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Intervention Services for Intimate Partner Violence

Intimate Partner Violence -

A Training Resource

By: James J Messina, Ph.D., CCMHC, NCC, DCMHS-T

Assessment to Use to Identify IPV

The United States Preventive Services Task Force (USPSTF) identified the first

four of these assessments because they showed the most sensitivity and are directed

at patients and can be self-administered or used in a clinician interview format. 

HITS (Hurt, Insult, Threaten, Scream) 

OVAT (Ongoing Violence Assessment Tool) 

HARK (Humiliation, Afraid, Rape, Kick)

WAST (Woman Abuse Screen Tool) 

Abuse Assessment for Women who are pregnant

Once a Safety Plan has been established this additional assessment can be used

by case managers, home visitors or therapist:

Relationship Assessment Tool

For a complete list of addition IPV Assessments available from the CDC go to:

Example of Use of HITS

One validated, easy-to-use screening  instrument to identify IPV in the healthcare

setting is the HITS tool. The HITS screening tool consists of four questions regarding

Hurting, Insulting, Threatening, and Screaming that help determine whether a person

is being abused. Individuals can be asked to report on current abuse (“How often

does your partner…”), short-term past  or current abuse (“Over the last 12 months,

how often did your partner…”), or long-term past abuse(“In your lifetime, how often

has a current or former partner…”). Assessing for current abuse is important for

identifying victims who may be in acute danger and may need immediate assistance.

Assessing for lifetime abuse also can be helpful for understanding  a person’s current

clinical profile because abuse often has long-term health consequences, even when

someone is no longer in the abusive relationship.

HITS scores range from 4 to 20, and a score of 10 or higher is considered positive for IPV.

The HITS tool has the benefit of gleaning information about both physical and verbal abuse.

Verbal aggression is a very strong feature of IPV and is often one of the earliest forms of

violence to appear in relationships. The table below shows the HITS scoring tool completed

for Angelica  a fictional client. Note how verbal aggression alone can indicate a positive finding.

The table shows how this woman, married for 14 years, scored after assuring her provider

that she definitely was not a “battered” woman because her husband had never hit or

threatened her.

HITS - Intimate Partner Violence Screening for Angelica

How often does your partner:
1. Physically hurt you?  NEVER (1)
2. Insult you or talk down to you?  FREQUENTLY (5)
3. Threaten you with harm?  NEVER (1)
4. Scream or Curse at you? FREQUENTLY (5)
                                          Angelica's SCORE  12

To score give the following points for each answer:

Score Interpretation:
A score of 10 or more indicates Intimate Partner Violence. In this case Angelica scored 12.
Sitting down and scoring the scale with Angelica at one's side will help her re-evaluate her
situation in a new light.
Photography, Diagrams and Body Maps


Separate written consent from the client before taking photos is required. Before

obtaining the photos, also explain to the client the procedure and its importance.

In medically stable individuals, obtain the photos before medical treatment if possible.

There are two methods for collecting photos: with film and digitally. Digital

photography is becoming more commonplace in the clinical setting; however, this

method is often criticized because of the ease with which digital photos can be

manipulated. Maintaining the security and chain of custody of images is of utmost

importance. In summary, the following principles should be followed:

- Include photographs of the face, along with the injured areas.

- Place an object of measurement (e.g., a ruler or quarter) next to the injury, and include           

  it in the photo to illustrate the size of the injury.

- Keep a photo log that includes the

    - victim’s name,

    - date and time the photo was taken,

    - photographer’s name,

    - type and speed of film (for film photography), and

    - electronic photography log from a digital camera (for digital photography).

- When possible, take subsequent photos to document changes in the injury over time.

Anatomical Diagrams or Body Maps

Anatomical diagrams or body maps are another useful way to document injuries, especially when photo documentation is not possible. This involves documenting the characteristics of
an injury on an image/drawing of a body. In addition to the location of the injury marked on
the figure, the size, shape, color, characteristics of the edges around the wound, and foreign material present in the wound should be documented.


Saferstein, R. (2011). Principles of forensic evidence collection and preservation.

In V. A. Lynch, & J.B. Duval (Eds.), Forensic Nursing Science (2nd ed., pp. 54-60).

St. Louis, MO: Elsevier Mosby.

