What is the role of the physician when a patient discloses intimate partner violence perpetration?
(Boston)–Intimate partner violence (IPV) is prevalent and has lasting impacts on the health and well-being of the entire family involved. Unfortunately, very little research and guidance about how to address perpetration of IPV in the health care setting, especially among primary care physicians who are in a role to potentially intervene has been available until now.
Researchers from Boston University School of Medicine (BUSM) reviewed the existing literature related to physicians' interactions with male perpetrators of IPV and summarized the recommendations including assessing for lethality, readiness to change and comorbid medical conditions that could impact treatment, such as substance abuse and mental illness.
"Experts agree that referrals to a Batterer Intervention Program should be the primary intervention. If there are none locally available or the patient is unwilling to go, then a physician should refer the abuser to a therapist who has been trained specifically to work with perpetrators of IPV," explained corresponding author Brian Penti, MD, assistant professor of family medicine at BUSM. "In addition, physicians should be prepared to offer education about the negative impact of IPV on the victim, on any children and on the abuser himself," added Penti, a family medicine physician at Boston Medical Center.
According to Penti, physicians should address any untreated substance abuse or mental health issues. Referral to couples' therapy should generally be avoided. Physicians should continue to have regular follow-up with their male patients to support them in changing their behavior.
The researchers believe further research is needed to assess the role the health care system can have in preventing IPV perpetration.
These findings appear in the Journal of American Board of Family Medicine.