Asking Routinely About Intimate Partner Violence in a Child and Adolescent Psychiatric Clinic: A Qualitative Study

Among children visiting child and adolescent psychiatric clinics (CAP), the prevalence of exposure to intimate partner violence (IPV) is reported to be approximately 25 %. The extent to which CAP clinicians are aware of this violence, however, is unclear. Some researchers recommend asking about IPV at intake, both to raise disclosure rates and to ensure adequate treatment. Many clinicians are reluctant to do so as a matter of routine when there is no indication of occurrence of IPV in the family. When we interviewed 14 clinicians about their experiences using a standard questionnaire about IPV, three themes emerged: (a) constraint (the questions hinder the development of good relationships with patients), (b) uncertainty (upon reflection, screening is acknowledged as important, but somewhat deficient), and (c) utility (the questionnaire provides a useful framework). Our findings indicate that clinicians' negative feelings and ambivalence make the implementation of routinely asking about IPV a long process.