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We performed content analysis using a qualitative descriptive approach of 15 semistructured interviews with pregnant and postpartum women who have experienced opioid use disorder (OUD) and intimate partner violence (IPV) regarding their experiences seeking help with both issues. Participants described that their partners impacted their ability to seek OUD care; seeking help for OUD and IPV was siloed; they felt more comfortable disclosing OUD than IPV; they perceived pregnancy as a barrier and facilitator to OUD care; and they wished for integrated services. Pregnant and postpartum women experiencing OUD and IPV acknowledged these phenomena intersect and identified a need for more comprehensive services., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Intimate partner violence (IPV) has negative health impacts for pregnant people and their infants. Although inpatient postpartum units offer an opportunity to provide support and resources for IPV survivors and their families, to our knowledge, such interventions exist. The goal of this study is to explore (1) how IPV is currently discussed with postpartum people in the postpartum unit; (2) what content should be included and how an IPV intervention should be delivered; (3) how best to support survivors who disclose IPV; and (4) implementation barriers and facilitators. Materials and Methods: We used individual, semistructured interviews with postpartum people and health care providers (HCPs). Interview transcripts were coded and analyzed using an inductive-deductive thematic analysis. Results: While HCPs reported using a variety of practices to support survivors, postpartum people reported that they did not recall receiving resources or education related to IPV while in the inpatient postpartum unit. While HCPs identified a need for screening and disclosure-driven resource provision, postpartum people identified a need for universal IPV resource provision in the postpartum unit to postpartum people and their partners. Participants identified several barriers ( i.e. , staff capacity, education already provided in the postpartum unit, and COVID-19 pandemic) and facilitators ( i.e. , continuity of care, various HCPs) to supporting survivors in the postpartum unit. Conclusion: The inpatient postpartum unit is a promising setting to implement an intervention to support IPV survivors and their infants. Future research and intervention development should focus on facilitating universal education and promoting resource provision to IPV survivors.

Background: Intimate partner violence (IPV) is an underreported public health crisis primarily affecting women associated with severe health conditions and can lead to a high rate of homicide. Owing to the COVID-19 pandemic, more women with IPV experiences visited online health communities (OHCs) to seek help because of anonymity. However, little is known regarding whether their help requests were answered and whether the information provided was delivered in an appropriate manner. To understand the help-seeking information sought and given in OHCs, extraction of postings and linguistic features could be helpful to develop automated models to improve future help-seeking experiences., Objective: The objective of this study was to examine the types and patterns (ie, communication styles) of the advice offered by OHC members and whether the information received from women matched their expressed needs in their initial postings., Methods: We examined data from Reddit using data from subreddit community r/domesticviolence posts from November 14, 2020, through November 14, 2021, during the COVID-19 pandemic. We included posts from women aged ≥18 years who self-identified or described experiencing IPV and requested advice or help in this subreddit community. Posts from nonabused women and women aged <18 years, non-English posts, good news announcements, gratitude posts without any advice seeking, and posts related to advertisements were excluded. We developed a codebook and annotated the postings in an iterative manner. Initial posts were also quantified using Linguistic Inquiry and Word Count to categorize linguistic and posting features. Postings were then classified into 2 categories (ie, matched needs and unmatched needs) according to the types of help sought and received in OHCs to capture the help-seeking result. Nonparametric statistical analysis (ie, 2-tailed t test or Mann-Whitney U test) was used to compare the linguistic and posting features between matched and unmatched needs., Results: Overall, 250 postings were included, and 200 (80%) posting response comments matched with the type of help requested in initial postings, with legal advice and IPV knowledge achieving the highest matching rate. Overall, 17 linguistic or posting features were found to be significantly different between the 2 groups (ie, matched help and unmatched help). Positive title sentiment and linguistic features in postings containing health and wellness wordings were associated with unmatched needs postings, whereas the other 14 features were associated with postings with matched needs., Conclusions: OHCs can extract the linguistic and posting features to understand the help-seeking result among women with IPV experiences. Features identified in this corpus reflected the differences found between the 2 groups. This is the first study that leveraged Linguistic Inquiry and Word Count to shed light on generating predictive features from unstructured text in OHCs, which could guide future algorithm development to detect help-seeking results within OHCs effectively., (©Vivian Hui, Malavika Eby, Rose Eva Constantino, Heeyoung Lee, Jamie Zelazny, Judy C Chang, Daqing He, Young Ji Lee. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 09.10.2023.)

