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Strategies veterinary practices can use to address the problem of intimate partner violence

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Abstract

1 Intimate partner violence (IPV) refers to violence in the home perpetrated by a loved one or romantic partner. 1 Although women between 18 and 24 years old are the most common victims of IPV, 2 this problem affects people of all genders, races and ethnici-ties, income levels, and sexual orientations. Unfortunately , for a number of reasons, including a lack of knowledge about local resources, fear of disclosing IPV, and dissatisfaction with the response when seeking help in the past, many individuals who experience IPV go unrecognized. 3 Pets often represent a vital source of support for women experiencing IPV, 4,a and concerns for their an-imals' well-being likely brings them to the veterinary clinic, regardless of whether the pets themselves are being abused or threatened at home. 5,6 Thus, veterinary practice staff members can potentially play a unique role in IPV intervention, especially in instances when IPV occurs in conjunction with pet abuse. However, even when pet abuse is not apparent or suspected, veterinary staff members can help spread awareness and knowledge of IPV-related resources. Although scant literature exists on the use of veterinary services by women experiencing IPV, it is worth exploring how veterinary staff members could be more involved in addressing IPV among women seeking veterinary care for their pets and how veterinary practices could play a role in facilitating women's decisions to seek help—with their pets—before violence escalates further. Although standardized training and protocols for identifying and addressing suspected IPV among clients seeking care for their pets are not currently available, there are proactive strategies veterinary staff members could potentially use to assist women in these situations. Such strategies revolve around disseminating information about IPV and animal abuse, creating a relationship-centered care model, and developing partnerships with violence protection agencies. Strategies veterinary practices can use to address the problem of intimate partner violence Influencing the Decision to Seek Help Protecting their pets from abuse is a major concern for women experiencing IPV, and studies 7,8 have shown that this concern can lead affected women to delay seeking help for themselves. Perceived isolation and distrust of others may make it difficult for women with pets to reach out for help. 9 In addition, although pets may act as surrogates for human support when women experience isolation, they may also influence feelings of guilt and shame for wanting to leave an abuser, ultimately deterring women from taking action. 6,9 Guilt arising from leaving a pet behind and possibly subjecting it to abuse may also prevent women from leaving an abusive situation. 9 Rather, women may stay in an abusive environment out of loyalty to pets they perceive as family members, children, or spiritual support. 9 By recognizing the physical and emotional isolation , guilt, and shame felt by women experiencing IPV, with or without the co-occurrence of pet abuse, veterinary staff members can work to implement strategies that may address these factors and lead women to seek help for themselves and their animals much sooner than they might otherwise. An initial step veterinary practices can take is helping to disseminate information about IPV and the link between IPV and animal abuse, along with information about local resources that can assist women and their pets.
JAVMA • Vol 250 • No. 1 • January 1, 2017 1
Intimate partner violence (IPV) refers to violence in
the home perpetrated by a loved one or romantic
partner.1 Although women between 18 and 24 years
old are the most common victims of IPV,2 this prob-
lem affects people of all genders, races and ethnici-
ties, income levels, and sexual orientations. Unfortu-
nately, for a number of reasons, including a lack of
knowledge about local resources, fear of disclosing
IPV, and dissatisfaction with the response when seek-
ing help in the past, many individuals who experi-
ence IPV go unrecognized.3
Pets often represent a vital source of support for
women experiencing IPV,4,a and concerns for their an-
imals’ well-being likely brings them to the veterinary
clinic, regardless of whether the pets themselves are
being abused or threatened at home.5,6 Thus, veteri-
nary practice staff members can potentially play a
unique role in IPV intervention, especially in instanc-
es when IPV occurs in conjunction with pet abuse.
However, even when pet abuse is not apparent or
suspected, veterinary staff members can help spread
awareness and knowledge of IPV-related resources.
Although scant literature exists on the use of veter-
inary services by women experiencing IPV, it is worth
exploring how veterinary staff members could be more
involved in addressing IPV among women seeking vet-
erinary care for their pets and how veterinary practices
could play a role in facilitating women’s decisions to
seek help—with their pets—before violence escalates
further. Although standardized training and protocols
for identifying and addressing suspected IPV among
clients seeking care for their pets are not currently
available, there are proactive strategies veterinary staff
members could potentially use to assist women in these
situations. Such strategies revolve around disseminat-
ing information about IPV and animal abuse, creating a
relationship-centered care model, and developing part-
nerships with violence protection agencies.
