Most domestic and family violence (DFV) research has focused on establishing prevalence and screening rates in public health and community samples. This study sought to address a gap in the literature by evaluating DFV screening and response practices in a private mental healthcare inpatient service and determining if clients of the service had unmet DFV needs. A prospective, convenience sample, mixed methods, cross-sectional survey of adult inpatient mental health consumers was employed. Sixty-two participants completed the Royal Melbourne Hospital Patient Family Violence Survey. Quantitative Likert-type and categorical responses were collated and analysed descriptively (count and percentage). Free-text responses were analysed using qualitative description within a content analysis framework. Sixty-five percent of participants had been screened for at least one DFV issue, on at least one occasion, with 35% not being screened, to their recall. Twenty-three percent reported disclosing DFV concerns, 82% felt very supported by the clinician\'s response to their disclosure, and 86% were provided with information they found helpful. Unmet needs were identified in 13% of participants, who had wanted to disclose DFV concerns but not feel comfortable to do so. No unscreened respondents disclosed DFV concerns, highlighting the need to uphold best practice guidelines for direct enquiry. Most disclosing clients were positive about the support they received. Indicated areas for improvement were screening rates, active follow-up, increasing psychology support levels and safety planning.

BACKGROUND: Violence against children at home and at school is particularly prevalent in Africa and is associated with adverse and persistent health effects on children. The violence prevention intervention Interaction Competencies with Children - for Teachers (ICC-T) is an effective tool to reduce violence against children by fostering teachers\' non-violent communication and interaction skills. To enhance these effects, in the present study, ICC-T will be extended to parents (ICC-P) aiming to increase children\'s experience of consistent behavior and application of non-violent discipline strategies between teachers and parents.
METHODS: To investigate the effectiveness of the school-based combined implementation of ICC-T and ICC-P, a cluster-randomized controlled trial with 16 primary schools in the urban district of Morogoro in Eastern Tanzania will be conducted. Both quantitative (structured interviews) and qualitative (focus group discussions, in-depth interviews, evaluation forms) methods will be used to investigate the effects on teachers\' and parents\' violence against children in home and school settings. The intervention implementation will be accompanied by a comprehensive process evaluation to assess the implementation quality of and participants\' engagement with ICC-T and ICC-P. Potential downstream effects of violence reduction will be investigated by assessing the children\'s mental health and well-being.
CONCLUSIONS: The present study aims to provide evidence for the feasibility, acceptability, and effectiveness of the school-based combined implementation of ICC-T and ICC-P to reduce teacher and parental violence against children and contribute to children\'s well-being in home and school settings.
BACKGROUND: The clinical trial was registered at ClinicalTrials.gov (ClinicalTrials.gov, 2024) under the identifier NCT06369025 (Hecker, Preventing Physical and Emotional Violence by Parents and Teachers in Public Schools in Tanzania (ICC-T/ICC-P_Tanz) (PreVio), 2024) on April 17, 2024.

The aim of this scoping review was to synthesise the literature to identify what the psychological impacts of family court processes were on mothers who had experienced DFV. Twenty-five articles met inclusion criteria with four themes capturing the findings: Perpetrators using the system as a mode of coercive control; Secondary victimisation as a result of interacting with the system; Required to relive their abuse; and, Long-term psychological consequences of having engaged with the system. Key findings were that perpetrators manipulated the system to perpetrate further abuse and continue/reassert their control. Secondary re-victimisation was common, with poor knowledge of DFV and limited understanding of coercive control tactics and how these were employed by perpetrators by legal professionals identified as contributing factors. This review suggests that mothers who engage with the family court system experience a range of short- and long-term psychological impacts and court processes facilitate ongoing abuse by the perpetrator.

