August 28, 2012
Blog by: Carol Wick, CEO
On Aug. 14, the Los Angeles Times ran a story about a research study that examined brief interventions as a tool in partnership with screening for domestic violence. The headline read “Brief screening for domestic violence doesn’t help, study shows.” You can see the story here: http://tinyurl.com/8c8u3by.
In fact, the study does not show this but alas the story went viral and we were inundated with questions about the study and why physicians should screen (as we have recommended doing with our R3 App). In the referenced study, the researchers looked into three different interventions after a screen determined that the patient was in an abusive relationship. They either did nothing, gave them a referral via paper or had them watch a video about how to get help. Anyone in the domestic violence field could have told them from the start how this would have turned out. Not only did they find that none of their brief interventions worked, but few if any of the survivors escaped their abuser upon follow-up.
If solving the complex issue of domestic abuse were as easy as handing out a flyer or having everyone watch a video, we would have figured that out many years ago. The reality is that domestic abuse is far too complicated and far too dangerous to ever do anything “brief.” As we discovered early on in our partnership with Lakeside Alternatives, screening cannot be done in isolation without comprehensive policies and procedures regarding intervention when someone is identified as being in an abusive relationship. Otherwise, that potentially lethal information becomes yet another checked box on a chart that goes nowhere and helps no one.
As our partner Dr. Kevin Sherin, creator of the HITS screening tool (on which the R3 App is based) remarked, “It takes partnerships to place skilled staff along primary care providers to do the ‘heavy lifting’ required to break free of the cycle of power and control that goes with intimate partner violence. Those who were screened may be at significant risk for physical injury, verbal abuse or death. Worthwhile studies on this topic in the future must address more than ‘brief interventions.”
The correct response is to create partnerships with local domestic violence agencies and ensure that every time a screening is positive for abuse, the intervention is to connect that patient with a live, certified advocate who can properly assess the danger and create a safety plan. This process may only take 20-30 minutes and is certainly more effective than handing a piece of paper to a victim trapped in the abuse cycle of power, control and fear and saying “here you go, problem solved.” We can do better. They deserve better.
