Implementing a pluridisciplinary network of intimate partner violence prevention

Introduction. - The victims of a spouse's violence have a high risk of developing mental and physical health symptoms. The efforts aimed at preventing the consequences of domestic violence are encouraged by the current literature as well as the national and international recommendations. They highlight the fact that intervention and treatment programs have more or less failed. Background. - This publication introduces the main stages of the implementation of a network, the main goals of which are to improve the knowledge and professional practices aimed at the victims of domestic violence, and to enhance the continuation and quality of health and social care (screening, assessment and addressing). After relating the developments and the methodology of the victims' consultations carried out, we wilt show how such a network device enables one to exceed the usual practice limits. First, we point out certain specificities pertaining to postimmediate psychological care (psychological debriefing) of victims of intimate partner violence. Methodology. - After presenting a specific methodology of assessment of the global situation of the victim, three illustrations of the specific consequences of domestic violence will be made, in order to highlight the interest of collaborating between professionals who are used to tackling this issue. First, is the way to empower women and help them to avoid assaults and thus prevent victimisation. The overall goal of this specific intervention is to teach women that they can end the cycle of perpetuating of intimate partner violence by learning safety factors, such as what to do if more violence occurs and where and how to seek assistance if it were to recur. Second, is to prevent the consequences of domestic violence on a child's development. It is based on the fact that children who witness domestic violence are negatively affected, as children who witness abuse are likely to experience a number of psychological symptoms. So the network proposes preventive measures and specific addressing to reduce the impact of violence. The third example relates to the high proportion of sexual assault among the nature of violence women suffer from. Victims of marital rape experience significant levels of negative mental and physical health symptoms. Network professionals have improved the screening of sexual assault in order to propose to the victims specific addressing, in terms of gynaecologic and psychological care. Discussion. - As a consequence, we deal with the professional and deontological positioning that the medical professionals have towards this device. The network device aims at going beyond the limits of the usual care, both through a pooling of knowledge and multidisciplinary practices. The establishment of common models of intervention (working groups), also suggests a best practice in relation to complex issues: the establishment of a network is a means of establishing the link between professionals. However, professionals in a network should routinely question their practice and ethics and to avoid "confusion of roles'' - the risk of multidisciplinary and standard practices. Differences and professional specialisation are essential components of a care offer tailored to the clinical complexity of victims of domestic violence. It now appears necessary to assess the impact of this care at the social, health and psychological levels of victims of domestic violence. (C) L'Encephale, Paris, 2009.