Evaluating the Relationship Between Intimate Partner Violence-Related Training and Mental Health Professionals' Assessment of Relationship Problems.

Samantha C Burns,Geoffrey M Reed,Chihiro Matsumoto,Amy M Smith Slep,Heather M Foran,Tecelli Domínguez-Martínez,Cary S Kogan,Jean Grenier,Richard E Heyman

doi:10.1177/08862605211005154

Abstract

Intimate partner violence (IPV) is a serious public health problem associated with increased risk of developing mental health conditions. Assessment of IPV in mental health settings is important for appropriate treatment planning and referral; however, lack of training in how to identify and respond to IPV presents a significant barrier to assessment. To address this issue, the World Health Organization (WHO) advanced a series of evidence-based recommendations for IPV-related training programs. This study examines the relationship between mental health professionals’ experiences of IPV-related training, including the degree to which their training resembles WHO training recommendations, and their accuracy in correctly identifying relationship problems. Participants were psychologists and psychiatrists (N = 321) from 24 countries who agreed to participate in an online survey in French, Japanese, or Spanish. They responded to questions regarding their IPV-related training (i.e., components and hours of training) and rated the presence or absence of clinically significant relationship problems and maltreatment (RPM) and mental disorders across four case vignettes. Participants who received IPV-related training, and whose training was more recent and more closely resembled WHO training recommendations, were more likely than those without training to accurately identify RPM when it was present. Clinicians regardless of IPV-related training were equally likely to misclassify normative couple issues as clinically significant RPM. Findings suggest that IPV-related training assists clinicians in making more accurate assessments of patients presenting with clinically significant relationship problems, including IPV. These data inform recommendations for IPV-related training programs and suggest that training should be repeated, multicomponent, and include experiential training exercises, and guidelines for distinguishing normative relationship problems from clinically significant RPM.

Highlights

Intimate partner violence (IPV) is defined as any behavior within a relationship that causes—or has reasonable potential to cause—physical, sexual, or psychological harm to a partner (Foran et al, 2015; World Health Organization (WHO), 2012)
We hypothesized that IPV-trained clinicians with training more closely resembling WHO recommendations (WHO, 2013) would be more likely than those without training to accurately distinguish among different forms of clinically significant relationship problems and maltreatment (RPM) and normative relationship problems
The main findings of this study described the relationship between IPVrelated training and mental health clinicians’ performance when assessing for RPM across two study conditions: when RPM was present, and when RPM was absent

Summary

Introduction

Intimate partner violence (IPV) is defined as any behavior within a relationship that causes—or has reasonable potential to cause—physical, sexual, or psychological harm to a partner (Foran et al, 2015; WHO, 2012). Systematic reviews suggest that women living with serious mental illness (i.e., who have a recurrent or persistent mental disorder that significantly impacts their functioning) are more than twice as likely to have experienced violence of any kind, including IPV, compared to the general population (Khalifeh & Dean, 2010; Mauritz et al, 2013). WHO guidelines recommend that health professionals screen for IPV when assessing or treating individuals with mental health symptoms (WHO, 2013). Identification of IPV by global mental health professionals (i.e., clinicians who are involved in the assessment and treatment of individuals living with mental health symptoms) may lead to more accurate IPV prevalence data (Ellsberg & Heise, 2005), and help enhance our understanding of IPV risk factors and mental health consequences (Foran et al, 2015). Advocacy-based interventions have been shown to improve survivors’ quality of life and perceived social support (Sullivan & Bybee, 1999), whereas psychological treatments (e.g., cognitive behavioral therapy) have contributed to improved coping and social adjustment (Johnson & Zlotnick, 2006; McNamara et al, 2008) and decreased ratings of PTSD symptom severity (Johnson et al, 2011)

Results

Discussion

Conclusion