Strengthening Health System Responses to Gender-based Violence in Eastern Europe and Central Asia

A resource package

8. risk assessment and service planning

8.1        Outline of the module

Duration of the module

2 hours

Aim of the module

To provide participants with knowledge and skills to

  • understand the importance of risk assessment and safety planning, and
  • support the patient in identifying risk factors for repeating or increasing intimate partner violence and in developing a safety plan.  

Key learning messages

  •  Health care professionals play an important role in supporting a survivor of GBV through jointly assessing potential risks, supporting her in her safety planning and referring her to other services needed (e.g. shelter).
  • Risk factors for repeating or increasing intimate partner violence include previous acts of violence, threats, possession and/or use of weapons and extreme jealousy and possessiveness.
  • Separation and divorce are high times of risk. Therefore, health care providers should not encourage women to leave a violent partner, as this can put them at further risk.
  • Risk assessment should follow standardized tools and procedures, for instance the Danger Assessment developed by Jacqueline Campbell. Acronyms can be a practical tool to help health care professionals to memorize key risk factors in day-to-day work practice (e.g. SPECSS used in the UK); developing local acronyms that fit the respective context and language is recommended.
  • Developing a safety plan together with the patient can help her to leave the relationship in case the violence escalates. This should include precautions such as identifying neighbours, friends or relatives that can offer support or having a packed bag ready with essential items in case the woman needs to leave the home in a hurry. 
  • Networking and establishing referral pathways with other service providers is important. In particular women’s shelters may be specialized in risk assessment and safety planning and can make an important contribution to protecting the patient’s safety.
  • In the absence of women’s shelters, health facilities could consider practical solutions, such as offering women short-term stays in the facility.

Background readings for trainer

UNFPA-WAVE Resource Package, Part I, chapter 3.4

Further readings:

WAVE 2013


  • Presentation by trainer (PPT slides 1-6, handout 29)
  • Presentation by trainer (PPT slides 7-10, handout 30)
  • Individual exercise: Identifying risk factors – the case of Mrs. Y (handouts 30-31) – duration: 25 minutes
  • Presentation by trainer (PPT slides 11-13, handouts 32-33, handout 17 on victim support rooms/module 4)
  • Role play: Safety Planning – the case of Dilorom (handouts 32-34) – duration: 45 minutes

Notes for trainers

Individual exercise: Identifying risk factors – the case of Mrs. Y(handout 31) – duration: 25 minutes

Ask participants to read handout 31 and to identify risk factors, using the Danger Assessment by Campbell (handout 30). Allow 10 minutes for individual work and 15 minutes for discussion in the group. When wrapping up the exercise, explain that this case study is based on a true story.–  Ms. Y, a woman of Turkish origin living in Austria was eventually killed by her husband because the criminal justice authorities had underestimated the risk. Her children took the case to the UN CEDAW Committee, which found that Austria had violated its obligations under the CEDAW Convention. You may also want to point out that it is very important that all agencies involved are aware of the risk factors, use the same standardized risk assessment tool and are trained on applying, are trained on using it, and that risk assessment becomes a routine standard in their everyday work.


Role play: Safety Planning – The Case of Dilorom (handouts 30-32) – duration: 45 minutes

Disseminate handout 34 with the instructions; ask participants to also refer to handouts 32 and 33. Ask for volunteers for the following three roles: patient, doctor/nurse, and observer. A bigger training group can be divided into small groups (factor in more time for the discussion). Allow 10-15 minutes for the role play. Parties can change roles, if there is enough time. After the role play, facilitate a discussion (15-20 minutes):

  • Questions to the person playing the survivor: How did you feel in your role? Was the behaviour of the doctor/nurse useful? What could the doctor/nurse have done differently?
  • Questions to the person playing the doctor/nurse: How did you feel in your role? What did I handle well? What was the most difficult for me? What could I have done differently? What do I need to in my work practice to support a patient in safety planning?
  • Ask the observer to share her/his observations and feedback.

Then open the discussion to the group. 

Materials for training session

Presentation: PowerPointpresentation Module 8 ( download it at the bottom of the page)


Handout 29: Risk factors indicating a high degree of dangerousness in case of intimate partner violence

Handout 30: Example of a risk assessment tool: Danger Assessment by Jacquelyn C. Campbell

Handout 31: Individual exercise: Identifying risk factors – the case of Mrs. Y

Handout 32: Check list for developing a safety plan with the survivor

Handout 33:Individual safety plan for women who experienced violence by intimate partners or other family members

Handout 34: Role Play: Safety Planning – The Case of Dilorom