Few studies have empirically examined patient-clinician conversations to assess how intimate partner violence (IPV) screening is performed. Our study sought to examine audio-recorded first obstetric encounters' IPV screening conversations to describe and categorize communication approaches and explore associations with patient disclosure. We analyzed 247 patient encounters with 47 providers. IPV screening occurred in 95% of visits: 57% used direct questions, 25% used indirect questions, 17% repeated IPV screening later in the visit, 11% framed questions with a reason for asking, and 10% described IPV types. Patients disclosed IPV in 71 (28.7%) visits. There were no associations between disclosure and any categories of IPV screening.

Title X is a federally funded family planning initiative that provides low-cost and confidential reproductive health services to its clients. In recent years, Title X has been the subject of debate as its core tenants have been revised by the current administration. Though advocates have fought against these changes, the voices of survivors on intimate partner violence are absent from this conversation. This study was designed to elicit the opinions and experiences on survivors of intimate partner violence on reproductive decision-making, their access to care, and their opinions about political efforts to restrict this access. Twenty-six semi-structured interviews were conducted with women who were seeking services for intimate partner violence. These interviews were audio-recorded, transcribed, and coded. Codes were then organized into themes. Participants endorsed the need for confidential services due to experiences of coercion from their partners and the fear of retaliation against them. Participants largely supported accessible contraception but reported the need for contraception to be reliable. Participants addressed pregnancy and its many complexities and advocated for nondirective options-counseling. Overall, participants spoke about their challenges with reproductive health care and their opinions on how best to service survivors of intimate partner violence. This study asserts the need for advocates for survivors to advocate for the preservation of Title X and establishes the need for future studies on the prevalence of intimate partner violence in Title X clinics.

Qualitative research on batterer intervention programs (BIPs) has primarily consisted of interview-based studies of clients and facilitators. To date, no research has utilized observational data to understand how BIPs "work," or the processes occurring in BIPs that promote prosocial behavioral change. Forty-four observations of BIP group sessions were conducted. Two key processes were found: "facilitator processes" (e.g., managing group dynamics and engaging clients in learning) and "client processes" (e.g., mutual aid, help-seeking, and support). More observational research on BIPs is needed to uncover the full range of processes occurring during BIPs and that can link group processes to client outcomes.

Intimate partner violence (IPV) is a prevalent women's health problem that affects the health and well-being of midlife women. Clinicians who provide care to women have a responsibility to address IPV with their patients. Given the complexities surrounding IPV disclosure, the latest recommendations for IPV move beyond prior approaches that emphasize IPV screening and identification to that of universal education about IPV. Women experiencing IPV have indicated the utility of receipt of IPV information and resources regardless of disclosure. Further, a universal-education approach raises awareness about IPV for all patients to understand that IPV is prevalent, that IPV is associated with numerous negative health consequences, and that help is available., (Copyright © 2021 by The North American Menopause Society.)

Intimate partner violence is common among people with opioid use disorder (OUD), but little research has focussed on identifying barriers survivors with OUD face when trying to leave an abusive relationship. Semi-structured interviews were conducted with 40 postpartum women with OUD. Interview questions were designed to identify barriers to help-seeking and facilitators and supports that have helped survivors make positive changes. Qualitative data were coded and analyzed, using a phenomenological approach to develop emerging themes. Most participants were white, 24-29 years old, single, unemployed, Medicaid insured, and used medications for OUD. All participants ( n  = 40, 100%) shared that a current or past partner physically, sexually, emotionally, or verbally abused them. Participants identified multiple barriers to help-seeking including abusive partner control of money and resources, fear of retaliatory violence, and concerns related to police and child welfare. Participants also described supports that helped them make positive changes, including being treated with care and support from domestic violence shelters and treatment programs. Finally, survivors offered suggestions for ways providers can better meet survivors' needs. Clinicians and policymakers should prioritize overcoming multiple barriers to service access and engagement faced by survivors and their children.

