: Immigrant Women of Colour, Violence and Health Care | PDF PDF (102 p.)
    by Yasmin Jiwani, Simon Fraser University (July 2001)
    This report shows that physicians tend to be inadequately prepared to respond to patients who have experienced domestic violence, and that physicians’ response to immigrant women who have been abused tend to be influenced by cultural stereotypes.
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Documenting abuse

Debra Holbrook of Mercy Medical Center discusses the importance of gathering forensic evidence to document abuse. See the transcript here.

  • Documenting Domestic Violence: How Health Care Providers can Help Victims | PDF PDF (6 p.)
    by Nancy E. Isaac & V. Pualani Enos, National Institute of Justice (September 2001)
    This research brief discusses the importance of documenting domestic violence in health care settings to establish factual evidence of the abuse and thereby strengthening legal cases for domestic violence survivors.
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  • Coding and Documentation of Domestic Violence | PDF PDF (21 p.)
    by William J. Rudman, Futures Without Violence (December 2000)
    This article discusses the importance of coding and documenting domestic violence by health care providers to improve services for victims and to increase knowledge about the impact of domestic violence on patients' health.
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  • Subpoena Response Toolkit: A Guide for Mental Health Services Providers on How to Respond to Subpoenas and Other Demands for Client Information or Records | PDF PDF (7 p.)
    by Julie Fields and Rachel White-Domain
    This toolkit provides guidance to mental health practitioners and agencies on how to respond to subpoenas and other demands to produce client mental health records in ways that will maximize client safety and autonomy.
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  • Body Map: Abuse Assessment Screen | HTML HTML (7 p.)
    by Futures Without Violence (2013)
    This assessment tool for healthcare providers includes screening questions and a body map to document abuse.
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Enhancing collaboration for domestic violence prevention | Back to top

The documents in this section highlight the need for collaborative efforts between health care providers and domestic violence advocates to prevent, identify, and respond to domestic violence. Recommendations and practical tools for health care settings and providers, as well as advocates, are included here to support community partnerships and to enhance services for domestic violence survivors experiencing health/mental health or substance abuse conditions.

This section also highlights information on “best practices” and model policies designed to promote inter-disciplinary collaboration.* Sample protocols are included to assist both health care settings and domestic violence programs in the development of prevention and intervention approaches that are comprehensive, trauma-informed, and responsive to victims’ multiple needs.

*For information on federal regulations, state statutes and policies relevant to address­ing domestic violence in health care settings, including information on mandatory reporting laws, please visit the website of the National Health Resource Center on Domestic Violence.

