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This article reviews the background, introduction, and critical response to new criminal offenses of coercive control in England/Wales and Scotland. How the new Scottish offense is implemented will determine whether it can overcome the shortcomings of the English law. We then review new evidence on four dimensions of coercive control: the relationship between "control" and "violence," coercive control in same-sex couples, measuring coercive control, and children's experience of coercive control. Coercive control is not a type of violence. Indeed, level of control predicts a range of negative outcomes heretofore associated with physical abuse, including post-separation violence and sexual assault; important differences in coercive control dynamics distinguish male homosexual from lesbian couples; measuring coercive control requires innovative ways of aggregating and categorizing data; and how children experience coercive control is a problem area that offers enormous promise for the years ahead. [ABSTRACT FROM AUTHOR]

We describe the development of an evidence-based training intervention on domestic violence and child safeguarding for general practice teams. We aimed - in the context of a pilot study - to improve knowledge, skills, attitudes and self-efficacy of general practice clinicians caring for families affected by domestic violence. Our evidence sources included: a systematic review of training interventions aiming to improve professional responses to children affected by domestic violence; content mapping of relevant current training in England; qualitative assessment of general practice professionals' responses to domestic violence in families; and a two-stage consensus process with a multi-professional stakeholder group. Data were collected between January and December 2013. This paper reports key research findings and their implications for practice and policy; describes how the research findings informed the training development and outlines the principal features of the training intervention. We found lack of cohesion and co-ordination in the approach to domestic violence and child safeguarding. General practice clinicians have insufficient understanding of multi-agency work, a limited competence in gauging thresholds for child protection referral to children's services and little understanding of outcomes for children. While prioritising children's safety, they are more inclined to engage directly with abusive parents than with affected children. Our research reveals uncertainty and confusion surrounding the recording of domestic violence cases in families' medical records. These findings informed the design of the RESPONDS training, which was developed in 2014 to encourage general practice clinicians to overcome barriers and engage more extensively with adults experiencing abuse, as well as responding directly to the needs of children. We conclude that general practice clinicians need more support in managing the complexity of this area of practice. We need to integrate and further evaluate responses to the needs of children exposed to domestic violence into general practice-based domestic violence training. [ABSTRACT FROM AUTHOR]

Background: Domestic violence and abuse (DVA) and child safeguarding are interlinked problems, impacting on all family members. Documenting in electronic patient records (EPRs) is an important part of managing these families. Current evidence and guidance, however, treats DVA and child safeguarding separately. This does not reflect the complexity clinicians face when documenting both issues in one family.Aim: To explore how and why general practice clinicians document DVA in families with children.Design and Setting: A qualitative interview study using vignettes with GPs and practice nurses (PNs) in England.Method: Semi-structured telephone interviews with 54 clinicians (42 GPs and 12 PNs) were conducted across six sites in England. Data were analysed thematically using a coding frame incorporating concepts from the literature and emerging themes.Results: Most clinicians recognised DVA and its impact on child safeguarding, but struggled to work out the best way to document it. They described tensions among the different roles of the EPR: a legal document; providing continuity of care; information sharing to improve safety; and a patient-owned record. This led to strategies to hide information, so that it was only available to other clinicians.Conclusion: Managing DVA in families with children is complex and challenging for general practice clinicians. National integrated guidance is urgently needed regarding how clinicians should manage the competing roles of the EPR, while maintaining safety of the whole family, especially in the context of online EPRs and patient access. [ABSTRACT FROM AUTHOR]

