Intimate Partner Violence Counseling Research Articles

A Comprehensive Review of Intimate Partner Violence During Pregnancy and Its Adverse Effects on Maternal and Fetal Health.

Intimate partner violence (IPV) is a significant public health issue that affects many women, including pregnant women. The aim of this comprehensive review is to examine the prevalence of IPV during pregnancy and its adverse effects on maternal and fetal health. IPV during pregnancy can take various forms, including physical, sexual, emotional, and financial abuse. The consequences of IPV during pregnancy can be severe, with adverse effects on maternal and fetal health including an increased risk of preterm birth, low birth weight (LBW), fetal injury, maternal depression, anxiety, post-traumatic stress disorder (PTSD), and even maternal death. Identifying women experiencing IPV during pregnancy and providing appropriate support and care can help mitigate the adverse effects on maternal and fetal health. The review also discusses various interventions and strategies that can be used to prevent IPV during pregnancy, such as screening and counseling for IPV, training healthcare providers to identify and manage IPV during pregnancy, and providing resources and support for women who experience IPV. Overall, the review highlights the need for increased awareness, research, and resources to prevent and address IPV during pregnancy and to promote the health and well-being of women and their infants.

“Looking Back, the Programs Kept Me Alive”: Women’s Impressions of Counseling for Intimate Partner Violence

The copious research on formal help-seeking of women abused by intimate partners, rarely narrows to counseling services. This mixed-methods secondary analysis examined 660 Canadian women and their use and impressions of counseling. The women’s racial backgrounds were 50.8% Indigenous, 43.1% White, and 6.1% visible minority. Women who did not seek counseling reported less serious IPV and fewer PTSD symptoms. Most rated counseling as quite a bit/very helpful (77–87%), with the exception of marital counseling (8.3%). The women commented about IPV-specific counseling, general counseling, faith-base, addictions, couples counseling, and Indigenous traditions. Comments revealed strengths and concerns, including counselors lacking IPV knowledge and difficulties accessing resources. Implications are provided for clinicians and researchers.

Intimate Partner Homicide and Recommendations for Counselors

Intimate partner homicide (IPH) is a global public health issue. Intimate partner violence (IPV) is the highest risk factor and predictor of IPH. The emotional and psychological distress from IPV often leads clients to seek counseling services. As a result, counselors interact with individuals experiencing IPV who are at risk of IPH. The counseling literature is replete with IPV counseling interventions and discussion, but scant attention has been paid to IPH in counseling journals. Increasing discussion of IPH in the counseling literature helps counselors gain insight into preventative measures and interventions, such as assessing risk, expanding resource accessibility, and developing a safety plan to better ensure client safety. This article examines IPH literature, IPH vulnerabilities and risk factors, prevention efforts, and recommendations for counselors, such as assessing IPH risk, providing referrals to community resources, and developing safety plans.

Intimate Partner Violence Before and During Pregnancy, and Prenatal Counseling Among Women with a Recent Live Birth, United States, 2009-2015.

Background: Intimate partner violence (IPV) is a leading cause of injury for reproductive-aged women. Clinical guidelines exist to assist providers in counseling women for IPV, but information on provider counseling among pregnant women from population-based sources is limited. Materials and Methods: Data for 2009-2015 from 37 states and New York City participating in the Pregnancy Risk Assessment Monitoring System (PRAMS) were analyzed (n = 258,263). We compared prevalence estimates overall and by site, of physical IPV occurring before and/or during pregnancy, and prenatal counseling on physical IPV. Multivariable logistic regression was used to identify factors associated with receiving prenatal counseling on physical IPV. Results: Overall, 3.8% of women reported experiencing any physical IPV in the 12 months before and/or during pregnancy (range: 1.5% [Connecticut] to 7.2% [Mississippi]). Prevalence of prenatal IPV counseling was 51.0% (range: 30.2% [Utah] to 63.1% [New Mexico]). Receipt of prenatal counseling on depression predicted a fourfold increase in prevalence of receiving counseling on physical IPV (adjusted prevalence ratio [aPR] = 4.20, 95% confidence interval [CI]: 4.06-4.34). In addition, non-Hispanic black race versus non-Hispanic white race, and having less than a high school education were associated with higher prevalence of receipt of IPV counseling ([aPR = 1.16, 95% CI: 1.14-1.18] and [aPR = 1.11, 95% CI: 1.08-1.13], respectively). Conclusion: Almost 4% of women with a recent live birth reported physical IPV before and/or during pregnancy. Only half of women received counseling on IPV during prenatal care, with counseling rates varying widely among states. Increased adherence to guidelines for universal screening and counseling of women could ensure all women are offered appropriate support and referral.

