A study led by the University of Bristol, in collaboration with University of Central Lancashire, found many GPs and practice nurses are uncertain how to manage consultations involving children exposed to domestic violence. The research has led to the development of a new training programme for clinicians dealing with some of the complex issues around abuse.
The free training resource, launched on 1 October as part of the RESPONDS (Researching Education to Strengthen Primary care ON Domestic violence and Safeguarding) project, aims to improve the knowledge, skills, attitudes and self-efficacy of primary care clinicians in managing consultations involving children who witness domestic violence. The training materials, which includes videos of different scenarios and how they can be managed and information about the project, are available from www.bristol.ac.uk/responds-study.
Designed in collaboration with clinicians and experts on domestic abuse, health and child safeguarding, the resource comprises a pack designed to be used by trainers. It includes advice on the main principles GPs should consider when documenting domestic violence in the adult victim’s medical records and in that of family members. The training will equip clinicians with knowledge of the range of services available to them and the relevant referral routes as well as information about what they can expect following a referral and what referral information is most helpful to provide. The pack also includes advice on when to ask about domestic violence and abuse, suggestions for initial questions to the child and how to discuss the issues appropriately with their non-abusive parent plus guidance on time constraints and the role of children’s services.
Professor Gene Feder, a GP and the RESPONDS project study lead at the Centre for Academic Primary Care in the School of Social and Community Medicine at the University of Bristol, said: “GPs and nurses who took part in the pilot study were more confident about how to proceed in a consultation, when they suspected exposure of children to domestic violence and abuse, and the appropriate next steps. They had a greater awareness of current relevant services and referral routes. Training participants also reported increased willingness to engage directly with children and to discuss this appropriately with their non-abusive parent."
Professor Nicky Stanley, Co-Director of the Connect Centre for International Research on Interpersonal Violence and Harm at the University of Central Lancashire, who contributed child protection expertise to the study said: “GPs lack confidence in talking directly to children about domestic violence. However, when there is domestic violence in the family, children are likely to be seriously affected. The RESPONDS training package aims to increase GPs’ skills and competence in this important aspect of their work.”
Dr Eszter Szilassy, RESPONDS research lead at the Centre for Academic Primary Care in the School of Social and Community Medicine, added: “Childhood exposure to domestic violence and abuse can result in long-term behavioural, mental health and education problems. Our research showed that many doctors and nurses are unsure how to support the parent experiencing abuse while protecting their safety and autonomy, maintaining confidentiality, and ensuring the safety of their children. The lack of clear guidance and training on the interface between domestic violence and child safeguarding is resulting in variation of care and uncertainty in managing these families. We hope that our training materials will help bridge this gap and ensure that opportunities to support women and children experiencing domestic violence are not being missed.”The RESPONDS training pack was designed and developed collaboratively using multi-professional clinical, academic, front-line practitioner and training expertise in domestic violence, child safeguarding and health. The research study was carried out by the Universities of Bristol, Central Lancashire, Manchester and Leeds. The development of the training package was led by SafeLives, a national charity supporting a multi-agency and risk-led response to domestic violence. The project was funded by the Department of Health Policy Research Programme.