Background: Intimate partner violence (IPV) and substance use are intersecting health problems that adversely impact sexual and reproductive health outcomes for women seeking care at family planning (FP) clinics. We aimed to characterize whether and how FP clinic providers (1) assessed for IPV and substance use and (2) combined IPV and substance use assessments. Methods: Providers and patients (female, 18-29 years old, English speaking) at four FP clinics participating in a larger randomized controlled trial on provider communication skills were eligible. Providers received training on universal education, a research-informed IPV assessment approach. Visits were audio recorded, transcribed verbatim, and coded by two independent coders. We used inductive and deductive coding to assess providers' communication approaches and examined codes for patterns and categories. We then converted these approaches into variables to calculate frequencies among recorded visits. Results: Ninety-eight patient-provider encounters were analyzed. In almost all encounters (90/98), providers assessed for IPV. Many providers adopted best practice IPV assessment techniques, such as universal education (68/98) and normalizing/framing statements (45/98). Tobacco use screening was common (70/98), but alcohol (17/98) and other drug use screening (17/98) were rare. In only one encounter did a provider discuss IPV and substance use as intersecting health problems. Conclusion: This study provides insight on how FP clinicians, as key providers for millions of women in the United States, assess patients for IPV and substance use. Results show providers' willingness to adopt IPV universal education messaging and demonstrate room for improvement in substance use assessments and integrated discussions of IPV and substance use. Trial Registration Number: NCT01459458.

Batterer intervention programs (BIPs) constitute the primary treatment for perpetrators of intimate partner violence (IPV). Systematic evaluations of BIPs, however, have yielded modest results in terms of these programs' ability to reduce perpetration. Descriptive studies, which can provide information on the contexts and process associated with BIPs, can provide insights into the underlying mechanisms that might promote change among BIP clients, and as such are important to improving efficacy measures for BIPs. To date, however, limited research exists on what challenges BIPs encounter in working with clients, and how those challenges present barriers to behavioral change among perpetrators at the intervention level. As part of a 2-year ethnographic study, we conducted 36 individual semistructured interviews with professionals working with BIPs. We identified six themes related to challenges to promoting behavioral change among men who perpetrate violence: (a) social acceptance of IPV, (b) hypermasculine attitudes, (c) emotional problems, (d) childhood exposure to violence, (e) co-morbid mental health issues, and (f) denial, minimization, and blame. Our results have implications for thinking about some of the contextual factors that may impede BIPs ability to produce desired outcomes and for identifying areas in which programs can be tailored to improve the overall client experience. Our results also point to the need for a more coordinated community response to IPV, and in particular to helping provide resources that support BIPs sustained, safe, and as effective as possible work.

Background: Women with opioid use disorder (OUD) report high rates of intimate partner violence (IPV) and there is limited understanding of how IPV influences substance use behaviors among women with OUD. Methods: Semi-structured qualitative interviews were conducted with a sample of 40 women with OUD participating in an ongoing clinical trial evaluating postpartum contraceptive utilization patterns for this population. Interviews were audio-recorded, transcribed verbatim and lasted approximately 45 min. Interview questions focused on women's perceptions and experiences with IPV and how these experiences impacted their substance use behaviors. Transcripts were coded independently in Atlas.ti and qualitatively analyzed using a general qualitative inquiry approach for emerging themes. Results: Participants were aged 24-29, and the majority were white, single, unemployed, had Medicaid insurance and a high school degree. Although personal IPV experiences were not necessary to be selected for this qualitative sub-study, all participants reported some lifetime experience with IPV. Four overarching themes emerged: (1) women attributed physical IPV to their partner's substance use; (2) emotional abuse prevented women from fully engaging in their recovery; (3) financial abuse prevented women from gaining independence from abusive partners; and (4) women coped with IPV experiences through substance use. Conclusions: IPV had a significant influence on women's substance use behaviors including their perceived risk of relapse and treatment discontinuation. These findings demonstrate the need to integrate assessment, evaluation and management of IPV into substance use treatment settings.

Seventy-six adult male perpetrators of intimate partner violence enrolled in a batterer intervention program (BIP) were interviewed on their perspectives of the intra-BIP group peer interactions. A majority of participants endorsed positives aspects of working with peers in the group context. Only one negative aspect arose, namely, other group members who disrupted the BIP process in some way. More importantly, a minority of participants expressed indifference toward the group process. This study has implications for training of BIP facilitators and for future research on BIPs that helps to tailor the approaches these groups use to maximize client engagement.

