Multidisciplinary primary care outreach for women experiencing domestic and family violence and/or homelessness: a rapid evidence review.

Purpose To investigate massage therapists’ attitudes, consultation processes, and confidence to respond to situations involving domestic and family violence (DFV) in clinical practice. Methods An online survey-based study was conducted and Australian massage therapists, 18 years of age or over were recruited. The survey included 64 questions in 3 sections: 1) Demographics, 2) Recognize Family and Domestic Violence, and 3) Respond to domestic and family violence with 4 subsections; i) disclosures, ii) referrals, iii) further education, and iv) final comments. Results Two-hundred and seventeen respondents were included in the analysis. Knowledge about DFV, having a client disclose DFV and confidence to manage a disclosure, were all significantly higher with massage therapists with a personal experience of DFV. The main qualitative theme was antithetical attitudes with two subthemes: a) not in my world: I’d be enormously surprised that a person in an abusive environment would come in for a massage, b) in my world: I want to be prepared. Conclusion Having personal experience of DFV significantly impacted the way that respondents felt about and managed DFV in their clinic. Several massage therapists’ who had no personal experience of DFV demonstrated a lack of knowledge about DFV and less confidence to respond to it in their clinic. It is important to upskill and educate massage therapists, particularly those with no personal experience, to improve their confidence to have discussions around DFV and to respond to DFV disclosures.

Domestic and family violence (DFV) is recognised as a health care priority. Women experiencing DFV use health services at a higher rate than the general population. Hospital social workers are an important component of a public hospital response to domestic and family violence but how prepared are they for this role? This research study explored the readiness of social workers in a Melbourne metropolitan hospital setting to respond to DFV. Results indicated that although the social workers had a knowledge base highly relevant for responding to DFV, many lacked specific knowledge of risk assessment, safety planning, legislative responsibilities, and referral pathways for support, including legal support. As a result, it was likely that they were not adequately responding, either by not recognising when they needed to, or with knowledge and confidence when they did. They also identified a range of organisational enablers, including policy, time, and safe conversation spaces. IMPLICATIONS Hospital social workers have a central role to play in responding to domestic and family violence. Hospital social workers need to be better prepared for domestic and family violence responses. Social workers require ongoing training and organisational support including practice protocols and guidelines, and the provision of time and private, safe spaces for sensitive conversations to occur. Universities should ensure that the role of hospital social workers is considered within curriculum addressing the area of domestic and family violence (DFV).

