Module 7: Principles of interorganisational cooperation and risk assessment in cases of domestic violence in multi-professional teams

  1. Inter-agency cooperation
  2. Risk assessment
  3. Excursus: Domestic Violence in Times of Disasters
  4. Cooperation between agencies with focus on the health sector
  5. Criminal procedure in cases of domestic violence
  6. National criminal procedures
  7. Risk Assessment Integration Module RAIMO

Sources

Learning objectives

+ to understand how frontline responders work with a special focus on the medical sector

+ to understand why cooperation in multi-professional teams is most successful in tackling domestic violence.

+ to understand the multi-faceted challenges associated with multi-professional cooperation in times of a pandemic such as COVID-19

Of note: The learning materials are not tailored to the needs of every country; they include generic cases that need local adaptation.


IMPRODOVA: Why is cooperation in cases of domestic violence important?

The video points out why cooperation is important in cases of domestic violence.

1. Inter-agency cooperation

Domestic violence has harmful impacts for individuals, families, and relationships. It affects the health, well-being and education of children witnessing or experiencing abuse. It affects the economy, businesses, and employers in the community where victims/survivors or perpetrators work. It increases demands of housing and results in other health and social care needs. All these service providers and agencies often deal with the same issues in divergent ways, with different interventions and different outcomes.

Working in a multi-agency partnership is the most effective way to respond to domestic violence at an operational and strategic level. Initial and ongoing training and organisational support and supervision are essential.


Challenges associated with multi-agency working

Multi-agency working has its own challenges. Fundamentally, different agencies and service providers have different organisational missions, visions, values, aims and objectives. They have different targets and tasks and may also have different rules, regulations and working mechanisms. This makes it difficult for professionals in these agencies to work together at the same pace. There could also be a lack of understanding of the role and responsibilities of staff and the language used by individuals and organisations could be different leading to issues in working together.

A good example to elaborate this is the difference in the language, definitions and labels used to refer to the victim-survivor with various labels in operation including ‘victim’ (criminal justice system), ‘survivor’ (women-centred organisations), ‘patient’ (healthcare services), ‘tenant’ (housing services), ‘service user’ (welfare agencies) and ‘customer’ (adults’ social care). When working with perpetrators, the term victim is also used in the sense of criminal law, but it can also refer to ‘relatives’ and ‘clients’ in general.

Data gathered by different agencies is not comparable due to variations in the type of data collected, ways it is recorded, data storage and lack, or data portability mechanisms. There may also be different understandings of what constitutes domestic violence and its impact among different organisations. High staff turnover in organisations is also a barrier and affects communication as it takes time for people to develop trusting relationships.

In addition, different services do not always communicate with each other, and are often not allowed to exchange information, partly for data protection reasons, resulting in the lack of sharing information. Consequently, the victims must repeatedly provide their information, including details of their abusive experiences to different people in different organisations. Recalling experiencing can itself be traumatic for victim-survivors and consequently may deter them from accessing support.

Principles of multi-agency working

To ensure a successful partnership, certain principles can be developed and agreed on by different agencies working together. The points listed below can help professionals and organisations to draw and agree on certain principles that all agencies working together should adhere to.

  • Understand that without effective prevention and early intervention domestic violence often escalates in severity and, therefore, it is important to make every effort to identify and support adult and child victims earlier.
  • Prioritise safety of the victim-survivors and their children when considering interventions and acting immediately on disclosure of risk of harm.
  • Data about all incidents of domestic violence should be recorded, analysed, and shared with management of agencies working together regularly and appropriately.
  • Encourage cooperation with institutions and authorities that work with perpetrators in order to assess risks on a multi-professional basis and to prevent new incidents of violence.
  • At the initial engagement with the services, informed consent of the victim-survivor should be gained to ensure information between agencies can be shared, when required, without unnecessary delay.
  • Work cooperatively to provide a supportive and enabling environment which encourages people to report domestic violence to the police and other professionals and agencies.
  • Respect confidentiality and privacy wherever possible and understand the risks associated with information sharing in the context of domestic violence.
  • Develop and adhere to shared policies and procedures to guide information sharing between different organisations.
  • Ensure that victim-survivors are treated with respect and dignity. By listening to them and believing their experiences and assuring them that they are never to blame.
  • Empower domestic violence victim-survivors to make well-informed choices and decisions for themselves, wherever possible. Do not make decisions for them without their involvement.
  • Ensure that services are sensitive to the diverse need of the victim-survivors considering their age, disability, gender, race or ethnicity, religion or belief, sexual orientation, but recognise that such differences are not used as an excuse for accepting or perpetrating domestic violence or other harmful practices.
  • Recognise that victim-survivors and their children are most at risk when attempting to leave an abusive relationship or seeking help.

2. Risk assessment

  • It is essential to assist victims in evaluating both their present and future safety, along with that of their children.
  • Often victims do not want to go to other specialised services immediately or report to the police. Therefore, it is very important that members of the health sector have some background knowledge about risk assessment and how to ask and support victims accordingly. But it is not necessary to perform a comprehensive risk assessment.
  • A comprehensive risk assessment, following best practices, involves gathering pertinent information about the domestic environment, inquiring about the victim’s perception of risk, and making a professional judgment regarding current risk factors. 1 This is usually done by specialised victim support services or the police.
  • A risk assessment and a clear protocol for referring patients with injuries resulting from domestic violence to further interventions after an emergency room visit are required. The disclosure of domestic violence is also associated with certain reporting and notification obligations, which vary depending on the professional group.
  • This may concern the reporting and notification obligations of pedagogical and psychosocial occupational groups in cases of suspected immediate danger to self or others and danger to the well-being of children.
  • Medical professions are also subject to special reporting obligations, which are regulated in the respective professional laws.

Make sure to

  • Priorities victim’s safety
  • Adopting a victim-centred approach
  • Taking a gender-sensitive approach
  • Applying an intersectional approach: “The characteristics of each individual case are considered when identifying victims’ individual safety needs, including the victim’s gender and gender identity or expression, ethnicity, race, religion, sexual orientation, disability, residence status, communication difficulties, relationship to or dependence on the perpetrator and previous experience of crime.” 2
This video is an introduction to the techniques of risk assessment when working with women and children experiencing violence. It should be used in conjunction with the Introduction to Safety Planning and the Risk Assessment Frameworks.

It highly suggested to use a standardised risk assessment instead of using one gut feeling. Many hospitals or support centres have their standard risk assessment tool they usually use. This can vary however between institutions and countries.

Risk assessment instruments

Find the internationally most frequently used risk assessment instruments here:

  • Danger Assessment (DA)
  • Domestic Violence Risk Appraisal Guide (DVRAG)
  • DASH Risk Assessment
  • BIG 26
  • DyRiAS Intimate Partner
  • The Spousal Assault Risk Assessment Guide (SARA)

Multi-Agency Risk Assessment Conference (MARAC)

A MARAC is a meeting where information is shared on the highest risk domestic abuse cases between representatives of local police, health, child protection, housing practitioners, Independent Domestic Violence Advisors (IDVAs), probation and other specialists from the statutory and voluntary sectors. At the heart of a MARAC is the working assumption that no single agency or individual can see the complete picture of the life of a victim, but all may have insights that are crucial to their safety. 3

Please note that different risk assessments tools are used in different countries. Please consult the national pages on risk assessment:

Italy, Germany, Sweden, Greece and Austria



3. Excursus: Domestic Violence in Times of Disasters

 Description: The video highlights the influence of disasters on the rate of domestic violence.

Quarantine, restrictions, closed schools, home office, short-time work, financial worries, and fear of the future – all these factors have the potential to cause increased stress in relationships and family life. It is therefore suspected that there has been and will continue to be a significant increase in violence at home. As on example how disasters can have an impact, COVID-19 is presented here as case study.

What constitutes a successful partnership in the context of multi-agency working?

An understanding of the challenges of multi-agency working can help to identify components of successful multi-agency partnerships. The importance of leadership for any group and organisation cannot be underestimated. For an effective multi-agency partnership, it is essential that all the partners have a clear and shared vision, clearly articulated and agreed goals, aims and objectives. It is equally important that the staff in all organisations are aware of the vision, mission and goals of the partnership and have had the opportunity to clarify any misconceptions or questions. For any services, including multi-agency partnerships, to work effectively, it is important to understand the needs from the perspective of various stakeholders including service users as well as frontline practitioners providing services, to have respect for all cooperation partners and to meet them at eye level (despite power imbalances). Such an understanding may help identify concerns and issues affecting the provision of services and, thereby, help set priorities for the services.


Components of a successful multi-agency partnership

It is essential to use a joined-up approach, where various agencies are working together in order to smartly and effectively provide services. Such an approach may, on the surface, not seem different from agencies working separately, but for victim-survivors and their children it can be beneficial as there will be less duplication of assessment, and provision of services would be integrated and efficient. An understanding and clarity of the roles of various professionals working in the multi-agency context is very important. Professionals in different organisations and diverse disciplines bring different but complementary expertise. For example, the expertise, knowledge, and skills of a practice nurse will be completely different from those of a social worker. Similarly, a police officer brings a very different set of experience and knowledge than a domestic abuse counsellor.

The disclosure of domestic violence is also associated with certain reporting and notification obligations, which vary depending on the professional group. This may concern the reporting and notification obligations of pedagogical and psychosocial occupational groups in cases of suspected immediate danger to self or others and danger to the well-being of children. Medical professions are also subject to special reporting obligations, which are regulated in the respective professional laws.

Cooperation with organisations and authorities in the field of perpetrator work is also essential for the prevention of new acts of violence. These include, in particular, men’s counselling centres, probation and parole services, as well as judicial authorities and their associated social services (prisons, public prosecutors, courts, lawyers). These institutions work with perpetrators both after an incident of violence and before a new act of violence is committed. These institutions can therefore observe corresponding risk indicators that serve to protect the victims. Prisons, the public prosecutor’s office and the courts are therefore important cooperation partners for victim protection, especially with regard to the imposition of pre-trial detention and the risk of release or release of offenders.

Appropriate and timely information sharing is very important. There should be clear mechanisms and protocols for sharing information between agencies, and these should be promoted and monitored by management and supported by compatible IT (information technology) systems. Effective information sharing relies on open communication and collaboration and facilitates the use of a common language among various professionals. Provision of shared training events for various professionals is also a good strategy to bring people in one place to facilitate the development of a shared language and understanding of information sharing as integral in the response to domestic violence.

