Survivor-Defined Practice in Domestic Violence Work: Measure Development and Preliminary Evidence of Link to Empowerment

Natural Health Community Program and Well-Being: An Uncontrolled Study of Women Survivors of Domestic Violence

The purpose of this study was to evaluate a local natural healing service program and to explore how engagement in natural healing services related to the well-being of survivors of domestic violence. Using longitudinal secondary data, we conducted t-tests, regression, and correlation analysis on three measures (hope, distress, and empowerment) that were completed by the participants (N = 31). We provided evidence of the positive impact of a community-based natural healing services program on the well-being of survivors of domestic violence, specifically their sense of hope. This research represents the potential for natural healing services provided at the community level.

Examining second-stage shelters: insights into housing instability and tailored support for IPV survivors

BACKGROUND

Intimate Partner Violence (IPV) exposes women and children to a wide range of challenges across housing, employment, social connections, and child well-being and is a public health issue. IPV survivors are at heightened risk of housing insecurity and homelessness. Emergency shelters have historically offered respite and support, but the emergence of second-stage shelters provides longer-term solutions. Despite their significance, there has been a lack of comprehensive research on second-stage shelters. This study focuses on understanding the needs of IPV survivors accessing second-stage shelters, aiming to illuminate unexplored aspects of support. To examine the current published peer-reviewed literature and gray literature on second-stage shelters, a scoping review was conducted.

METHODS

This scoping review used the method suggested by Arksey & O'Malley (2005) and considered all studies that focused on women who had experienced IPV and were accessing transitional housing/second-stage shelters.

RESULTS

Sixteen articles, mainly from the USA and published between 1985 and 2022, were included in the analysis. The findings highlighted themes of (1) a safe(r) place, with the subtheme of 'gated' communities, and (2) programming and services, with the subtheme of does one size fit all? and (3) insider support, with subthemes of paid insider support and peer insider support.

CONCLUSIONS

Housing instability was evident, and the need for multiple and individualized tailored options of programming and support along with housing security was identified. Second-stage housing policy and practice implications are addressed which illuminate unexplored aspects of support.

The CARE Health Advocacy Intervention Improves Trauma-Informed Practices at Domestic Violence Service Organizations to Address Brain Injury, Mental Health, and Substance Use

OBJECTIVE

The aim of this study was to evaluate the impact that domestic violence (DV) service organizations' (SO) agency-wide adoption of CARE had on improving DVSO trauma-informed care (TIC) practices, overall, and in relation to addressing brain injury and mental health. CARE is an advocacy intervention designed to raise DVSOs' capacity to C ONNECT with survivors; A CKNOWLEDGE that head trauma, strangulation, and mental health challenges are common; R ESPOND by accommodating needs in services and providing targeted referrals; and E VALUATE effectiveness of response to meet survivors' stated concerns. We hypothesized that TIC would significantly improve among DVSO staff with the agency's use of CARE.

SETTING/PARTICIPANTS/DESIGN

Pre- ( n = 53) and 1-year post-CARE ( n = 60) implementation online surveys were completed by staff at 5 DVSOs in Ohio from 2017 to 2019.

MAIN MEASURES

Trauma-Informed Practice Scales (TIPS) were used to assess agency support and overall staff impression of implementing TIC; scales were modified to assess the use of TIC-practices related to head trauma, strangulation, mental health, suicide, and substance use. Attitudes Regarding Trauma-Informed Care (ARTIC-45) subscales assessed DVSO staff's endorsement of personal and organizational support in implementing TIC practices. Response options on the Survivor Defined Practice Scale (SDPS) were modified to gain staff insight into DVSO's ability to facilitate survivor empowerment. Differences in endorsement of TIC practices between pre- and post-CARE implementation were evaluated using regression models.

RESULTS

DVSO agency environment ( P < .01) and overall staff impression ( P < .001) regarding implementing TIC practices, and in respect to head trauma ( P < .01), strangulation ( P < .01), mental health ( P < .01), suicide ( P = .04), and substance use ( P < .01), significantly improved with the agency's use of CARE. CARE increased DVSO staff's belief in personal and organizational support to implement TIC ( P < .01 and P = .02, respectively) and in their agency's ability to foster survivor empowerment ( P < .01).

CONCLUSION

CARE improved TIC practices of DVSOs, overall, and to address brain injury and mental health.

