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Domestic and interpersonal violence screening and counseling

Interpersonal violence is a pattern of behavior used to establish power and control over another person through fear and intimidation.

The term “intimate partner violence” refers to physical violence, sexual violence, psychological aggression (including coercive tactics, such as limiting access to financial resources), or stalking by a romantic or sexual partner, including spouses, boyfriends, girlfriends, dates, and casual “hookups.” Severe physical violence includes being hit with a fist or something hard, kicked, hurt by pulling hair, slammed against something, hurt by choking or suffocating, beaten, burned on purpose, or threatened with a knife or gun.

The term “elder abuse” refers to acts whereby a trusted person (e.g., a caregiver) causes or creates risk of harm to an older adult. According to the Centers for Disease Control and Protection (CDC), an older adult is considered to be 60 years or older. The legal definition of “vulnerable adult” varies by state but is generally defined as a person who is or may be mistreated and who, because of age, disability, or both, is unable to protect him or herself. Types of abuse that apply to older or vulnerable adults include physical abuse, sexual abuse, emotional or psychological abuse, neglect, abandonment, and financial or material exploitation.

If you or someone you love is experiencing abuse, call the National Domestic Violence Hotline at 1-800-799-SAFE (7233) or TTY, 1-800-787-3224.

If you or someone you love is in immediate danger, call 911.

Who is at risk

Although women are more likely to be targeted, anyone can be a victim of interpersonal violence including those in the GLBTQ communities, men, disabled persons, seniors, and elders.

Warning signs of abuse

Are you with someone who…

  • Puts you down?
  • Scares you or loses his/her temper quickly?
  • Hits, pushes, chokes, restrains or physically harms you (or your children or pets) in any way?
  • Pressures you for sex or forces you to have sex?
  • Threatens to disclose personal/sensitive information (LGBTQ status, immigration status)?
  • Is jealous and possessive, checks up on you, or won’t accept breaking up?
  • Prevents you or makes it difficult for you to see family and friends?
  • Takes your money or won’t let you have access to money?

What you can do

  • Get help.
  • Get a restraining order.

Leaving an Abusive Relationship

Preventive service at no cost

Women of reproductive age

The USPSTF recommends that clinicians screen for intimate partner violence (IPV) in women of reproductive age and provide or refer women who screen positive to ongoing support services.


Why screening is important

Intimate partner violence and abuse of older or vulnerable adults are common in the United States but often remain undetected.

In addition to the immediate effects, such as injury and death, there are other health consequences, including depression, posttraumatic stress disorder (PTSD), anxiety disorders, substance abuse, and suicidal behavior, sexually transmitted infections, unintended pregnancy, and chronic pain, and other disabilities. Violence during pregnancy may result in preterm birth and low birth weight, postpartum mental health problems, and hospitalization during infancy.

Long-term negative health effects from elder abuse include death, higher risk of nursing home placement, and distress, anxiety, and depression.

What the screening is

Your doctor will ask you questions to assess emotional and physical IPV in the past year. You should be separated from your partner during screening, during the intervention, or both, so screening and the intervention can be delivered in private.

Intervention services include, but are not limited to, counseling, education, harm reduction strategies, and referral to appropriate supportive services.

State and local reporting requirements vary from one jurisdiction to another, with differences in definitions, whom and what should be reported, who should report, and to whom. Some states require clinicians (including primary care providers) to report abuse to legal authorities, and most require reporting of injuries resulting from guns, knives, or other weapons. For elder abuse, mandatory reporting laws and regulations also vary by state; however, most states require reporting.

Treatment

Treatment may include counseling for the mental and emotional aspects of abuse as well as medical care for physical aspects of abuse.

Additional Resources