Strategies veterinary practices can use
to address the problem of intimate partner violence
Influencing the Decision
to Seek Help
Protecting their pets from abuse is a major con-
cern for women experiencing IPV, and studies7,8 have
shown that this concern can lead affected women to
delay seeking help for themselves. Perceived isolation
and distrust of others may make it difficult for women
with pets to reach out for help.9 In addition, although
pets may act as surrogates for human support when
women experience isolation, they may also influence
feelings of guilt and shame for wanting to leave an
abuser, ultimately deterring women from taking ac-
tion.6,9 Guilt arising from leaving a pet behind and
possibly subjecting it to abuse may also prevent wom-
en from leaving an abusive situation.9 Rather, women
may stay in an abusive environment out of loyalty to
pets they perceive as family members, children, or
spiritual support.9
By recognizing the physical and emotional isola-
tion, guilt, and shame felt by women experiencing
IPV, with or without the co-occurrence of pet abuse,
veterinary staff members can work to implement
strategies that may address these factors and lead
women to seek help for themselves and their animals
much sooner than they might otherwise. An initial
step veterinary practices can take is helping to dis-
seminate information about IPV and the link between
IPV and animal abuse, along with information about
local resources that can assist women and their pets.
Role in Human and Animal
Violence Education
Making educational materials on IPV and ani-
mal abuse available to clients may encourage poten-
tial victims to view veterinary clinics as supportive,
Commentary
From the Department of Preventive Medicine and Public Health, University of Kansas Medical
Center, Kansas City, KS 66160.
Address correspondence to Ms. Allison (mallison2@kumc.edu).
Molly Allison mph
Catherine Satterwhite phd, msph, mph
Megha Ramaswamy phd, mph
Mary T. Hynek mph
Zoe Agnew-Svoboda
JAVMA—16-06-0330—COM—Allison—0 g—0 tab—TTL—KJM
2 JAVMA • Vol 250 • No. 1 • January 1, 2017
nonjudgmental environments, and acknowledging
through flyers, brochures, or a clinic website the
ways that animal abuse is linked with human vio-
lence may address women’s feelings of isolation and
shame.4,10 Types of information that could be incor-
porated in these materials might include findings
from studies exploring the co-occurrence of IPV and
animal abuse, advice for establishing an emergency
plan of action that includes one’s pets, signs of ani-
mal abuse, legal requirements for establishing pet
ownership, and contact information for local animal
organizations and domestic violence shelters that ac-
commodate pets.4,10,11
This type of information sharing may be of direct
benefit to women experiencing IPV, but may also be
relevant to clients who are not personally affected by
IPV but who know someone who is. According to The
Allstate Foundation’s National Poll on Domestic Vio-
lence,12 74% of Americans personally know someone
who is or has been abused. Veterinary clients who are
co-workers, friends, or loved ones of IPV victims may
be led to acknowledge the signs of IPV and provide
support for individuals they know who are affected.
On the other hand, although distributing edu-
cational materials may address concerns or hesita-
tion some women feel about disclosing IPV or may
help allay concerns veterinarians and staff members
feel about raising the topic, solely relying on this ap-
proach may not be enough to prompt action toward
seeking help. Simply presenting information and re-
sources for women and their pets affected by IPV
may promote a message that it is exclusively the vic-
tims’ responsibility to seek help. Attitudes and beliefs
about the inadequacy of local resources, a distrust
of others, or the fear of getting caught by an abuser
may inhibit some women from taking action on their
own.3,13 Thus, although veterinary practices can play
an important role in disseminating information, im-
plementing a multilayered approach to address IPV
and potential animal abuse may be more effective in
reducing the delay in seeking help.
Importance of Communication
in Reducing Delays in Seeking Help
Women seeking help because of IPV more com-
monly reach out to informal support networks, such
as friends and family members.14 When women do
seek help from formal services, they experience great
variability in how helpful they find those services to
be.14 Of particular interest, however, is that women
have perceived formal services to be more helpful
when they feel a sense of control and when service
staff behave and react in a positive way.14
Perceived helpfulness may have been related
to how service staff communicated, listened to the
women’s needs, and demonstrated compassion. Thus,
for veterinary clinic staff inquiring about IPV and ani-
mal abuse, using appropriate methods of communica-
tion is key. In particular, use of nonjudgmental and
compassionate communication with women poten-
tially experiencing IPV may be a key component to
those women feeling comfortable enough to disclose
their experiences as well as relate any concerns they
may have about their animals being threatened or
harmed. The published literature4,10 presents conflict-
ing attitudes about women’s willingness to confide
in veterinarians about IPV, with women reluctant to
confide in their veterinarians because of fears that
they will be adversely judged, that their pets will be
taken away from them, or that the veterinarian will
not be able to provide any assistance. Similarly, vet-
erinarians appear to have conflicting attitudes about
identifying and addressing animal and human abuse,
likely because of fears of losing clients or income,
worries about breaching client confidentiality, con-
cerns about endangering themselves or the victim,
or uncertainty about the proper response.10,15,16 Over-
coming these concerns on both parts by providing re-
lationship-centered care can potentially improve the
ability of veterinary staff members to help affected
women and their pets.4,15,17
A lack of standardized training in regard to identi-
fying and addressing IPV appears to be commonly as-
sociated with nonreporting of IPV.15,16,18 Thus, training
in the skills needed for veterinarians to appropriately
address animal and human abuse should be included in
veterinary school curricula and provided through con-
tinuing education workshops and seminars. One en-
couraging development is that veterinarians’ requests
for training in identifying pet abuse have led to the
establishment of veterinary forensics as a recognized
field of study.19 New textbooks and training also focus
on differentiating animal cruelty, abuse, and neglect.19
Although there is less training available to veterinar-
ians on identifying and addressing human abuse, vet-
erinarians could focus on implementing relationship-
centered care as a way to combat the negative feelings
some women experiencing IPV may associate with
confiding in veterinarians. Moreover, relationship-cen-
tered care could positively affect the well-being of pets
by possibly leading women to seek help sooner.