Criminal orders of protection for survivors of intimate partner violence, future system engagement, and well-being: Understanding the importance of prior abusive relationships

This study investigated women's court experiences, mental health, and willingness to engage the system in the future for intimate partner violence (IPV), with a primary focus on the role of prior abusive relationships. Among 298 women whose partners were arrested for IPV, chi-square analyses found that women who had (vs. did not have) a prior abusive relationship were less likely to have contact with a court-based victim advocate, but there were no differences in the criminal order of protection level of restriction they requested. Regression analyses indicated that women with (vs. without) prior abusive relationships reported greater depression symptoms and perceived stress, and less willingness to engage the system in the future. No differences emerged in PTSD symptoms. This study provides insight into the experiences women have in the court system following their partner's arrest for IPV, considers their past abusive experiences, and has implications for women's safety and well-being.

Intimate Partner Violence (IPV) in Bhutan: Understanding Women's Responses to IPV Using the Transtheoretical Model of Behavior Change

Intimate partner violence is highly prevalent in Asian region. It is largely committed by male against their female intimate partner. This is often associated with the region's unique social and cultural norms which subordinate women throughout their lives. IPV is an ongoing concern in Bhutan. The country's age-old traditions and customs are closely related to culture of silence among women experiencing IPV. This study examined women's responses to intimate partner violence (IPV) in Bhutan. Semi-structured interviews were conducted to explore sensitising concepts such as how and when women recognised IPV and how they responded to it. Fifteen women who had sought supportive services at the institution `RENEW' (Respect, Educate, Nurture, Empower Women) as a result of IPV participated in the interview. The Trans-theoretical model of behaviour change (TTM) was used as a theoretical framework to understand women's cognitive, affective and behavioural change processes. The interviews were audio-recorded and transcribed. Thematic analysis was used to identify the patterns of women's responses. From the analysis, women's experiences of IPV and their responses were located within the four stages of change, including contemplation, preparation, action and maintenance. Women used nine traditional processes of change among which consciousness raising and helping relationships were critical and appeared across all four stages of change. This study provides important insights of Bhutanese women's cognitive and behavioural responses to IPV. The appearance of consciousness raising and helping relationships across all the stages of change represents a potential opportunity for intervention to initiate and promote changes in women's response to IPV in the early stages.

Criminal Protection Orders: Implications of Requested Versus Issued Orders on Domestic Violence Revictimiztion and Mental Health Among Women

Criminal protection orders (POs), with varying degrees of restrictions on offenders' behavior, are issued by the criminal justice (CJ) system to enhance the safety and well-being of victims of domestic violence (DV). Yet, little research exists to elucidate outcomes associated with their issuance, and no research has examined outcomes of POs that are issued with greater restrictions than what victims requested. Among 187 women who were victims in a criminal DV case with a male intimate partner and who voiced their preference about a PO in the court system, this study examined if women's DV revictimization by their partner and mental health (i.e., posttraumatic stress disorder and depression symptom severity, perceived stress, and fear) are differentially impacted by whether criminal POs issued by the court were more restrictive than what was requested by victims. Results showed that regardless of whether the level of criminal PO issued was more restrictive or not, victims reported significant decreases in victimization and improvement in mental health over time. However, there was greater benefit regarding victimization and mental health outcomes in the degree of change over time for victims with POs that were not more restrictive than those whose POs were more restrictive. Findings are discussed in the context of Therapeutic Jurisprudence and survivor-defined practice, which underscore the importance of victims' input and requests in criminal PO proceedings.

Criminal Protection Orders Among Women Victims of Intimate Partner Violence: Women's Experiences of Court Decisions, Processes, and Their Willingness to Engage With the System in the Future

Consistent with a therapeutic jurisprudence framework, court decisions and processes can have a therapeutic or antitherapeutic effect on intimate partner violence (IPV) victims. To maximize therapeutic effects, IPV scholars have advocated for survivor-defined practices that emphasize the importance of engaging with victims in a collaborative manner that promotes autonomy, choice, and control. However, limited research exists in the context of criminal protection orders (POs). The current study addressed this gap by assessing whether criminal PO match (whether victims received the level PO they requested [i.e., PO match] or not [i.e., PO mismatch]) and victims' subjective experiences of the court process were associated with their willingness to use the system in the future to address IPV. In a sample of 187 women whose partners were arrested for IPV, experiencing the court processes as positive (β = .36, p = .001) and court-related fear (β = .41, p < .001) were positively associated with willingness to use the system in the future. Additionally, PO match moderated the association between subjective court experiences and willingness to use the system in the future. Experiencing the court processes as negative (b = .33, p = .005) and validating (b = -.36, p = .001) was associated with willingness to use the system in the future only for participants who did not receive the PO level they requested. While experiencing the court as positive (b = -.40, p ≤ .001) was associated with willingness to use the system regardless of PO match, it was most strongly associated for participants who did not receive the PO level they requested. Results suggest the importance of ascertaining strategies to improve victims' experiences with the court, especially when victims' requests are not met, to increase future engagement with the system.

