Screening for Stalking:
A Training for Healthcare Professionals
Start
Click here to read the audio transcript
This project was supported by Grant No. 15JOVW-23-GK-05470-STOP awarded by the Office on Violence Against Women, U.S. Department of Justice. The opinions, findings, conclusions, and
recommendations expressed in this publication/program/exhibition are those of the author(s) and do not necessarily reflect the views of the Department of Justice.
CONTENT WARNING
This module discusses stalking in detail. It is intended for informational purposes only.
If you or someone you know is a victim of stalking, contact local domestic violence, sexual assault, and/or crime victim service organizations for direct victim support from victim advocates (whether or not those crimes are part of the stalking). The Victim Connect Resource Center can help refer victims to local service agencies.
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More Help
Click here to read the audio transcript
Why healthcare settings?
It is rarely clear where stalking victims should go for help, as there are no stalking hotlines or stalking crisis centers in the United States. While victim service agencies (for example, rape crisis centers or domestic violence shelters) can and do provide services for stalking victims, most people are not aware that this is available.
Many healthcare facilities screen for sexual violence and/or intimate partner violence -- but not stalking, which frequently co-occurs. Asking patients who are survivors of domestic and/or sexual violence about stalking can help them better identify the full scope of harm, plan for safety, and connect with relevant resources.
Stalking may be the root cause of some of the patient’s health concerns. Identifying stalking in a healthcare setting can help more fully address the patient’s health needs.
Victims may be more comfortable disclosing to a health provider than talking to police. Not all victims want to involve the criminal justice system.
Use this side of the card to provide more information about a topic. Focus on one concept. Make learning and communication more efficient.
Use this side of the card to provide more information about a topic. Focus on one concept. Make learning and communication more efficient.
Use this side of the card to provide more information about a topic. Focus on one concept. Make learning and communication more efficient.
Use this side of the card to provide more information about a topic. Focus on one concept. Make learning and communication more efficient.
Identifying Underlying Conditions
A Safe Place for Disclosures
A Starting Point for Help
Recognizing Co-occuring Victimizations
Title
Title
Title
Title
Write a brief description here
Write a brief description here
Write a brief description here
Write a brief description here
Click here to read the audio transcript
Stalking is a Public Health Issue!
Stress and the BodyMove the mouse over the human figure and click to see how stress can impact different parts of the body. ***Extra credit: watch the short video >
Click here to read the audio transcript
Check for Understanding: 1
Consider this Scenario...
I really should've thought about that before asking these questions.
You know, after you've explained all that...I do think I'm being stalked.
I'm so sorry you're experiencing that. I'm glad you told me.
Let's prepare!
I'm really scared.
What should I do now?
Oh, uh...
Screening is only meaningful if a positive screen leads to helpful action. Let's go back and prepare! Where to?
I'M PREPARED! Let's do this.
Click on the clock icon for the topic you'd like to explore in the order of your choice. When you've seen all four, click the green "I'm prepared!" button. Or, just click the right arrow to go to the next page, which will take you through each section.
LEARN ABOUT STALKING BEHAVIORS
ESTABLISH PARTNERSHIPS
ACQUIRE MATERIALS
REVIEW CUES FRAMEWORK
Identify & Build Partnerships
Howdy, partner!
Who serves stalking victims?
What services are available?
How do I build a partnership?
Stalking behaviors in healthcare settings
Bonus Features
Intersection with sexual violence
Who are stalkers?
Intersection with domestic violence
Stalking prevalence
THE BIG PICTURE
The goal is for healthcare providers to recognize signs of stalking, to educate all patients on stalking, and to provide resources for further help. Do not push the patient for disclosure and/or details of their experience.
Frame the Conversation with C.U.E.S.
Universal Education
Empowerment
Confidentiality
Support
The CUES Framework was developed by Futures Without Violence.
Acquire Materials
Check for Understanding: 2
Check for Understanding: 3
Check for Understanding: 4
Check for Understanding: 5
Check for Understanding: 6
Click here to read the audio transcript
Written Version
Oral Version
Sexual Assault Screening
Stalking Questions to add to
Domestic Violence Screening
Stalking Questions to add to
If there is a low likelihood of stalking...
Click here to read the audio transcript
- It is still helpful to remind the patient that you are a safe person to come to with any future issues.
- Explain that you are still going to share information in case they – or someone they know – does experience this problem in the future.
“Your answers to these questions indicated a low likelihood of stalking. If you do find someone bothering or scaring you, please know this is a safe place to discuss those concerns.”
