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Young MWIA

The Young MWIA’s (yMWIA) full name is Special Interest Group for Young Female Doctors and Medical Students. It is an opportunity for the younger members of the profession to meet and discuss issues relevant to their stage in their careers. More information you will find here.

Identifiying victims of violence and responding to disclosure

October 15th, 2014
Toolkit: Domestic violencefor healtcare providers
a Canadian source

October 14th, 2014
Sexual assault services procedure and protocol manual from Canada. This may of use for the MWIA manual.

October 14th, 2014
End of fear website
: a British initiative in the greater Manchester area
Anybody who is experiencing domestic or sexual violence can find help, support and advice here.

BSS- Battered Women´s Support Services
They contribute to the freedom and liberation of girls and women from violence. They have been providing counselling and healing spaces for those who have experienced abuse.
http://www.bwss.org/

Care for survivors of sexual violence
http://www.afmw.org.au/images/stories/AFMW/2010/hhwconsultationreport.pdf

Improving responses to refugees with backgrounds of multiple trauma:
for practitioners in domestic and family violence, sexual assault and settlement services

A  toolkit for doctors to ask the right questions- a summary is below
http://itstimetotalk.net.au/gp-toolkit/

How to ask your patient

‘In any situation that you suspect underlying psychosocial problems you can ask indirectly and then directly about partner abuse.’

If you have concerns that your patient is experiencing family violence, you should ask to speak with her alone, separate from her partner or any other family members.

You can always ask broad questions about whether your patient’s relationships are affecting her health and wellbeing. For example:

  • ‘How are things at home?’
  • How are you and your partner getting on?’
  • ‘Is anything else happening which might be affecting your health?’

‘It is important to realise that women who have been abused want to be asked about domestic violence and are more likely to disclose if asked.’

If appropriate, you can ask direct questions about any violence. For example:

  • ‘Are there ever times when you are frightened of your partner?’
  • ‘Are you concerned about your safety or the safety of your children?’
  • ‘Does the way your partner treats you make you feel unhappy or depressed?’
  • ‘Has your partner ever physically threatened or hurt you?’
  • ‘Violence is very common in the home. I ask a lot of my patients about abuse because no one should have to live in fear of their partners.’

If you see specific clinical symptoms, you can ask specific questions about these (e.g. bruising). These could include:

  • ‘You seem very anxious and nervous. Is everything alright at home?’
  • ‘When I see injuries like this, I wonder if someone could have hurt you?’
  • ‘Is there anything else that we haven’t talked about that might be contributing to this condition?’

If your patient’s fluency in English is a barrier to discussing these issues, you should work with a qualified interpreter. Don’t use her partner, other family members or a child as an interpreter. It could compromise her safety, or make her uncomfortable to talk with you about her situation.

Responding to a disclosure

Your immediate response and attitude when a woman discloses family violence can make a difference.

‘Patients… value emotional support from healthcare professionals, careful and non-judgmental listening, and reassurance that the abuse is not their fault and that negative feelings are understandable.’¹¹

Listen
  • Being listened to can be an empowering experience for a woman who has been abused.
  • Communicate belief
  • ‘That must have been frightening for you.’
  • Validate the decision to disclose
  • ‘I understand it could be very difficult for you to talk about this.’
  • Emphasise the unacceptability of violence
  • ‘Violence is unacceptable; you do not deserve to be treated this way.’
  • Be clear that she is not to blame
  • Avoid suggesting that the woman is responsible for the violence or that she is able to control the violence by changing her behaviour.
Do not ask:
  • ▪ ‘Why don’t you leave?’
    ▪ ‘What could you have done to avoid this situation?’
    ▪ ‘Why did he hit you?’