"I Felt Better When I Moved Into My Own Place": Needs and Experiences of Intimate Partner Violence Survivors in Rapid Rehousing

Accessing stable housing is a basic need for intimate partner violence (IPV) survivors, and rapid rehousing programs are a critical way to address homelessness. However, little is known about survivor experiences, needs, and outcomes in rapid rehousing services within IPV agencies. This study uses an exploratory approach to understand the needs and experiences of 31 survivors using vouchers facilitated by an IPV program in the U.S. Southwest. Thematic analysis of structured interviews resulted in four summary themes: getting to housing, managing multiple needs, accessing support, and facing barriers. Practice and evaluation implications are discussed.

Conceptualising the separation from an abusive partner as a multifactorial, non-linear, dynamic process: A parallel with Newton’s laws of motion

The present study focused on the dynamics and factors underpinning domestic abuse (DA) survivors’ decisions to end the abusive relationship. The experiences and opinions of 12 female DA survivors and 18 support workers were examined through in-depth, one-to-one, semi-structured interviews. Hybrid thematic analysis was conducted to retrieve semantic themes and explore relationships among the themes identified and the differences in survivors’ and professionals’ narratives of the separation process. The findings highlighted that separation decisions derived from the joint action of two sets of factors, the “promoters” and the “accelerators.” Whilst the “promoters” are factors leading to the separation from the abuser over time, the “accelerators” bear a stronger and more direct connection with survivors’ decision to end the abusive relationship. Despite their differences, both these factors acted as propelling forces, leading survivors to actively pursue the separation from the perpetrator. To portray the dynamic links among these factors, we propose a conceptualisation drawn from Newton’s laws of motion. Our findings also highlighted important differences in the views of survivors and support workers, as the former conceived themselves as proactive in ending the abuse, whereas the latter described the leaving process as mainly led by authorities and services supporting survivors. This study has potential implications for research, policy and clinical practice, as it suggests that far from being a linear sequence of multiple stages, leaving an abusive relationship results from a complex interplay of factors that facilitate (“promoters”) or drastically accelerate (“accelerators”) the separation process. We argue that future research should aim at improving our current understanding of the subjective and situational factors that can act as “accelerators” or “promoters” for women’s leaving decisions. Moreover, clinicians and policymakers should invest in creating interventions that aid victims to recognise and leverage promoters and accelerators, thus increasing their readiness to end the abuse.

Examining contextual influences on the service needs of homeless and unstably housed domestic violence survivors

Domestic violence (DV) is a leading cause of homelessness for women, yet many DV agencies are just beginning to focus on helping clients stabilize their housing situations. The purpose of this study was to better understand the contexts and service needs of unstably housed and homeless DV survivors, to promote more efficient and successful service matching from DV agencies. We examined whether DV survivors could be grouped by particular features, histories, and contextual factors, and how these group differences impacted what they needed from DV agencies. The sample included 406 homeless and unstably housed DV survivors who had recently sought DV services. Latent class analysis supported the identification of four distinct classes: (1) highest disadvantages service seeker, (2) moderate disadvantages-criminal legal system service seeker, (3) moderate disadvantages service seeker, and (4) lower disadvantages service seeker. Additionally, we were able to profile each class, and test the types of services survivors in each class needed from agencies.

"Walking on Eggshells:" A Qualitative Study of How Friends of Young Women Experiencing Intimate Partner Violence Perceive Their Role

Young women who experience intimate partner violence (IPV) are most likely to turn to their friends for help. Although friends can play a critical role in providing support, there is little research that examines friends' experiences. In this qualitative study, we explored how friends of young women experiencing IPV perceived their role in responding to IPV in the context of friendship. We held in-depth interviews with 15 friends of young women who had experienced IPV and used reflexive thematic analysis to develop key themes from the data. We developed two overarching themes that reflected participants' perceptions of the roles they had played or considered as a friend in responding to IPV: "taking action" (which included "providing an outsider's view," "being an advisor or coach," "being a protector," and "taking a stand"); and "being there" (which included "being a listener," "being a companion" and "being an ally"). Their perceptions were shaped by friendship expectations, as well as by understandings of IPV. However, deciding what role to play in supporting their friend was constructed as challenging due to conflicting expectations that arose in the context of friendship. It involved balancing a perceived responsibility to do what they thought was best for their friend's well-being, a need to promote honesty and mutuality in the friendship, along with a competing obligation to respect their friend's choices, maintain her trust and ensure equality in the friendship. Being friends with the abuser as well as with the victim created additional complexities. Based on our findings, we identify key areas to address in developing interventions to assist friends to respond to young women experiencing IPV. These could guide friends on how to play an effective support role while also maintaining the friendship and managing the significant emotional impacts of providing help.

