Client name/ID: _______________________
Date/Time: ____________________________
Assessor/Role/Service: ________________
Location/Mode: ☐ In-person ☐ Phone ☐ Telehealth ☐ Outreach
Interpreter: ☐ No ☐ Yes (language): ___________
Jurisdiction: __________________________

Is it safe to contact the client? ☐ Yes ☐ No ☐ Unsure
Safe method(s): ☐ Call ☐ Text ☐ Email ☐ App ☐ Through third party (who?): __________
Safe number/email: __________________________________________
Safe times: _________________________________________________
Code word / safety phrase: ___________________________________

Confidentiality explained + limits discussed (mandatory reporting, duty of care):
☐ Yes ☐ No

Immediate safety screen (right now):

• Client reports imminent danger today/tonight ☐ Yes ☐ No
• Perpetrator knows client is seeking help ☐ Yes ☐ No
• Client has a safe place to go in the next 24–48 hours ☐ Yes ☐ No ☐ Unsure
• Children currently safe? ☐ Yes ☐ No ☐ Unsure
  Action taken: ☐ Safety plan ☐ Crisis referral ☐ Police/000 ☐ Shelter ☐ Other: _________
   

Reason for contact / presenting concerns (client’s words if possible):

Incident summary (most recent):

• Date/time: __________________________
• What happened (brief): __________________________________________
• Injuries/medical needs: ☐ No ☐ Yes (details): ______________________
• Witnesses: ☐ No ☐ Yes (who): ____________________________________
• Police attended: ☐ No ☐ Yes (details): ____________________________
• Which Inspector on Duty was assigned to reported to victim_____________
• Was the DVSAT completed and by whom ______________________
• Was it reported to porfessional standard and by whom___________________
• Was it assigned to SAMs and by whom______________________________
• Where was the details recorded from the victim and who is responsible for confidentiality_____________________________________________
• Was the incident recorded as Police misconduct and breach of the oath of office__________________________________________________
• Was the NSW Police Policy followed: Domestic and Family Violence Guidelines  Version 2.0 2025 (22)_________________________________________
• Evidence available (messages/photos/records): ☐ No ☐ Yes ☐ Unsure
  Safety note: Do not pressure client to produce evidence if it increases risk.
   

Pattern over time (frequency, escalation, coercive control):

Separation status: ☐ Together ☐ Separated ☐ Planning to leave ☐ Recently left
High‑risk period present (separation/escalation): ☐ Yes ☐ No

Is the alleged perpetrator in law enforcement? ☐ Current ☐ Former ☐ Other (security/corrections/military): ______

Agency/Employer (if safe to record): ___________________________
Role/rank/duties: _____________________________________________
Work location/command/area: __________________________________
Known local connections relevant to client safety (if disclosed):

Client concerns about conflicts of interest:
☐ Local station/command knows perpetrator
☐ Friends/colleagues may influence response
☐ Fear of not being believed / credibility bias
☐ Fear of retaliation / “closed ranks” dynamics
☐ Privacy/information safety concerns
Notes: _______________________________________________________

☐ Threats to kill client/children/others
☐ Strangulation/pressure to neck ever (even once)
☐ Use/threat with weapons or objects
☐ Escalation in frequency/severity
☐ Stalking / monitoring / following
☐ Forced sex/sexual coercion
☐ Extreme jealousy / possession / “ownership” beliefs
☐ Suicide threats by perpetrator / murder-suicide talk
☐ Forced isolation / captivity / blocked exits
☐ Pregnancy/new baby in household
☐ Prior breaches of orders/bail/conditions
☐ Prior serious violence (towards others/animals)
☐ Client believes perpetrator is capable of killing them
☐ Recent separation or pending court/discipline/employment action
Other high-risk indicators: ______________________________________

Current risk level (clinical judgment):
☐ Low ☐ Moderate ☐ High ☐ Imminent / Extreme
Rationale: _________________________________________________

Tick what is known or reasonably suspected (do not interrogate if unsafe).

☐ Service firearm access (current)
☐ Personal firearms in home/accessible
☐ Other weapons / prohibited weapons access
☐ Client reports fear linked to firearms/weapons
Notes / actions (safe, factual): _______________________________

☐ Client fears perpetrator can access personal information via work systems
☐ Client fears monitoring through workplace networks/colleagues
☐ Client reports intimidation linked to “I’ll have you arrested / no one will believe you”
☐ Client fears leaks of their report/location
Notes: _______________________________________________________

☐ Perpetrator denies/minimises and attacks credibility
☐ Perpetrator claims client is “unstable/crazy”
☐ Counter‑allegations (client portrayed as aggressor)
☐ Smear campaign / reputation attacks
☐ Threats linked to career/reputation/children/court
Notes: _______________________________________________________

☐ Client reports fear of “the code” / colleagues backing perpetrator
☐ Client reports discouragement from reporting by others
☐ Prior help‑seeking resulted in minimisation or unsafe response
Notes: _______________________________________________________

Tick what applies; record examples in client’s words.

