Intended for healthcare professionals

Clinical Review

Violence between intimate partners: working with the whole family

BMJ 2008; 337 doi: (Published 04 August 2008) Cite this as: BMJ 2008;337:a839
  1. Kelsey Hegarty, associate professor1,
  2. Angela Taft, senior research fellow2,
  3. Gene Feder, professor3
  1. 1Primary Care Research Unit, Department of General Practice, University of Melbourne, Carlton, VIC 3053, Australia
  2. 2Mother and Child Health Research, La Trobe University, VIC 3000, Australia
  3. 3Unit of Academic Primary Health Care, University of Bristol, Bristol
  1. Correspondence to: K Hegarty, 200 Berkeley Street, Carlton, VIC 3053, Australia k.hegarty{at}
  • Accepted 1 July 2008

Violence between intimate partners (one area of domestic violence) is a common violation of human rights, with long term consequences for the health of survivors and their children.1 2 Health services have lagged behind other agencies in responding appropriately to this problem. Here we review the evidence on identification and management of intimate partner violence in families and summarise primary care guideline recommendations from an international consensus group that we led.3

Sources and selection criteria

We searched Medline, Embase, CINAHL, PsycINFO, DARE, and Cochrane for recent (1999-2005) clinical guidelines or recommendations about the management of survivors or perpetrators of intimate partner violence and their children, including guidance on care of the whole family. We referred to reviews in Clinical Evidence and systematically reviewed primary studies of advocacy and psychological interventions for survivors.4 We are the key authors on the systematic reviews and consensus guidelines that this review draws on.

Defining intimate partner violence

Intimate partner violence is defined as any behaviour within an intimate relationship that causes physical, psychological, or sexual harm. This includes:

  • Physical aggression, such as hitting, kicking, and beating

  • Psychological violence, such as intimidation, constant humiliation

  • Forced intercourse and other sexual coercion

  • Various controlling behaviours, such as isolation from family and friends, monitoring movements, financial control, and restricting access to services.5

Lifetime prevalence of isolated violent acts within relationships, is comparable for men and women, but repeated coercive, sexual, or severe physical violence is perpetrated largely against women by men.6 Although intimate partner violence also occurs in same sex relationships, research evidence on the health consequences of intimate partner violence and the management of survivors is largely confined to women in heterosexual relationships, and they are the focus of this review. We do not know to what extent our conclusions can be extrapolated to male patients and to women in …

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