Safety Plans

Interactive guide to safety planning available through National Domestic

Violence Hotline at:


Download the form in a traditional format: Domestic Violence Personalized Safety Plan

The National Domestic Violence Hotline presents the following tips to help victims to
better understand if they are indeed victims of Intimate Personal Violence (IPV)

Local Resources for Dealing with IPV

The National Domestic Violence Hotline Website contain the contact of all 50 state &

territory coalitions who are fighting IPV at the local community level. The list is at:

In State of Florida: The state of Florida has a list of all the Local Domestic Violence

Centers available to victims of IPV at:

In West Central Florida Counties:

Citrus County

Citrus County Abuse Shelter Association
Phone: 352-344-8112
FAX: 352-344-0548
Hotline: 352-344-8111
TDD: 352-344-8111


Hernando County

Dawn Center of Hernando County
Phone: 352-684-7191
FAX: 352-684-7941
Hotline: 352-686-8430
TDD: 352-686-8430


Hillsborough County

The Spring of Tampa Bay
Phone: 813-247-5433
FAX: 813-247-2930
Hotline: 813-247-7233
TDD: 813-248-1050


Manatee County

HOPE Family Services
Phone: 941-747-8499

FAX: 941-749-1796
Hotline: 941-755-6805
TDD: 941-755-6805


Pasco County

The Salvation Army Domestic Violence Program of West Pasco
Phone: (727) 856-6498
FAX: (727) 857-1907
Hotline: (727) 856-5797
TDD: (727) 364-6132


Pasco County

Sunrise Domestic and Sexual Violence Center, Also Known As: Sunrise of Pasco
Phone: (352) 521-3358
FAX: (352) 521-3099
Hotline: (352) 521-3120


Pinellas County

The Haven of RCS, Also Known As: RCS Pinellas
Phone: (727) 584-3528
FAX: (727) 461-4702
Hotline: (727) 442-4128
SMS Text: (727) 465-6549
TDD: (727) 223-4946


Pinellas County

Community Action Stops Abuse
Also Known As: CASA
Phone: (727) 895-4912 (Ext. 100)
FAX: (727) 821-7101
Hotline: (727) 895-4912 (Ext. 1)
TDD: (727) 828-1269


Polk County

Peace River Center Domestic Violence Shelter
Also Known As: Peace River
Phone: (863) 413-2708
FAX: (863) 413-3079
Hotline: (863) 413-2700
TDD: (863) 413-2700


Sarasota County

Safe Place and Rape Crisis Center
Also Known As: SPARCC
Phone: (941) 365-0208
FAX: (941) 365-4919
Hotline: (941) 365-1976
TDD: (941) 365-1976

Batterer Intervention Programs (BIPs)

Batterer Intervention Programs (BIP) are programs that batterers attend—some voluntarily,

some under court order—to educate and rehabilitate the batterer. The goal of BIPs is to

change offender thinking and behavior with the result that offenders are held accountable

and victim safety is enhanced and to decrease the likelihood of further violence. An important

feature of BIPs is that the programs are designed to first promote survivor safety, which is

achieved through accountability. All offender participants must sign a waiver of confidentiality

to permit disclosure of participation to survivors, probation, and the courts, as needed.

This assists BIPs’ accountability to survivors by ensuring that survivors have information

needed to make informed decisions through sharing information with courts and probation.

The main purpose of BIPs is to assist batterers in learning skills for nonviolence. Programs

are designed to teach offenders to monitor their actions and to understand their feelings

when they become violent, such as anger, inadequacy, jealousy, or the need to control.

rograms will often help offenders understand the root of their impulses and violent habits.

Importantly, programs emphasize that while a batterer may feel angry or upset, he remains

responsible for his actions. His use of violence or other forms of abuse is a personal choice.

Facilitators in BIPs often challenge men about their negative or patriarchal attitudes and

beliefs, willingness to accept or support abusive behaviors, and their denials of abuse.

This practice of challenging thinking and behavior helps men examine the origins of their

beliefs and actions with the group and to take responsibility for the abuse.

History of BIPs

The first BIPs in the United States were established in the 1970s in response to hotline

calls from victims and offenders. Around the same time that legal systems began

criminalizing domestic violence and mandating prosecution protocols, judges began

requiring that offenders attend BIPs.