Domestic and family violence (DFV) against women is an important public health problem, placing significant health and economic burdens on individuals and families worldwide. The prevalence rates of DFV and its mental health sequelae are significantly higher in developing countries compared to developed countries, as women in these settings often lack resources to address DFV-related issues and improve their safety. Pregnancy is considered as a ‘window of opportunity’ to intervene against DFV. Psychosocial interventions that include the components to empower and provide psychosocial support to pregnant women exposed to DFV have potential to enhance their mental health and coping against DFV. This study aimed to develop and test a simple and brief psychosocial intervention targeting the mental health, self-efficacy, social support, and help-seeking behaviours of pregnant women experiencing DFV in Nepal. An assessor-blinded 1:1 parallel randomised controlled trial (RCT), with a nested descriptive qualitative study, was conducted to evaluate the effectiveness of the psychosocial intervention. A total of 140 eligible pregnant women were randomly assigned into two groups. Women allocated to the intervention group (IG) received a counselling session, an information booklet, and contact details of the counsellor. Women in the control group (CG) received a booklet, including a referral list of locally available DFV support organisations. Participants from both groups were interviewed three times using standard and valid questionnaires: the Hospital Anxiety and Depression Scale (HADS) for assessing anxiety and depression, the World Health Organization Quality of Life – Abbreviated Version (WHOQOL-BREF) for quality of life (QOL), the Medical Outcomes Study–Social Support Survey (MOS-SSS) short form for perceived social support, the Generalised Self-Efficacy Scale (GSES) for self-efficacy, and the modified safety behaviours checklist for the use of safety behaviours. Sociodemographic, obstetric, and newborns’ characteristics were also collected. Follow-up interviews were conducted at four to six weeks post-intervention (T1) and at six weeks after birth (T2). Generalised Estimating Equation (GEE) models with an intention-to-treat approach were used to assess changes in the outcome measures between the two groups over time. Data were analysed using the Statistical Package for Social Sciences (SPSS, version 25), and statistical significance was set at p < .050. During the follow-up interviews, intervention participants were asked about the strengths and weakness of the intervention, as well as recommendations on how the intervention could be improved for future use. In addition, seven purposively selected healthcare providers (HCPs) were interviewed to explore their perceptions regarding the intervention. Inductive thematic analysis was conducted to analyse the qualitative data. Out of 625 women screened, the lifetime prevalence of DFV was found to be 27.7% (n = 173). DFV in the last 12 months was significantly associated with mental health, QOL, social support, self-efficacy, and use of safety behaviours (p .050). Nearly 22.0% of women were lost-to-follow-up (LTFU) at T2, but baseline characteristics did not differ significantly between the participants who completed the study and those who were LTFU. Participants allocated to the IG showed significant improvements in anxiety (β = -3.24, p < .001) and depression (β = -3.16, p < .001) at T1. Such improvements were also sustained at T2 (p < .001). Similarly, significant improvements were seen in QOL at both T1 (β = 2.98, p < .001) and T2 (β = 2.45, p < .001) in the IG. There were greater increases in perceived social support and help-seeking behaviours in the IG compared with the CG at both T1 and T2 (p < .001). Thematic analysis of qualitative interviews identified ten themes which were grouped into three broad domains: i) DFV and its response mechanisms, ii) reflection on the program and its contents, and iii) recommendations for improving the intervention for future use. Participants were positive about the intervention and indicated that it improved their confidence and skills in managing stress. HCPs also supported the intervention; however, they suggested that for its successful and continual delivery in the future, additional infrastructure needs to be arranged in the hospital. Participants expressed that this intervention offered only a partial solution to the problem by addressing individual-level outcomes. This is the first known trial to test the effectiveness of a psychosocial intervention addressing mental health and safety needs of DFV victims in an antenatal setting in Nepal. The intervention was feasible to be implemented in an antenatal setting and showed promising effects on the mental wellbeing, perceived social support, self-efficacy, and help-seeking behaviours of DFV victims. Several avenues for further research are suggested, including expanding on the intervention to include family members, integrating the program into regular antenatal care, and conducting larger controlled trials with longer follow-up. Additionally, the findings underscore the pre-eminence of screening and managing negative emotional symptoms, such as depression and anxiety, among women experiencing DFV.

Police attitudes, knowledge, and beliefs about domestic and family violence (DFV) are crucial for promoting a sense of safety and security for victim-survivors seeking criminal justice support and protection. Using survey data collected from a statewide sample of police officers (N = 243) in one jurisdiction in Australia, this study investigates the influence of police attitudes toward DFV on their decision-making in relation to providing support services, taking proactive actions, and seeking domestic violence protection order (DVO) applications in response to DFV. This study further examines whether the receipt of DFV training as well as confidence in handling aspects of DFV moderate police response to DFV situations. Based on multivariate logistic regression adjusted models, police officers who had proactive attitudes (e.g. pro-arrest attitudes) were more willing to provide support services and take other actions, whereas those who possessed reactive attitudes (e.g. minimum police involvement attitudes) were less likely to seek DVO applications and take other actions. Moreover, both training and confidence in handling aspects of DFV cases had a moderating effect such that the likelihoods of making DVO applications, taking other actions, and providing support services are substantially and significantly higher among officers who have received DFV training and have confidence in handling cases. Police attitudes about DFV appear instrumental in shaping responses to victims and survivors of DFV. These findings reinforce the importance of increasing access to officers’ training for DFV as well as finding opportunities to strengthen officers’ confidence in responding to DFV.