"Since this issue is so common, I’d still like to share some information just in case this ever happens to you or someone you care about. Can I give you this brochure?"
Rad!
If there is a high likelihood of stalking...
- Respond with empathy and make it clear that the patient did the right thing by telling you.
Click here to read the audio transcript
- Provide information and options.
- Make a warm referral, ideally personally connecting the patient to specific local providers.
“Sadly, stalking is a really common issue that I see with my patients and I know it can be really confusing, stressful, and scary.”
"This brochure has some basic information about stalking that may be helpful. Why don't we take a look together?"
Written Questions
Oral Questions
“What happens next is up to you, but I want to make sure you know about some options.”
“I know this really nice person over at [name of agency] who has helped other patients of mine before. Can we give him/her/them a call together right now?”
Check for Understanding: 7
Check for Understanding: 8
Check for Understanding: 9
Check for Understanding: 10
eLEARNINGMODULES
FACT SHEETS & INFOGRAPHICS
MUCH MORE
YOU ARE HERE
SHORT VIDEOS
RECORDED WEBINARS
HEALTHCARE PROVIDER RESOURCES
Click here to read the audio transcript
THANK YOU!
Please explore our resources at StalkingAwareness.org.
Session Evaluation & Certificate Request
This project was supported by Grant No. 15JOVW-23-GK-05470-STOP awarded by the Office on Violence Against Women, U.S. Department of Justice. The opinions, findings, conclusions, and
recommendations expressed in this publication/program/exhibition are those of the author(s) and do not necessarily reflect the views of the Department of Justice.
Click here to read the audio transcript
- Always see patients alone for every visit so that you can bring up this issue safely. Other people at the appointment may not be safe or trusted by the patient.
- Know your state/territory’s requirements and share any limits of confidentiality with your patient at the beginning of the clinical encounter.
- While privacy and confidentiality are critical and well-regulated for all patients, be aware that stalkers may try to impersonate their victims to gain access to private health information.
Confidentiality
What might this sound like?
The same privacy principles for protecting survivors of intimate partner and sexual violence apply to survivors of stalking. If you’re new to privacy considerations in this context, review this guide.
STALKER-VICTIM RELATIONSHIPS
Intimate Partner
(Current or former)
Acquaintance
Stranger
Brief Encounter
Family Member
Female Victims
Male Victims
Person of Authority
10%
20%
30%
40%
50%
Combined percentages exceed 100% because some victims had multiple perpetrators.
Stalking and Sexual Violence
Many healthcare facilities screen for sexual assault/sexual violence. If a patient reports sexual assault or physical assault, follow your
facility/ hospital/jurisdictional protocols to offer medical forensic care by a
trained clinician.
If the patient has disclosed sexual violence, ask about stalking as well:
- Has the person who did this been showing up, watching you, following you, threatening you, disrespecting your privacy, or otherwise making it difficult to live your normal life?
- Did they follow you, contact you, learn information about you, or otherwise seem to target you before or after they harmed you?
- After the [assault/incident], have they done or said anything to threaten you (or others in your life)?
- Are you worried they will harm you again or that they might continue to show up, watch you, follow you, threaten you, disrespect your privacy, or otherwise make it difficult to live your normal life?
Oral Screen
The oral and written screening questions are the same. When screening orally, briefly introduce the topic to provide some context to the questions.Introductory Statement Options:
- I don’t know if this is a problem for you, but many of the people I see as patients are dealing with an unwanted person in their life who is causing them stress. Since this often has real impacts on health, I’ve started asking everyone about it.
- Many people have someone in their lives who will not leave them alone, which can cause a lot of stress and actually impacts their physical and mental health.
- Stalking is so common in our society and has real effects on health, but it’s often not taken seriously -- so I have started asking all of my patients about it.
Additional Infographics & Materials
Check out the SPARC website for infographics, fact sheets, and other resources that explore how stalking may impact different populations and/or intersect with relevant victimizations that your patients may be experiencing. Feel free to print and share these materials for patients.
Written Screen
- Print and share the written screening questions form with the patient and have the patient complete it independently.
- Please ensure the patient is able to read and
understand the questions.
- If using the written tool, still follow up verbally and offer the brochures.
Lungs
- Shortness of Breath
- Increased Risk for Asthma
Stalking frequently intersects with sexual violence.
- 48% of sexual assault survivors (ages 18-24) also experienced stalking victimization.
- 31% of women stalked by an intimate partner were also sexually assaulted by that partner.