"So Why Should I Call Them?": Survivor Support Service Characteristics as Drivers of Help-Seeking in India

Women in South Asia face the highest lifetime prevalence of intimate partner violence in the world, which is just one form of violence against women (VAW). In India, few women seek help after experiencing violence, particularly from formal resources, such as physicians or the police. While many studies have investigated the impact of survivor characteristics and patterns of violence on help-seeking behaviors, there is scant research on support service characteristics and their impact on help-seeking. The introduction of a novel crisis helpline in Gujarat, India provided an opportunity to better understand how successful help-seeking can be driven by the perceived and experienced characteristics of the helpline. We conducted in-depth interviews with helpline users to identify factors and pathways that promoted or discouraged help-seeking in general, help-seeking from a formal source, and help-seeking from this particular helpline. We analyzed 32 interviews of women who used the helpline. Participants were from eight districts across the state, representing a diverse range of sociodemographic backgrounds. After conducting a thematic analysis, we found that action-oriented service, timeliness, and women-focused staff influenced (positively and negatively) participants' feelings of safety, empowerment, and trust in the helpline, which ultimately impacted their decision to seek help from the helpline or even to seek help at all. This study illuminates how service characteristics, in and of themselves, can influence the likelihood that survivors will seek help, emphasizing the need for survivors to have a voice in the growth and refinement of VAW support services. Consequently, these areas must be a focus of future research and initiatives to improve help-seeking by VAW survivors.

Listening to Athletes' Voices: National Team Athletes' Perspectives on Advancing Safe Sport in Canada

With increased media scrutiny, public awareness, and research on the prevalence of maltreatment experiences in sport, sport organizations have faced increased pressures to combat unsafe practices in sport. A consequence has been the emergence of the Safe Sport movement whereby organizations including the International Olympic Committee, Safe Sport International, US Center for SafeSport, Sport Canada, and others, have developed policies, initiatives, and education intended to create safer sport environments for all participants. Most of these policies have been implemented using a top-down approach, driven by government officials and sport leaders. However, if safe sport initiatives are to benefit athletes, consideration and incorporation of athletes' perspectives in the development and implementation of initiatives are imperative. The purpose of this study, therefore, was to examine athletes' perspectives on the challenges and recommendations to advancing safe sport. As part of a large-scale survey of current and retired Canadian National Team Athletes' experiences of maltreatment, open-ended questions were asked about athletes' recommendations and considerations for safe sport. Responses to these questions (n = 386) were analyzed using thematic analysis. According to the participants, barriers and challenges to safe sport included emphasizing performance excellence at-all-costs, normalization and complicity of harm, lack of attention to equity, diversity and inclusion, a culture of fear and silence, and a lack of trust in organizations to handle cases of harm. In an effort to advance safe sport, participants recommended prioritizing holistic athlete development, improving and strengthening accountability measures, implementing an independent 3rd party for disclosure, reporting and support, increased attention to equity, diversity and inclusion, stakeholder education, prohibition of sexual relations between athletes and those in positions of power and authority, and adoption of a broader perspective of harms and perpetrators. Findings are interpreted and critiqued in light of previous literature and recommendations for future research and practice are suggested.

A systematic review and qualitative meta-synthesis of the roles of home-visiting nurses working with women experiencing family violence

AIMS

To systematically review and synthesize qualitative research exploring home-visiting nurses' roles and identify the challenges for nurses working with women experiencing family violence.

DESIGN

We undertook a thematic synthesis of qualitative studies, focusing on the family violence work of nurse home visitors.

DATA SOURCES

A systematic search of four scientific databases (ProQuest Central, CINAHL, MEDLINE, EMBASE) was undertaken in August 2021. Grey literature was searched, including government and non-government research documents, theses, clinical guidelines, policy documents and practice frameworks.