Predictors of Session Attendance in Intimate Partner Violence Treatment for Trauma-Exposed Veterans

Understanding factors associated with intimate partner violence (IPV) treatment attendance is of particular importance given high rates of attrition from IPV counseling programs. Individuals who drop out from IPV counseling remain at an increased risk for recidivism. Although numerous studies have examined correlates of IPV treatment completion in civilian samples, no study to date has examined IPV treatment attendance in veterans. Thus, we sought to examine demographic, military, and diagnostic correlates of IPV session attendance in Veterans seeking IPV treatment. The current study examined data from 135 veterans presenting to IPV treatment within the Veteran Affairs (VA) healthcare system. Analyses were conducted from data collected as part of a randomized controlled trial evaluating the efficacy of a 12-session trauma-informed IPV intervention with veterans, Strength at Home. Results indicated that age, courtinvolvement, treatment condition, and substance use disorder were unique predictors of IPV session attendance above and beyond other demographic, military, and diagnostic predictors. Substance use disorder emerged as the most robust predictor of session attendance. These findings suggest that similar to civilian studies, routine assessment of substance use is indicated in IPV programs delivered within the VA healthcare system and that coordinated care between substance abuse and IPV treatment is needed. Our findings also suggest the need for additional efforts to enhance treatment initiation and retention among younger veterans.

Christian Counseling for Intimate Partner Violence as A Psychological Trauma -Centering around psychology of assailant and victim-

Christian Counseling for Intimate Partner Violence as A Psychological Trauma -Centering around psychology of assailant and victim-

Screening and Counseling for Intimate Partner Violence in Pregnancy [23F

INTRODUCTION: An estimated 1.5 million experience physical or sexual violence from an intimate partner each year in the United States, however little data exists on how obstetric providers assess intimate partner violence (IPV), or on how IPV-affected women experience the discussions. METHODS: Patients who disclosed IPV on a computerized pre-visit survey or during an audio-recorded first obstetric visit were asked to return for qualitative semi-structured interviews during which they reviewed their recorded visit and provided their reflections regarding the IPV screening and counseling. Transcripts from these interviews were qualitatively coded for common themes. RESULTS: Of the 250 participants, 91 disclosed IPV either by computer survey or in-person during the recorded visit. Thirty-two women returned for semi-structured interviews. Interviews revealed women’s reasons not to disclose, positive and negative aspects about current approaches, and recommendations for providers. Reasons not to disclose included fears regarding confidentiality, stigma, and concern for involvement of child protective services. Positive attributes of current interviewing included expressions of care, direct questioning, telling patients they are not alone, and open body language. Negative attributes included asking about IPV in an insensitive manner. Recommendations for addressing IPV included being direct, nonjudgmental, and caring, and providing follow-up counseling after IPV disclosure. Women advised that post-disclosure discussions should include emotional support, strategies for emergency situations, housing resources, and self-defense resources. CONCLUSION: Understanding the experiences of pregnant IPV-affected women provides insight into specific approaches to use or avoid when addressing IPV. IPV training for obstetric care providers should include these strategies to improve IPV screening and counseling.

Assessing Intimate Partner Violence in a Control Balance Theory Framework.