The earliest programs often modeled themselves on substance abuse or mental health

programs, with some taking the form of couples counseling. However, BIPs are not the

same as marriage or couples counseling because those programs presume equality in

the relationship and the presence of domestic violence negates this presumption.

Moreover, couples counseling in situations of domestic violence is not a recommended

best practices and can place victims at a continued risk of harm.

Later, more effective BIPs focused on altering batterers’ beliefs surrounding power and

control over their intimate partner. One strategy developed by these programs was to

have offenders draw the chain of events that lead to their abusive behaviors, helping

batterers identify abusive behaviors and recognize when they are becoming violent.

Rather than acting as a diversionary program and allowing batterers to avoid criminal

consequences, BIPs offer an opportunity to suspend sentences, as long as the batterer

completes all requirements of the program and does not reoffend. In some places

in the U.S., perpetrators attend BIPs as a result of a criminal conviction and successful

completion of a program may result in a lesser conviction or sentence.

The Duluth Model of BIP

The Duluth Model, developed in the 1980s, is a feminist, psycho-educational approach to

ending domestic violence. This is achieved through “identifying behaviors that men use to

create power and control, presenting options other than dominance and control, promoting

behavioral and attitudinal changes, and confronting denial of violent behavior.” The Duluth

Model BIP is a best practice when it is properly implemented as one part of a larger community structure designed to comprehensively address domestic violence and intimate partner

battering. Some of the requirements of a community implementing a Duluth Model BIP will:

     Prioritize the voices and experiences of women who experience battering in the creation

of those policies and procedures.

     Believe that battering is a pattern of actions used to intentionally control or dominate

an intimate partner and actively work to change societal conditions that support men’s use

of tactics of power and control over women.

     Offer change opportunities for offenders through court-ordered educational groups for


     Have ongoing discussions between criminal and civil justice agencies, community

members, and victims to close gaps and improve the community’s response to battering.

Implementing BIPs

In 2009, a group of domestic violence and batterer intervention experts from the

United States identified the ideal components of a BIP. A model program should involve:

1. Partnering with other individuals and organizations to enhance accountability
and offer a range of services
2. Working closely with court and probation to monitor court-ordered referrals to BIPs
3. Creating a solid program infrastructure, which includes having ongoing training
and supervision of staff and implementing policies that are consistent with best practices
4. Developing coordinated community responses that go beyond legal sanctions
5. Shaping interventions and programs based on input from adult survivors and children
6. Using risk assessment and risk management to provide more effective interventions
for individual men who batter
7. Engaging men early in their role as parents and partners

The experts insist that “if these following components are not in place, programs should

not proceed.” The list endorses the key elements mentioned by other experts:

1. Position and implement BIPs as part of a larger inter-agency approach
2. Prioritize the safety of women and children and develop appropriate ethical standards
3. Undergo risk assessments and use results to help develop a risk management plan
4. Develop a BIP model and train staff in the principles of believing in program participants
potential for change, holding participants accountable for using violence against an intimate
partner, ending participants’ use of violence, and requiring program completion.
5. Use “gender transformative approaches” to train staff to address men’s background,
societal tolerance of violence, and norms that excuse violence against an intimate partner
6. Know the incidence and nature of domestic violence in their community.


Florida Batterer's Intervention Program

The 2020 Florida Statues




741.281?Court to order batterers’ intervention program attendance. - If a person is

found guilty of, has adjudication withheld on, or pleads nolo contendere to a crime

of domestic violence, as defined in s. 741.28, that person shall be ordered by the

court to a minimum term of 1 year’s probation and the court shall order that the

defendant attend and complete a batterers’ intervention program as a condition

of probation. The court must impose the condition of the batterers’ intervention

program for a defendant under this section, but the court, in its discretion, may

determine not to impose the condition if it states on the record why a batterers’

intervention program might be inappropriate. The court must impose the condition

of the batterers’ intervention program for a defendant placed on probation unless

the court determines that the person does not qualify for the batterers’ intervention

program pursuant to s. 741.325. The imposition of probation under this section

does not preclude the court from imposing any sentence of imprisonment

authorized by s. 775.082.

