Conducting routine screening: How to ask
While inquiring about abuse may seem difficult at first, recognizing that it is important, legitimate, and potentially life-saving to ask can help clinicians overcome their initial hesitations and become comfortable addressing domestic violence with their patients. Clinicians can help decrease a woman's potential discomfort by framing questions in ways that let her know that she is not alone, that the provider takes this issue seriously, is comfortable hearing about abuse, and that help is available. With practice, each clinician will develop his or her own style of asking questions about abuse.
Framing the question. Sometimes it feels awkward to suddenly introduce the subject of abuse, particularly if there are no obvious indications a woman is being abused. The following is an example of a way providers can introduce the issue:
"Because domestic violence is so common in women's lives, I've started asking about it routinely."
Direct questions. However one initially raises the issue of domestic violence, it is important to include direct and specific questions:
"Has your partner or ex-partner ever hit you or physically hurt you? Has he ever threatened to hurt you or someone close to you?"
"Did someone hit you? Was it your partner/husband?"
"I'm concerned that your symptoms/condition may have been caused by someone hurting you. Has someone been hurting you?"
"Has he/she ever tried to restrict your freedom or keep you from doing things that were important to you (e.g., going to school, working, seeing friends or family)?"
Indirect questions. In some clinical settings, it may be appropriate to start the inquiry with an indirect question before proceeding to more direct questions. The following are examples of this approach.
"Every couple fights-what are fights like in your home? Do the fights ever become physical?"
"Have you been under any stress lately? Are you having any problems with your partner? Are you ever afraid? Have your fights every become physical?"
Source: Adapted from material prepared by Carole Warshaw, MD, for the Family Violence Prevention Fund
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