Exposure of children to domestic violence and abuse (DVA) is a form of child maltreatment with short- and long-term behavioural and mental health impact. Health care professionals are generally uncertain about how to respond to domestic violence and are particularly unclear about best practice with regards to children's exposure and their role in a multiagency response. In this systematic review, we report educational and structural or whole-system interventions that aim to improve professionals' understanding of, and response to, DVA survivors and their children. We searched 22 bibliographic databases and contacted topic experts for studies reporting quantitative outcomes for any type of intervention aiming to improve professional responses to disclosure of DVA with child involvement. We included interventions for physicians, nurses, social workers and teachers. Twenty-one studies met the inclusion criteria: three randomised controlled trials (RCTs), 18 pre-post intervention surveys. There were 18 training and three system-level interventions. Training interventions generally had positive effects on participants' knowledge, attitudes towards DVA and clinical competence. The results from the RCTs were consistent with the before-after surveys. Results from system-level interventions aimed to change organisational practice and inter-organisational collaboration demonstrates the benefit of coordinating system change in child welfare agencies with primary health care and other organisations. Implications for policy and research are discussed. © 2015 The Authors. Child Abuse Review published by John Wiley & Sons Ltd. Key Practitioner Messages We reviewed published evidence on interventions aimed at improving professionals' practice with domestic violence survivors and their children., Training programmes were found to improve participants' knowledge, attitudes and clinical competence up to a year after delivery., Key elements of successful training include interactive discussion, booster sessions and involving specialist domestic violence practitioners., Whole-system approaches aiming to promote coordination and collaboration across agencies appear promising but require funding and high levels of commitment from partners. [ABSTRACT FROM AUTHOR]

The ultimate goal of trials is to identify interventions that can benefit individuals in the future. It is crucial, therefore, that they measure outcomes that reflect the priorities and expectations of those using the interventions. We consider this issue in relation to trials of interventions for children exposed to domestic violence and abuse (DVA). To explore this, we drew on data collected as part of a larger study to consider whether the types of outcomes measured in clinical trials reflect: (1) the perceived benefit of interventions reported in qualitative evaluation studies; and (2) the views of parents, professionals and young people as to what constitutes a 'good outcome'. We found that trials most frequently evaluated changes in children's symptoms and disorders, whereas children and parents, along with practitioners, had broader concepts of success that extended beyond narrow health-focused outcomes. A number of studies measured other types of outcomes, although there was inconsistency in the types of outcomes that were measured. Based on these findings, we discuss the need to reach consensus on an expanded set of outcomes to be measured in child-focused DVA trials. This will mean that the effectiveness of interventions is judged against outcomes that are important to those who use interventions. It will also facilitate greater consistency in outcome measurement across studies, thereby enhancing the quality of evidence in this emerging field. Copyright © 2015 John Wiley & Sons, Ltd. Key Practitioner Messages In order to adequately assess what works to reduce the impact of domestic violence on children, researchers should: Work with stakeholders to understand which outcomes are important to them., Seek consensus about a standardised set of outcomes to be measured and reported in all trials., Ensure that the success of interventions is measured against these outcomes. [ABSTRACT FROM AUTHOR]

Despite the development of much positive work by to tackle domestic violence, frustrations are often voiced by social care and other professionals - and echoed in women's and children's experiences - that it can be difficult to ensure and sustain safe outcomes for women and children in circumstances of domestic violence. The article takes as its starting point these frustrations and difficulties, and provides an attempt at understanding some of the systemic problems practitioners may be facing that undermine the effectiveness of their practice. The article explores in particular some of the tensions and contradictions that are evident in professional discourses and practices across work with victims and perpetrators of domestic violence; child protection and safeguarding; and child contact. These three areas of work are especially difficult to bring together into a cohesive and co-ordinated approach because they are effectively on separate ‘planets’ - with their own separate histories, culture, laws, and populations (sets of professionals). The notion of separate ‘planets’ can also be understood in light of what Bourdieu (1989) would call the ‘habitus’ of groups, where the particular structures, orientations and approaches in the work of a professional group may create divides between their own everyday and common place professional assumptions and practices and those of other professional groups. Tackling the ‘three planet problem’, and dealing more effectively with domestic violence as it impacts on adults and children, requires both a unified approach across the separate ‘planet’ areas and acknowledgement of the processes of gendering that are situating women as culpable victims. It requires much closer and coherent practices across the three areas of work, with acknowledgement and understanding of professional assumptions and practices of different professional groups. [ABSTRACT FROM PUBLISHER]