Limited information exists on the extent to which male perpetrators of Intimate Partner Violence (IPV) are engaged in the use of human services for co-occuringpsychosocial and health issues. The current analysis uses administrative data from one batterer intervention program (BIP) and data from the local Department of Human Services to explore perpetrators' engagement with human services, and the relationship of that use to timing and completion of the BIP. Data for 330 adult male clients referred to the participating BIP from 2010 to 2015 were collected. A majority (63%) had engaged in at least one human service program. The most common kind of service was mental health (46%). The most specific service engagement was child welfare as a parent (41%). Engagement largely concluded prior to beginning the BIP. BIP completers had less service use overall. Future work should explore how these services could be utilized to improve the success of BIPs and reduce perpetration., (© Copyright 2019 Springer Publishing Company, LLC.)

Batterers intervention programs (BIPs) constitute a primary intervention for perpetrators of intimate partner violence (IPV). There is little understanding as to what operational, or program-level, challenges BIPs face that can impede their effectiveness and adherence to state standards. As part of a 2-year ethnographic study, we conducted 36 individual semistructured interviews with professionals working with BIPs and identified five themes related to program-level challenges for BIPs: (a) information barriers, (b) safety issues, (c) facilitator retention and training, (d) the need for monitoring, and (e) funding constraints. We conclude that continued work needs to be done at both the state and local level, and in coordination with community judicial, mental health, human services, and other agencies to help provide resources that support BIPs in sustained, safe, and as effective as possible work.

Little is known about altered eating behaviors that are associated with the experience of intimate partner violence (IPV) victimization. Our aim was to explore the experiences and perspectives of IPV victims regarding their eating behaviors and their attitudes toward and use of food. We conducted focus groups and individual interviews with 25 IPV victims identified at a domestic violence agency and asked them about their eating behaviors and how, if at all, these behaviors related to their experience of IPV. Qualitative analysis of the transcribed encounters identified themes explicating the relationship between their eating behaviors and experiences of IPV. All women described altered eating behaviors related to IPV that were categorized into several major themes: (a) somatization (victims experience significant somatic symptoms as a result of abuse); (b) avoiding abuse (victims modify their eating behaviors to avoid abuse); (c) coping (victims use food to handle the psychological effects of abuse); (d) self-harm (victims use food to hurt themselves as a reaction to the abuse); and (e) challenging abusive partners (victims use their eating behaviors to retaliate against their abusers). IPV can provoke altered eating behaviors in victims that may be harmful, comforting, or a source of strength in their abusive relationships. Understanding the complex relationship between IPV and victims' altered eating behaviors is important in promoting healthy eating among victims., (© The Author(s) 2015.)

To explore pediatricians' perspectives on supporting intimate partner violence (IPV) survivors, including (a) clinical practices and resource use, (b) ideal resources, and (c) barriers to the use of existing resources, we conducted dyadic and individual virtual interviews with pediatricians recruited through Twitter and the American Academy of Pediatrics Council, section, and chapter listservs. The interviews were approximately 60 minutes in length, audio recorded, and transcribed verbatim. We used a thematic analysis approach and hybrid deductive–inductive coding. Twenty-three pediatricians participated in 14 interviews. We identified four themes. Participants' current practices primarily focused on IPV screening and response to disclosure. They described strategies for IPV resource provision and decision-making involving child protective services. They identified multilevel barriers to addressing IPV, including barriers, such as time, identified in previous studies as well as barriers related to the COVID-19 pandemic, telehealth, the electronic health record, and disclosure-focused approaches. The participants desired provider-facing and caregiver-facing resources to strengthen the capacity to address IPV; some were unaware of currently available resources. They noted the need for continued attention to optimizing systems to enhance their capacity to support IPV survivors. Pediatricians report varying practices to address IPV and identify several surmountable barriers to supporting IPV survivors. Our study suggests that disclosure-driven clinical practices, confidentiality concerns, and lack of resources limit pediatricians' capacity to address IPV. Additional resource development and dissemination efforts are needed to improve the awareness of IPV resources currently available to pediatricians and families. [ABSTRACT FROM AUTHOR]

