Intervention Services for Intimate Partner Violence
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Intimate Partner Violence -
A Training Resource
By: James J Messina, Ph.D., CCMHC, NCC, DCMHS-T
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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:
https://www.cdc.gov/violenceprevention/pdf/ipv/ipvandsvscreening.pdf
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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.
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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:
NEVER = 1; RARELY = 2; SOMETIMES = 3; FREQUENTLY = 4 and FREQUENTLY = 5
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.
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Photography, Diagrams and Body Maps
Photographs
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.
Reference:
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.
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Safety Plans
Interactive guide to safety planning available through National Domestic
Violence Hotline at: https://www.thehotline.org/plan-for-safety/create-a-safety-plan/
Or
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
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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: https://www.thehotline.org/get-help/local-resources/
In State of Florida: The state of Florida has a list of all the Local Domestic Violence
Centers available to victims of IPV at:
https://www.myflfamilies.com/service-programs/domestic-violence/map.shtml
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
Website: http://www.casafl.org/
Hernando County
Dawn Center of Hernando County
Phone: 352-684-7191
FAX: 352-684-7941
Hotline: 352-686-8430
TDD: 352-686-8430
Website: http://www.dawncenter.org/
Hillsborough County
The Spring of Tampa Bay
Phone: 813-247-5433
FAX: 813-247-2930
Hotline: 813-247-7233
TDD: 813-248-1050
Website: http://www.thespring.org/
Manatee County
HOPE Family Services
Phone: 941-747-8499
FAX: 941-749-1796
Hotline: 941-755-6805
TDD: 941-755-6805
Website: http://www.hopefamilyservice.org/
Chat: http://www.hopefamilyservice.org/
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
Website: http://www.salvationarmywestpasco.org/
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
Website: http://www.sunrisepasco.org/
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
Website: http://www.rcspinellas.org/
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
Website: http://www.casa-stpete.org/
Chat: http://www.casa-stpete.org/chat/
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
Website: http://www.peacerivercenter.org/
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
Website: http://www.sparcc.net/
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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.
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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.
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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 batterers.
Have ongoing discussions between criminal and civil justice agencies, community
members, and victims to close gaps and improve the community’s response to battering.
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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 batter7. 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 approach2. Prioritize the safety of women and children and develop appropriate ethical standards3. Undergo risk assessments and use results to help develop a risk management plan4. 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 partner6. Know the incidence and nature of domestic violence in their community.
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Florida Batterer's Intervention Program
The 2020 Florida Statues
Title XLIII DOMESTIC RELATIONS
Chapter 741 MARRIAGE; DOMESTIC VIOLENCE
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.
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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.
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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.
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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.”
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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.
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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
requires
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
violence
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
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The Duluth Model
Power and Control Wheel of Factors
Contributing to Intimate Partner Violence
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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.
Mission
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
concerns.
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
battering.
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: https://www.theduluthmodel.org/
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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:
https://nccpsafety.org/assets/files/library/Preventing_IPV_Technical_Package.pdf
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: https://www.nsvrc.org/sites/default/files/2021-02/Comprehensive%20Sexuality%20Education_Final508_0.pdf
Topics
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:
https://online.rider.edu/online-bachelors-degrees/nursing/intimate-partner-violence-guide/
Topics:
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
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4. Futures Without Violence’s A Road Map for Ending Domestic Violence
in California: A life Course Approach to Prevention (January, 2021) at:
https://www.futureswithoutviolence.org/wp-content/uploads/CA-Road-Map-FWV.pdf
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
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4. SART Toolkit - Sexual Assault Response Team Tool Kit
The National Sexual Violence Resource Center (NSVRC) has a complete resource for
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.
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