Dr Natalia Lewis, Research Fellow, Centre for Academic Primary Care, University of Bristol
GPs provide health care for multiple members of the same family including victims and perpetrators of domestic violence and their children. Children’s exposure to domestic violence can cause harm, yet many clinicians remain uncertain of their responsibilities towards child patients in cases of domestic violence. To address such professional uncertainty, a multidisciplinary research team developed and piloted an evidence-based training on domestic violence and child safeguarding for general practice – RESPONDS
An overview, training pack and publications related to RESPONDS are available here
You can download the full text paper here
Researchers piloted the RESPONDS training with 88 clinicians in 11 GP practices in the south of England and the Midlands. Evaluation of the pilot training through 37 repeated questionnaires, 15 interviews and 11 observations produced mixed results. On one hand, the training was well received; clinicians’ knowledge and confidence/self-efficacy regarding domestic violence and child safeguarding improved post-training. On the other hand, beliefs and attitudes of some clinicians remained unchanged. Evidence of a change in clinical practice was rare, but one GP reported increased confidence in ‘discussing this with children, you know, being able to ask them how it was affecting them’. There could be varied reasons for such mixed results, including the limitations of the scope of pilot training and of the study methods.
Participants suggested improvements to the training, such as using more socially diverse scenarios and discussing cases of families with multiple needs. Training participants also suggested addressing multi-agency work in the context of changing and under-resourced referral services.
The authors conclude that the development and piloting of this evidence-based training is a crucial first step towards strengthening the response to all family members experiencing or perpetrating domestic violence and their children. They also argue that the RESPONDS training requires further refinement, integration with existing training on general practice response to domestic violence, and more rigorous evaluation. The development and testing of such an integrated general practice-based domestic violence intervention is underway as part of the REPROVIDE programme
Please find details of the REPROVIDE programme here
Why GPs need training about domestic violence and children: you can access a blog discussing this topic here
Call for national guidance to help GPs document domestic violence: you can access here
General practice clinicians’ perspectives on involving and supporting children and adult perpetrators in families experiencing domestic violence and abuse. You can download this paper here
The RESPONDS project is independent research commissioned and funded by the Department of Health Policy Research Programme (Bridging the Knowledge and Practice Gap between Domestic Violence and Child Safeguarding: Developing Policy and Training for General Practice, 115/0003). The views expressed are those of the author(s) and not necessarily those of the Department of Health.