Finally, the importance of monitoring, evaluation and auditing cannot be underestimated as it will help in identifying strengths, weaknesses, opportunities, and challenges for the multi-agency partnership. Areas of improvement identified through such activities should be considered learning and improvement opportunities in which views of victim-survivors and all other stakeholders should be sought and incorporated.


Principles of multi-agency working

To ensure a successful partnership, certain principles can be developed and agreed on by different agencies working together. The points listed below can help professionals and organisations to draw and agree on certain principles that all agencies working together should adhere to.

  • Understand that without effective prevention and early intervention domestic violence often escalates in severity and, therefore, it is important to make every effort to identify and support adult and child victims earlier.
  • Prioritise safety of the victim-survivors and their children when considering interventions and acting immediately on disclosure of risk of harm.
  • Data about all incidents of domestic violence should be recorded, analysed, and shared with management of agencies working together regularly and appropriately.
  • Encourage cooperation with institutions and authorities that work with perpetrators in order to assess risks on a multi-professional basis and to prevent new incidents of violence.
  • At the initial engagement with the services, informed consent of the victim-survivor should be gained to ensure information between agencies can be shared, when required, without unnecessary delay.
  • Work cooperatively to provide a supportive and enabling environment which encourages people to report domestic violence to the police and other professionals and agencies.
  • Respect confidentiality and privacy wherever possible and understand the risks associated with information sharing in the context of domestic violence.
  • Develop and adhere to shared policies and procedures to guide information sharing between different organisations.
  • Ensure that victim-survivors are treated with respect and dignity. By listening to them and believing their experiences and assuring them that they are never to blame.
  • Empower domestic violence victim-survivors to make well-informed choices and decisions for themselves, wherever possible. Do not make decisions for them without their involvement.
  • Ensure that services are sensitive to the diverse need of the victim-survivors considering their age, disability, gender, race or ethnicity, religion or belief, sexual orientation, but recognise that such differences are not used as an excuse for accepting or perpetrating domestic violence or other harmful practices.
  • Recognise that victim-survivors and their children are most at risk when attempting to leave an abusive relationship or seeking help.

Risk Assessment Integration Module RAIMO

Learning objectives

The learning objectives of this module are to become familiar with the domestic violence risk assessment process, risk and vulnerability factors and the purpose of multi-agency cooperation in risk management.

Introduction

Dear frontline responder, welcome to learn about the domestic violence risk assessment process in a multiprofessional context!

The purpose of this modular tool is to link various risk assessment procedures and enhance the identification of domestic violence among key agencies (e.g. police officers, social work and healthcare professionals, NGO workers, educators) who come into contact with victim-survivors and perpetrators. This tool demonstrates different risk factors and different approaches to identifying and responding to risk.

You can use this tool e.g. as a training material or a database.

We present the four steps of the domestic violence risk assessment process from risk identification all the way to follow-up.

The Good-read section provides you with recommendable reading. From the Materials section you will find printable items such as checklists. Do not forget to print your own pocket version of the risk assessment checklist – with it, you may save somebody’s life.

Content:
Principles of the risk assessment process
Step 1: Identification of risk factors
Step 2: Risk assessment
Step 3: Outlining necessary actions
Step 4: Follow-up
Good-read
Materials


Principles of the risk assessment process

Risk assessment is a cornerstone in domestic violence prevention (Kropp 2004). The purpose of domestic violence risk assessment is to prevent repetitious violence by identifying the perpetrator’s risk of recidivism (Svalin & Levander 2019, 1), circumstances that may increase the risks of violence as well the victim’s vulnerability factors by conducting a risk assessment and implementing interventions to manage the sources of risks.
In the European Manual for Risk Assessment, Albuquerque et al. (2013, 41) define the principles of risk assessment as following:

  1. Risk Assessment is a process that can only be made with the victims’/survivors’ collaboration
  2. Victims/Survivors own assessment of their safety and risk levels must be considered. Research shows that victims/survivors have the most accurate assessment of their own risk level
  3. Victims/Survivors must be listened to without the presence of the perpetrator, family and/or their community members
  4. Children should have the opportunity to talk
  5. Professionals have the responsibility to assess, manage and monitor the perpetrators risk
  6. Professionals, in case of significant harm to children, must consider and agree on the best procedure that safeguards and protects them
  7. It is important to clarify the limits of the risk assessment and management process
  8. No improbable or unrealistic promises should be made

Professionals should also have knowledge of the dynamics of domestic violence, the impact of IPV on victims-survivors, the factors that influence women’s decisions on leaving or remaining in the violent relationship, the strategies perpetrators use and the risk factors (Albuquerque et al. 2013, 35).


Step 1: Identification of risk factors

Learning objectives

The learning objectives of this module are to become familiar with the domestic violence risk and vulnerability factors and to understand why all the professionals should have basic knowledge regarding the risk identification.

Risk assessment is a process, that begins with identifying the presence of risk factors and determining the likelihood of an adverse event occurring, its consequences and its timing (Australian Institute of Health and Welfare 2010; Braaf & Sneddon 2007).

This is Nora. She will be our guide in demonstrating the steps of risk assessment.

Read first about Nora’s case and then learn more about risk identification.


Case scenario

Nora is a 34-year-old woman with an immigrant background. She has lived here in your country for three years with her parents and sisters. Nora married Peter two years ago. Peter is the son of a family friend of Nora’s parents. Nora’s family comes from a patriarchal culture where the community comes before the individual.

Nora’s marriage with Peter was a relief for Nora’s family since in their culture a woman at Nora’s age should not be single. However, quite soon after Nora and Peter got married, Peter started to control her everyday behaviour. Peter does not let Nora see her friends or go anywhere without him. A mandatory language course is the only place where Nora can go alone.

Peter takes away Nora’s debit card and takes loans under her name. When Nora tries to resist, Peter turns violent and abuses her. Peter threatens to send Nora back to her home country.
Nora discloses the situation to her parents, asking for help. First, the parents take Peter’s violent behaviour seriously, but suddenly Nora’s father passes away. Nora’s grieving mother is not capable of standing against Peter’s will on her own.

At the same time, Peter spreads rumours about Nora’s immorality in order to justify the claims of his violent actions to their community. The rumours humiliate Nora’s family. The community pressures Nora’s mother and her sisters’ families to clear their name.

Nora’s mother begs Nora to stay with Peter to calm the situation and her sisters ask her not to bother their mother with the issue any more. Nora feels that she is responsible for the violence and her family’s reputation, and accepts that divorcing Peter is out of the question.

Over time, the violence gets more serious and more frequent. On one occasion, Peter strangles Nora for so long that she loses consciousness. After the strangulation, she starts to have speech impairment issues especially in stressful situations. Nora feels isolated, helpless and depressed.

Peter has threatened to share some private pictures of Nora in public if Nora ‘ruins his reputations as a husband’, as he puts it. Nora feels anxious since she cannot talk to anyone – even her family – about her feelings.

Tasks

This was the story of Nora. Take one minute to think of the following questions:

(1) Which acts, situations or conditions endanger Nora?

(2) Which situations described in the story you consider unfortunate but not your business as a frontline responder?

There may be some risk factors that do not concern your profession. However, identifying and documenting these risk factors is important in order to have a comprehensive understanding of the sources of risks. This is needed in the phase of risk management.

Now, read more about the identification and documentation of risk factors.

Risk factors to identify

Critical domestic violence risk factors

Key point: There may be some risk factors that do not concern your profession. However, identifying and documenting these risk factors is important in order to have a comprehensive understanding of the sources of risks. This is needed in the phase of risk management.

Several factors may indicate escalation of domestic violence. Every frontline responder should have sufficient training and knowledge to be able to identify these critical risk factors. By every frontline responder, we mean uniformed police officers, crime detectives, social workers, nurses, doctors, educators or NGO workers.
In the table below, we present the critical risk factors and their explanations.

Risk factorJustification
Previous physical violencePrevious physical violence is the best predictor for future violence
Violence is occurring more frequently or violence is more intensive (harmful, injurious)Escalation over time is characteristic of some violent relationships, particularly where the offender is persistent and engages in serious behaviours. Note that not all the violent incidents are reported to the frontline responders, thus it is possible that assessments made by victim–survivors better account for all acts of violence including both non-physical behaviours and coercive control. (Boxall & Lawler 2021)
Coercive controlCoercive control is a pattern of behaviour that intimidates and frightens the victim.
Extreme jealousy

Obsessive thinking
Extreme jealousy and obsessive thinking are risk factors for domestic violence. Severe jealousy can be a crucial risk factor. Severe cases of jealousy may also meet the diagnostic criteria for delusional disorder. Jealousy in intimate relationships should therefore be assessed as a part of psychiatric evaluation. (Koskelainen & Stenberg 2020.)
Victim has left for another partnerVictim leaving an abusive partner for another partner poses a significant risk factor for femicide (Campbell et al. 2003)*.
Perpetrator’s stepchild in the homeHaving a child living in the home who is not the abusive partner’s biological child more than doubles the risk of femicide (Campbell et al. 2003)*.
StrangulationStrangulation in the context of domestic violence is a ‘red flag’ risk factor for future serious harm and death (Douglas & Fitzgerald 2014.) Prior non-fatal strangulation increases the risk of attempted homicide by over six times and a completed homicide by more than seven times (Glass et al. 2008).
Victim-survivor is trying to divorce/separate or has divorced/separatedThe risk of intimate partner femicide was increased 9-fold by the combination of a highly controlling abuser and the couple’s separation after living together (Campbell et al. 2003)*.
Mental health issues of perpetratorThere is significant relationship between anger problems, anxiety, depression, suicidal behaviour, personality disorders, alcoholism or problem gambling and perpetration of domestic violence (Sesar et al. 2018)
Substance abuse issues of perpetrator/victim-survivor

Perpetrator’s access to a firearm
Both abuser’s access to a firearm and abuser’s use of illicit drugs are strongly associated with intimate partner femicide. Neither alcohol abuse nor drug use by the victim was independently associated with her risk of being killed (Campbell et al. 2003)*. However, substance abuse issue of a victim-survivors may prevent them from seeking or receiving help as they may not be considered as ‘ideal victims’ (see Christie 1986).
Social isolationSocial isolation has been linked to the risk of being abused (Farris & Fenaughty 2009). Social isolation may also be a consequence of abuser’s controlling behaviour.
Negative life changes of the perpetrator and economic stressSuch as unemployment or bankruptcy. Economic stress may increase the risk of domestic violence but domestic violence may also cause financial problems for victims and entrap them in poverty and an abusive relationship (Renzetti 2009).
Other forms of domestic abuseIncluding e.g. economic, sexual, psychological, chemical and digital violence, negligence, forced marriage, FGM and human trafficking.
Victim-survivor is pregnant or has a babyAbuse during pregnancy is a significant risk factor for future femicide (Campbell et al. 2003).
Violence towards petsThere is a correlation between cruelty to animals and family and domestic violence. Abuse or threats of abuse against pets may be used by perpetrators to control and intimidate family members.
Threatening to killIn intimate partnerships, threats to kill are often genuine.
*) = when compared victims of femicide (n = 220) and randomly identified abused women (n = 343).