The purpose of this study was to examine the role that control occupies in the motivation for, and development of, intimate partner violence (IPV). The research literature often theorizes about the importance of control in gender-based crimes; however, few studies have empirically tested these assumptions. Given the breath of theoretical approaches in examining IPV and the need for individualized explanations, the current study used concepts from Tittle's control balance theory. This integrated theory accounts for many of the known risk factors, such as self-control and routine activities, while accounting for individual perceptions of control. A college student sample (N = 401) was used, in accordance with the literature that has found this subpopulation to be at high risk for IPV. An online survey was distributed to potential participants to capture self-reported incidents of victimization and perpetration of IPV within the past year. Statistical analysis using segmented nonlinear regression models was estimated to assess sex difference effects. The results showed no difference in control continuums between the sexes but did find significant associations between control deficits and female victimization and perpetration, as well as significant association between control deficits and male perpetration of IPV. These findings have implications beyond the theoretical confirmation that control is key factor to this type of violence. In addition to greater education regarding dating expectations, control deficits may be particularly important for socially marginalized groups, such as those from the lesbian, gay, bisexual, and transgender (LGBT) community. Efforts can then be made to identify issues with control in IPV counseling, victim services, treatments for offenders, and other gender-based crimes, such as rape, sexual assault, and stalking.

Are Men With a History of Head Injury Less Responsive to Cognitive Behavioral Therapy for Intimate Partner Violence?

Head injury is highly prevalent among intimate partner violence (IPV) offenders. This study investigates responsiveness to cognitive behavioral therapy (CBT) for partnerviolent men with and without a history of head injury using archival data on 310 males seeking IPV counseling at a community domestic violence agency. Participants reported on their history of head injury, age at injury, and length of time unconscious in a structured interview at program intake. Criminal justice outcomes were assessed for the 2-year period after scheduled completion of treatment using a publicly available state database. A significantly greater percentage of men with a history of head injury (N = 84) than those without (N = 226) had criminal involvement for incidents of partner abuse during the follow-up period. In addition, men with a history of moderate-to-severe head injury (n = 25) had more criminal involvement for general violence than those with no history of head injury. The findings highlight the need to screen partner-violent men for head injury and to develop and investigate intervention enhancements for those individuals.

Who Seeks Counseling for Intimate Partner Violence? The Role of Emotional Distress

Intimate partner violence (IPV) is a pervasive problem in the United States affecting every demographic group. Victims of IPV suffer a wide range of negative health issues including depression, anxiety, and loss of self-esteem. However, little is known about help-seeking behaviors among IPV victims. This study utilized a university sample to explore who seeks counseling for exposure to threatening IPV. Results revealed that older students and females were more likely to seek counseling than younger students and males. Students who were exposed to greater levels of IPV and reported greater emotional distress were more likely to seek counseling than those with lower exposure to IPV and distress. Importantly, victimization accompanied by emotional distress was the key to explaining help-seeking help behavior. Programs and policies should focus on outreach to young students and males who have experienced IPV and provide focused services to victims with high levels of emotional distress.

