Child Abuse

Updated Adverse Childhood Experiences Clinical Guide

I’ve updated the adverse childhood experiences (ACEs) clinical guide–there’s so much available it’s impossible to be exhaustive, so I have tried to provide a reasonable overview of some of the resources available. I’d love to be able to sit down and do the deep dive, but I simply don’t have the capacity for it, so consider this a healthy intro to the topic.


Teen Dating Violence Research Webinar

I just got notice of this in my inbox this morning, so apologies for the late notice: OJP is hosting a webinar, Relationship Dynamics and their Contribution to Adolescent Relationships and Dating Violence. If this title looks familiar it’s because it was originally slated for last month, but a technical difficulty caused them to reschedule it for March 30th at 2pm ET. From the announcement:

Teen dating violence is a common and serious public health problem that persists into adulthood. While it is evident that relationship dynamics are important to consider in teen dating violence, there is limited understanding about how these relational interactions shape relationships and impact dating violence among youth. Furthermore, current intervention and prevention efforts generally do not consider and incorporate these relationship dynamics into their strategies.

This webinar will provide newly emerging information from two NIJ-funded longitudinal studies regarding important relationship dynamic contexts in dating violence among youth. In the first presentation, Drs. Michael Lorber and Amy Smith Slep will discuss the role of negative interaction patterns in dating relationships and violence over time in a sample of 200 adolescent dating couples in New York City. In the second presentation, Drs. Megan Bair-Merritt and Ty Ridenour will present findings about how daily changes in relational factors like feelings of jealousy, intimacy, and instrumental support are associated with dating violence victimization and perpetration in a sample of 158 high-risk adolescent females. Kelly Miller with the Idaho Coalition Against Sexual & Domestic Violence will provide an overview of the possible impact of the presented research on primary prevention strategies on adolescent relationship abuse and how these studies can better inform approaches across the socioecological level.

Register here.


Since Last We Spoke, 3-27-17

If you are playing along at home, this month I have been at Ft Drum, Ft Bragg, Joint Base Lewis-McChord, and now Ft Sill, with a trip to San Antonio (not on post, but still for the Army), tossed in there for good measure. I will round out this marathon with 18 hours in CLE to see my girl child perform as one of the leads in her high school musical and then I am home for a week. Really looking forward to all of you coming to DC for the Leadership and Lobby Day (and dinner at my house!)–a perfect way to re-enter polite society and spend quality time with people who are not lawyers.

This was one of the only full weekends I had with my wife, so I stayed pretty unplugged. However, an almost 4 hour layover at DFW gave me time to catch up on the events of the world. Here’s what caught my eye since last we spoke:

My wife is baffled by how many of us wear these (I will never give them up)

I can’t tell you how much I hate that science is political

Good–seems like we need her now more than ever

My entire professional life is a side-hustle

Is this a surprise to anyone?

I really value how much we try not to let this hierarchy play out in our clinic


Best tweet I read this weekend:


Revictimization After Adolescent Dating Violence

There’s an interesting new study looking at the rates of revictimization for adults who experienced teen dating violence. The study, Revictimization After Adolescent Dating Violence in a Matched, National Sample of Youth, found that “…heterosexual victims of teen dating violence were significantly more likely to be re-victimized five years later compared to their non-victim counterparts with other similar risk factors. Those who were victims again, by the five-year mark, were also more likely to be re-victimized by romantic partners 12 years later.” (source)

Anytime you entertain the idea that forensic healthcare is limited to response and has no place in the prevention world, or you think to yourself, prevention work is for other folks, read studies like this that really drive home how important it is that we all are reaching beyond documenting injuries. Prevention is a key pillar in all aspects of healthcare, ours included.

Read more about the study over at the Washington Post.

Sexual Assault

Sexually Transmitted Infections: Epidemiology in Indian Country (CE Opportunity)

Understanding the landscape of sexually transmitted infections in your community is a critical part of effectively caring for sexual assault patients. National treatment guidelines are well and good, but if the clinical picture is different where you are, then adapting those guidelines becomes a necessity. To that end, Indian Health Services has an upcoming webinar that should be helpful for those providing care in Indian Country–Sexually Transmitted Infections: Epidemiology in Indian Country and Screening and Treatment Recommendations. The session will be held April 14th at 3pm ET. CEs are available for nurses.


At the end of this presentation, participants will be able to:

  1. Summarize the epidemiology of STIs in Indian Country.
  2. Apply appropriate standard screening and treatment recommendations for STIs to help increase screening rates in Indian Country.
  3. Identify the special populations and their different STI testing needs to increase case finding in those populations and in turn reduce total STI burden.

Since Last We Spoke, 3-20-17

Ok, stop me if you’ve heard this (from me) before (this month)–on the road this week at (fill in name of military installation here), time isn’t my own, inconsistent posting possible, oh look, I was in several airports and had an opportunity to surf for a few. You have? Great– here’s what caught my eye since last we spoke:

And Jesus Said Unto Paul Ryan…

One way to fund kit testing

What you need to know about the anti-racism movement

Love this new entry into the doll market

This was satirical; the President missed that memo when he endorsed it as a must read

Best story about grammar ever.

This is me 🙁

Sexual Assault

Best Practices in Communicating with Survivors of Sex Trafficking

The National Criminal Justice Training Center has a webinar coming up, Best Practices in Communicating with Survivors of Sex Trafficking. The session will be held March 23rd at 2pm ET. The session will:

…[provide] an overview of trauma-informed techniques for communicating with victims and survivors of sex trafficking. Gather strategies for building rapport and fostering open communication for the various professionals that victims of sex trafficking interact with in justice, advocacy, and recovery.