Risk related information to check by each professional

Key agencies should work to a shared understanding of risk, but the nature of their work may mean that they will be able to identify different risk factors. The perspective of a police officer differs from the perspective of a social worker. In the table below, we present the risk factors that relate to different professionals’ perspectives.

POLICESOCIAL WORK/EDUCATIONHEALTH CARE 
The perpetrator has access to firearmsThe victim is not allowed to meet a social worker aloneThe victim has symptoms of strangulation
The perpetrator has used a weapon in the most recent event.Signs of substance or non-substance addictive behavior including co-addiction (by partners or family members).The victim is not allowed to see the nurse/doctor alone or the victim seems fearful.
The perpetrator  has previous criminal record entries, especially records of violent crimes.Signs of conflict behavior that may lead to potential escalation of conflict.There are prior (partly healed) injuries on victim caused by trauma.
The perpetrator has previously violated a restraining order.The perpetrator is experiencing high levels of stress.Victim’s or/and perpetrator’s depression or the symptoms of PTSD of victim.
More than three house-calls to the same address within one year. Victim’s or perpetrator’s suicide attempts.

Victim’s vulnerability factors

Key point: Identification of victim’s vulnerability factors helps professionals to invite the relevant key agencies in the cooperation, to support the victim in a holistic manner, and to strengthen the victim’s capacity to follow the security strategies.

Victim’s vulnerability factors relate to the victim’s person and life circumstances. They may relate, e.g. to the capacity to trust public authorities, leave the abuser, or the dependency on the abuser. However, these are not reasons why the abuse happens. Perpetrators may choose to exploit vulnerabilities of victims; some victims’ life experiences and circumstances may make it more difficult to survive or escape abuse. Below we have listed the vulnerability factors and explained why and how these factors may affect the victim’s resources and life situations as well as the ability to cooperate with the professionals.

Elderly person

  • A victim may be dependent on a violent family member or the victim may be the only responsible caregiver for a violent family member. Thus, leaving a violent family member may not be an option for the victim. Victim may already be socially isolated.
  • Leaving may require moving to a new address and securing the contact information.
  • A perpetrator may have experienced caregiver burnout.
  • An elderly person may experience overwhelming shame for the situation especially if the perpetrator is an adult child.
  • Abuse can occur in many forms, such as physical, sexual, emotional, or financial abuse, negligence, isolation and abandonment. Note also signs of depriving of dignity (e.g. untidy appearance, soiled clothes) or choice over daily affairs, signs of insufficient care (e.g. pressure sores) or over- or under-medicating (WHO 2020).

Minor

  • Minors are nearly always dependent on the perpetrators.
  • Growing up in a hostile environment normalizes the experiences of violence and thus the victims may not perceive their experiences as violence.
  • Minors may think their experiences are not believed by the outsiders.
  • The patterns of coercive control, such as restriction, isolation and a deprivation of personal freedom may be difficult to discriminate from parental upbringing and protective measures

Note: In some immigrant or otherwise socially or religiously strongly controlled families, differences between cultural values, lifestyles and views may inflict conflicts between the minors and their parents. Authorities’ non-diplomatic contacts or rash measures may increase the risk that the parents send the child to their native countries to boarding schools or to be raised by relatives. This may increase the risk for FGM, child-marriage as well as breaks in education, social relations and integration.

Disabled person

  • Disabled persons may be functionally dependent on the perpetrator in everyday life, needing assistance in moving, eating, communicating, medicating
  • The violent family members or caregivers may experience caregiver burnout
  • Victim-survivors may have difficulties to make themselves heard, understood or believed

The perpetrator may explain injuries as accidents caused by dyskinesia.

Dependency on perpetrator

There are several forms of dependency such as financial and emotional dependency. Also structural reasons such as hierarchical gender relations or rural disparity contribute to dependencies; for instance, when compared to urban women, rural women experience higher rates of DV yet live farther away from available resources (Peek-Asa et al. 2011).

Refugee background

Rates of mental health disorders, such as anxiety disorders, PTSD and depression are higher among refugee populations in comparison to the general population. This increased vulnerability is linked to experiences prior to migration, such as war exposure and trauma. (Hameed et al. 2018.) In addition, language barriers or negative experiences of police and distrust towards authorities may prevent the victims from seeking help.

Homeless person

Homelessness is often a consequence of domestic violence and it increases the vulnerability and dependency of the victim. Social marginalization may prevent the victims from seeking help.

Victim belongs to an ethnic minority

Language barriers, negative or discriminative experiences of the police, fear of not being believed, experiences of racism, social marginalization or the power of parallel societies may prevent the victims from seeking help.

Victim belongs to sexual or gender minority

A victim may fear of being ‘outed’ to family members, friends, and co-workers if they report police about domestic violence. A victim may fear discrimination or disrespectful treatment by the police.

Strong fear

Fear of an abusive partner may weaken women’s ability to improve their life situations (Sabri et al. 2014). An atmosphere of fear is likely to increase maladaptive thinking patterns inhibiting problem-solving and increasing denial and avoidance (Calvete, Susana & Este’Vez 2007).

Mental health issues

Apart from being a consequence of domestic violence, e.g. posttraumatic stress disorder (PTSD) can also be a risk factor for IPV revictimization (Kuijpers, van der Knaap & Winkel 2012).

Family or community is justifying violence based on honour/culture/religion

If the family or the community of the victim approves and justifies violence, the victim may be extremely scared, isolated, coerced and controlled. The victim may feel powerless to seek help. For many victims it may be an unthinkable to abandon their entire community to live without violence, and even if they did so, leaving the family or community may escalate the violence.



Guidelines for case documentation

Key point: Case documentation of DV is an important procedure. The professionals may need previously documented information in the dynamic risk assessment and management process. Standardized risk assessment tools support frontline responders’ work in documenting the case.

Since risk assessment is – or at least should be – a dynamic process that needs be started over again if the risk situation changes, case documentation of domestic violence and its’ risk factors is an important procedure. A careful case documentation should ensure that the professional find previously documented information to revise the risk assessment. Standardized risk assessment tools support frontline responders’ work in documenting the case. Nevertheless, risk assessment should not endanger the victim’s safety at any point. Thus, there should be clear protocols and safety restrictions for documenting the risk assessment, risk management and certain risk factors. For example, this data should not be included the pre-trial investigation records that are part of the judicial process: the perpetrator should not have access to victim-survivors’ risk assessment documentation. Data protection and the boundaries confidentiality as well as the victim-survivors consent to share information are key issues when intervening domestic violence and abuse (Albuquerque et al. 2013).

In the tables below we present the basic guidelines for the case documentation.

General guidelines for case documentation
Document to the confidential risk assessment form:
1. all identified risk factors
2. your overall assessment of the risk situation
3. victim’s own assessment of his/her level of risk and fear of being killed   

Guidelines for case documentation for police, social work and health care

POLICESOCIAL WORKHEALTH CARE
Documentto the crime report:
1. a verbal description of all injuries and other signs of violence
2. whenever possible e.g. photos of the injuries, other photos, videos, message transcriptions
Document to the citizen/client database:
1. case specific cooperation and communication with other FLR
2. specific behaviour reported e.g. who did what to whom and who provided the information
3. impact on the child 4. known protective factors of the child, adult victim and perpetrator
Document to the patient database:
1. right diagnostic codes and follow all defined registration procedures for DV situations
2. photos of injuries
3. use of body scheme

Step 2: Risk assessment

Learning objectives

The learning objectives of this module are to become familiar with the domestic violence risk assessment procedure, different risk assessment tools and high-risk moments that may increase the risk.

Risk assessment is a phase, during which the level of the risk and its nature are assessed. Start with reading how risks are assessed in Nora’s case. Then take a look at the general guidelines, risk assessment tools and high-risk moments.


Case scenario: Nora

One day Nora finds a phone number of an NGO that helps immigrant women. The phone service is also in Nora’s native language. Nora calls the service phone anonymously to ask for legal advice about what happens to her residence permit in the case of a divorce. The NGO worker asks Nora about her life situation. Nora discloses her difficult situation and anxiety.

The NGO worker meets Nora at the school after the language course since it is the only place where Nora can go alone. With Nora’s consent, the NGO worker contacts the police and a responsible social service worker.

In some EU-countries the legislation allows the professionals to share and exchange information for more comprehensive risk assessment, if it is necessary to protect a child, to prevent a violent act or if the victim has given her consent. In some EU-countries, however, there is no legislative support in relation to information exchange between the police, social work or health care sectors. Hence, multi-agency mechanisms within the EU range from the adoption of formal or informal referral mechanisms to the presence of multidisciplinary teams or conferences that are mandated by legislation or by policy documentation on risk assessment.

The Istanbul Convention requires the State parties to take the necessary legislative or other measures to ensure that an assessment of the lethality risk, the seriousness of the situation and the risk of repeated violence is carried out by all relevant authorities in order to manage the risk and if necessary to provide co‐ordinated safety and support.

The next example of how Nora’s case is brought into the multi-agency risk assessment process is based on the requirements of the Istanbul Convention. This may differ from your national legislation.
With the consent of Nora, the police, the social service worker, the NGO worker and a representative of the health care sector participate in a risk assessment conference. Nora has given her consent that the professionals can share and exchange information regarding Nora.