Batterer intervention programs (BIPs) continue to be the primary mode of intervention for male perpetrators of intimate partner violence (IPV). The extent, however, to which BIPs are effective remains unclear. In particular, studies are needed that can provide detailed information on how accountability is promoted during the BIP process, and if clients leave a BIP with a clear sense of what it means to be responsible for their behaviors. The present study seeks to expand our knowledge of accountability as it is understood in the BIP context through an exploration of clients' written reflections on their experiences with such a program. A random sample of 555 exit letters were collected from a participating BIP in 2015 and analyzed to understand clients' perceptions on accountability. A three-coder iterative approach to analysis, focusing on content and global coding of broad thematic and subthematic categories was used. Our findings show that many clients admitted to the use of some type of abusive behavior as the precipitating factor for their involvement in the BIP, and that additionally, they generally recognized the need to be responsible for their behaviors and the consequences associated with their abuse. However, we also found that an increased emphasis on accountability in BIPs may be warranted. In particular, more research is needed to explore how BIPs promote accountability among their clients, and how individuals who complete a BIP understand and interpret their role in perpetrating abuse. [ABSTRACT FROM AUTHOR]

As part of a two-year ethnographic study of batterer intervention programs (BIPs) we interviewed 76 male perpetrators of intimate partner violence (IPV) on their perspectives regarding BIP facilitators. Participants endorsed a number of characteristics of facilitators that helped to reduce their resistance to the group process and assisted in engaging them in the learning process, including facilitators who were invested in the program and its mission, and displayed a non-judgmental demeanor. At the same time, they also endorsed facilitators who were honest with them and challenged them on their behavior, and who exhibited a high degree of experience in IPV. Additionally, participants endorsed the need to have a female facilitator as part of the group to further promote engagement and learning. This study has implications for thinking about what components of BIP facilitation might be important for reducing some of the resistance that may lead to client attrition, and how BIPs can better engage clients in prosocial behavioral changes. [ABSTRACT FROM AUTHOR]

To describe how stakeholders involved in intimate partner violence prevention and treatment at different levels of the Social Ecological Model view accountability in relationship to the key actors at various levels in the intervention process and their role in addressing future incidence of IPV. We conducted 36 in-depth qualitative interviews with BIP facilitators, IPV advocates, socio-judicial officials, and local and state policy makers. Participants were recruited via snowball sampling and interviews were audiorecorded, transcribed verbatim, and coded in ATLAS.ti. Interviews broadly explored the challenges and best practices in facilitating BIPs, as well as perceptions on the etiology of IPV. The current analysis focuses on participant views related to accountability, and the role that various groups and institutions have in addressing IPV perpetration. Interview participants emphasized a multi-systems level approach to addressing IPV, one that required the responsibility of both programs and judicial systems in establishing IPV as a serious crime, and stressed the need to ensure accountability across all relevant stakeholders engaged in the broader scope of IPV intervention. In order to have a sustainable impact on IPV perpetration, stakeholders across the Social Ecological Model will need to utilize crucial intervention periods using a standardized response to improve outcomes for IPV survivors, perpetrators, families and communities. [ABSTRACT FROM AUTHOR]

Background: Intimate partner violence (IPV) is a serious public health problem that disproportionately affects adolescent women seeking family planning services. Current clinical guidelines recommend routine IPV assessment yet provide limited guidance on how to establish patient comfort in addressing this sensitive issue. Few studies exist describing the perspectives of adolescent female patients who have experienced IPV and their suggestions on how providers should communicate about IPV. Methods: This study is a subset of a larger IPV intervention trial in family planning clinics. For this study, we chose a qualitative approach using individual interviews to explore patient perspectives in an open, in-depth manner without limiting potential responses with predetermined answers or investigator-imposed assumptions. We audio recorded clinic encounters for participating providers and patients and interviewed patient participants, asking them to listen to and reflect on how their provider talked about IPV in their audio-recorded clinic encounters. Results: The mean age for the 44 participants was 22.8 years old. Participants named 'comfort' as a main component for discussing and disclosing IPV in the clinical setting. The sub-themes associated with how to create patient comfort include: build the patient-provider relationship, provider should communicate like a friend/be on the patient's level, patient needs to feel cared for by provider, and appropriate timing and space. Conclusion: Methods for establishing patient comfort via communication should be incorporated into and examined within sensitive healthcare areas such as IPV and can be extended to HIV, palliative, and oncological care to improve patient health outcomes. [ABSTRACT FROM AUTHOR]