REVIEW METHODS

Inclusion criteria included research from high-income countries, peer-reviewed qualitative studies in English published from 1985 to 2021, and included research on home-visiting nurse family violence practice. The first author conducted the data search and the initial screening. The first and second authors independently reviewed the full text of 115 papers, identifying 26 for inclusion in the thematic synthesis (Figure 1-PRISMA flowchart).

RESULTS

The thematic synthesis identified two themes: (1) relationship building-with the client, with services and with colleagues/self; and (2) family violence practice-ask/screen, validate/name, assess risk/safety plan and safeguard children.

CONCLUSION

The thematic synthesis confirmed the multiple roles fulfilled by home-visiting nurses and enabled insight into the challenges they face as they undertake complex and demanding work. The roles of the home-visiting nurse have evolved, with the initial focus on safeguarding children leading to broader family violence nursing practice roles, including the identification of family violence and safety planning discussions with women.

IMPACT

Our meta-synthesis has confirmed the high-level communication and rapport-building skills required by nurses undertaking complex and conflicting roles. Nurses need support and supervision to undertake emotionally demanding work. Integrated health systems, clinical practice guidelines and tools, and training programmes need to encompass the breadth and complexity of the roles of these specialist practitioners.

Women Tell All: A Comparative Thematic Analysis of Women's Perspectives on Two Brief Counseling Interventions for Intimate Partner Violence

Background: Intimate partner violence (IPV) is a significant public health problem that is commonly experienced by women and associated with psychosocial health issues. Recovering from IPV through Strengths and Empowerment (RISE) is a brief, clinician-administered, variable-length (1–6 sessions), modular, individualized psychosocial counseling intervention developed for women experiencing IPV. We present qualitative feedback and quantitative helpfulness ratings from women patients of the Veterans Health Administration who completed a randomized clinical trial (RCT) comparing RISE to a clinician-administered advocacy-based Enhanced Care as Usual (ECAU; a single structured session consisting of psychoeducation, safety-planning, resources, and referrals). Methods: 58 participants (_Mage = 39.21) completed post-intervention semi-structured qualitative interviews, including helpfulness ratings, at two follow-up assessments (10- and 14-weeks post-enrollment) to assess the acceptability, usefulness, and perceived fit of the interventions for women’s needs. Interviews were transcribed and analyzed using a hybrid deductive-inductive analytic approach. Results: While both the RISE and ECAU interventions were deemed helpful (interventions were rated as ‘highly helpful’ by 77% of RISE and 52% of ECAU participants), differences were identified in perceived impacts of the intervention, application of content, approach to patient-centeredness, and implementation recommendations. Conclusions: Findings shed light on women Veterans’ experiences and preferences for IPV psychosocial counseling interventions. Such knowledge can inform evidence-based, trauma-informed, and individualized care for women Veterans who experience IPV and may have relevance to other populations of women who experience IPV.

An Analysis of Comparative Perspectives on Economic Empowerment among Employment-Seeking Survivors of Intimate Partner Violence (IPV) and Service Providers

Purpose: The purpose of this study is to compare perspectives on economic empowerment in the context of employment seeking among intimate partner violence (IPV) survivors and service providers specializing in IPV-related trauma. This study addressed the following question is: How do employment-seeking IPV survivors and service providers conceptualize and understand empowerment? Insights into how each group conceives of economic empowerment and its attainment following IPV experiences can help to inform an effective service curriculum that can be used to facilitate optimal employment outcomes among survivors. Methods: A constructivist grounded theory method was used to develop a theoretical framework for conceptualizing how economic empowerment is understood by employment-seeking survivors of IPV, and IPV service providers. Twenty-six participants were recruited (survivors, n = 16; service providers, n = 10) in a large northeastern U.S. city. Interview questions focused on how IPV survivors and service providers identify and conceptualize economic empowerment, and how support services respond to survivors’ needs around empowerment, particularly through help with employment seeking. Results: Data were coded and analyzed following data analysis stages: (a) initial coding; (b) constant comparison; and, (c) focused coding. Three main themes emerged from the narrative data: (1) structural characteristics shape individual experiences and perspectives of empowerment; (2) peer support as an integral component to empowerment; and (3) employment attainment as economic empowerment. Though perspectives on economic empowerment were often aligned, some key differences emerged. Whereas providers tended toward a more restricted, micro-level view of empowerment as primarily an attribute of the individual, survivors were inclined toward a structuralist perspective that considers how individuals’ experiences of empowerment are shaped by broader, institutional-level factors. Conclusions: Findings from this study build on prior research on the experiences of IPV survivors. The focus on experiences of empowerment in the context of employment-seeking can inform work on building more effective support services for survivors that avoid reductionist approaches that could be perceived by survivors as “victim-blaming” by incorporating a sensitivity to empowerment as derived from structural factors that shape individual experience.