Look at the boxes to see what kind of information can be collected by multi-agency co-operation:

If Nora is asked about her situation, she may tell us this:

– Her speech issues developed four months ago after Peter had strangled her
– She fears that Peter will kill her if she separate from him
– She is worried that her residence permit will be cancelled if she separates; this is what Peter has told her
– She is worried that the police won’t believe her since she is an immigrant but Peter has the nationality of this country
– Peter has told that he will publish private sexual pictures of her if she tells anyone about the violence or tries to leave him
– Peter has said that he will make sure that no decent man will ever even look at Nora if she separates from Peter.

The identified risk factors

The purpose of risk assessment tools is to help frontline responders identify all the risk factors and to create a complete overview of the victim’s situation in order to ascertain whether she remains at risk of serious harm and can assist in the development of a safety plan.
A calculation of the probability of becoming a victim of serious violence does not help the victim, but the calculation and the frontline responders’ own judgment of the situation support the frontline responders in taking necessary action to protect the victim, and to prevent future violence. In this scenario, the frontline responders have identified the following risk factors and victim’s vulnerability factors:

Peter is
• using violence more frequently
• using more intensive (harmful, injurious) violence

Peter has
• strangled Nora
• used coercive control
• used physical violence
• used economic, digital and psychological violence
• previous criminal record entries

Nora
• is planning a divorce
• has an immigrant background

Nora experiences
• strong fear
• social isolation
• mental health issues

The community of Nora and Peter is justifying violence by
• honour

Task

In order to enable constructive and smooth co-operation between different agencies, the legislation should be clear and every partner should understand their roles and responsibilities.

(1) Do you know, in which situation you can share and exchange information with other agencies?

General guidelines for risk assessment

Key point: Risk assessment is needed in the safety planning of the victim and in managing the sources of risks.

  • Collect as much information as possible about the identified risk factors
  • Risk assessment needs to address both adult and child victim-survivors
  • Risk assessment should be done with the victim-survivor, not to her/him
  • Ideally, with the consent of the victim-survivor, information is shared e.g. with the police, prosecutor, social work, health care sector and relevant NGOs
  • Respect the victim-survivors wish with whom to cooperate
  • Assess the immediate risks to the safety of the client/patient or any children
  • Use your national/local risk assessment tool to assess the risks and ask for training
  • In case you cannot access national/local risk assessment tools, use internationally accepted risk assessment tools and ask for training. You find tools under “Risk assessment tools”
  • If possible, also assess the risk based on the information you have about the perpetrator (for example as a probation officer, prosecutor or prison employees)

Risk assessment tools

Key point: There are several risk assessment tools for screening and documenting domestic violence as well as to assess the level of the risk. Appropriate use of these tools requires training.

There are different kinds of risk assessment tools used by the frontline responders. Some organisations have developed their own tools. However, below you can see some of the most widely used risk assessment tools.

DASH/MARAC

The DASH risk assessment checklist is based on research of e.g. indicators of homicides. The form can be filled in by any public official (e.g. a police officer, a social worker, a nurse, a doctor, an NGO worker) who works with a victim of violence, however, training on this risk assessment tool should be undertaken before it is used.
DASH risk assessment form includes questions about financial, psychological and physical violence and as well as threats. If a certain number of the risk indicators is met, the professional will refer the case to his/her local MARAC (Multi-Agency Risk Assessment Conference).
Scoring a certain number of points on the checklist is not an absolute requirement for referral to a MARAC since the professional may refer the case to a MARAC if s/he has concern for a victim.
A third criterion for referral to a MARAC is the escalation of recent violence, which is measured in terms of the number of domestic disturbance calls made to the police over the last twelve months. A common practice is to submit a case to a MARAC if at least three domestic disturbance calls have been made within a single year.
Source: https://rikoksentorjunta.fi/en/marac
See also VS-DASH 2009 – The Stalking Risk Identification Checklist

DA (Danger Assessment)

The series of 15 questions on the Danger Assessment is designed to measure a woman’s risk in an abusive relationship.
The tool can with some reliability identify women who may be at risk of being killed by their intimate partners. According to studies, almost half of the murdered women studied did not recognise the high level of their risk. Thus, risk assessment tools like the Danger Assessment may assist women and the professionals who help them to better understand the potential for danger and the level of their risk. Completing the Danger Assessment can help a woman evaluate the degree of danger she faces and consider what she should do next. Practitioners are reminded that the Danger Assessment is meant to be used with a calendar to enhance the accuracy of the assaulted woman’s recall of events. Read more: https://www.ncjrs.gov/pdffiles1/jr000250e.pdf
The Danger Assessment can be printed from http://www.son.jhmi.edu/research/CNR/homicide/DANGER.htm, which also gives directions regarding permission for use.

VRAG

The violence risk appraisal guide (VRAG) is an actuarial instrument. It assesses the risk of further violence among men or women who have already committed criminal violence. It is empirically supported actuarial method for the assessment of violence risk in forensic populations.
The VRAG is a 12-item actuarial instrument that assesses the risk of violent recidivism among men apprehended for criminal violence. The recommended basis for scoring the VRAG for research and individual assessment is a comprehensive psychosocial history addressing childhood conduct, family background, antisocial and criminal behavior, psychological problems, and details of offenses. Adequate psychosocial histories include more than past and present psychiatric symptoms and rely on collateral information (i.e., material gathered from friends, family, schools, correctional facilities, the police, and the courts). Scoring the VRAG is not a clinical task in its typical sense because it does not require contact between the assessor and the person being assessed. Nevertheless, compiling the required psychosocial history clearly is a clinical task, and expertise is required to score VRAG items from psychosocial histories.
http://criminal-justice.iresearchnet.com/forensic-psychology/violence-risk-appraisal-guide-vrag/

PATRIARCH

The PATRIARCH assessment tool is a victim-focused checklist. It is based on the structured professional judgement approach to assess the risk of honour-based violence and forced marriage. The tool is comprised of 10 risk factors and five victim vulnerability factors. Its goal is safety planning.
Proper use of the PATRIARCH risk assessment tool requires specialised education and training. http://www.rpksundsvall.se/wp-content/uploads/2009/05/PATRIARCH-4.pdf

ODARA

The ODARA is an actuarial risk assessment tool that calculates whether a man who assaulted his female partner, will repeat it in the future. The 13 ODARA items include domestic and non-domestic criminal history, threats and confinement during the index incident, children in the relationship, substance abuse, and barriers to victim support. Each is scored 0 or 1 and the total score is simply the sum of the items.
The ODARA is considered simple to use and can be used by a wide range of service providers e.g. police officers, shelter workers, victim services workers, health care professionals and social workers. It can be used in safety planning with the victims. The use of such a tool allows service providers from a wide variety of backgrounds to share a common language when talking about risk. ODARA training has improved scoring accuracy.
http://grcounseling.com/wp-content/uploads/2016/08/domestic-violence-risk-assessment.pdf
https://pathssk.org/wp-content/uploads/2017/02/06-b-ODARA-Waypoint.pdf

SARA (Spousal Assault Risk Assessment) and B-SAFER (Brief Spousal Assault Form for the Evaluation of Risk)

The B-SAFER is a condensed version of SARA. It is a structured risk assessment instrument designed to identify persons who are at risk from intimate partner violence. B-SAFER is constructed specifically for police officer use because of their role as frontline responders in domestic abuse incidents. SARA has been considered time-consuming for police officers to complete. Therefore SARA’s 20 items were reduced to 10 items in the B-SAFER.
The B-SAFER 10 items are divided into two subsections: Perpetrator Risk Factors (items 1-5) and Psychosocial Adjustment (items 6-10). Each subsection has an option to note an additional risk consideration that the assessor believes may be important to a particular case.
The purpose of B-SAFER is to “guide and structure an assessor’s decision-making regarding a perpetrator’s future intimate partner violence risk through evaluation of risk factors that are empirically associated with spousal violence”.
https://www.unb.ca/saintjohn/ccjs/_resources/pdf/ipvrisktoolsynopsis2013.pdf

High-risk moments and triggers for increasing risk

Key point: Be aware of high-risk moments and triggers for increasing risk. Agencies should be aware of the need for additional safety planning and support for victims around events that may contribute to risk.

  • Perpetrator is given a (court) decision of
    • a restraining order
    • a divorce/obligation to share assets
    • a negative residence permit
    • different than desired child custody decision/child contact arrangements
  • The perpetrator realizes that the situation was reported to police
  • The perpetrator is released from custody
  • The perpetrator is being charged
  • Trial is scheduled/occurred
  • Lead-up to a trial
  • Sentence reading is scheduled/occurred
  • Release from a prison sentence
  • Expiry of a court order
  • A previously violent perpetrator wants to meet “one last time”
  • The perpetrator discovers the new address of the victim
  • The victim declares intention of leaving/separation
  • The victim attempts to leave for separation
  • The victim starts a new relationship

Step 3: Outlining necessary actions

Learning objectives

The learning objectives of this module are to become familiar with the safety planning, risk management and multi-agency cooperation.

Outlining necessary actions is a phase where the frontline responders in close co-operation plan safety measures and take action to ensure the victim’s safety. Again, read first about Nora’s case. Then, look at the to do –list and read why a strong co-operation network is crucial.


Case scenario: Nora

Comprehensive risk assessment should lead to effective risk management. Look at the boxes below: supporting a domestic violence victim sometimes requires help from several different agencies. All the agencies have their own role in supporting the victim. It is important to take legal actions and to support Nora’s well-being, in addition to her relationship with her mother and sisters. Nora needs support from her family members to be able to leave an abusive relationship.

Why we need a strong co-operation network?

Effective multi-sectoral and multi-agency interventions require that all policy sectors and actors are engaged and accountable, namely law enforcement, the judiciary, health, social welfare and child services, employment, education, and general and specialised services for victims. Extensive research and evaluation of existing co-ordinated interventions also demonstrate the importance of involving – in addition to sectoral stakeholders – autonomous victims’ rights advocates and other relevant NGOs working in the field of violence against women. Developing a shared understanding of violence against women, as well as improving information-sharing and risk assessment through the development of common standards, guidelines and protocols can greatly contribute toward the pooling of valuable resources and establishing systematic co-operation. Such tools are also instrumental in securing the active commitment of all stakeholders. (Krizsan & Pap 2016, 12.)

