Cover -- Title Page -- Copyright -- Contents -- Contributors -- Foreword -- Introduction -- Chapter 1 The Epidemiology of Gender-Based Violence -- What are domestic violence and sexual violence and why are they gender-based? -- Prevalence in the UK -- Domestic violence internationally -- Health impacts -- Intergenerational impact -- Intersections with other adversity -- Epidemiological research -- Further reading -- Chapter 2 'Culture' and Violence -- What is 'culture'? -- Thinking about 'culture' -- Thinking 'culture' and violence against women and girls -- Forced marriage -- Urban violence/youth gang settings -- Humanitarian catastrophes -- Moving into practice -- Assessing need -- Planning support -- Conclusion -- Further reading -- Chapter 3 Domestic Violence and Abuse -- Gender -- Teenagers -- Power and control: an explanatory psychosocial model -- Who is at risk? -- Women -- Pregnant women -- Women at risk of so-called 'honour'-based violence and forced marriage -- Same-sex relationships -- Children -- Disabled children -- The impact of childhood abuse: a psychosocial cycle -- Range of abusive behaviours -- Definitions of violence -- Narratives that alert the questioner to a high degree of risk -- Hearts and flowers -- Health impacts -- The links between mind and body -- Myths, fears and responses -- Of the abused -- Of the abuser -- Further reading -- Chapter 4 The Impact of Trauma -- What is a traumatic event? -- Does everyone who experiences trauma get PTSD? -- What are the signs and symptoms of PTSD? -- Assessment -- Treatment -- What all doctors need to know -- Further reading -- Chapter 5 Children -- Scope of the problem -- Forms of sexual violence affecting children and young people -- Sexual exploitation -- Forced marriage -- Female genital mutilation -- Infant male circumcision.

Forms of domestic violence affecting children and young people -- Domestic violence from family members -- Intimate partner violence in adolescent relationships -- Child perpetrators of sexual violence -- Adverse effects of sexual and domestic violence on children and young people -- Management of sexual and domestic violence against children -- Recognising and raising concerns about children in all settings -- Further reading -- Chapter 6 Sexual Assault of Men and Boys -- Definitions of rape and sexual assault -- Myths about male rape -- Response to the assault -- Assessment of recent sexual assault of a man -- Aftercare -- What to do if the man does not report the assault -- Further reading -- Chapter 7 Identifying Domestic Violence and Abuse -- How to ask about domestic violence and abuse -- What to ask -- Why ask whether anyone tries to control the woman or what she does? -- Why ask whether the woman is ever humiliated by anyone? -- Why ask whether the woman is afraid of anyone at home? -- Why 'state the obvious' about health impacts? -- Reasons for nondisclosure -- Five practical tips on how to overcome barriers to disclosure -- Reasons for lack of overt action and helplessness in the face of offered help -- Five more practical tips on how to get past barriers to perceived inertia -- Further reading -- Chapter 8 Community-Based Responses to Domestic Violence -- Background -- Gender and language -- Advocacy -- Individual or personal advocacy -- Strategic/political advocacy -- Coordinated response: the practitioner and the community -- Resilience of survivors -- Working with survivor-centred groups -- Further reading -- Chapter 9 Sources of Referral and Support for Domestic Violence -- What this chapter covers -- Safety and assessment of risk -- Overview of specialist violence support services.

What kinds of specialist support service are available? -- MARACs, IDVAs and SDVCs -- Multi-Agency Risk Assessment Conferences (MARACs) -- Specialist Domestic Violence Courts (SDVCs) -- Domestic homicide reviews -- Further reading -- Chapter 10 Perpetrators -- Why should I be concerned about this issue? -- Look and listen during presentation -- Ask questions -- Think about risk -- Respond and refer -- Confidentiality and the safety of others -- Patients who frighten you -- Further reading -- Chapter 11 General Practice -- Common presentations in general practice -- Asking the question -- Managing a disclosure of domestic violence -- Management plan -- After the consultation -- Practice response -- Further reading -- Chapter 12 Emergency Medicine and Surgical Specialities -- Emergency medicine and surgical specialties -- When to suspect domestic and sexual violence in the emergency department -- How to approach the patient -- Examination and investigations -- Treatment, referral and follow-up -- Discharge -- Being prepared for a patient experiencing domestic or sexual violence -- In the emergency department -- In the area -- Further reading -- Web sites -- Chapter 13 Elder Abuse -- What is elder abuse and how much is there? -- Who are the abusers? -- Why does it happen? -- The doctor's role -- Anticipate -- Prevent -- Identify -- React -- Neglect in institutions -- Further reading -- Web site -- Chapter 14 The Dental Team -- Context of dental consultation -- Dentists' knowledge and skills -- Threshold of suspicion -- Further reading -- Chapter 15 Mental Health Services -- Headlines -- Myths and myth busters -- Typical presentations -- Clinical tips -- Complicating factors -- How to ask -- What to do after disclosure -- Assess risk and check immediate safety -- Document -- Offer referral to services.

