Breaking the silence: training healthcare providers to recognise the signs of psychological violence

Image courtesy of Safer Families Centre

Sometimes, a compassionate listening ear is all it takes to encourage someone to share their story. For women who are being abused by a partner, opening up can be a vital first step towards getting the help they need.

The Safer Families Centre, a research centre based out of Melbourne Medical School in Australia, knows that doctors and healthcare providers have the unique opportunity to be a listening ear for their patients. That’s why their research on psychological violence informs training programmes that help healthcare providers identify and assist survivors of abuse.

In 2021, the centre surveyed 1,000 women who had experienced psychological violence. The results were striking— coercive control, which includes psychological violence and financial abuse, is the most common form of domestic violence. Furthermore, even when perpetrators use physical violence, they have almost always used psychological tactics first. These results highlighted the importance of early intervention when abusers use psychological violence, to prevent further harm down the line.

Based on this research and 90 interviews with women on their expectations from healthcare providers, the Centre created a comprehensive provider training programme on psychological violence. Recognising that providers may feel unsure about how to begin difficult conversations, especially when there is no physical evidence of abuse, the Centre launched a practical framework called the 5As: Alone, Ask, Assess, Ally, and Advocate. The step-by-step instructions are accompanied by conversation prompts meant to build providers’ knowledge on the subject and raise their self-confidence in speaking with patients sensitively.

The framework was recently piloted with different health providers in Melbourne and the surrounding areas, including family doctors and maternal health nurses. It has already enabled providers to connect affected women with services and support. Providers found that the different prompts in the framework were helpful in starting conversations and “picking up on situations of psychological violence I otherwise might have missed,” according to one family doctor based in a rural area.

Patients have also reported the benefits of these conversations. “I found that [providers in] the local clinic were just so supportive,” says one patient, “I was having my blood pressure taken because it was sky high, and I burst into tears. Then we sat and talked for a little while. She said, ‘would you consider seeing a counsellor?’”

The Centre hopes its research and training tools can be used to help more women around the world and has disseminated the framework and survey results through various social media channels. The training has already been adapted by Oak partner, Trag Foundation, for replication in the Balkans.

Oak Foundation supports the Safer Families Centre in its research into psychological violence as part of our Issues Affecting Women Programme, which seeks to contribute to a world in which all women and girls are safe, free, and have an equal chance to thrive. To learn more about the Safer Families Centre, click here, or to access its 5As training framework, click here. To learn more about Oak’s Issues Affecting Women Programme, click here.