• "Are you in any relationships where you are afraid for your personal safety, or where someone is hurting you, threatening you, forcing sexual contact, or trying to control your life?

B. Screening for Past Violence

• "As an adult, have you ever been a victim of violence such as assault or sexual assault?"
• "Have you ever been in a relationship where your partner hurt you, threatened you, forced sexual contact, or tried to control your life?"
• "When you were a child or adolescent did anyone ever physically hurt you, force sexual contact or hurt you psychologically (for example by telling you that you were worthless or unwanted)?"

C. Case Finding With General Signs of Distress

• "In my experience these types of symptoms are sometimes caused or made worse by stress. Are there any sources of stress in your personal life, family life or at work?"
• Screen for current violence (A) and past violence (B).
• Screen for other causes of distress (positive & negative life events; family problems; depression or anxiety; etc.)

D. Case Finding With Specific Signs Of Violence

• "In my experience, this type of injury is sometimes caused by other people's actions. Are you safe? Is anyone hurting you or threatening you?"
• Screen for current violence (A).

E. When you suspect abuse, but the patient denies abuse

• "I'm concerned about your safety and would like to tell you about several community resources you can use if you ever need them."
• Describe resources, offer follow-up and document as in protocol.
• Do not confront or challenge the patient.

© B. Ambuel & L. K. Hamberger, Family Peace Project, Family & Community Medicine, Medical College of Wisconsin, 210 NW Barstow, #201, Waukesha, WI, 53188, (414)548-6903. The Family Peace Project provides training and consultation to professionals, organizations & communities. Permission granted to copy this protocol for noncommercial use. Your contribution to the Family Peace Project is tax-deductible. Updated: 03/20/95 4:17 PM

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