Consider safeguarding issues and safeguarding referral -- Vulnerable adults -- Vulnerable children -- Consider referral to a MARAC -- Staff well being -- Further reading -- Chapter 16 Women's, Reproductive and Sexual Health Services -- Introduction -- Obstetrics -- Gynaecology -- Contraception -- Genitourinary medicine -- Further reading -- Chapter 17 Female Genital Mutilation -- What is FGM? -- Why is FGM performed? -- What does FGM consist of? -- Outcomes -- Legal status in the UK -- Management of FGM in the UK -- Provision of services -- Safeguarding -- Medicalisation -- Conclusion -- Further reading -- Chapter 18 Sexual Violence: What to Consider First -- Disclosure of sexual assault -- Offering choices and options -- Consent and confidentiality -- When does a patient's disclosure put a doctor under a duty to report to someone else, such as social services or the police? -- Capacity and the Mental Capacity Act -- The MCA lays out five statutory principles -- Assessment of capacity -- Time frames that matter -- History taking -- The examination -- Forensic samples -- Locard's principle -- Chain of custody -- Male rape -- Summary -- Further reading -- Chapter 19 Rape and Sexual Assault: Medical and Psychosocial Care -- Introduction -- History -- Examination and tests -- Prevention of pregnancy -- Testing for STIs (including HIV) -- Chain of evidence for STI samples -- Post-exposure prophylaxis -- HIV post-exposure prophylaxis following sexual exposure -- Hepatitis B -- Psychosocial support -- Safety and child protection -- Legal aspects of STIs and indication of sexual abuse or assault -- Further reading -- Useful contacts -- Learning resources -- Web site -- Chapter 20 Documenting in the Notes -- Documentation of the history -- Documenting physical findings -- Further reading.

Chapter 21 Law and Prosecuting Practice in Relation to Serious Sexual Assaults and Domestic Violence -- The prosecution process in England and Wales -- What is a sexual assault? -- Domestic violence -- What to do if your patient may be the victim of a sexual assault or domestic violence -- The prosecution approach to cases of sexual assault and domestic violence -- Confidentiality and information sharing -- Further reading -- Chapter 22 Writing a Statement as a Professional Witness -- Introduction -- Purpose -- Duties and obligations -- Do I need the patient's permission to write a statement? -- How do I start? -- What do I do next? -- When it is ready, what do I do? -- Summary -- Further reading -- For help with writing your statement -- Chapter 23 Going to Court -- Preparation -- On the day the trial starts -- What to take with you -- What else should you do? -- Before you go into court -- When you go in -- What do I do afterwards? -- Conclusion -- Further reading -- Chapter 24 Violation of Professional Boundaries -- Introduction -- Rules and regulations -- Are there risky (or at-risk) doctors? -- Are there risky (or at-risk) patients? -- Are there risky institutions? -- When is a patient not a patient? -- Your role as a witness -- Further reading -- Web sites -- Chapter 25 Moving Forward: Developing Care Pathways within the Health Service -- Background -- Committed leadership within the health care setting -- Awareness raising and sensitisation of health practitioners -- Clinical guidelines -- Develop a rolling programme of domestic violence training -- Identifying and developing appropriate referral pathways -- Listen to survivors -- Evaluation and monitoring -- Challenges and opportunities -- Further reading.

Chapter 26 Moving Forward: Pursuing a Career and Implementing Better Services.