Threads of Practice: Enhanced Maternal and Child Health Nurses Working With Women Experiencing Family Violence

Family violence is a serious public health issue with significant health consequences for women and children. Enhanced Maternal and Child Health nurses (EMCH) in Victoria, Australia, work with women experiencing family violence; however, scholarly examination of the clinical work of nurses has not occurred. This qualitative study explored how EMCH nurses work with women experiencing abuse, describing the personal and professional challenges for nurses undertaking family violence work. Twenty-five nurses participated in semi-structured interviews. Using interpretive description methodology has enabled an insight into nurses' family violence work. Threads of practice identified included (1) Validating/Reframing; (2) Non-judgmental support/Safeguarding and (3) Following/Leading. The nurses highlighted the diversity of experience for women experiencing abuse and nurses' roles in family violence nurse practice. The research contributes to understanding how EMCH nurses traverse threads of practice to support women experiencing family violence.

Nurturing Hope and Well-Being Among Survivors of Domestic Violence Within the Family Justice Center Model

Family Justice Centers (FJCs) represent a multi-disciplinary coordinated approach co-located to serve survivors of domestic violence. This study examined the change in hope and well-being among 130 survivors receiving domestic violence services through seven FJCs. Using a pretest, posttest design, Analyses of Variance results indicated that survivors exhibited robust increases in hope, emotional well-being, and flourishing. Correlational analyses showed that survivor defined goal success has important relationships with hope and well-being. Finally, hierarchical regression analyses revealed hope contributed unique variance of survivor flourishing over-and-above survivor defined success and emotional well-being. These findings are discussed in the context that hope may be an important coping resource for survivors of domestic violence and offers a common conceptual framework for FJCs.

Housing Interventions for Intimate Partner Violence Survivors: A Systematic Review

Intimate partner violence (IPV) survivors are much more likely to experience housing insecurity or homelessness than those who have not experienced IPV. However, little comprehensive research has evaluated the effectiveness of interventions used to address IPV survivors' housing insecurity. To address this knowledge gap, our team conducted a systematic review guided by three questions: (a) What are current interventions for addressing IPV survivors' housing needs? (b) What are the methodological strengths and limitations of the research evaluating those interventions? (c) How effective are the identified interventions? We identified potentially relevant peer-reviewed and gray literature using variations of predetermined search terms and four search methods. Twelve articles met inclusion criteria. Accordingly, this study showed that there is an overall dearth of research concerning interventions that address IPV survivors' housing insecurity and needs. Shelter is the most commonly assessed and available housing intervention for IPV survivors, but only limited empirical evaluation is available of shelter effectiveness. In addition, findings indicate both traditional shelter services and innovative interventions (e.g., rapid rehousing, flexible funding) would benefit from rigorous evaluation including examining survivor and situation characteristics contributing to housing strategy effectiveness.

Understanding How Domestic Violence Shelter Rules May Influence Survivor Empowerment

Domestic violence shelters have historically gone beyond providing emergency residential space for survivors by assisting in obtaining future housing, employment, health care, child care, or legal services. Domestic violence shelters are expected to operate within an empowerment philosophy, with an understanding that survivors are self-determining, can identify their needs, and know what it takes to meet those needs. Recent research has indicated that, as many shelters have become more rigid in creating rules that survivors must follow to access and retain free temporary housing, the result has been survivors' feelings of disempowerment, the complete opposite of what was originally intended. This study builds on the small amount of research conducted regarding survivors' experiences of shelter rules by specifically examining how rules were perceived to affect empowerment. Seventy-three survivors from two domestic violence shelters were asked about their experiences around specific shelter rules relating to curfew, parenting, chores, time limits, food, alcohol, drugs, and medications. A transcendental phenomenological approach was used to analyze the qualitative data, seeking explanations of how survivors made meaning of the rules and how those rules influenced their empowerment. Among those survivors who found the rules problematic, three major themes emerged: (a) rules acted as barriers to carrying out their normal, day-to-day activities; (b) the shelter staff's flexibility with rules was based on contingencies; and (c) rules negatively affected their psychological well-being, and required them to engage in protective behaviors. Recommendations are made for the reexamination and restructuring of rules within domestic violence shelters.