Citations & further learning: https://www.stalkingawareness.org/wp-content/uploads/2022/04/Stalking-Sexual-Violence-Fact-Sheet.pdf
- Anxiety
- Depression
- PTSD
- Flashbacks and dissociations
- Suicidal Ideation
- Drug and alcohol use/misuse
- Intrusive thoughts
- Aggression
- Difficulty sleeping
- Frequent headaches
- Vision issues
Brain
Written Screen
- Print and share the written screening questions form with the patient and have the patient complete it independently.
- Please ensure the patient is able to read and
understand the questions.
- If using the written tool, still follow up verbally and offer the brochures.
1 in 6
MEN
1 in 3
WOMEN
Stalking is a prevalent victimization. In the United States, nearly one in three women and one in six men experience stalking at some point in their lifetimes.
EXPERIENCE STALKING IN THEIR LIFETIMES
Smith, S.G., Basile, K.C., & Kresnow, M. (2022). The National Intimate Partner and Sexual Violence Survey (NISVS): 2016/2017 Report on Stalking. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention.
Click here to read the audio transcript
Universal Education & Empowerment
- Screen for stalking, using the statements and questions recommended in the Screening Guide.
- If they’ve already completed a stalking screening, review the results with the patient.
What might this sound like?
- Show patients the brochure to start the conversation about stalking and how it can affect health. Open the brochure and encourage them to take a look.
- Ask if they would feel safe taking materials with them and/or visiting the website.
- If so, give each patient two safety cards/brochures.
- If unsure or no, share the online version of the brochure with the QR code on the written screening tool.
- Offer a safe place and device to view the online version of the brochure, as stalkers may monitor a victim’s devices.
What might this sound like?
Laci Smith, MSN, RN, CPN, SANE-A, SANE- P
International Association of Forensic Nurses
Excerpt from "The Health Impacts of Stalking" Webinar -- Full Recording Available Here
- Chronic Pain
- Increased risk of chronic disease
Whole Body
Thank you for all of your critical work and for taking the time to learn more about stalking. We hope that you benefitted from this course and are ready to incorporate stalking screening into your healthcare setting. Please complete the evaluation, access the screening guide, and keep in touch with SPARC to stay informed on new resources.
Written Screen
- Print and share the written screening questions form with the patient and have the patient complete it independently.
- Please ensure the patient is able to read and
understand the questions.
- If using the written tool, still follow up verbally and offer the brochures.
Finally, it's time for the screening questions! The written and oral versions include the same questions, but the way you introduce the topic of stalking may vary depending on how you're screening. If you're already screening for domestic violence or sexual violence, ask about stalking as well. Click on each column to learn more.
Stalking survivors are usually eligible for the same services and resources that domestic violence victims are.
Where do you refer patients who disclose dating violence, domestic violence, and/or sexual violence? That is most likely the correct place to refer stalking survivors. Consider family violence centers, rape crisis agencies, and domestic violence shelters.Even when the stalking is not related to domestic or sexual violence (for example, the stalker is a neighbor or estranged friend), domestic violence agencies generally serve stalking survivors.
Not sure where to start? These national hotlines provide local referrals.
Audio transcripts are available on every page with voiceover. Just click the text that says “click here to read the audio transcript” under the white rectangle.
Heart
- Chest pain
- Heart palpitations
- Increased risk of heart disease, hypertension, heart attack and stroke
Support
- Know how to support someone who discloses.
- Make a warm referral to your local domestic/sexual violence partner agency or national hotlines.
- Ideally, connect the patient to a specific person at an agency while they are with you at the appointment.
- If they decline, share resources that they can utilize at a later time if they so choose.
- Offer health promotion strategies and a care plan that takes surviving stalking into consideration.
What might this sound like? Click the quotation marks above for examples of each step.
Patients may answer "yes" to one more questions, seem uncertain, and/or disclose. Make it clear that the patient did the right thing by telling you and that you hope they'll take some action to get a better sense of their full situation and seek help. Go back to the CUES framework, providing education, empowerment, and a warm referral.
Gastrointestinal
- Gastrointestinal upset
- Abdominal pain
- Nausea
- Acid Reflux
- Appetite disturbance
While many healthcare settings screen for domestic violence and/or sexual assault, very few ask patients about stalking victimization. So, why should they start? Click on each card to explore some of the reasons.
Stalking and Domestic Violence
Many healthcare facilities screen for domestic/dating
violence. If a patient reports sexual assault or physical assault, follow your facility/hospital/jurisdictional protocols to offer medical forensic care by a trained clinician.
If the patient has disclosed domestic/dating violence, ask about stalking as well:
- Has your current or previous partner been showing up, watching you, following you,
threatening you, disrespecting your privacy, or otherwise making it difficult to live your
normal life?
