Table 1.

VEGA principles for a common approach to recognizing and safely responding to family violence [51].

Care Pathway	Common Approach
Trauma- and violence-informed care	Trauma- and violence-informed care is a useful way to approach the provider-patient care encounter as it brings to awareness the high prevalence of violence experiences in patient’s lives and acknowledges the overlapping and additive effect of violence in people’s lives.
Recognizing family violence	Any time providers are concerned about a patient’s social, emotional, or behavioural responses, they should consider what environmental factors, including family violence, could be influencing these responses. Some patients show no signs or symptoms of family violence. For patients who do show signs and symptoms, they are usually not sufficient to confirm family violence. To move from considering to suspecting family violence, further inquiry about a sign or symptom is often required.
Asking about family violence	Before inquiring about potential family violence, certain conditions of safety must be achieved, such as a private space for discussion (this includes considerations of privacy for children). Safe inquiries about potential family violence experience must involve discussions about the limits of confidentiality and ideally follow a phased approach to questioning (first asking about the presenting problem, then about general well-being, then about safety in the home if needed).
Safe responses to disclosures of family violence	Safe responses to disclosures of family violence build upon the provider’s communication skills and at the very least convey an understanding of the patient’s experience and offers of support. In addition to immediate safety, it is important to consider an assessment of the patient’s physical and mental health symptoms, as well as any academic/workplace or social problems and to offer a referral to evidence-based services as needed. In jurisdictions where mandatory reporting is in place, if providers suspect child maltreatment (including children’s exposure to intimate partner violence), they are required to make a report to child protection services. Caregivers should be involved in the report when it is safe to do so.
Documentation	Providers should accurately and completely document findings of their interaction with patients for the purposes of follow-up and to support patients in accessing appropriate services.
Used with permission by the © 2020 VEGA Project, McMaster University-All rights reserved. For more detailed information, please see the VEGA Family Violence Education Resources.