BACKGROUND: Indigenous women experience high rates of family violence-related head injuries. At present, lived experience accounts from Indigenous women are absent, which results in incomplete understandings and inadequate responses that have detrimental impacts on them and their families. The aim of this study was to gain insight into Indigenous women\'s personal and family perspectives regarding violence-related traumatic brain injury (TBI), including impacts on life, as well as decision-making processes about healthcare access and engagement.
METHODS: Purposeful sampling was used to complete semi-structured interviews with 18 Indigenous women living in regional and remote Australia who had experienced TBI from family violence. The data from these interviews were augmented by data from interviews and focus groups with 28 community members, including family members or carers of Indigenous women living with TBI from family violence.
RESULTS: Three themes were conceptualised based on the data and research aims: interweaving of the past and the present-ways women experience brain injury; factors that inform decision-making to access healthcare; and managing everyday changes that result from TBI from family violence. Indigenous women described living with a range of symptoms following repeated head injuries including problems with memory, cognition and concentration. A range of strategies to manage long-term symptoms of TBI were used by Indigenous women and when they did seek healthcare, Indigenous women were required to navigate a range of barriers.
CONCLUSIONS: The findings identify a range of gaps in healthcare and housing supports for Indigenous women with TBI from violence, highlighting the significant investment needed to develop responsive and appropriate pathways of care in regional and remote areas. A range of suggestions are discussed including development of a specialised workforce who can provide apppropriate follow-up support, co-designed concussion clinics and educational resources. TBI must also be a key aspect of policy and practice for services working with Indigenous women who have experienced violence to ensure appropriate responses are provided.
UNASSIGNED: Indigenous women shared their views and experiences of TBI from family violence as well as decision-making about accessing healthcare and managing TBI symptoms. As such, study participants provided public contributions to the research.

OBJECTIVE: To determine the associations between lid and conjunctival injuries (LACI), non-fatal strangulation (NFS) and domestic family violence (DFV) in non-sexual assault.
METHODS: The present study involves an analysis of LACI in a clinical audit of 85 sequential non-sexual assault presentations.
RESULTS: LACI was present in 26.9% of non-sexual assault cases, and 47.4% of LACI patients also experienced NFS. LACI was sustained in the context of DFV in 62.9% of cases. Females made up 69.2% of LACI patients, with those between 14 and 29 years most at risk. Children were present in 12.8% of cases, 78.2% of perpetrators were male and 44.9% of patients had previously been assaulted by the same perpetrator.
CONCLUSIONS: LACI is frequently associated with NFS and/or DFV. Since NFS increases future homicide attempts and events more than sixfold, LACI is an important signal about a patient\'s homicide risk, expanding the dimensions of the care needed. Those experiencing LACI during an assault also need to be referred for comprehensive eye examination as soon as possible. With consent, systematic forensic photography of LACI enables its assessment and documentation, which assists the legal process. These conclusions should drive legislative consideration and reform, plus expanded education for clinicians and police.

Romantic relationships are an important part of many people\'s lives and at least partly shaped by experiences during childhood. Youth exposed to family violence during childhood are more likely to experience difficulties in their later romantic relationships. However, a more holistic perspective on the romantic relationships of youth with a history of family violence is lacking. Using both theoretical and inductive thematic analysis, this qualitative study explored challenges as well as positive experiences within romantic relationships of youth exposed to family violence during childhood. In-depth individual interviews were conducted with 18 youth aged between 16 and 20 years, who were reported to child protection services. The narratives reflected that youth experienced challenges related to support, connection, trust, boundary setting, emotion regulation and conflict resolution. Furthermore, family violence during childhood seemed to be important in the emergence of these challenges, consistent with theoretical mechanisms described in observational learning theory and attachment theory. However, youth also described positive experiences in their romantic relationships and demonstrated an ability to learn from others (e.g., their current romantic partner) how to communicate effectively or solve problems. Therefore, with the right social or professional support, at-risk youth may be able to overcome these challenges.

BACKGROUND: Sibling sexual abuse (SSA) is a pervasive form of intrafamilial sexual violence. A review of existing literature underscores ongoing challenges to comprehensive understanding of this offense due to definitional inconsistencies, small sample sizes, data constraints, methodological shortcomings including reporting practices, and a dearth of empirical scrutiny. Previous studies have relied on retrospective, non-representative, clinical, or homogeneous samples.
OBJECTIVE: The present work updates knowledge on SSA addressing several persistent limitations in previous studies and offering contemporary victim, offender, and incident-based profiles to promote avenues for future risk assessment, prevention, and intervention strategies.
METHODS: This study, both exploratory and descriptive, draws on the five most recent years (2018-2022) of data from the National Incident-Based Reporting System (NIBRS), the largest available dataset (N = 30,640), containing SSA incidents reported to law enforcement.
RESULTS: Significant sex differences were noted across age, race, victim injury, offense type, and relationship. Female victims were more likely to experience abuse from older siblings and were nearly 2.5 times more likely to be victimized as an adult than their male counterparts. Female victims were also more likely to report injury, yet less likely than male victims to experience forcible penetration during an SSA incident.
CONCLUSIONS: Findings substantiate the ongoing need for continued refinement of SSA definitional criteria, which, in turn, will lead to greater identification and reporting of incidents. Moreover, findings here underscore the importance of considering age and gender dynamics to guide risk assessment, intervention, and prevention strategies.

