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

Molly Allison Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, KS 66160.

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Catherine Satterwhite Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, KS 66160.

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Megha Ramaswamy Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, KS 66160.

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Mary T. Hynek Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, KS 66160.

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Zoe Agnew-Svoboda Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, KS 66160.

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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 ethnicities, 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 animals’ 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.

Influencing the Decision to Seek Help

Protecting their pets from abuse is a major concern 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 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.

Role in Human and Animal Violence Education

Making educational materials on IPV and animal abuse available to clients may encourage potential victims to view veterinary clinics as supportive, nonjudgmental environments, and acknowledging through flyers, brochures, or a clinic website the ways that animal abuse is linked with human violence may address women's feelings of isolation and shame.4,10 Types of information that could be incorporated 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 animal abuse, legal requirements for establishing pet ownership, and contact information for local animal organizations and domestic violence shelters that accommodate 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 Violence,12 74% of Americans personally know someone who is or has been abused. Veterinary clients who are coworkers, 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 educational materials may address concerns or hesitation some women feel about disclosing IPV or may help allay concerns veterinarians and staff members feel about raising the topic, solely relying on this approach may not be enough to prompt action toward seeking help. Simply presenting information and resources for women and their pets affected by IPV may promote a message that it is exclusively the victims’ 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, implementing 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 commonly 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 animal abuse, using appropriate methods of communication is key. In particular, use of nonjudgmental and compassionate communication with women potentially 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 conflicting 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, veterinarians 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, concerns about endangering themselves or the victim, or uncertainty about the proper response.10,15,16 Overcoming these concerns on both parts by providing relationship-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 identifying and addressing IPV appears to be commonly associated 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 continuing education workshops and seminars. One encouraging 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 veterinarians on identifying and addressing human abuse, veterinarians 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-centered 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 stories, 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 “negotiation 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

Veterinary practices should focus on building confidence and knowledge among staff members in providing guidance to women suspected to be experiencing IPV, while still maintaining their relationships 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 veterinarians 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 generalizable, they suggest that initiating conversations about seeking help is primarily the veterinarian's responsibility 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 veterinary 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 invited to provide training to staff members on recognizing 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 veterinary services (eg, physical examination or routine vaccinations) would be provided, and how confidentiality of the victims of violence and their pets would be maintained.21 Partnerships between veterinary practices and violence protection agencies that promote training, effective communication, and sharing of services 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, veterinary 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 women experiencing IPV delay in seeking help.

Footnotes

a.

Lockwood R. Animal abuse and family violence: what veterinary professionals need to know (oral presentation). North Am Vet Conf, Orlando, Fla, January 2002.

References

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  • 15. Williams VM, Garrett N, Dale A. Animal abuse and family violence: survey on the recognition of animal abuse by veterinarians in New Zealand and their understanding of the correlation between animal abuse and human violence. N Z Vet J 2008; 56:2128.

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    • Export Citation
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    • Export Citation
  • 18. Green PC, Gullone E. Knowledge and attitudes of Australian veterinarians to animal abuse and human interpersonal violence. Aust Vet J 2005; 83:619625.

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    • Export Citation
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  • 1. Breiding MJ, Basile KC, Smith SG, et al. Intimate partner violence surveillance: uniform definitions and recommended data elements. Version 2.0. Atlanta: CDC, 2015.

    • Search Google Scholar
    • Export Citation
  • 2. CDC. National Intimate Partner and Sexual Violence Survey Infographic. Available at: www.cdc.gov/violenceprevention/nisvs/infographic.html. Accessed Oct 25, 2016.

    • Search Google Scholar
    • Export Citation
  • 3. Fugate M, Landis L, Riordan K, et al. Barriers to domestic violence help seeking: implications for intervention. Violence Against Women 2005; 11: 290310.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 4. Hardesty JL, Khaw L, Ridgway MD, et al. Coercive control and abused women's decisions about their pets when seeking shelter. J Interpers Violence 2013; 28: 26172639.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5. Upadhya V. The abuse of animals as a method of domestic violence: the need for criminalization. Emory Law J 2014; 63: 11631209.

  • 6. Flynn CP. Woman's best friend: pet abuse and the role of companion animals in the lives of battered women. Violence Against Women 2000; 6:162177.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7. Ascione FR. Battered women's reports of their partners' and their children's cruelty to animals. J Emotional Abuse 1998; 1: 119133.

    • Search Google Scholar
    • Export Citation
  • 8. Faver CA, Strand EB. To leave or to stay? Battered women's concern for vulnerable pets. J Interpers Violence 2003; 18: 13671377.

  • 9. Liang B, Goodman L, Tummala-Narra P, et al. A theoretical framework for understanding help-seeking processes among survivors of intimate partner violence. Am J Community Psychol 2005; 36: 7184.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 10. Tiplady CM, Walsh DB, Phillips CC. Intimate partner violence and companion animal welfare. Aust Vet J 2012; 90: 4853.

  • 11. Colorado Link Project. Quick facts: why is the link important for…veterinary medicine? Available at: coloradolinkproject.com/wp-content/uploads/2012/11/HAB-LINK-veterinary-medicine.pdf. Accessed May 15, 2016.

    • Search Google Scholar
    • Export Citation
  • 12. Allstate Foundation. First annual Allstate Foundation national poll on domestic violence: executive summary. Available at: www.ncdsv.org/images/1stannualallstatenationalpolldvexecsum.pdf. Accessed Oct 25, 2016.

    • Search Google Scholar
    • Export Citation
  • 13. Postmus JL, Severson M, Berry M, et al. Women's experiences of violence and seeking help. Violence Against Women 2009; 15: 852868.

  • 14. Kennedy AC, Adams A, Bybee RC, et al. A model of sexually and physically victimized women's process of attaining effective formal help over time: the role of social location, context, and intervention. Am J Community Psychol 2012; 50: 217228.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 15. Williams VM, Garrett N, Dale A. Animal abuse and family violence: survey on the recognition of animal abuse by veterinarians in New Zealand and their understanding of the correlation between animal abuse and human violence. N Z Vet J 2008; 56:2128.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 16. Benetato MA, Reisman R, McCobb E. The veterinarian's role in animal cruelty cases. J Am Vet Med Assoc 2011; 238: 3134.

  • 17. Shaw JR, Adams CL, Bonnett BN. What can veterinarians learn from studies of physician-patient communication about veterinary-client-patient communication? J Am Vet Med Assoc 2004; 224: 676684.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 18. Green PC, Gullone E. Knowledge and attitudes of Australian veterinarians to animal abuse and human interpersonal violence. Aust Vet J 2005; 83:619625.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 19. Arokow P, Boyden P, Patterson-Kane E. Practical guidance for the effective response by veterinarians to suspected animal cruelty, abuse and neglect. Available at: ebusiness.avma.org/Files/ProductDownloads/AVMA%20Suspected%20Animal%20Cruelty.pdf. Accessed Oct 25, 2016.

    • Search Google Scholar
    • Export Citation
  • 20. Lue TW, Pantenburg DP, Crawford PM. Impact of the owner-pet and client-veterinarian bond on the care that pets receive. J Am Vet Med Assoc 2008; 232:531540.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 21. Phillips A. Understanding the link between violence to animals and people: a guidebook for criminal justice professionals. Alexandria, Va: National District Attorneys Association, 2014.

    • Search Google Scholar
    • Export Citation

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