The Big Question:Has anyone in your life been following you, watching you, showing up unexpectedly, or communicating with you in ways that seem obsessive or make you concerned for your safety or the safety of others?
1) Has this person been tracking, following, or monitoring you in any way without your consent?This could happen in-person or through technology. Examples include:- Reading your text messages, e-mails, or other communications that should be private
- Watching you, following you, or waiting for you places you go (like the gym or your house)
- Tracking where you go, who you talk to, or other information about you
4) Has this person significantly and directed interfered with your life? (e.g., spread rumors or publicly humiliated you, jeopardized your job, interfered with finances, interfered with your housing)?This could happen in-person or through technology. Examples include:- Damaging your property, stealing your property, or breaking into your home
- Spreading rumors about you, including sharing private images or information
- Physically harming you
Surveillance
Interference (through Sabotage or Attack)
3) Has this person, more than one time, intimidated or scared you through threats, property damage, threats or actual harm of pets, or other means?This could happen in-person or through technology. Examples include:- Threatened to share or post private information, photos, or videos of you or people you care about
- Made gestures, said words, or left objects that felt threatening but were not direct threats
- Threatened to harm or kill you, friends, family, pets or others that you care about
- Gotten other people threaten, harass, intimidate, stalk, or attack you or your friends/family
Intimidation
2) Has this person repeatedly initiated unwanted contact with you (e.g., repeated phone calls, texts, messages, emails, gifts, etc. or through third parties)?This could happen in-person or through technology. Examples include:- Contacting you again and again even though you don’t want to communicate
- with them (phone calls, texts, messages, emails)
- Showing up at your work, school, or other places where they are not wanted
- Sending or leaving unwanted gifts, objects, mail, or other items
Life Invasion
Asking one question is efficient in terms of time, but the generic nature of the question leaves room for confusion – the patient may not know what kinds of experiences you are trying to identify. If you have any sense that the patient may not be clear on what you’re asking, consider asking about these common stalking behaviors for a more accurate response. You do not need to read the examples in full, but providing one or two often helps patients better identify what kinds of behaviors you are asking about – use your judgment and assess patient comprehension.
ASK ABOUT:
Life Invasion
Intimidation
Interference
(through Sabotage or Attack)
Surveillance
Click on the icon for the question recommendations.
Only your local agency knows what they can (and cannot) offer to stalking survivors -- so ask them!
Generally, victim advocates can provide individualized safety planning and connect stalking survivors to a range of resources, like legal aid and housing.
Ask your partner(s) what services they do (and do not) provide to stalking survivors -- and be sure this includes intimate partner and non intimate partner victims.
If they aren't sure what they can provide and/or don't have clear answers, encourage them to connect with SPARC for training and resources on better serving survivors of stalking (they can start with this guidance for victim service providers).
Handbook for Stalking Victims
SPARC offers printable handbooks on understanding stalking available on our website in 10 different languages. This includes more detailed information than the short brochure. We recommend having a few of these printed and ready-to-share.
Heart
- Chest pain
- Heart palpitations
- Increased risk of heart disease, hypertension, heart attack and stroke
Stalking is a public health issue. Victims of stalking experience higher rates of a variety of health impacts than people who are not stalked, from chronic pain to cardiovascular disease to injury from the stalker. Explore the classroom to learn more.
Stalkers may interfere with the patient's access to medical care.
While privacy and confidentiality are critical and well-regulated for all patients, be aware that stalkers may try to impersonate their victims, or family members of the victim, to gain access to private health information.- Ask the patient if the stalker may have (or gain) access to patient portals or other online health accounts.
- Be mindful of what notes are included.
- Sample documentation: “Universal education offered, health promotion and harm reduction strategies shared, referrals offered, and follow up discussed.”
- Stalkers may sabotage the patient by making or canceling appointments, picking up prescriptions, or otherwise causing harm and creating barriers to the patient accessing care.
- Stalkers may also impersonate healthcare professionals and contact the patient.
The same privacy principles for protecting survivors of intimate partner and sexual violence apply to survivors of stalking. If you’re new to privacy considerations in this context, review this guide.
Healthcare settings area critical parts of a coordinated community response (CCR)!
Is the partnership formal or informal? Who at the victim service agency do you know?Try to find a specific point of contact that you feel comfortable referring the patient to (i.e., "Sheryl at Safe Place helps my patients out all the time, can we call her together right now?" vs "Try Safe Place.") Let your partner agency know that you plan to begin screening for stalking so they are ready for the referrals.