Since 2010, Futures Without Violence (“Futures”) and the US Department of Health and Human Services Office on Women’s Health (“OWH”) have worked in partnership on Project Connect: A Coordinated Public Health Initiative to Prevent and Respond to Violence Against Women (Project Connect), a national initiative to build collaborations between the public health and domestic violence fields to improve the public health response to domestic and sexual violence.
Recommendations and tools for collaboration
  • The Business Case for Domestic Violence Programs in Health Care Settings | PPT (23 p.)
    by Futures Without Violence
    This PowerPoint presentation provides information about the high cost of health care for women who have been abused and argues that domestic violence screening and intervention programs may reduce the health care cost.
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  • Simplifying physicians' response to domestic violence | PDF PDF (3 p.)
    by Barbara Gerbert, James Moe & Nona Caspers, PubMed Central (May 2000)
    This article notes physicians' limited time and skills as barriers in responding to their patients' experiences of domestic violence. It proposes an approach (AVDR) to allow physicians to be proactive in responding to domestic violence.
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  • How Can Practitioners Help an Abused Woman Lower Her Risk of Death? | PDF PDF (4 p.)
    by Carolyn Rebecca Block, National Institute of Justice (2003)
    This article presents key findings from the Chicago Women’s Health Study about domestic violence, its effects, and women’s responses to violence.
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  • Trauma, Resiliency, Wellness: Mental Health, Domestic Violence & Sexual Assault | PDF PDF (37 p.)
    by Washington State Coalition Against Domestic Violence (WSCADV) (2009)
    The goal of this presentation is to help mental health practitioners best support domestic and sexual violence survivors. Information on how to include advocates in the recovery planning process of survivors with mental health related issues is discussed.
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  • Real Tools: Responding to Multi-Abuse Trauma - A Tool Kit to Help Advocates and Community Partners Better Serve People with Multiple Issues | PDF PDF (353 p.)
    by Debi S. Edmund and Patricia J. Bland for the Alaska Network on Domestic Violence and Sexual Assault (2011)
    This toolkit focuses on survivors of multi-abuse trauma - those who are affected by multiple issues that negatively affect safety, health, or well-being. A primary focus of the toolkit is on how on many survivors of domestic violence experience alcohol and drug dependence, complex trauma, homelessness, and other hardships.
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  • Locating Mental Health & Substance Abuse Supports for Survivors: A Reference Sheet for Domestic Violence Advocates | PDF PDF (2 p.)
    by the The National Center on Domestic Violence, Trauma & Mental Health (February 2012)
    This document contains resources that you can use to locate additional supports for survivors who are experiencing mental health or substance abuse conditions.
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Best practices and sample protocols
Domestic Violence and Health Care Protocols are available from the National Health Resource Center on Domestic Violence of Futures Without Violence.
  • Building Domestic Violence Health Care Responses in Indian Country: A Promising Practices Report | PDF PDF (64 p.)
    by Anna Marjavi and Vicki Ybanez for Futures Without Violence, formerly Family Violence Prevention Fund (2010)
    This report provides information and tools to help Indian health and community advocacy programs strengthen their clinical and community responses to victims of domestic violence.
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  • An assessment of Minnesota’s health care and public health response to violence against women | PDF PDF (90 p.)
    by Minnesota Department of Health (2003)
    This report emphasizes the important role of public health and health care providers in preventing and responding to violence against women.
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  • Delphi Instrument for Hospital-based Domestic Violence | PDF PDF (11 p.)
    by Agency for Healthcare Research and Quality
    This validated tool, which can be self-administered or administered by external evaluators, can be used to track and measure the progress of a hospital in improving its response to domestic violence.
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  • Family Violence Quality Assessment Tool for Primary Care Offices | PDF PDF (7 p.)
    by Therese Zink for Futures Without Violence
    The tool may be used to assess family violence efforts in primary care practices at the beginning and intermittently (every 6 months, every year, every few years) when focusing on family violence as a quality improvement goal. It is meant to be a tool for identifying deficiencies and so that they can be remedied and the care to patients living with violence and abuse can be improved.
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  • Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS) | PDF PDF (173 p.)
    by Lynn Short, Elaine Alpert, Joh M. Harris Jr, and Zita Surprenant for the American Journal of Preventive Medicine (2006)
    This instrument is a 15-minute survey that is a comprehensive and reliable measure of physician preparedness to manage IPV patients. It can also be used to measure the effectiveness of IPV educational programs.
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  • Minimal Elements of a Domestic Violence Protocol & Implementation of a Domestic Violence Protocol | PDF PDF (2 p.)
    by Futures Without Violence (1995)
    This short document provides guidance for the development and implementation of a domestic violence protocol for use within a health care setting.
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  • Model Medication Policy for DV Shelters | PDF PDF (9 p.)
    by Mary Malefyt Seighman, JD, Kelly Miller, JD, and Rachel White-Domain, JD for the National Center on Domestic Violence, Trauma & Mental Health (November 2011)
    The Model Medication Policy is designed to offer guidance to domestic violence programs on adopting medication policies that are accessible, trauma informed, and compliant with anti-discrimination laws.
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Training and Education | Back to top

This section provides training resources such as manuals and tutorials to teach health care providers in various settings how to identify and document domestic violence, plan for safety of the patients, and make referrals to advocates. Because academic institutions still provide health professional students with little to no training related to domestic violence, this section also brings attention to this important curricular gap. Included are documents providing information on student-led organizing efforts, as well as recommendations for ensuring that all students receive solid education on domestic violence prevention, identification and responses.