In Florida, the Batterer’s Intervention Program (BIP) is a 6-month intensive program

designed and monitored by the Florida Department of Children and Families (DCF)

to address the root causes of domestic violence and prevent participants from

committing acts of domestic violence in the future. It consists of an initial assessment,

orientation, and at least twenty-six (26) weeks of group counseling sessions.

The program address the root causes of domestic violence and prevent participants

from committing acts of domestic violence in the future. It consists of an initial

assessment, orientation, and at least twenty-six (26) weeks of group counseling sessions.

741.325. Requirements for batterers' intervention programs

(1) A batterers’ intervention program must meet the following requirements:

(a) The primary purpose of the program shall be victim safety and the safety

of children, if present.

(b) The batterer shall be held accountable for acts of domestic violence.

(c) The program shall be at least 29 weeks in length and include 24 weekly

sessions, plus appropriate intake, assessment, and orientation programming.

(d) The program content shall be based on a psychoeducational model that

addresses tactics of power and control by one person over another.

(e) The program shall be funded by user fees paid by the batterers who attend

the program, which allows them to take responsibility for their acts of violence.

An exception shall be made for local, state, or federal programs that fund batterers’

intervention programs in whole or in part.

(2) The requirements of this section apply only to programs that address the
perpetration of violence between intimate partners, spouses, ex-spouses, or
those who share a child in common or who are cohabitants in intimate relationships
for the purpose of exercising power and control by one over the other. It will endanger
victims if courts and other referral agencies refer family and household members who
are not perpetrators of the type of domestic violence encompassed by these
requirements. Accordingly, the court and others who make referrals should refer
perpetrators only to programming that appropriately addresses the violence committed.

Program Description

To commence the Florida Batterer’s Intervention Program, participants will first

undergo an initial assessment, which is described by the Department of Children

and Families as a ‘psychosocial’ evaluation to determine if [participants] will benefit

from mental health or substance abuse treatment programs prior to or concurrent

with batterer intervention.”

The participant must also sign a contract, admit responsibility for his or her acts,

and follow strict rules and procedures as outlined by the program’s administrators.

Violation of Batterer Intervention Program rules and procedures can result in a

participant’s immediate expulsion from the program. Upon completion of the initial

assessment, the participant attends a one-time orientation, followed by at twenty-six

consecutive weeks of group “counseling” sessions. Each group session is typically

an hour and a half long and is presided over by a designated “facilitator.”

Failure to Complete Program

The failure of a defendant to attend all scheduled Batterer Intervention classes can

result in termination from the program. This will cause the participant to violate probation,

have a warrant issued for his or her arrest, and face the possibility of significant jail time.

Goals of Batterer’s Intervention Program

The curriculum used in the Florida Batterer’s Intervention Program is based on a

so-called “intervention model,” which considers domestic violence to be the result

f “one person . . . systematically using tactics of emotional and physical abuse in

order to maintain power and control over the other.”

In following the “intervention model,” the Department of Children and Families


that the BIP curriculum incorporate the following elements:

An educational approach that assigns responsibility for the violence solely to the

batterer and provides a strategy for assisting the batterer in taking responsibility

for the violence

Content that:

Encourages the participant to develop critical thinking skills that will allow the

participant to rethink their behavior and identify behavior choices

other than violence

Supports the belief that domestic violence is primarily a learned behavior

Supports the belief that domestic violence is not provoked or the result of

substance abuse’

Challenges stereotypical gender role expectations

Identifies the effects of distorted thinking on emotions and behavior

Includes information on the relationship of substance abuse to domestic


Identifies the effects of domestic violence on children

Content designed to

Improve the batterer’s ability to identify and articulate feelings

Improve communication skills and listening with empathy

Improve negotiation and conflict resolution skills

The Duluth Model

Power and Control Wheel of Factors
Contributing to Intimate Partner Violence

Duluth Power and Control Wheel Videos

1. Overview of the Power and Control Wheel at:

2. Physical and Sexual Violence at:

3. Using Intimidation at:

4. Using Emotional Abuse at:

5. Using Isolation at:

6. Minimizing, Denying and Blaming at:

7.Using Children at:

8. Using Male Privilege at:

9. Using Economic Abuse at:

10. Using Coercion and Threats at:


Other Programs on the Duluth Model

Changing Men, Changing Lives - The Duluth Model at:

The Duluth Model, CCR and Men's Nonviolence Program at:

History of the Duluth Program

Domestic Abuse Intervention Programs (DAIP) began in 1980 as an initiative to reform

the criminal justice system in Duluth, Minnesota. At that time, victims of domestic

violence had little recourse when being assaulted by their intimate partners.