Learn more about building partnerships between healthcare professionals and advocates.
Stalking and Health Brochures
Universal education on stalking is critical! As detailed in the CUES framework, healthcare providers should share information on stalking with their patients. Show patients the brochure to start the conversation about stalking and how it can affect health. If it's not safe to provide print materials, have patients view the information on the SPARC website using a safe device.
Preview Content
Access &/or Print Web Version
Request mailing (free)
This training has provided foundational information about stalking, its health impacts, and strategies for screening -- but there's much more to learn! Please explore our many resources for further learning at stalkingawareness.org.
Pelvis
- Chronic muscle tension
- Chronic pain
Reproductive Organs
- Absent or irregular menstrual cycles
- Effects on fertility (both male and female anatomy)
Welcome! This eLearning module will help prepare healthcare professionals to effectively screen patients for stalking victimization.
If the patient answers "no" to every question -- either orally or through the written screening -- they are unlikely to be experiencing stalking. Still, they may simply not want to disclose, have a friend who could use some help, or have this experience in the future. Remind the patient that you are a safe place to come with any future issues and share information and resources.
Stalking frequently intersects with domestic violence.
- 40% of stalkers are current or former intimate partners.
- 81% of women stalked by a current or former husband or cohabitating partner were also physically assaulted by that partner.
Citations & further learning: https://www.stalkingawareness.org/wp-content/uploads/2018/11/Stalking-IPV-Fact-Sheet.pdf
Universal Education & Empowerment
- Screen for stalking, using the statements and questions recommended in the Screening Guide.
- If they’ve already completed a stalking screening, review the results with the patient.
What might this sound like?
- Show patients the brochure to start the conversation about stalking and how it can affect health. Open the brochure and encourage them to take a look.
- Ask if they would feel safe taking materials with them and/or visiting the website.
- If so, give each patient two safety cards/brochures.
- If unsure or no, share the online version of the brochure with the QR code on the written screening tool.
- Offer a safe place and device to view the online version of the brochure, as stalkers may monitor a victim’s devices.
What might this sound like?
Stalking and Health Brochures
Universal education on stalking is critical! As detailed in the CUES framework, healthcare providers should share information on stalking with their patients. Show patients the brochure to start the conversation about stalking and how it can affect health. If it's not safe to provide print materials, have patients view the information on the SPARC website using a safe device.
Preview Content
Access &/or Print Web Version
Request mailing (free)
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Transcript
Screening for Stalking:
A Training for Healthcare Professionals
Start
Click here to read the audio transcript
This project was supported by Grant No. 15JOVW-23-GK-05470-STOP awarded by the Office on Violence Against Women, U.S. Department of Justice. The opinions, findings, conclusions, and recommendations expressed in this publication/program/exhibition are those of the author(s) and do not necessarily reflect the views of the Department of Justice.
CONTENT WARNING
This module discusses stalking in detail. It is intended for informational purposes only.
If you or someone you know is a victim of stalking, contact local domestic violence, sexual assault, and/or crime victim service organizations for direct victim support from victim advocates (whether or not those crimes are part of the stalking). The Victim Connect Resource Center can help refer victims to local service agencies.
Tips for Using SPARC eLearning Modules
More Help
Click here to read the audio transcript
Why healthcare settings?
It is rarely clear where stalking victims should go for help, as there are no stalking hotlines or stalking crisis centers in the United States. While victim service agencies (for example, rape crisis centers or domestic violence shelters) can and do provide services for stalking victims, most people are not aware that this is available.
Many healthcare facilities screen for sexual violence and/or intimate partner violence -- but not stalking, which frequently co-occurs. Asking patients who are survivors of domestic and/or sexual violence about stalking can help them better identify the full scope of harm, plan for safety, and connect with relevant resources.
Stalking may be the root cause of some of the patient’s health concerns. Identifying stalking in a healthcare setting can help more fully address the patient’s health needs.
Victims may be more comfortable disclosing to a health provider than talking to police. Not all victims want to involve the criminal justice system.
Use this side of the card to provide more information about a topic. Focus on one concept. Make learning and communication more efficient.
Use this side of the card to provide more information about a topic. Focus on one concept. Make learning and communication more efficient.
Use this side of the card to provide more information about a topic. Focus on one concept. Make learning and communication more efficient.
Use this side of the card to provide more information about a topic. Focus on one concept. Make learning and communication more efficient.