To do -list for the frontline responders

Police

  • Inform the victim about shelters and guide the victim to a shelter if needed
  • Initiate child protection procedures if not yet done
  • File a crime offence report if not yet done
  • By the victim’s consent, contact the victim support services
  • Document information produced by risk assessment and keep it confidential
  • Inform the victim about a restraining order or issue a temporary restraining order
  • Inform the victim of possible moments when the police is going to contact the perpetrator
  • Inform the victim when the perpetrator will be released from custody*
  • Create a safety plan for the victim
  • In case of physical injuries, guide the victim to Health Care services to have them treated and documented
  • Guide the victim to Social Services based on her/his needs for support
  • Make sure all relevant NGOs are invited to participate in the risk assessment process
  • Assist the victim in protecting her/his personal data
  • Take into account the risks of digitally assisted stalking and cyberstalking and help the victim in protecting their digital devices
  • Depending on the legislation, the police can also consider secret means of gathering intelligence prevent crimes or avoid danger
  • Consider the benefits of a portable alarm system for the victim
  • Assist the perpetrator in joining a perpetrator programme*

 * = if this duty does not belong to an another agency

Social work

  • If there is an immediate or even likely risk to the safety of the client or any children, consider contacting the police
  • Initiate child protection procedures if not yet done
  • Inform the victim about shelters and guide the victim to a shelter if needed
  • Help the victim to solve financial problems
  • Secure safe housing for the victim
  • Assist the victim in protecting her/his personal data
  • Assist the victim in getting immediate crisis help and psychosocial support

Health care

  • Always examine the patient without their family members or spouse being present
  • Assist the victim in receiving immediate crisis help and psychosocial support
  • If there is an immediate risk to safety of the patient or any children, consider contacting the police
  • Initiate child protection procedures if not yet done
  • Ask for victim’s consent before letting in any visitors

Step 4: Follow-up

Learning objectives

The learning objectives of this module are to become familiar with the purpose of the follow-up phase and to understand the need for a dynamic risk assessment process.

Follow-up is a phase, during which the frontline responder is in regular contact with the victim. Read first why we need the follow-up phase and then see what the follow-up looks like in Nora’s case.


Why do we need the follow-up phase as a part of the risk assessment process?

Despite an effective intervention, an abuser may continue being violent and oppressive towards the victim. There are many reasons why a victim of DV may not be able to leave the abuser: e.g. (mutual) dependency, fear or financial issues. Usually it takes several attempts to leave an abuser before staying away for good. Sometimes separation escalates the violence. The victim may try to control the violence by staying in the relationship. The victim may leave the abuser, but the abuser starts stalking and harassing the victim. Child contact arrangements may be used as way to carry on subjecting victims to violence. In a nutshell, the situation may get worse.

Ideally, risk assessment is a dynamic process. Risk assessment needs to be regularly revised. If the threat of violence continues, the process of risk assessment needs to start over again. Effective prevention of DV and breaking the cycle of violence may require several interventions.

Case scenario: Nora

A lot has happened since Nora’s first meeting with an NGO worker.

Nora currently stays in a shelter. She has a support person from the Victim Support Service as well as from an NGO that provides assistance for immigrant women who have faced violence. She also has regular meetings with a psychiatric nurse.

Police has filed a report of assaults, defamation, threatening and frauds committed by Peter. Nora has got a restraining order against Peter. Nora has learnt from her lawyer that divorce does not affect her immigration status.

Nora has a new bank account and a new secret phone number. She attends the language course in another school. Nora meets the NGO worker every week. The NGO worker has mediated the conflict between Nora and her mother and sisters successfully.

Everything seems to be fine now, right?

However, Nora is scared. She is terrified of the possibility that Peter will find her. A fear of death is taking over her life.

When Nora lived with Peter, she felt that she was able to control her fear. She was able to sense Peter’s agitation and she always did everything to avoid an explosion. She pleased Peter and tried to reason with him. She felt how the tension was building and when the violence began, she felt relief: ‘Soon this is going to be over for some weeks. Soon I can breathe again’.
Traumatising experiences make Nora doubt and blame herself.

The NGO worker and the psychiatric nurse always ask about Nora’s fear, but she cannot tell them. She feels overwhelming shame to admit to her helpers that, despite all the help and support she has received, she is terrified. Living with an abusive partner was easier when she did not have to be frightened all the time. She cannot reveal these thoughts to anyone.

Nora becomes even more confused when she meets a friend of Peter by chance. The friend tells that Peter is sad and upset. The friend says that Peter has been extremely worried about Nora and has tried to find her.

‘He is not doing very well.’

‘Please call him.’

The human mind is complex. What could happen next in Nora’s case? What if Nora calls Peter? Will Peter find Nora or will Nora return to Peter? What if Nora tells about this incident in the next meeting with the NGO worker?

Monitoring the situation and keeping a trustful and safe relationship with the victim are extremely important. Here, Nora discloses to the NGO worker how she is worried about Peter’s condition. This leads to a discussion of Nora’s fears and self-blame. The NGO worker pays attention to the message that Peter has been trying to find Nora.

If Nora’s situation changed, the frontline responders would revise the risk assessment and take new appropriate measures. For example, depending on the legislation, the police can consider secret means of gathering intelligence to prevent crimes or avoid danger. A portable alarm system could ease the fear Nora is experiencing. There are many options.

Thank you for reading Nora’s story.

Learn more about domestic violence risk assessment from the Good-read section. Don’t forget to print your own risk assessment checklist from the Materials section.


Good-read


References

Albuquerque, M., Basinskaite, D., Medina Martins, M., Mira, R., Pautasso, E., Polzin, I., Satke, M., Shearman de Madeco, M., Alberta Silva, M., Sliackiene A., Manuel Soares, M., Viegas, P. & Wiemann, S. (2013). E-MARIA: European manual for risk assessment. Bupnet, Göttingen. Retrieved from: https://e-maria.eu/wp-content/uploads/2011/10/Manual-latest-version-light-colours.pdf

Australian Institute of Health and Welfare (2015). Screening for domestic violence during pregnancy: options for future reporting in the National Perinatal Data Collection. Cat. no. PER 71. Canberra: AIHW. Retrieved from: www.aihw.gov.au/getmedia/62dfd6f0-a69a-4806-bf13-bf86a3c99583/19298.pdf.aspx?inline=true

Boxall, H. & Lawler, S. (2021). How does domestic violence escalate over time? Trends & issues in crime and criminal justice no. 626. Canberra: Australian Institute of Criminology. Retrieved from: https://www.aic.gov.au/publications/tandi/tandi626

Braaf, R., & Sneddon, C. (2007). Family Law Act Reform: the potential for screening and risk assessment for family violence – Issues paper 12.

Calvete E., Susana C. & Este’Vez, A. (2007.) Cognitive and coping mechanisms in the interplay between intimate partner violence and depression. Anxiety, Stress, Coping. 2007;24(4):369–382.

Concha, M., Sanchez, M., de la Rosa, M., & Villar, M. E. (2013). A longitudinal study of social capital and acculturation-related stress among recent Latino immigrants in South Florida. Hispanic Journal of Behavioral Sciences, 35(4), 469–485

Douglas, H. & Fitzgerald, R. (2014). Strangulation, Domestic Violence and the Legal Response. The Sydney law review. 36. 231.

Gurm, B., Salgado, G., Marchbank, J., & Early, S. D. (2020). Making Sense of a Global Pandemic: Relationship Violence & Working Together Towards a Violence Free Society. Kwantlen Polytechnic University: Surrey, BC. Ebook ISBN 978-1-989864-14-2 or Print ISBN 978-1-989864-13-5. https://kpu.pressbooks.pub/nevr/

Hameed, S., Sadiq, A., & Din, A. U. (2018). The Increased Vulnerability of Refugee Population to Mental Health Disorders. Kansas journal of medicine, 11(1), 1–12.

Koskelainen, M. & Stenberg, J-H. (2020). Mustasukkaisuudesta harhaluuloisuushäiriöön: tunnistaminen ja väliintulot osana lähisuhde-väkivallan estämistä. Lääketieteellinen Aikakauskirja Duodecim 2020;136(6):611-6

Krizsan, A. & Pap, E. Implementing a Comprehensive and Co-ordinated Approach: An assessment of Poland’s response to prevent and combat gender-based violence (Council of Europe, 2016), page 12 https://rm.coe.int/168064ecd8

Kropp, P. R. (2004). Some Questions Regarding Spousal Assault Risk Assessment. Violence Against Women, 10(6), 676–697. https://doi.org/10.1177/1077801204265019

Kuijpers, K., van der Knaap, L. & Winkel F. (2012). PTSD symptoms as risk factors for intimate partner violence revictimization and the mediating role of victims’ violent behavior. J Trauma Stress. 2012 Apr;25(2):179-86. doi: 10.1002/jts.21676. PMID: 22522732.

Peek-Asa, C., Wallis, A., Harland, K., Beyer, K., Dickey, P., & Saftlas, A. (2011). Rural disparity in domestic violence prevalence and access to resources. Journal of women’s health (2002), 20(11), 1743–1749. https://doi.org/10.1089/jwh.2011.2891

Sabri, B., Stockman, J. K., Campbell, J. C., O’Brien, S., Campbell, D., Callwood, G. B., Bertrand, D., Sutton, L. W., & Hart-Hyndman, G. (2014). Factors associated with increased risk for lethal violence in intimate partner relationships among ethnically diverse black women. Violence and victims29(5), 719–741. https://doi.org/10.1891/0886-6708.VV-D-13-00018

Svalin, K. & Levander, S. (2019). The Predictive Validity of Intimate Partner Violence Risk Assessments Conducted by Practitioners in Different Settings—a Review of the Literature. Journal of Police and Criminal Psychology. 35. https://doi.org/10.1007/s11896-019-09343-4.

WHO (2020). World Health Organisation. Elder abuse. [Referred 21st of April 2021.] Retrieved from: https://www.who.int/news-room/fact-sheets/detail/elder-abuse


Materials

Domestic Violence Risk Assessment Checklist (PDF, 0.3 MB)


Good practice examples

In the eight countries IMPRODOVA took place, we identified different good practice examples regarding inter-agency cooperation that we want to introduce to you.