Perpetrators were rarely arrested unless the assault happened in front of an officer

or the injuries sustained by the victim were serious. Choices for victims were

limited—initiate criminal justice charges, endure the abuse or flee the relationship.

DAIP organizers—activists in the battered women’s movement—set out to understand the

laws, policies and procedures of the criminal justice system, as well as understand the

cultures of each of the involved agencies. In doing so, they built relationships that allowed

new interventions to be proposed and tested. The results were strikingly effective in keeping

batterers from continuing their abuse. Eventually, eleven community agencies agreed to

continue to formally work together to continue to make positive change in the criminal justice

system around battering. This effort became

known as “The Duluth Model.”

The Duluth Model has evolved and changed over the last 30 years and has spread across

the globe. DAIP continues to work toward ending violence against women through its

programs in Duluth and in partnership with domestic violence practitioners around the world.


The mission of Domestic Abuse Intervention Programs is to end violence against women.

They give voice to diverse women who are battered by translating their experiences into

innovative programs and institutional changes that centralize victim safety. They partner

with communities worldwide to inspire the social and political will to eliminate violence

against women and their families.

Values of the Duluth Program

To live this mission:

1. We listen to battered women: Our work involves active engagement with women

who have experienced violence so that our efforts are guided by their realities and


2. We educate to promote liberation: An educational process of dialogue and critical

thinking is key to our efforts to assist women in understanding and confronting the

violence directed

against them, and to our efforts to challenge and support men who commit to ending


3. We advocate for institutional and social change: We examine the practices and

policies of social and governmental agencies that intervene in the lives of battered

women, and address systemic problems by engaging with institutional practitioners

and leaders in the development

of creative and effective solutions.

4. We struggle against all forms of oppression. Women are not defined by a single

identity, but live in the intersection of their race, gender, class, ethnicity, nationality,

disability, age, religion and sexual orientation. Our work must also challenge all

systems of oppression that create a climate of supremacy and intolerance that facilitates

violence and exploitation in women’s lives.

5.We promote non-violence and peace: Every step we take, every interaction we

have with others, is an opportunity to advance non-violence, continually working

toward and building a culture and a future of peace.

Reach the Domestic Abuse Intervention Programs the Home of the Duluth Model at:

Guidelines for Addressing Intimate Partner Violence

1. Strategies for Prevention of IPV

1. CDC’s Preventing Intimate Partner Violence Across the Lifespan:

A Technical Package of Programs, Policies, and Practices (2017) at:

Goals of this Program:

Teach safe and healthy relationship skills

Engage influential adults and peers

Disrupt the developmental pathways towards Partner Violence

Create protective environments

Strengthen Economic supports for families

Support survivors to increase safety and lessen harms

2. National Sexual Violence Resource Center (NSVRC): Key Finding -

From Comprehensive Sexuality Education As a Primary Strategy

for Sexual Violence Prepetration at:


1. Standards for developing and evaluating Sexuality Education Programs

2. Effective Prevention Programming

3. Known Risk Factor for Perpretration

4. The Social-Ecological Model

5. Findings

6. What can this mean for the future of sexual violence prevention?

3. Rider University Online's: Intimate Partner Violence (IPV) and

Abusive Relationships: A Guide to Prevention and Intervention at:


1. What is Intimate Partner Violence?

2. What is Domestic Violence?

3. What are the Signs of Abuse?

4. Risk Factors

5. Protective Factors

6. Prevention Strategies and Resources

7. Educate Children form a Young Age

8. Education Materials and Videos

9.  Encourage Healthy Relationships for Couples

10. Healthy Relationship Information and Programs

11. Empowerment Information and Programs

12. Improve Economic Conditions for Families and Survivors

13. Financial Assistance for Struggling Families and Survivors

14. Intervention Strategies and Resources

15. Educate Victims on How to Get a Restraining Order

16. Restraining Order Information

17. Direct Survivors to Victim Services and Treatment

18. Services and Treatment for IPV Survivors

19. Help Survivors Access Housing

20. Housing Programs for IPV Survivors

21. Take a Patient-Centered Approach

22. Patient Centered Resources

4. Futures Without Violence’s A Road Map for Ending Domestic Violence

in California: A life Course Approach to Prevention (January, 2021) at:

Four Evidence-Based Prevention and Intervention Strategies to Prevent

and End Domestic Violence

1. Support New and Young Families

2. Ensure Schools are Welcoming to All Students, Trauma-informed,

and Help Children Build Resiliency and Develop Healthy Safe Relationships

3. Provide Trauma-informed Services and Healing to Children and Families

Exposed to Violence to less Harms and Prevent Future Violence

4. Build Community Wealth and Strengthen Social Conditions to Help Stabilize

and Empower Families

Nine ways to utilize Federal Funds to Prevent and End Domestic Violence

1. Education and Assessments in Health Care Settings

2. Home Visiting Programs

3. Child Care and Early Childhood Education

4. Strengthening Families/Parenting Support

5. Mental and Behavioral Health Services

6. Gender Norms and Health Relationship Skills

7. Services to Survivors of Domestic Violence

8. Families Engaged in the Child Welfare System

9. Programs Assisting Individuals and Families

2. Resources for Dealing with IPV for for Women and

for the LGTB Community

1. US Department of Health & Human Services - Office of Women's Health:

Domestic or Intimate Partner Violence at:

Topics Covered:

1. Signs of violence or abuse

2. Getting a restraining order

3. Leaving an abusive relationship

4. Effects on children

5. Related Information

6. Resources

7. Blog Topics

    Sexual Coercion

    Violence against immigrant women

2.  Tales from Another Closet – Personal Stories of Domestic Violence

in Same-Sex Relationships at:


Topics Covered:

1. What is domestic Violence?

2. Types of Abuse

3. Domestic violence as a gay and lesbian issue

4. Effects of domestic violence

5. Myths and facts

6. Safe and healthy relationships

3. The American Psychiatric Association in 2019 published:

Click here to download:

Treating LGTBQ Patients Who Have Experience Intimate Partner Violence

Topics Covered:

1. Epidemiologuy and Risk Factors of IPV in LGTB Communities

2. IPV in LGBTQ Relationships

3. Screening and Risk Assessment

4. Best Practices


    Use Inclusive and Non-Judgmental Language

    Safety Planning

    Connecting Survivors to Community Support

    Create Inclusive Materials and Increase Visibility

4. The Battering Triangle from National Indigenous Women's

Resouce Center (NIWRC) Retrieved at:

4. SART Toolkit - Sexual Assault Response Team Tool Kit
The National Sexual Violence Resource Center (NSVRC) has a complete resource for
Sexual Assault Response at:

The Kits has the following Sections
1. About the Toolkit
2. Learn about SARTs
3. Build your SART
4. Meeting Logistics
5. Sexual Assault Response
6. Victim-Centered Approaches
7. SARTs and Sex Offender Management

NOTE: Given the importance of a coordinated approach to the provision of care to IPV

and SA survivors, the creation of a sexual assault response team (SART) may be

warranted. SARTs are one means of ensuring that all protocols are followed throughout

the trajectory of care and that expectations and requirements of different agencies are

met. Typically, these teams are composed of forensic nurses, law enforcement officials

with experience in IPV and/or SA casework, social workers or other social service

providers, community resource advocates, and prosecutors in a given locale. The team

works together to ensure    that victims’ needs are met, offenders are held accountable,

and public safety is ensured.

One important advantage of establishing an SART is clarification of what jurisdiction
is served by the team. This is important for prosecution of cases as well as for
establishing a chain of custody for forensic evidence. Jurisdictions can be determined
by law enforcement, local government, or team members themselves. Regardless of
how the jurisdiction is determined, it is important to recognize the need for engagement
with service providers from all the involved sectors in the service area. For example,
some IPV shelters are limited in their ability to accept clients beyond certain geographic
borders because of funding constraints or other regulations. A person reporting SA may
live in one county but was assaulted in another. Coordination among agencies is therefore
 crucial to successful resolution of the case. Establishing memoranda of understanding
among involved agencies may also be necessary.