Studies of batterer intervention programs (BIPs) have primarily focused on assessing program efficacy through reassault or recidivism rates with mixed results. Few studies have sought to describe the BIP process, or what components of BIPs might motivate and facilitate change among perpetrators of intimate partner violence (IPV) from the perspective of the men who attend such programs. As part of a two-year ethnographic study, we collected 76 semi-structured, open-ended interviews with male clients enrolled in one of two community-based BIPs. The current analysis uses those interviews to understand clients' perspectives on the lessons, changes or skills they gained during their tenure in a BIP. Clients reported gaining 1) a more holistic understanding of IPV, 2) a greater sense of accountability for their behaviors, 3) the ability to identify and deescalate anger, and 4) new skills to improve communication. These findings suggest that change is possible among BIP clients, and that perhaps we need to consider intermediary or alternative measure of program success for BIPs. In particular, measures are needed that can capture some of the more nuanced cognitive and behavioral changes that occur during the BIP process in "real time." [ABSTRACT FROM AUTHOR]

As part of a 2-year ethnographic study, 49 adult men who had been convicted of intimate partner violence (IPV) perpetration were interviewed on what they thought would have prevented them from engaging in perpetration behaviors, or rather what they believed prevention with young boys needed to include in order to prevent future IPV perpetration. The authors’ open-ended interviews yielded five main themes: (a) messages about healthy relationship behaviors, (b) the need to promote respect for women, (c) teaching effective skills for communicating and managing anger, (d) programs that provide role models and are school-based, and (e) addressing the impact of experiencing violence as a child. The authors conclude that prevention efforts focused on changing both attitudes regarding IPV and behaviors might be most effective for reducing perpetration, and that greater attention needs to be paid towards prevention among youth most at risk of IPV perpetration, those experiencing violence in their homes. [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV) accounts for up to 50% of all calls to police. In an effort to standardize arrest criteria, mandatory arrest laws were established. It is unclear whether subsequent increased rates of female arrest are due to greater recognition of female IPV perpetrators or of women acting in self-defense. This study aims to understand the context and consequences of IPV-related arrest from perspectives of women arrested in a single metropolitan area. Semi-structured qualitative interviews were conducted with women arrested and court-ordered to attend IPV education groups at a women’s shelter in the Northeast United States. Interviews addressed circumstances surrounding arrest, experience with past violence, and reasoning regarding use of partner violence. Two researchers independently coded transcripts and met to iteratively refine the code and review transcripts for themes. Eighteen women were interviewed. Major themes that emerged were as follows: (a) Women’s use of violence occurred within the context of their own victimization; (b) the arrest included a complex interplay between subject, partner, and police; (c) women perceived police arrest decisions to be based on a limited understanding of context; and (d) women experienced both positive and negative consequences of arrest. Many relationships did not fall under the traditional victim/perpetrator construct. Rather, women’s use of violence evolved, influenced by prior experiences with violence. More appropriate methods must be developed for making arrest decisions, guiding justice system responses, and developing interventions for couples experiencing IPV. Recognition that women’s use of partner violence often represented either a retaliatory or self-defensive gesture within the context of prior victimization suggests that victims’ interventions should not only focus on empowerment but also provide skills and strategies to avoid temptation to adopt aggression as a primary method of self-protection. [ABSTRACT FROM PUBLISHER]

Objective: To compare in person versus computerized screening for intimate partner violence (IPV) in a hospital-based prenatal clinic and explore women''s assessment of the screening methods. Methods: We compared patient IPV disclosures on a computerized questionnaire to audio-taped first obstetric visits with an obstetric care provider and performed semi-structured interviews with patient participants who reported experiencing IPV. Results: Two-hundred and fifty patient participants and 52 provider participants were in the study. Ninety-one (36%) patients disclosed IPV either via computer or in person. Of those who disclosed IPV, 60 (66%) disclosed via both methods, but 31 (34%) disclosed IPV via only one of the two methods. Twenty-three women returned for interviews. They recommended using both types together. While computerized screening was felt to be non-judgmental and more anonymous, in person screening allowed for tailored questioning and more emotional connection with the provider. Conclusion: Computerized screening allowed disclosure without fear of immediate judgment. In person screening allows more flexibility in wording of questions regarding IPV and opportunity for interpersonal rapport. Practice implications: Both computerized or self-completed screening and in person screening is recommended. Providers should address IPV using non-judgmental, descriptive language, include assessments for psychological IPV, and repeat screening in person, even if no patient disclosure occurs via computer. [Copyright &y& Elsevier]

