Abstract
The ABC of Domestic and Sexual Violence is part of the ABC series of books that are aimed towards primary health care professionals. This book aims to provide practical support to doctors early in their careers to assist with the detection, intervention and treatment of those impacted by domestic and sexual violence (DSV). The book is written with a focus on victim safety, and the doctor’s role in facilitating this, therefore, extensive guidance is provided on assessment, examination, management and referral. Readers are also guided on indicators of DSV, on how to make selective enquiries where DSV is suspected, and the importance of swift and appropriate action if a disclosure is made. This book is of considerable interest to readers of Sexualities, as there is a substantial focus on sexual violence.
Edited by Susan Bewley, Professor of Women's Health and Jan Welch, Consultant in HIV and Sexual Health, the book is broken into 26 individual chapters that are written by authors from a broad range of backgrounds. Chapters are concise and practical with all content very well signposted. The book highlights a number of complexities related to violence. First, the fact that violence is frequently multi-dimensional and many forms of violence such as sexual, emotional, physical, financial and psychological violence can co-occur, and second, the multi-sector nature of DSV. For this reason, multi-agency responses are necessary to address these issues. The book does well to elucidate these issues and provide support to doctors to understand the role that they have to play but also how they can work best with other professionals and systems to support those impacted by DSV. Doctors are cautioned against treating DSV as a ‘condition’ requiring medical diagnosis and treatment, but rather given extensive practical guidance on how to recognize and respond to DSV and offer appropriate referral.
The book covers an extensive range of relevant issues beginning with a helpful overview of the epidemiology of gender-based violence, and thus identifying the fact of being female as being the most consistent risk factor for sexual and domestic violence. The main focus of the book therefore is violence perpetrated by men against women, however, individual chapters also consider victims beyond this paradigm such as children, the elderly, those in same-sex relationships and men, with a further chapter on perpetrators of DSV. The early chapters do a sound job of providing background information and contextualizing understandings of DSV by looking at risk, the identification of violence and abuse, the relationship between culture and violence, the impact of trauma and various forms of violence including forced marriage and human trafficking. These chapters provide essential foundational knowledge on which the remainder of the book builds.
A range of contexts in which doctors work are also considered: general practice, emergency medicine and surgical specialities, mental health services, dental practice and sexual health services, with a chapter dedicated to each. These chapters consider signs of abuse, which may present in these specific contexts and best practice for doctors, including strategies for approaching the patient, assessing risk, providing treatment, support and follow up. While appropriate responses of doctors to DSV are considered throughout, two individual chapters consider responses more broadly – first, community-based responses, and second, sources of referral and support that include specialist violence support services.
While the majority of chapters consider some aspect of sexual violence, those that specifically focus on sexual violence include: the sexual assault of men and boys, female genital mutilation and sexual violence, and address what to consider first and the medical and psychosocial care for rape and sexual assault. These chapters walk readers through the safety, medical, forensic and psychological needs of the victim. Supporting chapters detail legal and prosecuting practice (in England and Wales), provide best clinical practice advice for documenting history and physical findings, the technique of writing professional witness statements and an overview of how to prepare if required to give evidence in court. Final chapters consider the violation of professional boundaries, and, moving forward, developing care pathways within the health service, pursuing a career and implementing better services within the DSV space.
This book is very timely given the unacceptably high rates of DSV evident in many countries such as the UK and Australia. As pointed out by Sir George Alberti in his foreword, the widespread occurrence of DSV sits alongside a general ignorance around the scale and characteristics of issues, particularly by those working in healthcare, as there is a paucity of undergraduate and postgraduate training opportunities on offer in this area. This book thus provides a very accessible and informative reference for healthcare professionals to enable them to work more effectively with those affected by DSV.