Screen to End Abuse (above) and Voices of Survivors are training videos available from Futures Without Violence.
Manuals and tutorials
  • Making the Connection: Intimate Partner Violence and Public Health | HTMLHTML
    by Linda Chamberlain for the Futures Without Violence (Revised 2010)
    This training manual identifies the link between domestic violence and public health and presents an overview, statistics, implications, strategies for prevention, issues in defining success, and promising practices in responding to domestic violence.
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  • Improving the Health Care Response to Domestic Violence: A Resource Manual for Health Care Providers | HTML HTML
    by Carole Warshaw, M.D. and Anne L. Ganley, Ph.D., Futures Without Violence (Revised 1998)
    This resource manual provides information about domestic violence and tools for identification and intervention by health care practitioners.
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  • Improving the Health Care Response to Domestic Violence: A Trainer’s Manual for Health Care Providers | PDF PDF (267 p.)
    by Anne L. Ganley, Ph.D., 1998
    This Trainer's Manual provides step-by-step instructions for teaching each section of the accompanying Resource Manual including the basics of domestic violence, clinical skills, legal issues, community resources, and role play scenarios.
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  • Domestic Violence: A Competency-Based Training Manual for Community Mental Health Staff | HTMLHTML (1 p.)
    by Institute of Family Violence Studies, Florida State University
    This manual provides guidelines to mental health care professionals for screening for domestic violence and for assisting victims of domestic violence with special services.
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  • Healthy Moms, Happy Babies: A Train the Trainers Curriculum on Domestic Violence, Reproductive Coercion and Children Exposed | PDF PDF (208 p.)
    by Linda Chamberlain and Rebecca Levenson for Futures Without Violence (2011)
    This curriculum was designed for home visitation programs. It provides training on the impact of violence on families as well as tools for staff to conduct effective assessment and education during home visits.
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  • Ask, Validate, Document, Refer (AVDR) Tutorial for Dentists | HTMLHTML
    by Barbara Gerbert, PhD, Director of the Center for Health Improvement and Prevention Studies for Futures Without Violence
    This short video provides a brief, interactive learning experience to help dentists, dental students and other oral health care professionals best respond to their patients who are victims of domestic violence.
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  • Competencies Needed by Health Professionals for Addressing Exposure to Violence and Abuse in Patient Care | PDF PDF (20 p.)
    by Academy on Violence and Abuse (AVA) (April 2011)
    These core competencies were developed to help ensure that all health care professionals have a solid understanding of violence and abuse and gain the skills and confidence to work with patients, clients, colleagues and health care systems in order to respond.
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Student organizing and curricular reform
  • Nursing Education and Violence Prevention, Detection, and Intervention | PDF PDF (40 p.)
    by Margaret M. Ross, Futures Without Violence Unit, Canada (2002)
    This document reviews the literature on education of nurses in domestic violence and informs educators, researchers, and policy makers about the gaps in nursing education in the area of violence against women.
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  • Family Violence Nursing Curriculum | HTML HTML
    by Marlene Jezierski, Maura Lynch, Margaret Dexheimer Pharris, and Judi Sateren for the Minnesota Center Against Violence and Abuse (MINCAVA) (January 2004)
    The content of this curriculum, which grew out of the 1999 American Association of Colleges of Nursing competencies, was developed ito provide Minnesota nursing faculty essential curricular information to develop student competence in preventing, assessing, and responding to family violence across the lifespan.
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  • A Domestic Violence Campus Organizing Guide for Health Professional Students and Faculty | PDF PDF (6 p.)
    by Futures Without Violence
    This brief notes that health care providers receive inadequate training on domestic violence prevention, identification, and response, and presents guidelines for students to organize fellow students and faculty to initiate policy change.
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  • Health Professional Students: Get Involved | HTML HTML
    by Futures Without Violence
    This page provides information about action steps that health professional students and faculty can take to support organizing efforts and improve health care responses to women, men, and children who have been impacted by domestic violence.
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Bibliography | Back to top

For websites related to health care and domestic violence, see: http://www.futureswithoutviolence.org/section/our_work/health. The journal articles referenced below can be accessed by subscription using the links provided.

Impact of domestic violence on health

Campbell, J. (2002). Health consequences of intimate partner violence. The Lancet, 359 (9314), 1331-1336. Available at: http://linkinghub.elsevier.com/retrieve/pii/S0140673602083368

Campbell, J. C., Woods, A. B., Chouaf, K. L. & Parker, B. (2000). Reproductive Health Consequences of Intimate Partner Violence: A Nursing Research Review. Clinical Nursing Research, 9 (3), 217-237. Available at: http://cnr.sagepub.com/cgi/content/abstract/9/3/217

Coker, A. L., Smith, P. H., Bethea, L., King, M. R. & Mckeown, R. E. (2000). Physical Health Consequences of Physical and Psychological Intimate Partner Violence. Archives of Family Medicine, 9 , 451-457. Available at: http://www.ncbi.nlm.nih.gov/pubmed/10810951

Huth-Bocks, A. C., Levendosky, A. A. & Bogat, G. A. (2002). The Effects of Domestic Violence During Pregnancy on Maternal and Infant Health. Violence and Victims, 17 (2). 169-185. Available at: http://www.ingentaconnect.com/content/springer/vav/2002/00000017/00000002/art00004

Machtinger, E. L., Wilson, T. C., Haberer, J. E., & Weiss, D. S. (2012). Psychological Trauma and PTSD in HIV-Positive Women: A Meta-Analysis. AIDS and Behavior. Available at http://www.springerlink.com/content/65735j14q7r70640/.

Machtinger, E. L., Wilson, T. C., Haberer, J. E., & Weiss, D. S. (2012). Recent Trauma is Associated with Antiretroviral Failure and HIV Transmission Risk Behavior Among HIV-Positive Women and Female-Identified Transgenders. AIDS and Behavior. Available at http://www.springerlink.com/content/n164716853x285h7/.