Identifying Underlying Conditions
A Safe Place for Disclosures
A Starting Point for Help
Recognizing Co-occuring Victimizations
Title
Title
Title
Title
Write a brief description here
Write a brief description here
Write a brief description here
Write a brief description here
Click here to read the audio transcript
Stalking is a Public Health Issue!
Stress and the BodyMove the mouse over the human figure and click to see how stress can impact different parts of the body. ***Extra credit: watch the short video >
Click here to read the audio transcript
Check for Understanding: 1
Consider this Scenario...
I really should've thought about that before asking these questions.
You know, after you've explained all that...I do think I'm being stalked.
I'm so sorry you're experiencing that. I'm glad you told me.
Let's prepare!
I'm really scared.
What should I do now?
Oh, uh...
Screening is only meaningful if a positive screen leads to helpful action. Let's go back and prepare! Where to?
I'M PREPARED! Let's do this.
Click on the clock icon for the topic you'd like to explore in the order of your choice. When you've seen all four, click the green "I'm prepared!" button. Or, just click the right arrow to go to the next page, which will take you through each section.
LEARN ABOUT STALKING BEHAVIORS
ESTABLISH PARTNERSHIPS
ACQUIRE MATERIALS
REVIEW CUES FRAMEWORK
Identify & Build Partnerships
Howdy, partner!
Who serves stalking victims?
What services are available?
How do I build a partnership?
Stalking behaviors in healthcare settings
Bonus Features
Intersection with sexual violence
Who are stalkers?
Intersection with domestic violence
Stalking prevalence
THE BIG PICTURE
The goal is for healthcare providers to recognize signs of stalking, to educate all patients on stalking, and to provide resources for further help. Do not push the patient for disclosure and/or details of their experience.
Frame the Conversation with C.U.E.S.
Universal Education
Empowerment
Confidentiality
Support
The CUES Framework was developed by Futures Without Violence.
Acquire Materials
Check for Understanding: 2
Check for Understanding: 3
Check for Understanding: 4
Check for Understanding: 5
Check for Understanding: 6
Click here to read the audio transcript
Written Version
Oral Version
Sexual Assault Screening
Stalking Questions to add to
Domestic Violence Screening
Stalking Questions to add to
If there is a low likelihood of stalking...
Click here to read the audio transcript
“Your answers to these questions indicated a low likelihood of stalking. If you do find someone bothering or scaring you, please know this is a safe place to discuss those concerns.”
"Since this issue is so common, I’d still like to share some information just in case this ever happens to you or someone you care about. Can I give you this brochure?"
Rad!
If there is a high likelihood of stalking...
Click here to read the audio transcript
“Sadly, stalking is a really common issue that I see with my patients and I know it can be really confusing, stressful, and scary.”
"This brochure has some basic information about stalking that may be helpful. Why don't we take a look together?"
Written Questions
Oral Questions
“What happens next is up to you, but I want to make sure you know about some options.”
“I know this really nice person over at [name of agency] who has helped other patients of mine before. Can we give him/her/them a call together right now?”
Check for Understanding: 7
Check for Understanding: 8
Check for Understanding: 9
Check for Understanding: 10
eLEARNINGMODULES
FACT SHEETS & INFOGRAPHICS
MUCH MORE
YOU ARE HERE
SHORT VIDEOS
RECORDED WEBINARS
HEALTHCARE PROVIDER RESOURCES
Click here to read the audio transcript
THANK YOU!
Please explore our resources at StalkingAwareness.org.
Session Evaluation & Certificate Request
This project was supported by Grant No. 15JOVW-23-GK-05470-STOP awarded by the Office on Violence Against Women, U.S. Department of Justice. The opinions, findings, conclusions, and recommendations expressed in this publication/program/exhibition are those of the author(s) and do not necessarily reflect the views of the Department of Justice.
Click here to read the audio transcript
Confidentiality
What might this sound like?
The same privacy principles for protecting survivors of intimate partner and sexual violence apply to survivors of stalking. If you’re new to privacy considerations in this context, review this guide.
STALKER-VICTIM RELATIONSHIPS
Intimate Partner
(Current or former)
Acquaintance
Stranger
Brief Encounter
Family Member
Female Victims
Male Victims
Person of Authority
10%
20%
30%
40%
50%
Combined percentages exceed 100% because some victims had multiple perpetrators.
Stalking and Sexual Violence
Many healthcare facilities screen for sexual assault/sexual violence. If a patient reports sexual assault or physical assault, follow your facility/ hospital/jurisdictional protocols to offer medical forensic care by a trained clinician.
