Center for the Study of Traumatic Stress
CSTS | Department of Psychiatry | Uniformed Services University | 4301 Jones Bridge Road, Bethesda, MD 20814-4799 | www.CSTSonline.org

Helping Victims of Intimate Partner
Violence: Guidelines for Military
Clinical Providers
Intimate partner violence (IPV)
aware of the signs of IPV, have
IPV involves controlling, coercive, andan understanding of the adverse
is a public health issue and clinicalconcern. IPV involves controlling,
health effects of IPV, provide
threatening behavior, violence, or abuse byappropriate initial clinical support,
coercive, and threatening behavior,a current or previous intimate partner.
document abuse effectively andviolence, or abuse by a current ordirect victims to appropriate
previous intimate partner. Victim
treatments and services.
shame, stigma, fear of retribution
Some providers may be concerned that asking aboutfrom the perpetrator, and occupational or financial
IPV will make patients uncomfortable. However, studies
consequences can serve as barriers to help-seeking for IPV
have shown that patients welcome clinician inquiries
victims.
and screenings for IPV, when done in a respectful,Clinical providers have an important role in IPV
nonjudgmental manner. Helpful and caring discussions
detection, prevention, and intervention because of theirwith clinicians about IPV reduce help-seeking barriers forunique relationship with patients. Moreover, healthcare
patients.
providers may be a victim’s first point of professional
contact after abuse has occurred. Providers need to be

Signs of IPVYour patient may be experiencing IPV if they show thefollowing physical and/or behavioral signs or symptoms:■ Multiple emergency room visits■ Frequent use of emergency contraceptives and/or
reduction in use of regular contraception■ Traumatic Brain Injury (TBI), which may be difficult
to detect and often takes the form of headaches orsensitivity to light■ Injuries to the face, mouth, and neck - often target areas
for the abuser■ Exhibits physical pain or is extremely anxious ordepressed■ Has trouble explaining bruises or injuries■ Evidence of strangulation (bruising on neck), bite
marks, trauma to hands (burn marks or bone fractures),hair loss (from being pulled)■ Partner (potential abuser) will not leave patient(potential victim) alone with healthcare provider and/or controls discussion with provider, cancels patient’s

appointments, and/or shows angry, threatening, andaggressive behaviors■ Patient describes partner as jealous, controlling, orangry with patient or children■ Isolation from family and friends
Potential Health Outcomes
IPV is associated with a number of adverse healthoutcomes such as:■ Sleep problems■ Somatic pain
■ Headaches■ Depression, anxiety, and PTSD
■ Increased use of alcohol, tobacco, and other drugs tocope with distress emotions■ DeathHow to Address IPV with Patients
Talking with patients about IPV can be challenging.
Below are examples of how to talk with patients about IPV:1.

Ask about injuries and suspect behavior. If patient
exhibits physical or behavioral signs/symptoms ofIPV, ask:
“In my experience, this type of injury/ behavior issometimes caused by other people’s actions. Is anyone
hurting you or frightening you?”If patient is willing to discuss exposure to IPV, you
should assess the safety of the patient and otherhousehold members using the following questions:“Do you feel safe in your current relationship?”“In general, how would you describe your relationship?”“Is there a partner from a previous relationship who ismaking you feel unsafe now?”

2.

Validate patients’ experiences: Offer validation thatthey deserve a healthy and safe relationship. Let themknow that you want to support them in a way thatwould be helpful and safe for them.
“Whatever is happening, you didn’t cause this.”“You do not deserve to be hit or hurt no matter 		what happened.”

3.

4.

Document abuse: Document presenting signs andsymptoms of abuse location, size, duration, color,shape, and date and time of occurrence. Takephotographs, if possible and use an injury location
chart or “body map,” write legibly if not using acomputer, include descriptions of patient’s demeanor
and identify them as the source of information. Use
medical terms to describe injuries.
Refer victim to IPV reporting and counselingresources.
“Relationships can be difficult and made even morechallenging by stressors within and outside the home.
In what you have told me, I have become concerned
about the impact of the challenges at home on yourwell-being. I would like to give you some information

for resources that can provide immediate assistance oradditional services.”» The Family Advocacy Program (FAP) assists withsafety planning and offers treatment services.
https://www.militaryonesource.mil/family-relationships/
family-life/preventing-abuse-neglect/the-familyadvocacy-program» Victim Advocates can be a confidential resource
and advise on reporting options, staying safe,
getting medical services, and finding counseling.
https://www.militaryonesource.mil/family-relationships/
relationships/relationship-challenges-and-divorce/howto-find-help-for-victims-of-domestic-abuse» The National Domestic Violence Hotline
provides crisis intervention, information, andreferral to victim advocate services. Can help
address concerns regarding kids, pets, job, finances,and other common areas of concern.
https://www.thehotline.org/» Military OneSource helps victims locate
counseling services and can help with a Military
Protective Order (MPO), taking away the service
member’s weapon and mandating the abusercannot enter the victim’s workplace.
https://www.militaryonesource.mil/
5.

Schedule a follow-up appointment. If a patient hasreported exposure to IPV or you suspect exposure,schedule a follow-up appointment to track anddocument patient’s health and safety.

Other Ways to Help
Display literature, brochures, and safety cards or posters
in your waiting area or restrooms that provide information
about where a victim can get help. Incorporate routine
screening for IPV into your clinical practice.

Center for the Study of Traumatic Stress
Department of Psychiatry
Uniformed Services University
4301 Jones Bridge Road, Bethesda, MD 20814-4799
www.CSTSonline.org