"The Average Counsellor Wouldn't Know": Exploring How General Health Practitioners Understand and Respond to Domestic Violence.
Nicole Loncar, Katreena L Scott
PMID 35726162WHAT IT FOUND
Generalist health providers consistently identify IPV risk factors but rarely assess children or perpetrators, often defaulting to mandatory reporting.
Most lack clear institutional guidelines, relying instead on informal experience and external referrals to manage domestic violence cases.
Key findings
01Participants consistently identified individual, relationship, and community-level risk factors for IPV, including substance use, legal breaches, and cultural or structural vulnerabilities.
02Children and perpetrators were largely excluded from generalist assessment and intervention, with safety often assumed to be the mother's responsibility or addressed only via mandatory reporting.
03Most participants lacked clear organizational protocols for responding to IPV, relying on informal learning, external referrals, and the experience of a few senior staff.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The sample size was small (n=17) and geographically concentrated in Ontario, limiting generalizability to all Canadian healthcare settings. As a secondary analysis, the study was constrained by the original interview questions, which may not have fully explored certain nuances of practice. Participants were self-selected, potentially representing those more motivated to address IPV, which may skew findings toward higher engagement than exists in the general workforce. Variability in roles (e.g., social workers vs. nurses) and settings (hospitals vs. community centres) makes it difficult to attribute specific practices to a single professional discipline.
Declared interests
Funded by the Social Sciences and Humanities Research Council of Canada. No other conflicts of interest were reported.
The easy way to misread this
Do not interpret the high level of provider concern or knowledge of risk factors as evidence of effective clinical intervention. The study shows that while providers identify IPV, they largely fail to address the needs of children and perpetrators due to systemic gaps, meaning awareness does not equate to safety planning.