Register for the webinar here.


How Trauma Lodges in the Body

I’m pretty interested in the impact of trauma on health, as so many of us are in this field. So when I saw that Krista Tippit (Do you tune in to the On Being podcast? You should.) had interviewed Dr. Bessel van der Kolk about the issue of trauma and its effects on the body, I bookmarked it to listen to during my travel. I haven’t finished listening to the whole program, but I thought what I had heard was interesting enough to post it here. It’s a bit woo-woo, and yet, the longer I do this work, the more comfortable I get with the whole idea of woo-woo, so…

Dr. van der Kolk is Medical Director of the Trauma Center at the Justice Resource Institute in Brookline, Massachusetts. He’s also a professor of psychiatry at Boston University Medical School. His books include Traumatic Stress: The Effects of Overwhelming Experience on the Mind, Body and Society and The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma.

Child Abuse

Joint Position on Care of Prepubescent Pediatric Sexual Abuse Patients

ENA and IAFN have released a joint position paper on the care of prepubescent pediatric sexual abuse patients in the emergency care setting. You can release the full statement here. The website also has a variety of relevant resources.


Since Last We Spoke, 3-13-17

Good morning from Ft. Bragg, NC. As is the case for weeks like this, my time is not my own, so we’ll see how regular posts are. I worked all weekend, but managed to peruse the interwebs during some down time last night. Here’s what’s caught my eye since last we spoke:

It never ends

There’s no time limit on the impact of a tragedy

You must have a life

Brainstorm like a Googler

Misogyny from the left is just as awful

The fight for transgender rights goes on

Death by PowerPoint

Telehealth may not be as cost effective as we hoped

I literally LOL’d

Articles of Note Uncategorized

Articles of Note, March 2017 Edition

Time once again for Articles of Note, our (mostly) monthly walk through the peer-reviewed literature. As always, here are some of the notable new publications related to forensic healthcare. It was actually a somewhat scant offering this go-round, but what was there (and a lot of it is peds-related) is certainly worth perusing. As always, please provide appropriate attribution if you reproduce any of this:



Sexual Assault

Informed Consent for Sexual Assault Exams

SAFEta has a webinar coming up in May (bless you, Kim for your advanced planning and scheduling)–Informed Consent for Sexual Assault Exams: It Is Not Just a Signature, It’s a Process. The session will be held May 2nd at 2pm ET. From the announcement:

Sexual assault victims must provide informed consent for a medical forensic exam. Although the concept of informed consent is a term that healthcare providers are very familiar with, there are additional legal implications associated with consent for the exam that providers need to understand. Victims need relevant information on the impact of participating in or declining each component of the exam.

Register here.


Sexual Assault

Public Health Approach to Preventing Human Trafficking

PreventConnect has a webinar coming up, Public Health Approach to Preventing Human Trafficking. The session will be held 23 March from 2-3:30 pm ET. Their webinars tend to fill, so if you’re interested I would encourage you to register quickly.  From their site:

A recently published book, Human Trafficking Is a Public Health Issue: A Paradigm Expansion in the United States, is the first book of its kind, with a comprehensive look – from a public health perspective – at human trafficking in the US. This web conference will explore the problematic nature of human trafficking in our communities through the public health lens and how it is linked to sexual violence and domestic violence. We will identify fundamental types and essential elements of human trafficking to consider and incorporate while developing primary prevention programs. We will also highlight examples of anti-human trafficking prevention work being pursued by community health organizations and discuss strategies and actionable goals to create programs to prevent human trafficking in your communities.

You can register here.


Since Last We Spoke, 3-6-17

Headed to San Antonio this morning to teach–it was great to get home a day early last week, but that still gave me exactly 2 days before having to repack and head out. As it stands now, I’ll have another 2 days once I return before I head out again, so everything feels like a sprint, including my social media consumption. Confession: I’ve been really trying to limit perusing my twitter feed as an act of self-care. But sometimes a girl just can’t help herself–so here’s what’s caught my eye since last we spoke:

Mourning Norma McCorvey

Jane Fonda discusses the sexual violence in her life (among other things)

Ugh–how is this still going on?

Not a fan (at all) of this site, but I did find this piece about conflict fascinating

I’ll be working/traveling on a Day Without A Womanhere are some good tips for what to do if you are in the same boat

Maybe you could just ask your partner what’s working (and what’s not) instead?

What a great idea

See what’s happened in your lifetime

The unintended consequences of the rise in deportations

On my reading list

Yep, got it: predict your future

Elder Abuse/Neglect

Polyvictimization in Later Life

OVCTTAC has a web series now available on polyvictimization in later life. It’s a series of 5 modules totaling 6 hours:

  1. Context of Polyvictimization
  2. Older Adults Affected by Polyvictimization
  3. Perpetrators of Late Life Polyvictimization
  4. Working With Older Adults Affected by Polyvictimization
  5. Lessons Learned from the Polyvictimization in Later Life Project

“The purpose of the training is to strengthen awareness of polyvictimization in later life and to provide knowledge and skills of professionals to address the needs of victims. The training addresses the context of polyvictimization; victims and perpetrators of polyvictimization; best practices to work with older adults affected by polyvictimization using trauma-informed, ethical, and culturally appropriate practices; and the latest research and best practices to serve this population.”