Domestic Violence is Your Problem, Too
LAS VEGAS—The media is a buzz this week with the story of young singers Chris Brown and Rihanna, who reportedly got into a domestic dispute the night of the Grammy’s.
Because of the controversy surrounding the story, it seemed like perfect timing for Claudia B. Fenderson, PT, EdD, PCS, of Dobbs Ferry, NY, to present “Addressing Domestic Violence: The Role of the Physical Therapist” at CSM.
The United States Department of Justice estimates that 974,000 physical therapy visits are related to domestic violence injuries. Yet, there are often no clear cut guidelines for addressing possible domestic abuse cases, and state reporting laws vary. These issues can lead to domestic violence not being screened by health care professionals as routinely as other conditions, diseases or injuries.
“Domestic violence is more prevalent than diabetes, breast cancer and cervical cancer. But all of those are screened routinely. Domestic violence is not,” Fenderson said.
A PT is likely to see a case of domestic violence in his or her career because it often results in the victim having chronic neck, back and pelvic pain or arthritis. Some signs that these conditions are related to domestic abuse include injuries to the breasts, abdomen, head, torso and genitals, a defensive posture and multiple injuries in various stages of healing. Behavioral signs of domestic abuse include a flat affect, anxiety, avoidance of touch, psychiatric disorders, sleep problems and panic attacks.
Fenderson said PTs often don’t ask patients about possible abuse because they feel awkward, assume it’s someone else’s responsibility, are fearful of retaliation or lack proper training. But reaching out to this patient population can work wonders. The APTA concluded in its Guidelines for Recognizing and Providing Care for Victims of Domestic Violence that patients have a longer and more frequent relationship with PTs than with other doctors, so they might feel more comfortable opening up. And other research has shown that when providers confirmed intimate partner abuse, women felt their concerns and fears were appropriate.
Fenderson suggests several ways for broaching the topic of abuse with patients. They include asking kindly and directly, providing options and referrals, documenting findings and assessing the patients’ safety. A therapist could ask, “Because domestic violence is so common, I routinely ask about it,” or, “We know about 25 percent of women are physically or emotionally abused by partners. Has this ever happened to you?” Phrasing the questions in these ways makes the patient feel like they’re not alone in their situation and decreases the likelihood that they will be offended by your concern, Fenderson said.