Intimate partner violence: counseling, community resources, and legal issues for IPV victims and perpetrators.

The family physician's office is a potentially safe place to discuss intimate partner violence (IPV). RADAR (Remember to ask routinely, Ask directly [in private], Document findings, Assess safety, Review options) is a tool for identifying and responding to IPV. Physicians should ask permission to document abuse, consider using a body map, and ensure confidentiality. They should also assess immediate safety by asking about weapons in the home, children's safety, and the likelihood that the perpetrator will harm him- or herself or others. Federal privacy laws require physicians to inform patients about health information disclosure. Because mandatory reporting varies by state, physicians should communicate clearly the office's responsibilities. Interventions are based on an advocacy model that requires appropriate training and establishment of links to community-based resources. Brief advocacy includes providing information cards, whereas intensive intervention includes IPV education, danger assessment, prevention options, safety planning, and community referrals. The Stages of Change Model may help physicians understand a patient's readiness and ability to make a change. For the IPV survivor who has left an abusive partner, physicians should be aware of the challenges of safety, health, legal, and financial issues; protection orders are a possible safety strategy. The most common intervention for perpetrators is a batterer intervention program. Couples counseling by family physicians is contraindicated.