Previous research exploring pathways into domestic and family violence (DFV) has primarily examined associations between early victimisation and future offending. Less is known about the relationship between adolescent DFV offending and adult DFV offending. This study examined the offending pathways of 8,465 young offenders aged 13–17, who were followed until age 23. Only seven percent of young people in the sample had been proceeded against for a DFV offence before the age of 18. However, relative to other offenders who had been proceeded against for other forms of violent or non-violent offending, adolescent DFV offenders were much more likely to become adult DFV offenders, and reoffended more frequently. These findings further highlight the need for interventions focusing on DFV offending among adolescents, and provide key evidence for identifying ideal points of intervention to prevent DFV in the community.

The role of alcohol and drugs (AOD) in domestic and family violence is increasingly difficult to ignore, yet challenging to reconcile with dominant feminist analyses of the problem. The landmark 2015–16 Victorian Royal Commission into Family Violence recommended service integration between the AOD and domestic and family violence (DFV) sectors, but this may be difficult to achieve due to differences in history, language use and treatment philosophy between the two sectors. A central point of contention about the role of AOD in DFV can be represented by the question: “are alcohol and other drugs a cause of DFV?” Unpacking this question is essential to understanding contested problem framing in this area, and requires attention to differences in language use and research traditions; varying acceptance of gender inequity as a central causal factor; cultural attitudes about alcohol and disinhibition; and notions of accountability across the different sectors. I argue that substance abuse affects DFV in gendered ways, and that more attention should be paid to how AOD and gender intersect to affect the perpetration and experience of DFV. This article will be useful to practitioners seeking to understand the sensitivities surrounding discussion of AOD in relation to DFV, and will assist them in navigating these sensitivities to improve service coordination and thus deliver better outcomes for those affected by DFV.

Domestic and family violence (DFV) is a pervasive social problem that social workers often encounter in practice. Responses to DFV require specialist and non-specialist services. Research suggests that first contact social workers can experience a lack of confidence, both in engaging with men who use violence and working with women and children who disclose experiencing violence. This article reports on the findings of an Australian survey (N = 100) that sought to identify the knowledge and practice skills that social workers draw on when they are the first responders to DFV. The survey invited qualified social worker participants from all sectors across Australia through the national online bulletins of the Australian Association of Social Workers (AASW) and Child Family Community Australia (CFCA). Whilst 28% of the respondents demonstrated working in specialist DFV and child protection sectors, 72% worked in other sectors. The research found that most participants recognised signs of DFV, but responses were mainly focused on referring women victims to practical or accommodation support, and children to psychological support. Responding to perpetrators was rarely mentioned. Equipping non-specialist DFV practitioners with knowledge and skills to respond safely can create an opportunity for engagement, earlier intervention, and increased interagency collaboration with specialist services. IMPLICATIONS Social workers need to be able to recognise domestic and family violence and know how to respond when it presents itself in their work contexts. Continuing professional development in domestic and family violence is required in social work so practitioners can maintain, improve, and broaden their knowledge and skills as first responders.

Wanton violence is being inflicted on women and children in Australia, and First Nations women are more likely to experience Domestic and Family Violence (DFV) than non-First Nations women. The Queensland Government’s Domestic and Family Violence Prevention Strategy 2016–2026 states that recognising DFV is foundational to ending violence against women and children. Part of this strategy involves the universal implementation of The Domestic and Family Violence Common Risk and Safety Framework (CRASF) risk assessment and safety planning tools. However, because of assessor confusion, this tool may not be suitable for homelessness organisations despite these services being likely to encounter many victim-survivors. A scoping review assessed which risk assessment tool would suit Queensland homelessness service providers with First Nations clients. The findings revealed a lack of research on DFV risk assessment tools for homelessness service providers with First Nations clients. Investigation into DFV risk assessment methods for homelessness service providers recommended by Australian States and Territories revealed an array of methods and no First Nations-specific DFV screening questions. Recommendations are made for a DFV risk assessment procedure suitable for homelessness services. IMPLICATIONS Social workers employed by homelessness services may need to assess if their clients are victim-survivors of domestic and family violence (DFV). Tools recommended by Australian State and Territory Governments need to be adapted for use by homelessness services. Use of The Northern Territory Domestic and Family Violence Risk Assessment and Management Framework is recommended for Queensland social workers working with First Nations victim-survivors.

