Photo Credit: John Gomez PIX

Our columnist from Education, Training, and Research provides physicians with tips to identify and support patients who may be experiencing dating violence.

Dating violence is a pervasive issue that can have significant physical, emotional, and social impacts.

Of those who have experienced dating or intimate partner violence, over 71% of women and over 55% of men were younger than 25 years old when the violence began. As a clinician, you are often in a unique position to identify and support patients who may be experiencing dating violence and connect them to the resources they need.

Here are some tips for effectively addressing this sensitive topic with your patients.

1. Create a Safe & Confidential Environment

Building trust is critical when discussing sensitive issues like dating violence. Begin by ensuring that your patient feels safe and respected.

• Privacy: For in-person and telehealth visits, conduct the conversation in a private setting where the patient feels secure. If a companion is present, politely ask to speak with the patient alone for a portion of the visit and explain how this is standard practice with any patients older than the age of 13.
• Non-judgmental Approach: Use open body language, maintain eye contact, and ensure your tone conveys empathy and understanding.
• Confidentiality: Explain the limits of confidentiality upfront, particularly if you’re required to report certain disclosures, such as those involving minors.

2. Use Universal Screening Techniques

Many patients may not volunteer information about dating violence without prompting. Incorporate universal screening questions into your practice:

• “Are you in a relationship where you feel safe and respected?”
• “Has anyone ever tried to control or hurt you in a relationship?”
• “Do you feel scared or unsafe with your partner?”

Frame these questions as a routine part of care to normalize the discussion. For example, you might say, “We ask all our patients these questions because relationship safety is an important part of overall health.”

3. Listen Actively & Validate Their Feelings

If a patient discloses dating violence, your response can significantly influence their willingness to seek further help. Focus on:

• Listening Without Interruption: Allow the patient to share their story at their own pace.
• Validating Their Experience: Acknowledge their feelings with statements like, “What you’re feeling is completely understandable,” or “I believe what you are telling me.”
• Avoiding Blame: Reassure the patient that the abuse is not their fault and that they deserve to feel safe and respected.

4. Provide Resources & Support

Keep an updated list of patient resources you can share during the visit or through a secure online portal.

• Local & National Hotlines: Provide contact information for organizations like the National Domestic Violence Hotline (1-800-799-SAFE) or local shelters.
• Safety Planning: Discuss strategies to enhance their safety, such as having a code word with trusted friends, packing an emergency bag, and creating a safety plan.
• Counseling Referrals: Recommend mental health professionals who specialize in trauma or abuse.

5. Document With Care

Accurate documentation is crucial but should be done sensitively to protect the patient’s privacy:

• Objective Language: Record the patient’s statements verbatim without inserting personal opinions or assumptions.
• Physical Findings: Document any visible injuries thoroughly, including descriptions, measurements, and photographs (with the patient’s consent).
• Confidential Notes: Avoid including sensitive information in records that could be accessed by the patient’s partner, particularly in cases of shared electronic health records.

6. Follow Up & Maintain Support

Dating violence is often a long-term issue, and your ongoing support can make a significant difference:

• Schedule Follow-Ups: Regular check-ins can help you monitor the patient’s safety and well-being.
• Collaborate With Multidisciplinary Teams: Work with social workers, counselors, and others on your team to provide comprehensive care.
• Empower the Patient: Respect the patient’s autonomy and decisions, even if they choose to remain in the relationship for the time being.

7. Educate Yourself & Your Team

Continuing education on dating violence can enhance your ability to support affected patients. Participate in continuing education, review updated guidelines, and ensure your staff is trained in trauma-informed care practices.

Additional Resources

• Relationship Check: Healthy or Un? (download a free patient pamphlet from ETR)
• Identifying Digital Dating Abuse (view a free on-demand webinar from ETR)
• National Sexual Violence Resource Center
• Love is Respect

About ETR

ETR | Education, Training, and Research is a non-profit organization that envisions a world where all people and communities achieve their best health. Through our work, we improve the health and well-being of youth and communities by championing science. To learn more, visit www.etr.org.