Seeing the Forest in Family Violence Research: Moving to a Family-Centered Approach

Abstract Victims of family violence are sorted into fragmented systems that fail to address the family as an integrated unit. Each system provides specialized care to each type of victim (child; older adult; adult; animal) and centers on the expertise of the medical and service providers involved. Similarly, researchers commonly study abuse from the frame of the victim, rather than looking at a broader frame - the family. We propose the following five steps to create a research paradigm to holistically address the response, recognition, and prevention of family violence. (1) Establish common definitions and data elements for family violence. Definitions and data elements should be useable across medical, social, and legal systems of care. Outcomes should be relevant to patients, family members, and providers. (2) Measure the efficacy and cost of the current medical-social-legal system that addresses violence. (3) Develop actionable screening recommendations for at-risk household contacts when violence is initially identified. (4) Develop and test family-centered interventions, especially those that target modifiable risk factors such as substance use or mental illness. (5) Target support and prevention strategies for families at highest risk. By developing an integrated research model to address family violence, and by using that model to support integrated systems of care, we propose a fundamental paradigm shift to improve the lives of families living with and suffering from violence.