☐ Gaslighting / reality manipulation
☐ Constant criticism/humiliation
☐ “Interrogation” / prolonged verbal pressure
☐ Threats, intimidation, bullying
☐ Isolation from friends/family
☐ Sleep deprivation / relentless conflict
Examples/notes: ______________________________________________

☐ Physical assaults
☐ Restraint / blocking exits / confinement
☐ Intimidation via physical presence
☐ Injury history (document safely)
Notes: _______________________________________________________

☐ Forced sex/sexual assault
☐ Coercion/humiliation
☐ Reproductive coercion
Notes: _______________________________________________________

☐ Controlled access to money/accounts
☐ Employment interference
☐ Post‑separation financial abuse (legal costs, resource draining)
Notes: _______________________________________________________

☐ Phone/device monitoring
☐ Location tracking
☐ Account control (email/social banking)
☐ Harassment via digital channels
Notes: _______________________________________________________

Has the perpetrator used people/systems to control or punish the client?
☐ Counter‑applications/orders/complaints used as pressure
☐ Child-related systems pressure (school, child protection, parenting disputes)
☐ Employer/community pressure or reputational harm
☐ Friends/family recruited to isolate or discredit client
☐ Service providers manipulated into adopting perpetrator narrative (“invitation to collude”)
☐ Client has experienced dismissive/blaming/unsafe system responses
Notes: _______________________________________________________

Children in client’s care: ☐ No ☐ Yes (names/ages optional): _____________
Exposure to DV: ☐ Direct witness ☐ Heard ☐ Aftermath ☐ Not sure
Child safety concerns:
☐ Threats involving children
☐ Coercion via custody/contact
☐ Child used to gather information/pressure
☐ Risks during handovers
School/childcare safety plan needed: ☐ Yes ☐ No
Referrals made: ______________________________________________

Present symptoms (tick):
☐ Anxiety/panic ☐ Depression ☐ PTSD/CPTSD symptoms
☐ Dissociation ☐ Sleep disturbance ☐ Hypervigilance
☐ Substance use concerns ☐ Chronic pain/fatigue
☐ Shame/self-blame ☐ Memory/concentration difficulties
☐ Social withdrawal ☐ Loss of identity/purpose

Self-harm / suicide risk screen:

• Thoughts of self-harm/suicide: ☐ No ☐ Yes ☐ Past ☐ Unsure
• Plan/means/intent: ☐ No ☐ Yes (details—keep minimal and safe): __________
  Actions taken: ☐ Safety plan ☐ Crisis referral ☐ GP/MH referral ☐ Emergency
   

☐ Supportive friend/family (safe)
☐ Stable housing options
☐ Financial resources/benefits
☐ Access to phone/internet safely
☐ Strong relationship with services
☐ Client insight/motivation
☐ Community/cultural supports
Notes: _______________________________________________________

Key risks (what increases danger):

Key protective factors (what reduces danger):

OIDV-specific amplifiers present: ☐ Yes ☐ No
Overall risk level: ☐ Low ☐ Moderate ☐ High ☐ Imminent/Extreme
Rationale (2–5 sentences):

☐ Emergency plan discussed (000 / safe exit / safe location)
☐ Safe contact plan confirmed
☐ Accommodation/shelter referral
☐ Safety planning for handovers/children
☐ Digital safety basics discussed
☐ Medical care arranged
Details: ______________________________________________________

☐ Client informed of options and supported to choose
☐ ADVO/Protection order information provided
☐ Legal advice referral (independent)
☐ Specialist OIDV‑aware advocacy referral
☐ Conflict-of-interest concerns documented and escalated (where applicable)
Details: ______________________________________________________

☐ Trauma counselling referral
☐ Financial counselling
☐ Centrelink/housing supports
☐ Victim services / compensation info
☐ Child/parenting supports
Details: ______________________________________________________

Follow‑up date/time: __________________
Responsible worker: ___________________
Review triggers (tick):
☐ New threats ☐ Separation escalation ☐ Court dates ☐ Order breach ☐ Stalking increase ☐ Firearms changes

Use selectively, only if safe:

• “What happens when you try to get help—what’s the worst outcome you fear?”
• “Are you worried about who might find out you’re speaking to me?”
• “Has anyone suggested you’re the aggressor, or asked you to ‘both take responsibility’?”
• “Are there times you feel most at risk—after separation, after you disclose, after court, after work shifts?”
• “Are there weapons in the home, or anything that increases fear?”
• “Who is safe for you—and who is not?”
   

OIDV risk flag: Alleged perpetrator is current/former law enforcement; conflict-of-interest, firearms, and systems-abuse risks considered.

The Integrated Domestic Violence Assessment Tool (IDVAT) acknowledges that it can require significant courage for women experiencing domestic and family violence to appear before a court and disclose abuse.