Reproductive Coercion and Partner Violence Among College Women

Objective To examine reproductive coercion and partner violence among college women, a group that has not been previously examined. Design Cross‐sectional, electronic survey. Setting A large public university in the Northeast United States. Sample Inclusion criteria included the following: college women age 18 to 25, enrolled full‐ or part‐time, currently or previously sexually active, and English speaking. Data from 972 women were analyzed. Methods After Institutional Review Board approval, an e‐mail invitation was sent to female students. A web link to the informed consent and inclusion criteria was provided. Students who met study criteria could proceed to the survey. Survey questions were guided by concepts from the theory of planned behavior and included the Abuse Assessment Screen, the Reproductive Coercion Scale, and sexual history questions adapted from the Centers for Disease Control and Prevention. Completion of the survey implied consent. Results Almost 8% of participants (n = 76) reported reproductive coercion, including pregnancy coercion, birth control sabotage, or both. Women reported more pregnancy coercion (6.8%) than birth control sabotage (3.9%). Being told not to use any birth control was the most commonly reported act (6.8%, n = 62). Of women reporting reproductive coercion (n = 76), 57% also screened positive for relationship violence (95% confidence interval [CI] [2.74, 7.29]). Women who experienced reproductive coercion were also more likely to report a history of pregnancy (p < .001), history of abortion (p < .001), and unintended pregnancy (p < .001). Conclusion/Implications for Nursing Practice Pregnancy coercion and birth control sabotage occur among college women often in the context of intimate partner violence. Many women seek health care during the college years, and there are multiple opportunities for interactions between nurses and college women. In addition to screening and counseling for intimate partner violence, college health providers need to assess for reproductive coercion and tailor contraceptive counseling discussions accordingly. Nurses who provide women's health care should assess status of relationships, occurrence of violence, coercion, and ability to negotiate safer sex. These conversations should be framed within health promotion messages and discussions about safety for women during routine and episodic visits. This report was published in its entirety: Sutherland, M., Fantasia, H. C., & Fontenot, H. (2015). Reproductive coercion and partner violence among college women. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 44(2), 218–227. To examine reproductive coercion and partner violence among college women, a group that has not been previously examined. Cross‐sectional, electronic survey. A large public university in the Northeast United States. Inclusion criteria included the following: college women age 18 to 25, enrolled full‐ or part‐time, currently or previously sexually active, and English speaking. Data from 972 women were analyzed. After Institutional Review Board approval, an e‐mail invitation was sent to female students. A web link to the informed consent and inclusion criteria was provided. Students who met study criteria could proceed to the survey. Survey questions were guided by concepts from the theory of planned behavior and included the Abuse Assessment Screen, the Reproductive Coercion Scale, and sexual history questions adapted from the Centers for Disease Control and Prevention. Completion of the survey implied consent. Almost 8% of participants (n = 76) reported reproductive coercion, including pregnancy coercion, birth control sabotage, or both. Women reported more pregnancy coercion (6.8%) than birth control sabotage (3.9%). Being told not to use any birth control was the most commonly reported act (6.8%, n = 62). Of women reporting reproductive coercion (n = 76), 57% also screened positive for relationship violence (95% confidence interval [CI] [2.74, 7.29]). Women who experienced reproductive coercion were also more likely to report a history of pregnancy (p < .001), history of abortion (p < .001), and unintended pregnancy (p < .001). Pregnancy coercion and birth control sabotage occur among college women often in the context of intimate partner violence. Many women seek health care during the college years, and there are multiple opportunities for interactions between nurses and college women. In addition to screening and counseling for intimate partner violence, college health providers need to assess for reproductive coercion and tailor contraceptive counseling discussions accordingly. Nurses who provide women's health care should assess status of relationships, occurrence of violence, coercion, and ability to negotiate safer sex. These conversations should be framed within health promotion messages and discussions about safety for women during routine and episodic visits.

Integrating intimate partner violence assessment and intervention into healthcare in the United States: a systems approach.

The Institute of Medicine, United States Preventive Services Task Force (USPSTF), and national healthcare organizations recommend screening and counseling for intimate partner violence (IPV) within the US healthcare setting. The Affordable Care Act includes screening and brief counseling for IPV as part of required free preventive services for women. Thus, IPV screening and counseling must be implemented safely and effectively throughout the healthcare delivery system. Health professional education is one strategy for increasing screening and counseling in healthcare settings, but studies on improving screening and counseling for other health conditions highlight the critical role of making changes within the healthcare delivery system to drive desired improvements in clinician screening practices and health outcomes. This article outlines a systems approach to the implementation of IPV screening and counseling, with a focus on integrated health and advocacy service delivery to support identification and interventions, use of electronic health record (EHR) tools, and cross-sector partnerships. Practice and policy recommendations include (1) ensuring staff and clinician training in effective, client-centered IPV assessment that connects patients to support and services regardless of disclosure; (2) supporting enhancement of EHRs to prompt appropriate clinical care for IPV and facilitate capturing more detailed and standardized IPV data; and (3) integrating IPV care into quality and meaningful use measures. Research directions include studies across various health settings and populations, development of quality measures and patient-centered outcomes, and tests of multilevel approaches to improve the uptake and consistent implementation of evidence-informed IPV screening and counseling guidelines.

Screening and counseling for Intimate Partner Violence: a vision for the future.

We describe a vision of screening and intervention for Intimate Partner Violence informed by deliberations during the December 2013 Intimate Partner Violence Screening and Counseling Research Symposium and the resultant manuscripts featured in this special issue of the Journal of Women's Health. Our vision includes universal screening and intervention, when indicated, which occurs routinely as part of comprehensive physical and behavioral health services that are both patient centered and trauma informed. Areas for future research needed to realize this vision are discussed.