Relationship-centered care involves showing a
willingness to listen to clients as they tell their sto-
ries, expressing sympathy and support, providing
clear information, and engaging in shared decision
making and has been recognized as an ideal model
for physician-patient relationships, where “negotia-
tion and shared decision-making are used to take the
patient’s perspective into consideration.17 This type
of health-care model translates well into veterinary
practice, where “respect for the client’s perspective
and interests and recognition of the role the animals
play in the life of the client are incorporated into all
aspects of care.17 Especially as it relates to women
seeking help with their pets because of IPV, effective
communication between veterinarians and clients
could be instrumental to positive health outcomes by
motivating women to follow recommendations that
could keep them and their pets safe.17,20
JAVMA • Vol 250 • No. 1 • January 1, 2017 3
Veterinary practices should focus on building
confidence and knowledge among staff members in
providing guidance to women suspected to be expe-
riencing IPV, while still maintaining their relation-
ships with their clients and preserving their clients’
safety and confidentiality. In 1 study,4 11 of 19 women
reported that it would be appropriate for veterinar-
ians to inquire about IPV,4 and even those who did
not find it appropriate for veterinarians to initiate
conversations about suspected IPV suggested that
veterinary clinics could provide “information about
safe haven programs through flyers and other media.”
Although these results are not necessarily generaliz-
able, they suggest that initiating conversations about
seeking help is primarily the veterinarian’s responsi-
bility if IPV or pet abuse is suspected.
Establishing Partnerships
One way to build knowledge on how to initiate
conversations and respond to women seeking help
with their pets could be to establish partnerships
with local violence protection agencies. Partnering
with community agencies that provide services and
resources to victims of violence could help veteri-
nary practices collaborate with women in developing
safety plans for themselves and their pets. There are
multiple ways such partnerships can benefit victims
and their pets and enhance veterinary staff members’
ability to respond to violence.11 In particular, officials
from local violence protection agencies could be in-
vited to provide training to staff members on recog-
nizing and reporting violence and abuse and on how
to effectively refer women to these agencies.19 At least
as it relates to reaching out to local animal protection
agencies, veterinary practices may find the AVMA’s
“Practical Guidance for the Effective Response by
Veterinarians to Suspected Animal Cruelty, Abuse
and Neglect”19 a helpful resource.
In addition, veterinary practices might consider
establishing a memorandum of understanding with
local violence protection agencies to provide low-cost
or free veterinary care and boarding services for pets
of women affected by violence.18 Important points to
negotiate in a memorandum of understanding include
how long pets would be allowed to stay, what veteri-
nary services (eg, physical examination or routine vac-
cinations) would be provided, and how confidential-
ity of the victims of violence and their pets would be
maintained.21 Partnerships between veterinary prac-
tices and violence protection agencies that promote
training, effective communication, and sharing of ser-
vices could create safer strategies for women and pets
wanting to leave abusive environments.
Conclusions
Veterinary staff members have a responsibility to
protect and advocate for the health and well-being of
animals. Ideally, staff members would receive formal
training in recognizing and addressing IPV and animal
abuse. But even in the absence of formal training, vet-
erinary practices could be of assistance in this area by
helping to disseminate information about IPV and local
resources that help victims and their pets, developing
a relationship-centered care model, and establishing
partnerships with local violence protection agencies.
These three approaches may save human and animal
lives by potentially reducing the amount of time wom-
en experiencing IPV delay in seeking help.
Footnotes
a. Lockwood R. Animal abuse and family violence: what veteri-
nary professionals need to know (oral presentation). Nor th
Am Vet Conf, Orlando, Fla, January 2002.
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For all commentaries, views expressed are those of the authors
and do not necessarily reflect the official policy of the AVMA.
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