If the patient has disclosed sexual violence, ask about stalking as well:
Oral Screen
The oral and written screening questions are the same. When screening orally, briefly introduce the topic to provide some context to the questions.Introductory Statement Options:
Additional Infographics & Materials
Check out the SPARC website for infographics, fact sheets, and other resources that explore how stalking may impact different populations and/or intersect with relevant victimizations that your patients may be experiencing. Feel free to print and share these materials for patients.
Written Screen
Lungs
Stalking frequently intersects with sexual violence.
Citations & further learning: https://www.stalkingawareness.org/wp-content/uploads/2022/04/Stalking-Sexual-Violence-Fact-Sheet.pdf
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Written Screen
1 in 6
MEN
1 in 3
WOMEN
Stalking is a prevalent victimization. In the United States, nearly one in three women and one in six men experience stalking at some point in their lifetimes.
EXPERIENCE STALKING IN THEIR LIFETIMES
Smith, S.G., Basile, K.C., & Kresnow, M. (2022). The National Intimate Partner and Sexual Violence Survey (NISVS): 2016/2017 Report on Stalking. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention.
Click here to read the audio transcript
Universal Education & Empowerment
What might this sound like?
What might this sound like?
Laci Smith, MSN, RN, CPN, SANE-A, SANE- P
International Association of Forensic Nurses
Excerpt from "The Health Impacts of Stalking" Webinar -- Full Recording Available Here
Whole Body
Thank you for all of your critical work and for taking the time to learn more about stalking. We hope that you benefitted from this course and are ready to incorporate stalking screening into your healthcare setting. Please complete the evaluation, access the screening guide, and keep in touch with SPARC to stay informed on new resources.
Written Screen
Finally, it's time for the screening questions! The written and oral versions include the same questions, but the way you introduce the topic of stalking may vary depending on how you're screening. If you're already screening for domestic violence or sexual violence, ask about stalking as well. Click on each column to learn more.
Stalking survivors are usually eligible for the same services and resources that domestic violence victims are.
Where do you refer patients who disclose dating violence, domestic violence, and/or sexual violence? That is most likely the correct place to refer stalking survivors. Consider family violence centers, rape crisis agencies, and domestic violence shelters.Even when the stalking is not related to domestic or sexual violence (for example, the stalker is a neighbor or estranged friend), domestic violence agencies generally serve stalking survivors.
Not sure where to start? These national hotlines provide local referrals.
Audio transcripts are available on every page with voiceover. Just click the text that says “click here to read the audio transcript” under the white rectangle.
Heart
Support
What might this sound like? Click the quotation marks above for examples of each step.
Patients may answer "yes" to one more questions, seem uncertain, and/or disclose. Make it clear that the patient did the right thing by telling you and that you hope they'll take some action to get a better sense of their full situation and seek help. Go back to the CUES framework, providing education, empowerment, and a warm referral.
Gastrointestinal
While many healthcare settings screen for domestic violence and/or sexual assault, very few ask patients about stalking victimization. So, why should they start? Click on each card to explore some of the reasons.
Stalking and Domestic Violence
Many healthcare facilities screen for domestic/dating violence. If a patient reports sexual assault or physical assault, follow your facility/hospital/jurisdictional protocols to offer medical forensic care by a trained clinician.
If the patient has disclosed domestic/dating violence, ask about stalking as well:
The Big Question:Has anyone in your life been following you, watching you, showing up unexpectedly, or communicating with you in ways that seem obsessive or make you concerned for your safety or the safety of others?
1) Has this person been tracking, following, or monitoring you in any way without your consent?This could happen in-person or through technology. Examples include:- Reading your text messages, e-mails, or other communications that should be private
- Watching you, following you, or waiting for you places you go (like the gym or your house)
- Tracking where you go, who you talk to, or other information about you
4) Has this person significantly and directed interfered with your life? (e.g., spread rumors or publicly humiliated you, jeopardized your job, interfered with finances, interfered with your housing)?This could happen in-person or through technology. Examples include:- Damaging your property, stealing your property, or breaking into your home
- Spreading rumors about you, including sharing private images or information
- Physically harming you
Surveillance
Interference (through Sabotage or Attack)
3) Has this person, more than one time, intimidated or scared you through threats, property damage, threats or actual harm of pets, or other means?This could happen in-person or through technology. Examples include:- Threatened to share or post private information, photos, or videos of you or people you care about
- Made gestures, said words, or left objects that felt threatening but were not direct threats
- Threatened to harm or kill you, friends, family, pets or others that you care about
- Gotten other people threaten, harass, intimidate, stalk, or attack you or your friends/family
Intimidation
2) Has this person repeatedly initiated unwanted contact with you (e.g., repeated phone calls, texts, messages, emails, gifts, etc. or through third parties)?This could happen in-person or through technology. Examples include:- Contacting you again and again even though you don’t want to communicate
- with them (phone calls, texts, messages, emails)
- Showing up at your work, school, or other places where they are not wanted
- Sending or leaving unwanted gifts, objects, mail, or other items
Life Invasion
Asking one question is efficient in terms of time, but the generic nature of the question leaves room for confusion – the patient may not know what kinds of experiences you are trying to identify. If you have any sense that the patient may not be clear on what you’re asking, consider asking about these common stalking behaviors for a more accurate response. You do not need to read the examples in full, but providing one or two often helps patients better identify what kinds of behaviors you are asking about – use your judgment and assess patient comprehension.