Mental and Active Preparation: Examining Variations in Women's Processes of Preparing to Leave Abusive Relationships

Although the process of leaving abusive relationships has received increased research attention, preparing to leave is still largely understudied. Despite an emphasis on safety planning, not all women take active steps to prepare, and the characteristics and experiences of those who do or do not actively prepare are unknown. We address this gap with a secondary data analysis of interviews with 25 abused mothers in the process of leaving. All women initially engaged in mental planning, where they had emotionally disconnected from their partners. Using constructivist grounded theory techniques, we identified two distinct groups: those whose mental planning led to active planning (n = 11), and those who moved directly from mental planning to leaving (n = 14) with little time or need to actively plan. The groups differed on several individual, relationship, and child factors, which may have impacted the ability or decisions to prepare. This study supports the feminist view that survivors are not helpless victims but active agents who strategize for safety. Those who engage solely in mental planning still prepare to leave, even if they do not engage in active planning. Practitioners should consider factors affecting preparations and acknowledge mental planning as a necessary effort in leaving.

A realist review of which advocacy interventions work for which abused women under what circumstances

BACKGROUND

Intimate partner abuse (including coercive control, physical, sexual, economic, emotional and economic abuse) is common worldwide. Advocacy may help women who are in, or have left, an abusive intimate relationship, to stop or reduce repeat victimisation and overcome consequences of the abuse. Advocacy primarily involves education, safety planning support and increasing access to different services. It may be stand-alone or part of other services and interventions, and may be provided within healthcare, criminal justice, social, government or specialist domestic violence services. We focus on the abuse of women, as interventions for abused men require different considerations.

OBJECTIVES

To assess advocacy interventions for intimate partner abuse in women, in terms of which interventions work for whom, why and in what circumstances.

SEARCH METHODS

In January 2019 we searched CENTRAL, MEDLINE, 12 other databases, two trials registers and two relevant websites. The search had three phases: scoping of articles to identify candidate theories; iterative recursive search for studies to explore and fill gaps in these theories; and systematic search for studies to test, confirm or refute our explanatory theory.

SELECTION CRITERIA

Empirical studies of any advocacy or multi-component intervention including advocacy, intended for women aged 15 years and over who were experiencing or had experienced any form of intimate partner abuse, or of advocates delivering such interventions, or experiences of women who were receiving or had received such an intervention. Partner abuse encompasses coercive control in the absence of physical abuse. For theory development, we included studies that did not strictly fit our original criteria but provided information useful for theory development.

DATA COLLECTION AND ANALYSIS

Four review authors independently extracted data, with double assessment of 10% of the data, and assessed risk of bias and quality of the evidence. We adopted RAMESES (Realist and meta-narrative evidence syntheses: evolving standards) standards for reporting results. We applied a realist approach to the analysis.

MAIN RESULTS

We included 98 studies (147 articles). There were 88 core studies: 37 focused on advocates (4 survey-based, 3 instrument development, 30 qualitative focus) and seven on abused women (6 qualitative studies, 1 survey); 44 were experimental intervention studies (some including qualitative evaluations). Ten further studies (3 randomised controlled trials (RCTs), 1 intervention process evaluation, 1 qualitative study, 2 mixed methods studies, 2 surveys of women, and 1 mixed methods study of women and staff) did not fit the original criteria but added useful information, as befitting a realist approach. Two studies are awaiting classification and three are ongoing.Advocacy interventions varied considerably in contact hours, profession delivering and setting.We constructed a conceptual model from six essential principles based on context-mechanism-outcome (CMO) patterns.We have moderate and high confidence in evidence for the importance of considering both women's vulnerabilities and intersectionalities and the trade-offs of abuse-related decisions in the contexts of individual women's lives. Decisions should consider the risks to the woman's safety from the abuse. Whether actions resulting from advocacy increase or decrease abuse depends on contextual factors (e.g. severity and type of abuse), and the outcomes the particular advocacy intervention is designed to address (e.g. increasing successful court orders versus decreasing depression).We have low confidence in evidence regarding the significance of physical dependencies, being pregnant or having children. There were links between setting (high confidence), and potentially also theoretical underpinnings of interventions, type, duration and intensity of advocacy, advocate discipline and outcomes (moderate and low confidence). A good therapeutic alliance was important (high confidence); this alliance might be improved when advocates are matched with abused women on ethnicity or abuse experience, exercise cultural humility, and remove structural barriers to resource access by marginalised women. We identified significant challenges for advocates in inter-organisational working, vicarious traumatisation, and lack of clarity on how much support to give a woman (moderate and high confidence). To work effectively, advocates need ongoing training, role clarity, access to resources, and peer and institutional support.Our provisional model highlights the complex way that factors combine and interact for effective advocacy. We confirmed the core ingredients of advocacy according to both women and advocates, supported by studies and theoretical considerations: education and information on abuse; rights and resources; active referral and liaising with other services; risk assessment and safety planning. We were unable to confirm the impact of complexity of the intervention (low confidence). Our low confidence in the evidence was driven mostly by a lack of relevant studies, rather than poor-quality studies, despite the size of the review.