Separation is recognized as elevating the risk of serious harm or death for a woman leaving domestic and family violence (DFV). When a couple separate, the party who has the majority care of the couple's children is generally required to seek child support from the other parent. Child support can play an important role in helping mothers escaping violence with their children to manage the financial demands of parenting post separation. However, a mother's claim for child support may also exacerbate other forms of DFV. It is possible for the mother to seek an exemption from receiving child support where there is a history of DFV. While exemption from pursuing child support for women leaving DFV may be helpful to them, there has been little investigation of this issue. This article draws on a qualitative study involving interviews with 65 women who have separated after DFV to explore their experience of engaging with legal systems in response to DFV. Of this group 25 women discussed the child support system and eight discussed the exemption from pursuing child support payments. Our paper discusses alternative approaches to child support and, in particular, alternative approaches to the exemption that might improve the safety of those who have experienced DFV.

Domestic and family violence (DFV) is a significant social problem that is found in all societies, cultures, and socio-economic backgrounds. Australian-Muslims are under-researched on DFV issues. This chapter explores the correlates associated with DFV using focus group data with various community-leaders living in South-East Queensland. Findings illustrate some unique characteristics of DFV relevant to Australian-Muslims that distinguish them from mainstream Australians such as misusing religious text and scriptures, contribution of culture, burden of men's financial responsibility vs women's work-choices, clash of cultures when living in Australia, loss of extended family support and social support networks, in-law contribution to abuse, and foreign spouses lack of awareness of the law. Findings are important for the design of effective strategies that challenge core assumptions towards DFV which promote and justify DFV. It highlights the importance of working within the cultural and religious framework in preventing DFV for cultural groups.

BackgroundIn 2020, Australia, like most countries, introduced restrictions related to the global pandemic of coronavirus disease 2019 (COVID-19). Frontline services in the domestic and family violence (DFV) sector had to adapt and innovate to continue supporting clients who were experiencing and/or at risk of DFV. There is a need to understand from the perspective of those on the frontline how DFV service responses in different contexts impacted their working conditions and subsequent wellbeing, and what they want to see continued in ‘the new normal’ to inform future effective practices. We address this by reporting on findings from in-depth interviews conducted with practitioners and managers from the DFV sector in Australia.MethodsBetween July and September 2020 semi-structured interviews were conducted with 51 DFV practitioners and managers from a range of services and specialisations across legal, housing, health and social care services. The data was analysed using iterative thematic analysis.ResultsThe most common service adaptations reported were shifting to outreach models of care, introducing infection control procedures and adopting telehealth/digital service delivery. Adjacent to these changes, participants described how these adaptations created implementation challenges including increased workload, maintaining quality and safety, and rising costs. Impacts on practitioners were largely attributed to the shift towards remote working with a collision in their work and home life and increased risk of vicarious trauma. Despite these challenges, most expressed a sense of achievement in how their service was responding to COVID-19, with several adaptations that practitioners and managers wanted to see continued in ‘the new normal’, including flexible working and wellbeing initiatives.ConclusionsThe pandemic has amplified existing challenges for those experiencing DFV as well as those working on the frontline of DFV. Our findings point to the diversity in workforce experiences and has elucidated valuable lessons to shape future service delivery. Given the continuing impacts of the pandemic on DFV, this study provides timely insight and impetus to strengthen the implementation of remote working and telehealth/digital support across the DFV sector and to inform better supports for DFV workforce wellbeing in Australia and other contexts.Trial registrationNot a clinical intervention.