ASK ABOUT:
Life Invasion
Intimidation
Interference
(through Sabotage or Attack)
Surveillance
Click on the icon for the question recommendations.
Only your local agency knows what they can (and cannot) offer to stalking survivors -- so ask them!
Generally, victim advocates can provide individualized safety planning and connect stalking survivors to a range of resources, like legal aid and housing.
Ask your partner(s) what services they do (and do not) provide to stalking survivors -- and be sure this includes intimate partner and non intimate partner victims.
If they aren't sure what they can provide and/or don't have clear answers, encourage them to connect with SPARC for training and resources on better serving survivors of stalking (they can start with this guidance for victim service providers).
Handbook for Stalking Victims
SPARC offers printable handbooks on understanding stalking available on our website in 10 different languages. This includes more detailed information than the short brochure. We recommend having a few of these printed and ready-to-share.
Heart
Stalking is a public health issue. Victims of stalking experience higher rates of a variety of health impacts than people who are not stalked, from chronic pain to cardiovascular disease to injury from the stalker. Explore the classroom to learn more.
Stalkers may interfere with the patient's access to medical care.
While privacy and confidentiality are critical and well-regulated for all patients, be aware that stalkers may try to impersonate their victims, or family members of the victim, to gain access to private health information.- Ask the patient if the stalker may have (or gain) access to patient portals or other online health accounts.
- Be mindful of what notes are included.
- Sample documentation: “Universal education offered, health promotion and harm reduction strategies shared, referrals offered, and follow up discussed.”
- Stalkers may sabotage the patient by making or canceling appointments, picking up prescriptions, or otherwise causing harm and creating barriers to the patient accessing care.
- Stalkers may also impersonate healthcare professionals and contact the patient.
The same privacy principles for protecting survivors of intimate partner and sexual violence apply to survivors of stalking. If you’re new to privacy considerations in this context, review this guide.
Healthcare settings area critical parts of a coordinated community response (CCR)!
Is the partnership formal or informal? Who at the victim service agency do you know?Try to find a specific point of contact that you feel comfortable referring the patient to (i.e., "Sheryl at Safe Place helps my patients out all the time, can we call her together right now?" vs "Try Safe Place.") Let your partner agency know that you plan to begin screening for stalking so they are ready for the referrals.
Learn more about building partnerships between healthcare professionals and advocates.
Stalking and Health Brochures
Universal education on stalking is critical! As detailed in the CUES framework, healthcare providers should share information on stalking with their patients. Show patients the brochure to start the conversation about stalking and how it can affect health. If it's not safe to provide print materials, have patients view the information on the SPARC website using a safe device.
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This training has provided foundational information about stalking, its health impacts, and strategies for screening -- but there's much more to learn! Please explore our many resources for further learning at stalkingawareness.org.
Pelvis
Reproductive Organs
Welcome! This eLearning module will help prepare healthcare professionals to effectively screen patients for stalking victimization.
If the patient answers "no" to every question -- either orally or through the written screening -- they are unlikely to be experiencing stalking. Still, they may simply not want to disclose, have a friend who could use some help, or have this experience in the future. Remind the patient that you are a safe place to come with any future issues and share information and resources.
Stalking frequently intersects with domestic violence.
Citations & further learning: https://www.stalkingawareness.org/wp-content/uploads/2018/11/Stalking-IPV-Fact-Sheet.pdf
Universal Education & Empowerment
What might this sound like?
What might this sound like?
Stalking and Health Brochures
Universal education on stalking is critical! As detailed in the CUES framework, healthcare providers should share information on stalking with their patients. Show patients the brochure to start the conversation about stalking and how it can affect health. If it's not safe to provide print materials, have patients view the information on the SPARC website using a safe device.
Preview Content
Access &/or Print Web Version
Request mailing (free)