The cross-referenced analysis of 18 case studies in the IMPRODOVA countries lets us conclude five organisational features that were found in “all good partnership practices” against domestic violence. This should not suggest that it would be sufficient to set up the “right organisation”, i.e., an organisational structure that displays these five characteristics, to generate dynamic, productive and sustainable inter-institutional cooperation.

The analysis of the 18 case studies shows that the consolidation of a partnership against domestic violence depends on many factors that have nothing to do with the partnership organisations’ design and management. By consolidation, we address the institutionalisation and systematic use of working procedures by which partnership bodies and partnership relays contribute together and in an integrated manner to provide efficient partnership services.

These factors include:

  • the existence of a legal framework or public policy that encourages or even enforces partner organisations to engage in the partnership and consider it a priority. These incentives can be negative (regulatory obligation, hierarchical order, etc.) or positive (granting of subsidies, allocation of additional resources, etc.);
  • increased social, political and media pressure to strengthen the war on domestic violence. These pressures are often linked to public opinion cases, advocacy, or the adoption of international standards;
  • strong involvement of institutional entrepreneurs and change agents in the design and promotion of the partnership mechanism, and their ability to build alliances with members of influential partner organisations;
  • securing political support, especially from local authorities;
  • reference to models applied elsewhere – on the national territory or abroad – that are already acknowledged as “good practices”. Such recognition is rarely linked to the availability of rigorous evaluations of “good practice” effectiveness. It most often results from the notoriety of the institutions that have pioneered the practice or are working to disseminate it.

Below, you may find detailed information about the good practices. To get more information about our research results, you may download our report:

National Crisis Telephone (Hungary)

The National Crisis Management and Information Telephone Service (OKIT) was launched in 2005, based on the findings and experiences of a pilot program related to a hotline focusing on domestic violence. At that time, mental health professionals, psychologists, social workers, social pedagogues, and experts in social policy took part in a complex training program and joined the team of counsellors.

OKIT aims to respond to this situation: it helps victims of domestic violence and human trafficking through a telephone line available free of charge, non-stop throughout the country. Trained domestic violence counsellors (operating two lines 24 hours a day, 7 days a week, with an additional line on workdays between 8 am and 4 pm when the service receives the most calls) primarily provide counselling and information about available victim support services. In addition, they refer victims leaving their homes and escaping the abusers to shelters which OKIT closely cooperates with. A risk assessment tool supports the counsellors in assessing crisis situations and making decisions about the adequate response. No physical evidence is required to support a client’s case. The organisation can offer a low-threshold service targeted to the complex needs of DV victims and thereby decrease latency.

The telephone service staff is made up of qualified helping professionals with many years of experience in the field. Staff receive internal training during the induction period as well as taking part in regular training events to improve their work. Colleagues regularly get supervision in a group setting, but individual supervision sessions are also available. Apart from this, the staff have regular meetings during which they discuss cases. OKIT is part of the Crisis Management Network (which also includes, crisis shelters, crisis clinics and secret safe shelters), the network members often meet up for workshops, training events and conferences, where new issues, trends, challenges, and developments are discussed to share goods practices, thinking together, and improving the services for clients. As a telephone service, OKIT also takes part in training events led by experts at other telephone support services.

OKIT has initiated a chat service as well, for victims of domestic violence, child abuse and human trafficking, who have difficulties acquiring help quickly via other channels. The website of OKIT has undergone further developments in recent years: it now has information in multiple languages and the accessibility of the website has also been improved.

http://bantalmazas.hu/

Living Free of violence (Austria)

Living FREE of violence is a campaign to prevent violence against women and children founded in 2014. “Living FREE of Violence” (GewaltFREI leben) is coordinated by the Federal Ministry for Education and Women’s Affairs and implemented by the association “Autonomous Austrian Women’s Shelters” (Verein Autonome Österreichische Frauenhäuser, AÖF) in cooperation with the Vienna Intervention Center against Violence in the Family (Wiener Interventionsstelle gegen Gewalt in der Familie) and the Austrian National Youth Council (Bundesjugendvertretung). In the years 2014 and 2015, numerous projects aiming at awareness-raising for the issue of violence against women and children and providing valuable prevention work will be implemented.“

http://www.gewaltfreileben.at/en

Their homepage provides a broad range of information on domestic violence as well as training material and guidelines for practitioners.

Anchor Team (Finland)

What is an Anchor team?

In Finland there are multi-agency teams (“Anchor teams”) working in several police departments. Anchor teams consist of police officers, social workers, and psychiatric nurses. Anchor teams vary in terms of composition in different locations.

The multi-agency cooperation and the exchange of information between the police, social services and health care, which is the core of the Anchor method, are based on an agreement between the police and the city (note: municipalities have a duty to provide social and health care services, also in situations of domestic violence).

The Anchor (“Ankkuri”) model supports the wellbeing of children and adolescents and is geared towards the prevention of juvenile delinquency and crime, violent radicalisation and extremism. In some places, like in case location 1, the Anchor model is also used to prevent domestic and intimate partner violence by intervening in incidents at the earliest possible stage and by referring the parties involved to relevant support services (see https://ankkuritoiminta.fi/en/frontpage).

The Anchor model is based on multi-agency cooperation, which involves different public authorities working together at police stations. An Anchor team may consist of a police officer, two social workers, a social advisor, a psychiatric nurse, and a youth worker. The social workers, the social advisor, the youth worker, and the nurse are municipal employees. The staff cooperates closely as a team, each bringing their own professional competence and the support and expertise of their own background organisation to the team.

Multidisciplinary cooperation makes it possible for professionals to serve the customer in a holistic manner based on a ‘one-stop shop’ principle. While the police officer from the investigation unit investigates the crime, the Anchor team’s health care and social work professionals look into the overall circumstances of the customer and his/her family. The Anchor team’s social workers and nurse assess the needs of the customer and refer him/her to further services such as victim support services, shelter services, NGOs working against domestic violence, mental health services etc. The benefits of this holistic approach and multi-agency cooperation are evident in challenging situations where the customer suffers from multiple problems like domestic violence, substance addiction and mental disorder.

Effective victim identification and detection

The involvement of handling domestic violence depends on the particular police station. Some of the anchor teams are very active in identification of domestic violence victims. The following case example describes the outreach work of an Anchor team.

The police officer of the Anchor team goes over all the local emergency reports two times per week and searches for expressions that indicate conflicts between couples, disturbing behaviour, mischief, or disorder. For example, an emergency report may be categorised as “disturbing behaviour” in the situation where there has been a noisy person in the corridor, but in reality, this person can be a person who has escaped to the corridor from her violent spouse. The police officer selects all the reports that refer to conflicts or arguments and collects these reports to generate an observation that is more precise.

After selection, the police officer tries to identify the persons from the emergency reports. The aim is to identify persons who associate with the reports by using different registers. After identification, the police officer collects data about the person’s living conditions, for example information about children and people living at the same address.

The Anchor team meets regularly. In the meeting, all of the selected, identified cases are presented to the social worker, the social advisor, and the psychiatric nurse. The police officer examines if the person has previously been in contact with the police. The social worker examines, among other things, if the family is a client of the child welfare service. The psychiatric nurse examines, for instance, if the medical reports give any information about mental disorders of the family’s children. This way, the Anchor team pieces together a huge amount of information about the family even before the family is contacted. The information exchange is easiest when the customer has children because the cooperation can be justified by the child’s interests without asking the customers to give her or his assent.

The family is contacted by the psychiatric nurse. The team has noticed that people are keener to speak about their life circumstances and potential domestic violence they experience, when they are contacted by the nurse of the multi-agency team. Similarly, people are not very responsive if they get a phone call from a police officer or a social worker who is associated to work for the child protection service.

After the psychiatric nurse has contacted a family or a couple, it often becomes clear that there actually have been violent conflicts in the family. In some cases, the police patrol has been on the spot solving the conflict but concluded that no violence has occurred, even though the family has actually suffered from domestic violence for a longer period of time.

Cooperation with other police units

Detective senior constables and detective sergeants of a Crime Investigation Unit consult the Anchor team members at the police department. The investigator can convince the victim or the perpetrator to meet the social worker or the psychiatric nurse of the Anchor team. Sometimes, with the permission of the person being questioned, the investigator asks the nurse or the social worker to attend the hearing as a role of a hearing witness. In the first place, the task of a hearing witness is to follow the hearing and make sure that no unappropriate methods are being used. When the hearing witness is the psychiatric nurse or the social worker of the Anchor team, they can hear the victim’s or perpetrator’s story as such. After the hearing is finished, they can start assisting the client without asking him/her to explain the circumstances all over again. In addition, the Anchor team may guide the victim to the Unit of Violence Work, shelters for victims of domestic violence, MARAC group or pass the information to the victim’s own social worker.

Cooperation with other professionals

The Anchor team will inform customers about the relevant services and tries to create bridges to other services and professionals. The Anchor team’s social worker cooperates with the municipality’s child welfare services and the psychiatric nurse has contacts to health sector professionals in addition to MARAC group professionals. In an individual process with the customer, it is decided which services are needed and would support the clients. Mainly meetings are organised in the police department but, for example if the customer is accommodated in a shelter, the psychiatric nurse and social worker can visit there.

The idea behind the Anchor teams is to prevent domestic violence by intervening at the violence’s earliest possible stage and guide customers to relevant services. Perpetrators are often informed about the local NGO’s services working against domestic violence (Unit of Violence Work). Victims are referred to MARAC groups, shelter services, psychiatrics, victim support services, and also to NGO services and other necessary services that are available in the area (some customers are ready to receive NGO services even from different cities, like from the capital area or other bigger cities).

Anchor team management

Secrecy of personal information is the main cause that limits the effective exchange of information between the authorities. The core of Anchor work – multi-professional cooperation and exchange of information between the police, social work, and health care – is based on an agreement between the police and the municipality. If the customer gives her/his consent, the Anchor team shares information with the police as well as social and health care authorities. Information sharing is easiest and most effective when the customer has a child. In such a situation, the cooperation can be justified by the interests of the child and the cooperation does not necessarily require the customer’s consent. Childless couples are losers in this system if they do not want to receive help from the multi-professional team.