Screening and Counseling for Intimate Partner Violence in Primary Care Yield Little Benefit

The U.S Preventive Services Task Force recommends screening women of childbearing age for intimate partner violence (IPV) and referral of women who screen positive to intervention services (JW Gen Med Feb 12 2013). But little evidence supports effectiveness of IPV screening in primary care settings. Using a survey that …

Impact of Emergency Department Intimate Partner Violence Intervention

The objective of the study is to assess the impact of emergency department (ED) intimate partner violence (IPV) counseling and resource referrals on patient-perceived safety and safety planning. ED patients with risk factors were offered consultation with trained IPV advocacy counselors who completed safety assessments, provided resource referrals, and helped patients develop safety plans. Patients were contacted after ED intervention to assess progress and further assist in IPV counseling. Over 96% of patients perceived an increase in their safety after the intervention, and approximately 50% had completed a portion of their safety plan. Legal assistance and/or law enforcement were considered the most beneficial resource referrals. Although follow-up was limited, this study appears to demonstrate that an ED IPV intervention program may be useful in helping IPV victims achieve safer living environments and access local resources.

Impact of emergency department–Based intimate partner violence intervention

Study objectives: Thirty percent of women and 5% of men treated in the emergency department (ED) have been victims of intimate partner violence (IPV); therefore, it is essential that EDs screen and offer intervention for IPV victims. Several studies investigated the performance of ED-based IPV intervention in decreasing medical recidivism and increasing community resource use. At the outset of this study, the investigators were unaware of any published studies assessing the impact of an ED-based IPV program on patient safety. This investigation sought to verify the benefit of ED-based IPV counseling and resource referral on patient safety. Methods: The study hospital was an urban Level I trauma center with an annual census of 110,000 patients. Female patients 12 years and older and male patients presenting with risk factors for IPV were screened using the Partner Violence Scale. Critically ill and non–English speaking, non–Spanish speaking patients were not screened. Consenting patients screening positively who accepted consultation with an IPV counselor made up the study population. Inclusion of a control population, to which intervention was not offered, was considered unethical. IPV counselors completed a safety assessment, developed an individualized safety plan, and provided resource referrals. Patients were contacted at 48-hour and 2-, 6-, and 12-week intervals after ED intervention to reassess safety. The intervention's effect on patient safety was assessed by patient-perceived change in safety and fraction of safety plan completed. Simple percentages were calculated to convey the amount of the safety plan completed and the number of patients with a patient-perceived increase in safety. Student's t test and Spearman coefficients were used for grouped and linear variables, respectively, to examine the relationship between recorded demographic and action variables and change in patient safety. Results: Two hundred seventy-eight patients with a mean age of 32 years and a mean annual income of $6,700 underwent initial IPV intervention during the first 16 months of the program. The group described themselves as predominantly black (64%) and white (26%). The mean length of victim-perpetrator relationship was 4 years, with the predominance (65%) described as heterosexual, unmarried partnerships. Seventy-four (27%) patients have been contacted in follow-up. The majority of failed follow-ups (65%) were due to inability to contact the victim after 3 attempts using the provided information; 22 had disconnected telephone numbers, whereas 4 refused to participate in follow-up after consenting initially. Sixty-eight (92%) of the 74 victims contacted after ED-based IPV intervention stated they felt safer. These 74 victims had implemented a mean of 68% of their safety plan tenets. Law enforcement and legal referrals were reported to be the most helpful in improving safety. Correlation between patient-perceived safety and demographic variables was unable to be examined because only 6 victims did not believe their safety improved after IPV intervention. No statistically significant correlation existed between the victim's age, race, income, or length of relationship with the perpetrator and safety plan implementation. In addition, no relationship could be demonstrated between previous attempts at safety (such as leaving the relationship and filing of a police report) and successful implementation of safety plan. Conclusion: This study was limited by insufficient follow-up, although the rate was consistent with that of previous studies involving similar populations. Such a limitation likely stems from the known difficulty of telephone follow-up in an urban ED patient population and is amplified by the focus of this study on a subsegment of that population with inherently unstable living environments. Assuming previously established recidivism of IPV is present in the study population, the data confirm that ED-based IPV intervention improves patient-perceived safety. In addition, ED-based intervention led to implementation of 68% of safety plans. Success of IPV intervention was equitable between victims of varied ages, races, and incomes. Previous attempts to increase safety did not indicate successful implementation of safety plan.