Miller, E., Decker, M. R., McCauley, H. L., Tancredi, D. J., Levenson, R. R., Waldman, J., Schoenwald, P., & Silverman, J. G. (2010). Pregnancy coercion, intimate partner violence and unintended pregnancy. Contraception, 81(4), 316-322. Available at http://www.contraceptionjournal.org/article/S0010-7824(09)00522-8/abstract.

Plichta, S. b. (2004). Intimate Partner Violence and Physical Health Consequences. Policy and Practice Implications. Journal of Interpersonal Violence, 19 (11), 1296-1323. Available at: http://jiv.sagepub.com/cgi/content/abstract/19/11/1296

Roberts, P. & Klein, A. J. (2005). Intimate partner abuse and the reproductive health of sexually active female adolescents. Journal of Adolescent Health, 36 (5), 380-385. Available at: http://linkinghub.elsevier.com/retrieve/pii/S1054139X04004379

Sheridan, D. J. & Nash, K. R. (2007). Acute Injury Patterns of Domestic Violence Victims. Trauma, Violence and Abuse, 8 (3), 281-289. Available at: http://tva.sagepub.com/cgi/content/refs/8/3/281

Warshaw, C. (2008). Domestic Violence, Trauma and Mental Health. In C. Renzetti & J. Edleson (Eds.), Encyclopedia on Interpersonal Violence. Thousand Oaks, California: Sage. Available at http://www.sagepub.com/books/Book227867.

Warshaw, C., Brashler, P. & Gill, J. (2009). Mental health consequences of intimate partner violence. In C. Mitchell and D. Anglin (Eds.), Intimate Partner Violence: A Health Based Perspective. New York: Oxford University Press. Available at http://www.oup.com/us/catalog/general/subject/Medicine/EmergencyMedicine/?view=usa&ci=9780195179323.

Identification and response

Coulthard, P. & Warburton, A. L. (2007). The role of the dental team in responding to domestic violence. British Dental Journal, 203 , 645-648. Available at: http://www.ncbi.nlm.nih.gov/pubmed/18065984

Gielen, A. C., et al. (2000). Women's Opinion about Domestic Violence Screening and Mandatory Reporting. American Journal of Preventive Medicine, 19(4), 279-285. Available at http://www.sciencedirect.com/

Glowa, P.T., Frasier, P.Y., Wangs, L., Eaker, K. & Osterling, W. L. (2003). What Happens After We Identify Intimate Partner Violence? The Family Physicians's Perspective. Family Medicine, 35 (10), 730-736. Available at: http://www.stfm.org/fmhub/fm2003/November/Glowa.pdf

Gutmanis, I., Beynon, C., Tutty, L. Wathen, C. N., & MacMillan, H. L.(2007). Factors influencing identification of and response to intimate partner violence: a survey of physicians and nurse. BioMed Central , 7(12), 1-11. Available at http://www.biomedcentral.com/1471-2458/7/12

Mayer, B. W. (2000). Female Domestic Violence Victims: Perspectives on Emergency Care. Nursing Science Quarterly, 13(4), 340-346. Available at: http://nsq.sagepub.com/cgi/content/citation/13/4/340

Miller, E., Decker, M. R., McCauley, H. L., Tancredi, D. J., Levenson, R. R., Waldman, J., Schoenwald, P., & Silverman, J. G. (2011). A family planning clinic partner violence intervention to reduce risk associated with reproductive coercion. Contraception, 83(3), 274-280. Available at http://www.contraceptionjournal.org/article/S0010-7824(10)00411-7/abstract.

Rodriguez, M. A., McLoughlin, E., Nah, G. & Campbell, J. C. (2001). Mandatory Reporting of Domestic Violence Injuries to the Police. What Do Emergency Department Patients Think? Journal of the American Medical Association, 286 (1), 580- 583. Available at: http://www.ncbi.nlm.nih.gov/pubmed/11476660

Warshaw, C. & Brashler P. (2009). Mental health treatment for survivors of domestic violence. In C. Mitchell and D. Anglin (Eds.), Intimate Partner Violence: A Health Based Perspective. New York: Oxford University Press. Available at http://www.oup.com/us/catalog/general/subject/Medicine/EmergencyMedicine/?view=usa&ci=9780195179323.

Warshaw, C., Gugenheim, A.M., Moroney, G., & Barnes, H. (2003). Fragmented Services, Unmet Needs: Building Collaboration Between The Mental Health And Domestic Violence Communities, Health Affairs, (22)5, 230-234. Available at http://content.healthaffairs.org/content/22/5/230.full.

Wrangle, J., Fisher, J. W. & Paranjape, A. (2008). He Sentido Sola? Culturally Competent Screening for Intimate Partner Violence in Latina Women. Journal of Women's Health, 17 (2), 261-267. Available at: http://online.liebertpub.com/doi/abs/10.1089/jwh.2007.0394?journalCode=jwh