Paeds Cases · child-safety-and-social-paediatrics
Discuss IPV exposure and safety planning with a non-offending parent — OSCE
OSCE communication and shared-planning station: explaining the recognition of intimate partner violence exposure and its impact on a child, the safety assessment and lethal-means question, the child-protection process, and how the child will be kept safe — while supporting the non-offending parent without blame and without making leaving the relationship a condition of help.
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You are the paediatric registrar. You have just interviewed a seven-year-old boy alone, referred for behavioural problems, who disclosed that he hears shouting and things breaking at night. His mother, seen separately, has now disclosed that her partner hits and frightens her. You have ten minutes with her. She is frightened and minimising, and she fears that telling anyone will make things worse. She wants to understand: (1) why what happens at home affects her son, when he is never hit; (2) what happens now and whether he will be taken away; (3) what you can do to help her; and (4) whether she has to leave. Explain with empathy and honesty, do not blame her, do not require her to leave, check understanding throughout, and agree a clear safety plan. [1]
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- [1]Holt S; Buckley H; Whelan S The impact of exposure to domestic violence on children and young people: a review of the literature. Child Abuse & Neglect, 2008.PMID 18752848
- [2]Rivara FP; Anderson ML; Fishman P; et al Intimate partner violence and health care costs and utilization for children living in the home. Pediatrics, 2007.PMID 18055676
- [3]Gilbert R; Widom CS; Browne K; Fergusson D; Webb E; Janson S Burden and consequences of child maltreatment in high-income countries. Lancet, 2009.PMID 19056114
- [4]Felitti VJ; Anda RF; Nordenberg D; et al Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study. American Journal of Preventive Medicine, 1998.PMID 9635069