BACKGROUND: As a key determinant of ill-health, family violence is inadequately responded to within Aotearoa New Zealand health policy and practice. Without adequate system support, health professionals can often be unsure of what to do, or how to help. Developed in response to this system gap, \'Atawhai\' aims to make it easier for primary care professionals to respond to family violence.
METHODS: Underpinned by indigenous Māori customs, Atawhai combines complexity theory and participatory research methodologies to be responsive to the complexity involved in family violence. We worked with 14 primary care professionals across ten whakawhitiwhiti kōrero wānanga (meetings for deliberate dialogue) to identify and develop primary care system pathways and tools for responding to family violence. This paper focuses on the development of Atawhai through wānanga and observation methods. Methods used to capture change will be reported separately.
RESULTS: Atawhai is a relational response to family violence, focused on developing a network of trusted relationships between health and social care professionals to support safe responses to those accessing care. This study identified four key health system pathways to responsiveness and developed associated tools to support health care responsiveness to family violence. We found the quality of relationships, both among professionals and with those accessing care, coupled with critical reflection on the systems and structures that shape policy and practice are essential in generating change within primary care settings.
CONCLUSIONS: Atawhai is a unique health care response to family violence evidenced on empirical knowledge of primary care professionals. Our theoretical lens calls attention to parts of the system often obscured by current health care responses to family violence. Atawhai presents an opportunity to develop a grassroots-informed, long-term response to family violence that evolves in response to needs.

BACKGROUND: Building therapeutic relationships and social presence are challenging in digital services and maybe even more difficult in written services. Despite these difficulties, in-person care may not be feasible or accessible in all situations.
OBJECTIVE: This study aims to categorize crisis counselors\' efforts to build rapport in written conversations by using deidentified conversation transcripts from the text and chat arms of the National Child Abuse Hotline. Using these categories, we identify the common characteristics of successful conversations. We defined success as conversations where help-seekers reported the hotline was a good way to seek help and that they were a lot more hopeful, a lot more informed, a lot more prepared to address the situation, and experiencing less stress, as reported by help-seekers.
METHODS: The sample consisted of transcripts from 314 purposely selected conversations from of the 1153 text and chat conversations during July 2020. Hotline users answered a preconversation survey (ie, demographics) and a postconversation survey (ie, their perceptions of the conversation). We used qualitative content analysis to process the conversations.
RESULTS: Active listening skills, including asking questions, paraphrasing, reflecting feelings, and interpreting situations, were commonly used by counselors. Validation, unconditional positive regard, and evaluation-based language, such as praise and apologies, were also often used. Compared with less successful conversations, successful conversations tended to include fewer statements that attend to the emotional dynamics. There were qualitative differences in how the counselors applied these approaches. Generally, crisis counselors in positive conversations tended to be more specific and tailor their comments to the situation.
CONCLUSIONS: Building therapeutic relationships and social presence are essential to digital interventions involving mental health professionals. Prior research demonstrates that they can be challenging to develop in written conversations. Our work demonstrates characteristics associated with successful conversations that could be adopted in other written help-seeking interventions.

BACKGROUND: Family violence, which includes intimate partner abuse, child abuse, and elder abuse, is a serious public health concern. Primary healthcare (PHC) offers a vital opportunity to identify and address family violence, yet barriers prevent the effective implementation of family violence interventions in PHC settings. The purpose of this study is to improve family violence identification and response in Alberta\'s PHC settings by exploring readiness factors.
METHODS: An integrated knowledge translation approach, combining implementation science and participatory action research, was employed to develop a readiness assessment tool for addressing family violence within PHC settings in Alberta. The research involved three phases: phase 1 involved a rapid evidence assessment, phase 2 engaged a panel of healthcare and family violence experts to explore readiness components in the Alberta context, and phase 3 utilized a 3-round Delphi consensus-building process to refine readiness indicators.
RESULTS: Phase 1 findings from a rapid evidence assessment highlighted five main models/tools for assessing readiness to implement family violence interventions in PHC settings. In phase 2, additional concepts were identified through exploration with healthcare and family violence expert panel members, resulting in a total of 16 concepts for assessing family violence readiness within the Alberta PHC context. The 3-round Delphi consensus-building process in Phase 3 involved nine panelists, who collectively agreed on the inclusion of all concepts and indicators, yielding a total of 60 items for the proposed readiness assessment tool for addressing family violence in PHC within Alberta.
CONCLUSIONS: The current study lays the groundwork for future family violence intervention programs, offering insights into key components that promote readiness for implementing comprehensive programs and supporting PHC organizations in effectively addressing family violence.