ABC of Domestic and Sexual Violence
Susan Bewley, Jan Welch (eds) BMJ Books, 2014 ISBN 978-1-118-48218-6
The topic of domestic violence features little in medical curricula. How many of us feel comfortable asking patients about any history of sexual violence, or know where to refer them in a crisis, or how to advise on basic safety precautions?
If you find your knowledge base lacking, the ABC of Domestic and Sexual Violence is the book for you. With contributors ranging from GUM consultants to psychiatrists and from GPs to the third sector, the book is wide-ranging in its scope and practical in its approach.
Early chapters focus on the epidemiology and impact of abuse. The role of the healthcare professional is set out in the three Rs: recognise, respond and offer to refer.
One chapter discusses sexual assault in men and boys, busting common myths that males cannot be forced to have sex against their will.
Case studies throughout provide examples and key learning points.
An invaluable chapter is dedicated to identifying domestic violence and abuse. Dos and don'ts of asking about abuse are made clear, with helpful text boxes giving example questions to use, from the open question, 'How are things at home?', to the more direct approach, 'Are you afraid of anyone at home?'
The validated HARK questions were new to me, but I am now incorporating them in consultations:
- Humiliation Have you ever been humiliated or emotionally abused by your partner/ex partner?
- Afraid Have you ever been afraid of your partner/ex partner?
- Rape Have you ever been raped or forced into any kind of sexual activity by your partner/ex partner?
- Kick Have you ever been kicked, hit, slapped or otherwise hurt by your partner/ex partner?
The ABC of Domestic and Sexual Violence is both a practical guide and a springboard for further learning - the chapters are well referenced, and useful websites and telephone numbers are listed.
One chapter is dedicated to managing a consultation on domestic violence, while another details how to document those consultations. There is also a brief, but timely, chapter on female genital mutilation.
Sections on the law in relation to sexual assault and domestic violence, and the ethics of professional boundaries, help to provide a thorough overview of a large topic.
The ABC of Domestic and Sexual Violence is an eye-opening read. With the UK police receiving one domestic violence call every minute, and almost one in three teenagers having experienced domestic or sexual violence, the question is whether this is a book you can afford not to read.
- Dr Fisher is a GP ST3 in Oxford.