Abstract: Objective: To study a mental health sample to assess (1) the prevalence of physical, sexual and emotional intimate partner violence (IPV) victimization and perpetration, (2) the extent this sample reported being asked about IPV by mental health clinicians and (3) how prevalence and screening rates varied by gender. Method: Women and men receiving services at a large psychiatric facility completed anonymous written questionnaires. Results: A total of 524 adults were approached for study participation, and 428 (158 men, 270 women) completed a survey. Over half (51%) of participants experienced some form of IPV; 63% of women and 32% of men reported IPV victimization. Experience of IPV was more likely if participants were women and had diagnoses of posttraumatic stress disorder, anxiety disorder or bipolar disorder. Both women (33%) and men (16%) reported perpetrating IPV. The reported IPV screening rate by mental health providers was 44% for the whole sample (women: 55%; men: 27%). Conclusion: IPV victimization and perpetration is a prevalent problem among women and men receiving mental health services. Clinicians are missing opportunities to screen for IPV as part of mental health evaluation and treatment. [Copyright &y& Elsevier]

Objective: When counseling women experiencing intimate partner violence (IPV), healthcare providers can benefit from understanding the factors contributing to a women's motivation to change her situation. We wished to examine the various factors and situations associated with turning points and change seeking in the IPV situation. Methods: We performed qualitative analysis on data from 7 focus groups and 20 individual interviews with women (61 participants) with past and/or current histories of IPV. Results: The turning points women identified fell into 5 major themes: (1) protecting others from the abuse/abuser; (2) increased severity/humiliation with abuse; (3) increased awareness of options/access to support and resources; (4) fatigue/recognition that the abuser was not going to change; and (5) partner betrayal/infidelity. Conclusions: Women experiencing IPV can identify specific factors and events constituting turning points or catalyst to change in their IPV situation. These turning points are dramatic shifts in beliefs and perceptions of themselves, their partners, and/or their situation that alter the women's willingness to tolerate the situation and motivate them to consider change. When counseling women experiencing IPV, health providers can incorporate understanding of turning points to motivate women to move forward in their process of changing their IPV situation. [ABSTRACT FROM AUTHOR]

Health professionals from two different clinical settings were asked about their comfort level in dealing with intimate partner violence (IPV). Focus groups and semistructured interviews were used to gather information. Staff in an obstetrics and gynecology setting relatively rich in IPV resources described feeling capable dealing with IPV. The staff in a general medicine setting dedicated to women's health but without a focus on IPV and with fewer supports described discomfort and difficulty dealing with IPV. Presence of systemic prioritization of and resources for IPV were described as contributing to the confidence in addressing the issue. Other necessary elements identified included (a) on-site resources, (b) adequate time, (c) focused IPV training, and (d) a team or systemic approach. [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV) victimization is a women’s health problem that imposes a significant health and health care cost burden. Although IPV victims cannot change the perpetrator’s behavior, they can take actions to reduce exposure to the partner’s abuse. The process of change for IPV victims has been described using the transtheoretical model (TTM), among others. We report results of a qualitative study with current and past IPV victims to 1) explicate the process of safety-seeking behavior change for female victims of IPV and 2) explore the fit of the TTM for explaining this process. Based on the results, we propose the psychosocial readiness model to describe the process of change for female victims of IPV. This model considers readiness as a continuum that ranges from robustly defending the status quo on 1 end to being ready to take action toward change on the other. Movement toward and away from change along the continuum results from a dynamic interplay of both internal factors and external interpersonal and situational factors. [Copyright &y& Elsevier]

Abstract: Objective: For women who are experiencing intimate partner violence (IPV), making changes toward safety is often a gradual process. When providing counseling and support, health care providers may benefit from better understanding of where women are in their readiness to change. Our objective was to apply the transtheoretical model''s stages of change to the experiences of women who experienced IPV and map their experiences of change as they moved toward increased safety. Methods: A multi-disciplinary team designed a qualitative interview process with 20 women who had current or past histories of IPV in order to explore their experiences. Results: The women in our study (1) moved through stages of readiness generally in a nonlinear fashion, with varying rates of progression between safe and nonsafe situations, (2) were able to identify a “turning-point” in their situations, (3) attempted multiple “action” steps and (4) were influenced by internal and external factors. Conclusions: Our study suggests that focusing on the transtheoretical model to develop stage-based interventions for IPV may not be the most appropriate given the nonsequential movement between stages and influence of external factors. Practice implications: The “change mapping” technique can be used as an educational and counseling tool with patients, as well as a training tool for health care providers. [Copyright &y& Elsevier]