In a recent news story about an alleged domestic violence assault, one detail has stayed with me. According to reporting, a woman arrived at an urgent care center with injuries that were serious enough to require transfer to a hospital emergency department. Recognizing the patient needed a higher level of care, staff offered to arrange a rideshare to the hospital. However, the man accompanying her insisted on driving her himself.
We don’t know everything the healthcare providers knew at that moment, and it’s important not to judge individual clinicians with the benefit of hindsight. We also don’t know whether the patient felt safe enough to disclose what had happened or whether she identified the person accompanying her as the individual responsible for her injuries.
Why Trauma Informed Healthcare is so Important
What this sequence of events does highlight, however, is a broader reality: domestic violence often hides in plain sight, and healthcare settings are uniquely positioned to recognize its warning signs and create safe opportunities for survivors to seek help. For many survivors, a visit to an urgent care center, emergency department, or primary care office may be one of the few times they are away from home and in contact with someone outside their immediate circle. These encounters are more than medical visits. They are critical intervention points.
For those of us who work with survivors every day, this story illustrates why trauma-informed healthcare is so important. A patient presenting with significant injuries, a transfer from urgent care to an emergency department, or a companion who insists on managing the patient’s transportation may not, individually, indicate abuse. Taken together, however, they may signal something more and call for additional privacy, thoughtful assessment, and an opportunity for the patient to speak alone with a healthcare provider.
Domestic Violence is About Much More than Physical Violence
Domestic violence is about power and control. An ongoing pattern of behaviors used to dominate, isolate, and intimidate another person is known as coercive control. Although it leaves no visible marks, coercive control is increasingly recognized as one of the defining features of abusive relationships and is often a precursor to serious physical harm.
Coercive control can look like monitoring a partner’s phone, controlling access to money, dictating where they go or who they see, threatening to take away their children, or insisting on speaking for them in public. It can also appear in healthcare settings. An abusive partner may refuse to leave the exam room, answer questions directed to the patient, minimize or explain away injuries, or insist on controlling how and when the patient leaves the hospital. To an untrained observer, these behaviors may seem protective or simply attentive. In the context of domestic violence, they can be warning signs that someone is being controlled.
Why Healthcare Settings are Positioned to Support Survivors
Healthcare settings are uniquely positioned to recognize these patterns, not because every provider can identify abuse immediately, but because they can create conditions that make disclosure possible. The goal is not to ask clinicians to become investigators. It is to ensure that every patient has the opportunity to speak privately, answer questions without fear, and learn that help is available if they choose to accept it.
Transitions in care are especially important moments to reassess a patient’s safety. When a patient is referred from an urgent care center to an emergency department, admitted to the hospital, discharged home, or transferred between providers, healthcare teams have another opportunity to ensure the patient can speak privately, assess whether they feel safe, and offer information about available resources.
In the recent case, the patient’s injuries were severe enough that the urgent care center determined she needed to be seen at an emergency department and staff offered her transportation to the hospital. When the accompanying individual insisted on driving her instead, it created another opportunity to pause and consider whether the patient was able to make that decision freely. While we cannot know what information was available to staff at that moment, situations like this underscore why every transition in care should include attention not only to medical needs but also to patient safety and autonomy.
What Trauma Informed Care Looks Like in Healthcare Settings
Trauma-informed care recognizes that a survivor may not disclose abuse the first time they are asked, or at all during a particular visit. That is why creating multiple opportunities for private conversations throughout a patient’s care is so important. Every transition is another chance to ask, “Would you like to speak with me alone?” or “Do you feel safe going home today?” Regardless of the answer, the survivor has learned that someone noticed, cared, and was willing to help.
Many healthcare organizations recommend universal education and private screening because coercive control is often invisible. Rather than trying to determine which patients may be experiencing abuse, providers can adopt practices that protect every patient’s privacy. Speaking with every adult patient alone for at least part of a visit helps normalize the practice, reduces stigma, and creates a safe opportunity for disclosure. It also prevents an abusive partner from remaining present throughout the entire encounter and controlling the conversation.
Trauma-informed care also means recognizing that violence doesn’t end when someone arrives at the hospital or doctor’s office. Cleveland Clinic has developed a program that supports survivors in the aftermath of abuse
At The Second Step, we partner with healthcare providers and other community organizations because we know that no single system can meet every survivor’s needs. Safety is built through collaboration. When healthcare professionals, advocates, attorneys, counselors, housing providers, and community organizations work together, survivors are more likely to receive coordinated, trauma-informed support that respects their choices and strengthens their path toward safety and stability.
What We Can Do as a Community
Domestic violence is not always obvious, and it rarely presents as a single incident. More often, it reveals itself through patterns of control that are easy to overlook without training and awareness. As a community, we have an opportunity to strengthen our response, not by assigning blame when tragedy occurs, but by investing in education, trauma-informed practices, and partnerships that help survivors access support when they need it most.
Sometimes, the most important intervention is not solving the problem in a single encounter. It is creating one moment where a survivor realizes someone sees what is happening, believes them, and is ready to help. Those moments restore dignity, build trust, and can ultimately save lives.
The Second Step works to prevent domestic violence by equipping individuals and communities with the knowledge and skills to create safer environments. Our Prevention Education Program builds understanding around power, control, harm, and healing, and provides practical tools people can use in real-life situations.
Contact Director of Prevention Education, Stacy Karabetsos – skarabetsos@thesecondstep.org – to learn more about our trainings and to schedule one for your group, organization, or business.