Universal screening for domestic violence is promoted as educational, preventative and helpful. However, if not done properly, it can also cause problems or even be dangerous. Consider the following example:

At the Center for Family Therapy, a University of Oregon training clinic for masters-level therapists, a couple recently entered counseling with concerns about "communication issues." Neither disclosed violence. It was discovered, though, that: (1) the male client was currently incarcerated for assault of the current partner, and was released only to attend therapy; (2) restraining orders were served in 1994, 1996, and two in 2000; (3) the male had been incarcerated 3 months prior to beginning therapy due to a violent incident; (4) he was sentenced to 4 years probation in 2000, and convicted on 2 counts of 4^th degree assault in 1998; (5) he had been released at that time and reoffended just prior to beginning therapy (Note: details have been changed slightly to protect confidentiality).

These clients did not disclose this essential information, yet they were requesting couples counseling. In this case, as in many others, the presence of domestic violence was not visible. The violence was only detected as a result of the therapist’s cautious, deliberate, and comprehensive assessment. With this information, the therapist could alter her course to address safety. What happens, however, when therapists, physicians, educators, clergy and others conduct business without knowing there is violence present in a relationship? What risks are there in acting without this information? On the other hand, what are the potential risks of inquiring about violence?

Acting without the information has numerous risks including the possibility of violent retaliation by the batterer if the survivor discloses embarrassing or incriminating information in front of them. It can also unintentionally reinforce the isolation the batterer imposes on the survivor by neglecting to offer vital support and resources. When professionals most likely to identify the presence of domestic violence miss it, or don’t ask, batterers gain more power over the survivor. They become legitimate in their assertion that no one else cares about the survivor and that they can continue to batter without fear of detection. In many situations such as court proceedings, counseling and mediation, unidentified batterers are more able to manipulate and control the outcomes. Careful and appropriate universal screening can shift the power dynamics and increase safety, even when the violence is not identified.

Dutton (1995) argues that communities can raise awareness and significantly increase early intervention in domestic violence by detecting violence. Universal screening can increase domestic violence detection (Bograd & Mederos, 1999). Universal screening is an assessment procedure with the purpose of educating about, identifying, preventing and intervening in domestic violence. The procedure is universal in that all individuals within identified populations (e.g., OB/Gyn’s screening every female patient) are questioned about their experience with violence. If done properly, this procedure can also educate community members about domestic violence and about local resources. When violence has occurred or is occurring, it can help identify the potential lethality and imminence of further violence. With this information, advocates, physicians, therapists, educators, clergy and others more completely understand their clients’ situation and can provide appropriate, tailored, and safety-conscious support. However, asking about violence can put people in awkward, even dangerous positions, so it is very important to exercise caution. For a list of suggested screening questions and important tips, please click here.

1. It can be embarrassing for all involved and can potentially induce client termination of services/relationship w/ advocate
2. It can potentially alienate clients
3. It can discourage people from seeking services; batterer becomes aware of the practice of universal screening and blocks access to services (reduces utilization of services)
4. It can feel insulting and accusatory
5. It can provoke defensiveness and, in so doing, can increase danger
6. Given gender discrimination/mother blaming, detecting violence may subject more women to institutionalized oppression (e.g., removal of children).
7. Current practices are not adequately tested; we may be unknowingly/unwittingly increasing risk
8. Current practices have not been adequately tailored to persons of color, ethnic communities, and the LGBT community

Universal Screening:

1. Is itself an important intervention. If done properly it communicates concern for the person and the issue and provides education about domestic violence and community resources.
2. Requires specific training, which provides opportunities for key sectors of the community to be educated about domestic violence
3. Through a coordinated community approach including cross-training, contributes to the community’s overall efforts toward a coordinated community response to domestic violence
4. Through a coordinated community approach creates an opportunity to study the impact of a community-wide assessment protocol
5. Can help us to distinguish between an isolated "minor" incident and a pattern involving a primary aggressor, and all categories in-between

1. Reducing inappropriate and potentially damaging diagnosis by psychologists and other therapist bodies (i.e., attributing to ones character that which is better explained by ones context)
2. Increasing the safety of care, i.e., helpers will alter practices to reduce risk (e.g., not conduct conjoint therapy)
3. Creating opportunities to educate about domestic violence (e.g., define violence, state no one deserves to be treated in this way)
4. Creating opportunities to explain/educate about resources in the community
5. Creating opportunities for helpers to place behavior in an appropriate frame of reference (e.g., you’re not crazy, you’re responding in a natural way to an abusive situation)
6. Creating opportunities to honor the right to choose, and to acknowledge circumstances where choices are being limited by abusive behavior

Questions for Discussion (please click here to submit your comments):

1. What problems have you seen in working with someone without knowing there was domestic violence present?
2. If reporting violence can be dangerous for survivors, how can we help increase safety for disclosure? Where do you see the gaps?
3. What do you see as the risks or problems of universal screening?
4. Do you think we are prepared as a coordinated system to handle disclosures? In what ways? How do we need to improve?
5. Have you seen positive outcomes as a result of screening for domestic violence?

For more information:

Jeff Todahl 541-346-0919
Elaine Walters 541-744-8507
MINCVA Web Site
CAVnet Web Site
Articles on FANet

Recommended Literature

Bograd, M., & Mederos, F. (1999). Battering and couples therapy: Universal screening and selection of treatment modality. Journal of Marital and Family Therapy, 25(3), 291-312.