Some limitations within the work of the Anchor team are related to turnover of personnel. The work of the Anchor team is highly independent and self-guided albeit the core is based on teamwork with other authorities. This kind of working environment demands the employees to be open-minded, committed, collaborative, dependable and communicative.

Istanbul Convention and multi-agency cooperation

The Istanbul Convention, article 18, orders the parties to take the necessary legislative or other measures in accordance with internal law, to ensure that there are appropriate mechanisms to provide for effective co‐operation between all relevant state agencies. This includes the judiciary, public prosecutors, law enforcement agencies, local and regional authorities as well as non‐governmental organisations and other relevant organisations and entities. They are supposed to protect and support victims and witnesses of all forms of violence as covered by the scope of this Convention, this includes referring victims to general and specialist support services as detailed in Articles 20 and 22 of the Istanbul Convention. Multi-agency methods like Anchor teams and MARAC groups are means that increase this kind of cooperation between different agencies. 

Domestic Violence Investigation Team (Finland)

Domestic violence-specialised investigation team

An investigation team that is specialised on domestic violence has got several positive outcomes. Specialising in one particular type of crime has produced highly skilled personnel and offered a possibility for motivated and emphatic people to apply for a job in the domestic violence investigation team. Inversely, police officers who are not motivated to investigate domestic violence cases are not forced to do so which lowers the possibility of secondary victimisation – for example in a situation where the victim blamed for the violence or would be treated without respect.

Due to the nature of domestic violence, its investigation demands highly skilled personnel with empathy, motivation, and commitment. The goal of the specialised team is to investigate the crime but also to find special support for the victims who are in a constant dependent or subordinate relationship to the suspect. A preliminary investigation of a domestic violence case means sometimes several long questionings, but the investigator needs to understand things like psychological response to trauma and victimisation. After the questioning is finished, the investigator tries to motivate a victim or a perpetrator to receive assistance. The detective senior constables and detective sergeants have to know how to approach a victim and a suspect to build trust, to motivate the person to talk about his/her situation and to motivate them to get help. This all takes more time than an average hearing in police work. The daily routine where a police officer focuses on one type of crime, and is not distracted by “easier” cases like thefts and forgeries, helps to achieve an environment where domestic violence cases are not skipped as more demanding or onerous tasks.

Allowing the personnel to specialise in domestic violence and feeding their motivation also generates subspecialisation. The supervisors in the domestic violence investigation team are motivated to develop the work among vulnerable groups. Specialisation has also made an effective service counselling possible. The Domestic Violence Investigation Unit has good connections to different governmental and non-governmental services. The employees have personally visited many of the cooperation partners. Knowing stakeholders personally and to be able to talk about their work diversely is an effective tool in motivating clients to receive help.

Istanbul Convention and domestic violence-specialised investigation teams

The specialisation in the Domestic Violence Investigation Unit has created many qualities that fulfil the guidelines of the Istanbul Convention. The skilled and motivated personnel meet the victims in a sensitive way to prevent repeated victimisation. The victim is asked if she/he wants to be informed when the perpetrator is about to be released from custody. All the victims are informed of their rights and the services at their disposal and the follow-up given to their complaint, the charges, the general progress of the investigation and their role therein. The victim is always asked to give her/his consent to pass the contact information to the Victim Support Finland and all the victims and perpetrators are asked to give their consent to pass contact information to the local Assistance Service for Domestic Violence.

The specialisation of Domestic Violence Investigation Units grants better protection of the victims, better information sharing, trust and knowledge of one another between partners, better problem solving capacity and better ability to take account of the particularities of each individual victim. The sub-specialisation within the team enables broader understanding of different phenomena like forced marriage and honour-related violence. Once, these sub-specialisation skills are acknowledged and seen as part of the organisation’s structure, they become part of the organisational memory and they are not bound to individuals anymore.

Berlin Initiative against violence towards women (BIG e.V., Germany)

The ‘Berlin Initiative against violence towards women’ (in the following: BIG), founded in 1993, commits itself to improving the living conditions of women affected by domestic violence, including their children. BIG works to create social and professional conditions in the field of frontline response to domestic violence that reduce the incidences of domestic violence and provide better protection and appropriate support to those affected by domestic violence. This includes strengthening the rights of the victims and ensuring that abusive men are held responsible for their actions. Only if practices are improved in all relevant areas, this deems possible and sustainable. Thus, in order to carry out this work, a multi-professional, well-connected and active network and collaborative approach as the one of BIG is needed.

BIG involves three work units: BIG Coordination, BIG Hotline and BIG Prevention.

BIG Coordination establishes inter-organisational collaboration by involving all relevant professional groups and societal forces involved in domestic violence and by creating efficient cooperation structures for them.

Focussing on the three groups involved in domestic violence (victims, children, and perpetrators), BIG Coordination analyses practices or gaps to then develop or improve practices, which enhance and increase the protection of victims. Its working methods aim to firstly identify weaknesses and gaps in practice through feedback from victims and the cooperation network. Identified problems relate, for example, to difficulties with authorities or in collaborations, tough procedures, lack of offers for certain target groups, gaps in the law, etc. BIG Coordination then invites the relevant experts for a problem to jointly develop solutions that hopefully can be implemented in practice.

The cooperation network of BIG Coordination

BIG Coordination has an extremely large and diversified cooperation network, in which all relevant stakeholders of different professions and institutions take part.

  • Psycho-social sector: all counselling and intervention centres, projects, and initiatives in the context of domestic violence and related fields, all women’s houses and shelters in Berlin as well as numerous others in Germany, asylum accommodations, Job Centres and many more
  • Sector of child and youth welfare: in particular youth welfare offices, the children’s emergency service, girls’ emergency service and, for example, a children’s theatre
  • Health sector: hospitals, trauma clinics, the Berlin Outpatient Clinic for the Protection against Violence to document the injuries, and S.i.g.n.a.l., another coordination NGO in Berlin, specialised on interventions in the health sector in the case of sexualised and domestic violence
  • Executive: officers of the Berlin Police on various levels from base to headquarters
  • Sector of justice: lawyers, district and public prosecutors, family courts
  • Educational sector: schools and other educational institutions, including universities
  • Political sector: all relevant senate administrations and federal ministries, the State Commission against Violence, integration commissioners of the Berlin Senate, equal opportunities commissioners of the districts

Measures of work

  • Work groups often only convene for a very specific question or dilemma. An example of such a practice is an expert group dealing with risk assessment and case conferences.
  • In contrast to the work groups formed on a transitional basis only, there also exists a number of regular round tables. The aim is to exchange information on current developments, requirements and challenges related with police work.

Outputs of inter-organisational collaborations

The following small selection of outputs of this system of collaborative action coordinated by BIG Coordination illustrates achievements at the legislative and police level.

  • The Protection Act against Violence (Gewaltschutzgesetz 2002) is based on an initiative of BIG Coordination.
  • The Berlin definition of Domestic Violence (2001) has been valid for almost two decades. It is postulated that in the Berlin Police force, every police officer who works in this context is familiar with it. During a time, in which many uncertainties of action in police operations of domestic violence still existed, in which such incidents were treated simply as “family disputes”, this definition made it possible to clearly categorise this form of violence, to compile meaningful statistics and to be able to describe and approach the phenomenon as such. However, with the implementation of the Istanbul Convention (2012), the dilemma aroused that the Berlin definition of domestic violence does not correspond to the one of the EU. The EU definition refers to intra-family violence, which can contain all kinds of violent crimes and not just domestic violence. Nowadays, cases must be counted nationwide according to the EU definition. Nevertheless, the Berlin definition is considered, as the police statistics of Berlin and the Federal Government additionally count violence in partnership. However, the presentation of homicides or other more specific forms of violence has become more difficult.
  • Police action in cases of domestic violence includes a proactive approach. This is also incorporated in the police quality standards. The intention is to make it easier for the victims to access suitable support services: with the consent of the victim, the Berlin Police pass on the contact details to the BIG Hotline and a counsellor contacts the woman by phone within a short period of time.
  • Particularly in the field of education and training, a great deal has been achieved through BIG Coordination, which also offers training and information events. This is important – after all, continuing education is an effective measure to consolidate the achieved results in practice.
HAIP Network (Hanover’s Intervention Program against Domestic Violence, Germany)

In 1992, the round table against male violence in the family was launched. It developed the Hanoverian intervention project against male violence in the family: HAIP. In 1997, HAIP was officially implemented with a corresponding order from the police chief and has since then been working successfully as an interdisciplinary networked program.

In 1997, the HAIP network was developed by the “Round Table against male violence within a family” (founded in 1992) and it was established in 1997, even before the Protection Against Violence Act was established in Germany, as an attempt to structure the work against domestic violence.

Goals of HAIP

  1. Provide extensive protection, assistance, and support to those affected by domestic violence.
  2. Hold perpetrators accountable and achieve their accountability and behavioural change.
  3. Reduce domestic violence through reasonably networked intervention of all those involved, and ensure sustainable long-term support, counselling, and intervention.
  4. Prevention, information, and public relations work.
  5. Take a public stand against domestic violence and on gender justice and work towards social developments and necessities.

Altogether to fight domestic violence, HAIP aims to provide a proactive, fast response towards victims and perpetrators of domestic violence.

Round Table

The largest body is the “Round Table” taking place twice a year. Members and HAIP committees inform each other about their work and activities, which are done according to the purpose of the Round Table. They make decisions about the work of HAIP including decisions that go into politics, develop opinions on current topics and accordingly distribute work orders to the HAIP committees. About 40 different institutions are part of this, including women protection shelters, the youth welfare office, the equal opportunities office, the medical network, different counselling centres, prosecutors, judges, the police, and representatives of all political factions in the city council.

Building Blocks

The center or heart of the HAIP is the committee that deals with actual cases, the eleven “Building Blocks” (Bausteine). They work independently and e. g., conduct case discussions especially on cases with high risk assessments. Additionally, orders and topics of the round table as well as own questions, case presentations etc. are processed there. Moreover, Building Blocks participate in HAIP’s public relations work and organise specialist courses, lectures, training, and seminars.

