Using the stages of change model to counsel victims of intimate partner violence

Medical expenses from intimate partner violence (IPV) total between $3 and $5 billion annually. Many abuse victims are exposed to serious injuries, and are likely to see their physicians more frequently than other patients. Practitioners must have a reliable and realistic approach to counseling patients who are victims of IPV. This paper presents the stages of change model as a practical guide for counseling victims. Through patients' responses to a series of questions, the practitioner can identify which of five stages of change (precontemplation, preparation, contemplation, action, maintenance) the patient is in. The practitioner can then employ stage-specific strategies for counseling the patient. Using this model shifts the definition of successful outcome from the traditional focus of trying to 'fix the problem' to a patient-centered focus, working with the patient to explore the most effective strategies given his/her stage of change.