AUTHORS' CONCLUSIONS

Results confirm the core ingredients of advocacy and suggest its use rests on sound theoretical underpinnings. We determined the elements of a good therapeutic alliance and how it might be improved, with a need for particular considerations of the factors affecting marginalised women. Women's goals from advocacy should be considered in the contexts of their personal lives. Women's safety was not necessarily at greatest risk from staying with the abuser. Potentially, if undertaken for long enough, advocacy should benefit an abused woman in terms of at least one outcome providing the goals are matched to each woman's needs. Some outcomes may take months to be determined. Where abuse is severe, some interventions may increase abuse. Advocates have a challenging role and must be supported emotionally, through provision of resources and through professional training, by organisations and peers.Future research should consider the different principles identified in this review, and study outcomes should be considered in relation to the mechanisms and contexts elucidated. More longitudinal evidence is needed. Single-subject research designs may help determine exactly when effect no longer increases, to determine the duration of longitudinal work, which will likely differ for vulnerable and marginalised women. Further work is needed to ascertain how to tailor advocacy interventions to cultural variations and rural and resource-poor settings. The methods used in the included studies may, in some cases, limit the applicability and completeness of the data reported. Economic analyses are required to ascertain if resources devoted to advocacy interventions are cost-effective in healthcare and community settings.

Elaborating the Connection between Social Class and Classism in College

Scholarship has documented the challenges that face college students of marginalized economic backgrounds, an issue that is relevant for Community Psychology because of the field's commitment to social justice. Community psychologists are concerned with facilitating access to social resources such as education across the full range of social identities. The current study builds on recent research that has identified the key role of classism in students' struggles. We developed a new measure of college student financial stress in order to investigate the relationship between indices of social class (financial stress, subjective social status, and parental education) and indices of classism (institutional, interpersonal, and citational). We also explored whether race or immigration status moderated these relationships in a sample of diverse students (N = 278). Findings show that students' current financial stress has the strongest relationship with classism, and immigration status moderates the exposure to citational classism. Specifically, we found evidence for perpetuation of classism among U.S. born students higher on the social class ladder. Implications for future research include the importance of considering multiple domains of social class, studying social class in a context-specific way, and differentiating dimensions of classism. Findings also suggest that financial stress is an important focus in the work to support marginalized students, and that classist narratives need to be addressed among students of higher social class.

"Give me some space": exploring youth to parent aggression and violence

A small scale qualitative project, undertaken by an interdisciplinary domestic violence research group involving academic researchers and research assistants, with colleagues from Independent Domestic Abuse Services (IDAS), investigated youth aggression and violence against parents. Following the literature review, data was generated through several research conversations with young people (n = 2), through semi-structured interviews with mothers (n = 3) and practitioners (n = 5), and through a practitioner focus group (n = 8). Thematic analysis and triangulation of the data from parents, practitioners and young people, elicited interconnected and complex overarching themes. Young people could be both victim and perpetrator. The witnessing or experiencing of domestic aggression and violence raised the concept of 'bystander children'. The impact of young people experiencing familial violence was underestimated by parents. For practitioners, the effects of working with domestic violence was shown to be significant - both positively and negatively.

An Updated Assessment of Personal Protective Order Statutes in the United States: Have Statutes Become More Progressive in the Past Decade?

The Personal Protection Order (PPO) is one civil intervention all states provide to victims of domestic violence; however, each state varies widely in who can access PPOs, what protections are included in PPOs, and how they are enforced. Given the many changes to state PPO statutes over the last decade, this research replicates and updates DeJong and Burgess-Proctor’s research on PPOs’ victim-friendliness (using states’ 2003 PPO statutes) by examining states’ 2014 PPO statutes. Findings suggest that states have become more victim-friendly with most states ranking in the highest category of victim-friendliness. Implications for policy and practice are discussed.