Domestic and family violence (DFV) is a global issue with significant impacts on victim-survivors. The emergency department (ED) serves as the initial point of contact for victim-survivors. Given the significant role that clinical notes play in the management of patients and the communication between healthcare professionals, understanding how healthcare practitioners describe and document abuse reported in emergency settings is crucial. Yet, there remains a gap in understanding how health professional document DFV in the medical records of women presenting to the ED. Therefore, this qualitative descriptive study explored how DFV is documented in patient records of women presenting to the ED. Clinical notes from healthcare workers, including medical practitioners, nurses, social workers, mental health clinicians and ambulance officers, were qualitatively analyzed. Overall, the study included 43 presentations from 32 women (aged 18–56 years old) who visited a regional ED, during which instances of DFV were noted. An inductive content analysis resulted in the identification of four categories, including (a) DFV articulated in direct speech, (b) Unambiguous DFV, (c) Unconfirmed DFV, and (d) Problematic relationship. Although most references to DFV in the clinical notes included direct quotations from the patient’s descriptions of abuse or were documented unambiguously by healthcare professionals, a notable number of clinical notes exhibited a degree of caution or reluctance to acknowledge DFV dynamics when describing these events. These findings support the need for sustained and consistent professional training among healthcare professionals concerning the identification, documentation, and response to disclosures, suspicions, and allegations of DFV to better support victim-survivors presenting to the ED and other hospital settings.

Domestic and family violence (DFV) is a significant social problem that is found in all societies, cultures, and socio-economic backgrounds. Australian-Muslims are under-researched on DFV issues. This chapter explores the correlates associated with DFV using focus group data with various community-leaders living in South-East Queensland. Findings illustrate some unique characteristics of DFV relevant to Australian-Muslims that distinguish them from mainstream Australians such as misusing religious text and scriptures, contribution of culture, burden of men's financial responsibility vs women's work-choices, clash of cultures when living in Australia, loss of extended family support and social support networks, in-law contribution to abuse, and foreign spouses lack of awareness of the law. Findings are important for the design of effective strategies that challenge core assumptions towards DFV which promote and justify DFV. It highlights the importance of working within the cultural and religious framework in preventing DFV for cultural groups.

Over the last five years, body-worn cameras (BWCs) have been embraced by Australian police agencies as a mechanism to improve responses to domestic and family violence (DFV). Yet, little is known about their use and potential merits in DFV specific applications. Addressing this deficit, we present findings from the first national study exploring BWC use in DFV incidents in Australia. Drawing on 452 survey responses from the Queensland Police Service (QPS) and Western Australian Police Force (WAPOL), this chapter firstly offers insights into the frequency and contexts of BWC use in DFV responses and generalist policing operations. We then examine how demographics and employment history shape officer’s views about the potential for BWCs to transform public perceptions of police levels of transparency and accountability in DFV responses, and public confidence in procedural fairness in police decision-making. Ultimately, we find a high frequency of BWC deployment in DFV incidents in both specialist and generalist policing responses, and that specialist DFV officers were more optimistic about the potential benefits of BWCs than non-specialists. We contend that ongoing investigation of BWCs is essential to review and realise the future impacts of this technology in the aid of justice for victim/survivors of DFV.

IntroductionGiven the relative recency of Domestic and Family Violence (DFV) management as a field of endeavour, it is not surprising that interventions for addressing DFV is still in its infancy in developing countries. In order to maximise the success of an intervention, it is important to know which aspects of the intervention are considered important and helpful by service providers and service users. This study, therefore, examined the acceptability of an antenatal-based psychosocial intervention targeting DFV in Nepal and explored suggestions for improving the program in future.Materials and methodsIntervention participants and health care providers (HCPs) were interviewed using semi-structured interviews. Data were audio-recorded and thematic analysis was used to analyse the data. Final codes and themes were identified using an iterative review process among the research team.ResultsThemes emerging from the data were grouped into domains including perceptions towards DFV, impact of the intervention on women’s lives and recommendations for improving the program. DFV was recognised as a significant problem requiring urgent attention for its prevention and control. Intervention participants expressed that they felt safe to share their feelings during the counselling session and got opportunity to learn new skills to cope with DFV. The majority of the participants recommended multiple counselling sessions and a continued provision of the service ensuring the intervention’s accessibility by a large number of women.DiscussionThis is the first study to document the perspectives of women and HCPs regarding an antenatal-based intervention targeting psychosocial consequences of DFV in Nepal. There was a clear consensus around the need to engage, support and empower victims of DFV and the intervention was well received by the participants. Ensuring good mental health and wellbeing among victims of DFV requires work across individual, organisational and community levels.