The eleven Building Blocks are:

  • Coordination Unit “BISS”,
  • Women and Children Protection Shelter,
  • Prosecution Hanover,
  • Police Hanover,
  • Youth Welfare Office “Waage e.V.” (counselling for perpetrator-victim-agreements),
  • Men’s Office Hanover e.V.,
  • Empowerment Office (“Bestärkungsstelle”, counselling for female victims),
  • “SUANA” (counselling for migrant women),
  • Managerial Director of the HAIP office,
  • Equal Opportunities Officer.

The coordination office, special working groups and the coordination unit “BISS” are further parts of the network.

https://www.hannover.de/Leben-in-der-Region-Hannover/Verwaltungen-Kommunen/Die-Verwaltung-der-Landeshauptstadt-Hannover/Gleichstellungsbeauf%C2%ADtragte-der-Landeshauptstadt-Hannover/Wir-f%C3%BCr-die-B%C3%BCrgerinnen-und-B%C3%BCrger/Hannoversches-Interventionsprogramm/%C3%9Cber-HAIP

GAIV (Gabinete de Atendimento e Informação a Vítimas da PSP-Porto, Portugal)

PSP-Porto Victims’ Support and Information Cabinet (Gabinete de Atendimento e Informação a Vítimas da PSP-Porto; GAIV) operates in the city of Porto and has 17 police officers on an exclusive basis: they deal with cases of domestic violence, 24/7, in a confidential and specialised way. Between 2010 and 2014, 725 citizens were arrested for domestic violence in the city of Porto alone. About 3,000 victims were followed, 1,200 individual security plans and 1,600 risk assessments were carried out in the last year.

GAIV manages all the domestic violence-related calls in the city. GAIV has become the domestic violence pivotal frontline responder in the city. In the backstage, PSP creates the Crime Investigation Special Teams for domestic violence (Equipas Especiais de Violência Doméstica; EEIV) which are specialised in the criminal investigation of these crimes. This new arrangement allowed the PSP to obtain a high level of public awareness regarding domestic violence.

Aligning with the IMPRODOVA conceptual framework, the Porto experience merges an organisational arrangement from the part of PSP, involving intra-organisational cooperation (GAIV and other police units), with inter-organisational cooperation between the police, several NGOs, health services, and public prosecutor services. These arrangements aim to clarify the limits of the problem at hand, goals and stakes, resources and actors involved.

As mentioned, GAIV emerged as a focal service to attend domestic violence victims and follow-up their cases, control the use of the teleassistance devices (if triggered, police officers are deployed to attend to the victim), and react promptly in case of emergency. In principle, all domestic violence cases in Porto would be dealt with in GAIV. For that purpose, PSP choose a new police facility – Esquadra do Bom Pastor, Bom Pastor Police Station – which was built considering modern technical recommendations, such as friendly interior, among other physical and functional attributes supporting the specific work with victims (e.g., attendance rooms, learning and training rooms, spaces for children, separation between victims and offenders when inside the station). Also, GAIV had the chance to gather specialised personnel working exclusively with domestic violence matters.

Therefore, this new response was able to remove pressure from the system and to increase the quality of service regarding domestic violence victims.

https://www.facebook.com/policiasegurancapublica/photos/o-gabinete-de-atendimento-e-informa%C3%A7%C3%A3o-%C3%A0-v%C3%ADtima-gaiv-que-funciona-na-cidade-do-p/784141198308063/

Espaço Júlia – RIAV (Integrated Victim Support Response, Portugal)

25 September 2011: officer João Sousa Dias is on duty when he receives a call from a man reporting a death in a house located two minutes away from the police station. Without wasting time, he goes to the house targeted and is the first officer to witness the crime of domestic violence. Her husband, with whom she had been living for 30 years, murdered Julia, a 77-year-old woman, following a breakfast argument. He himself contacted the police and identified himself as a murderer.

João Sousa Dias says he never forgot the scenario he witnessed. A crime without any alert issued to the police before, but that the neighbourhood had some knowledge about: “I asked the neighbours about Júlia. They all told me she was an excellent lady. But when I asked them about the couple’s relationship, they shrugged their shoulders, manifesting that ‘between husband and wife, you don’t pick'”.

Júlia’s episode marked the whole population around her. And now, there is one before and after Júlia. RIAV was founded in 2015, thanks to the will and initiative of the Santo António Parish Council, with the Lisbon Metropolitan Command of the Public Security Police and the Central Lisbon Hospital Centre.

The Júlia Space, in honour of Júlia, is on the same street as the house where the elderly woman lived and was designed to provide an integrated response to victims of domestic violence. A response that is lacking in many police stations in the country is here: to support and accompany the victims of domestic violence: 365 days a year, 24 hours a day, with specialised technicians.

In the Espaço Júlia, 10 agents from the PSP work – 5 male agents and 5 female agents with training in the area of domestic violence and victim care. There is also the signatory (Head of the PSP and Trainer of the PSP in the area of domestic violence), and there are two technicians of Victim Support from the Santo António Parish Council (with TAV training from the Commission for Citizenship and Gender Equality), which includes the Technical Director of the Espaço Júlia, Inês Carrolo.

Since July 2015, the opening date of the Espaço Júlia, 1573 complaints have been received. In 2019 alone 285 complaints have been received – most of them (224) from women between the ages of 25 and 44, and there is still a certain percentage of those under 18 (10 complaints in 2019).

“The occurrences of the Espaço Júlia, as a rule, are complex and sensitive, since they involve especially vulnerable victims of various ages, from various social strata. The most complicated occurrences are those involving sexual abuse and rape of children, not only because of the nature of the crime, but also because of the technical procedures and police measures that need to be taken urgently”, the Space’s officials say.

All cases of domestic violence, rape, and sexual abuse are conducted at the Espaço Júlia, which is signalled by the health units of the Dona Estefânia Hospital’s Paediatric Emergency Department and the São José Hospital’s Emergency Department. “However, any person who goes to this space will be attended. If necessary, the victim will be taken to a safe place, managed by entities with which we have partnerships”, adds the Santo António Parish Council.

https://www.jfsantoantonio.pt/index.php/projectos/espaco-julia

You can also download one of the following documents to learn what good practice means and what the fundamental requirements are.

EIGE (2015). Preventing domestic violence Good practices. Vilnius: EIGE. ISBN: 978-92-9218-496-4. doi: 10.2839/7904

QLS (2016). Domestic and Family Violence Best Practice Guidelines. Brisbane: Queensland Law Society.

WHO (2013). Responding to intimate partner violence and sexual violence against women: WHO clinical and policy guidelines. New York: WHO. ISBN 978 92 4 154859 5


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Professional responses to domestic abuse: The role of multi-agency cooperation

The video introduces the fictional domestic abuse case of ‘Rita’. It shows how the cooperation with other professionals can look to support Rita best.


Case study: Domestic violence has a negative impact on children

Gabby married her husband Nick after a long relationship and shortly thereafter moved to her husband’s family farm. The couple was happy at the farm and soon had their first child. During the pregnancy Nick’s behaviour began to change and by the time their daughter was born the relationship did not ‘feel’ as it had before. Nick seemed withdrawn and spent long periods of time by himself. He began to remind Gabby of Nick’s father who had always been a stern presence in his life.

Nick’s behaviour became threatening and controlling, especially in relation to money and social contact. He was increasingly aggressive in arguments and would often shout and throw objects around the room. Gabby thought that, because he wasn’t physically hurting her, his behaviour did not qualify as abuse. Nick did not show much interest in their daughter, Jane, except when in public, where he would appear to be a doting and loving father.

Jane was generally a well-behaved child, however, Gabby found that she was unable to leave her with anyone else. Jane would cry and become visibly distressed when Gabby handed her to someone else to be nursed. This was stressful for Gabby, and also meant that her social activities were limited further.

Jane took a long time to crawl, walk and begin talking. Her sleeping patterns were interrupted, and Gabby often did not sleep through the night, even when Jane was over 12 months of age. When Jane did begin to talk, she developed a stutter, and this further impeded her speech development. Gabby worried about Jane a lot. Their family doctor told her that this was normal for some children and that, if the speech problems persisted, she could always send Jane to a specialist at a later date.

After a number of years, Nick’s behaviour became unacceptable to Gabby. During arguments he would now hold on to the rifle that he had for farming purposes, and Gabby found this very threatening. On a number of occasions, items that Nick threw hit Gabby and she was increasingly afraid for their daughter. Gabby decided to leave and consulted the local women’s service, who assisted her to get an intervention order against Nick.

Once Gabby had taken Jane away from Nick, her behaviour changed. Jane’s development seemed to speed up and Gabby couldn’t understand why. As part of her counselling at a local women’s service, she discussed this issue, and her counsellor recognised the developmental delay, stutter, irritation, and separation anxiety as effects of Jane’s previously abusive situation.

This can be seen as a missed opportunity for identifying family violence. If the family doctor would have asked Gabby or Nick (who had presented with chronic back pain) about their relationship, about what was happening to the family, and specifically to Jane, the situation could have been identified much earlier.

Task for further reflection

(1) What could have been done better by those involved?
(2) Take a moment to consider which agencies and professionals should have been involved in supporting and/or providing services to Gabby from the beginning.
(3) Make a list of different professionals who make up the multidisciplinary team in your organisation and who could be involved in the provision of services for those who have experienced domestic violence (this will vary depending upon where you are based).

The answers to thoses tasks can be found in the corresponding sections of this module.

The wide range of professionals, provider services and specialist agencies who may be involved in supporting victim-survivors of domestic violence can include—but are not limited to—primary and secondary health care services, mental health services, sexual violence services, social care, criminal justice agencies, the police, probation, youth justice, substance misuse, specialist domestic violence agencies, children’s services, housing services and education.

Adapted from a case study from RACGP (2014): Abuse and Violence: Working with our patients in general practice


  1. Mann, L., & Tosun, Z. (2020, October 23). ASSESSING AND MANAGING RISKS IN CASES OF VIOLENCE AGAINST WOMEN AND DOMESTIC VIOLENCE. Council of Europe, p. 9. ↩︎
  2. EIGE “Risk assessment and risk management – Principle 4: Adopting an intersectional approach”, accessed 06.02.2024. https://eige.europa.eu/gender-based-violence/risk-assessment-risk-management/principle-4-adopting-intersectional-approach ↩︎
  3. www.safelives.org.uk, p. 1, https://safelives.org.uk/sites/default/files/resources/MARAC%20FAQs%20General%20FINAL.pdf ↩︎