Domestic violence frequently occurs within a context of fear, coercive control, intimidation, and psychological manipulation. These conditions can create substantial barriers for women seeking safety, assistance, or legal protection.

Women who appear before the court in relation to domestic violence matters may have experienced prolonged exposure to fear, threats, social isolation, economic dependence, and emotional harm. The process of reporting abuse, engaging with legal systems, and giving evidence may therefore involve overcoming considerable personal, psychological, and practical obstacles. 

Research and practice experience consistently demonstrate that women may delay reporting or seeking legal protection due to concerns including:

• fear of retaliation or escalation of violence
• fear for the safety of children or other family members
• economic dependence on the perpetrator
• coercive control, intimidation, or surveillance
• social isolation or lack of support
• fear of not being believed or being blamed
• prior negative experiences with systems or authorities
• trauma-related responses such as confusion, dissociation, or difficulty recalling events.
   

In this context, the act of attending court and speaking about experiences of abuse may represent a significant step in seeking safety and protection.

This acknowledgement does not make findings about the facts of any individual case. Rather, it recognises the well-documented challenges women may face when disclosing domestic violence and engaging with legal processes.

The IDVAT framework therefore recognises the courage involved when women come forward to seek protection, support, and justice.

Acknowledgement of Barriers to Accessing Protection in Domestic Violence Contexts

The Integrated Domestic Violence Assessment Tool (IDVAT) recognises that individuals experiencing domestic and family violence may face significant barriers when attempting to access their right to safety, protection, and justice.

Domestic violence frequently occurs within a context of coercive control, intimidation, fear, psychological manipulation, and social isolation. These conditions can significantly affect a survivor’s ability to recognise the abuse, disclose the abuse, seek assistance, or safely leave the abusive relationship.

Research consistently shows that survivors may delay reporting or seeking protection due to factors including:

• fear of retaliation or escalation of violence
• fear for the safety of children or other family members
• economic dependence on the perpetrator
• social isolation and lack of support networks
• threats, intimidation, or monitoring by the perpetrator
• psychological trauma, including dissociation, confusion, and memory disruption
• fear of not being believed or of being blamed
• prior negative experiences with institutions or systems
• cultural, immigration, or language barriers
• concern about family court, child protection, or legal consequences.
   

Domestic violence may also impair cognitive processing, emotional regulation, and decision-making due to trauma responses such as hypervigilance, dissociation, avoidance, and psychological distress. These trauma-related responses may influence how survivors recall events, communicate their experiences, and assess their own level of danger.

Accordingly, the absence of immediate reporting, delayed disclosure, fragmented recall, or ongoing contact with the perpetrator should not automatically be interpreted as evidence that abuse did not occur. Such responses may be consistent with well-documented trauma and survival adaptations in the context of domestic violence.

The IDVAT framework therefore places particular emphasis on the survivor’s experience of fear, perception of danger, and evolving awareness of abusive patterns, recognising these as important indicators within the broader assessment of domestic violence risk.

This acknowledgement is provided to assist practitioners, investigators, and courts in understanding the complex barriers that survivors may face when attempting to access their right to protection and safety.

Below is a draft IDVAT-aligned metacognitive topographical fear-based DV assessment you can use as a court-supporting reflective tool.

It is built around 3 domains:

• Conscious fear awareness — what the woman knows and can say no
• Preconscious fear awareness — what becomes clearer with reflection
• Subconscious fear responses — automatic bodily and psychological fear responses below immediate verbal awareness
   

In this draft, “subconscious” is used descriptively, to capture automatic responses beneath immediate awareness. It is not a diagnostic claim.

0 = not at all
1–2 = very low
3–4 = mild
5–6 = moderate
7–8 = high
9–10 = extreme / overwhelming / constant

For court use, each rated question has a statement section. A useful structure is:

What happened?
What did I fear?
What did I do to stay safe?
What effect did this have on me?

Instruction: 

Rate each question out of 10, then complete the court statement section.

Conscious assessment question

Score /10

Court statement prompt

A1How afraid am I of him right now?__Court statement: “Right now I feel afraid because…”

A2How afraid am I that he will seriously harm me if I disagree, leave, set a boundary, or report him?__Court statement: “I fear serious harm if I resist or leave because…”

A3How aware am I that I change my words, tone, behaviour, or decisions to keep him calm or to avoid conflict?__Court statement: “I change my behaviour in these ways to stay safe…”

A4How clearly can I identify the behaviour that made me feel unsafe, controlled, or intimidated?__Court statement: “The behaviour that made me feel unsafe was…”

A5How afraid am I for my children, family, pets, or other loved ones because of his behaviour?__Court statement: “I fear for others because…”

A6How aware am I that I go blank, freeze, shut down, or disconnect when I try to talk about what happened?__Court statement: “When I try to speak about the abuse, I…” 

Use this format under each rated question:

Date / time / period:
What happened:
What I feared:
What I did to stay safe:
Effect on me (sleep, work, parenting, health, concentration):