Some IPV programs offer legal advocacy, and in some cases, actual legal representation. Legal advocates can educate survivors about their legal rights and Translation services Professional interpreters or translators who are trained in maintaining patient confidentiality should be used whenever possible if a language barrier is evident in a clinical encounter involving IPV. Otherwise, there is a risk of compromising the quality of the information being translated and can put the survivor in danger or lead to a missed opportunity for intervention. Providers should never use accompanying persons (i.e., friends, relatives, children) as interpreters. The person chosen could actually be the perpetrator or they could inadvertently breach confidentiality by speaking about the conversation with others.
options, including applying for orders of protection, or representation in divorce and custody hearings.
Additionally, if the translator is a member of the survivor’s community, shame or stigma may prevent the survivor from disclosing the abuse. Remote telephone interpretation services are an appropriate alternative when an in-person interpreter is from the survivor’s small community or is not available. Regardless of language, providers need to avoid assuming literacy. Just because a patient can speak a language does not mean they can read or write it, and vice versa.
INTERVENTION STRATEGIES
The USPSTF, in a systematic review of the literature, found “adequate” evidence that effective IPV interventions that provide or refer patients to ongoing support services can reduce violence, abuse, and physical or mental harms for women of reproductive age. 1 Evidence from randomized trials support various interventions including counseling, home visits, information cards, referrals to community services, and mentoring support. Depending on the type of intervention, these services may be provided Patient safety Patient assessment, documentation, safety planning, communication, intervention, and follow-up must be conducted with utmost concern for the immediate and long-term safety of the survivor and their Survivor empowerment Abused individuals have often been denied their freedom to make informed, independent choices about their (and their children’s) lives. Facilitating the patient’s ability to make their own choices is key
by clinicians, nurses, social workers, non-clinician mentors, or community workers. Counseling generally includes information on safety behaviors and community resources. In addition to counseling, home visits may include emotional support, education on problem-solving strategies, and parenting support. 1 Health care providers should bear in mind four guiding principles of intervention when addressing IPV with their patients: 33
dependent children. The clinician should ask, “Is what I am asking/doing/recommending going to help my patient become safer, or at least not place the patient at risk for further harm?”
to restoring a sense of purpose and well-being for survivors of IPV, and can facilitate a patient’s readiness to take proactive steps to end the violence.
Perpetrator accountability It is important to frame violence as occurring because of the perpetrator’s behavior and actions, not the survivor’s. It thus follows that the problem of violence in the relationship, and thus the need to take definitive steps to end the violence, is the perpetrator’s responsibility. This guiding principle assumes the importance of survivor safety, but rejects victim-blaming and other excuses offered by the offender as "explanations" for the violence. Advocacy for social change
Clinicians acting alone cannot meet all the needs of survivors of IPV. As healthcare professionals and systems grapple with the complex issues involved in understanding and responding to IPV, the need to collaborate with others in healthcare, as well as those in law enforcement, the faith community, and society at large, becomes apparent. Establishing linkages with
dedicated violence prevention community agencies and sexual victims crime units in advance can provide a more seamless inclusion of these resources into clinical care when needed. Clinicians can be important catalysts for change so that IPV can be more effectively identified, and ultimately prevented.
SPECIFIC INTERVENTIONS
Clinicians need to establish realistic and achievable goals with their abused patients. One goal may be to aid the patient in leaving the relationship. That may not be what the patient wants or thinks is appropriate at that time. There are many goals from self-disclosure, education, and empowerment to
departure that often need to occur first. The survivor knows their situation better than anyone else and needs to incorporate information about risks and danger into decisions regarding leaving and safety. Leaving an abuser is usually a process that takes time—often years. Clinicians can help their patients
Book Code: CT24CME
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