Intimate Partner Violence Service Providers Research Articles

Using Simulation to Train Service Providers in Responding to Intimate Partner Violence (IPV) and Trauma

This study used simulation-based research (SBR) to gain a better understanding of how intimate partner violence (IPV) service providers engage in trauma-informed practice in a simulated session with a standardized patient. Our qualitative study recruited 18 IPV service providers from Canada and the United States. Each participant engaged in a virtual 30-minute case-based simulated session with an actor portraying a survivor of IPV experiencing vulnerabilities related to violence and immigration status. Following each simulation, IPV service providers participated in a 30- to 45-minute reflective dialogue. The data were analyzed using reflexive thematic analysis. Identified themes included: (a) simulation builds trauma-informed responses that recognize intersecting identities (e.g., race, immigration status, culture) and (b) simulation helps train service providers in responding to IPV. Implications for social work research and practice, including the benefits of using simulation for training IPV service providers, will be discussed.

Collaboration in providing intimate-partner violence services to women with disabilities

BackgroundThere is a consensus among scholars, policymakers, and implementers that addressing the complex nature of intimate partner violence (IPV) requires a collaborative response. However, there is limited literature on how various professionals work collaboratively to address the needs of women with disabilities who experience IPV. This study combines the perspectives of women with disabilities and those of professionals to understand collaboration in providing IPV services to women with disabilities.MethodsTwenty-nine in-depth interviews were conducted with 18 IPV service providers and 11 women with disabilities. The data were analyzed using reflective thematic analysis.ResultsThe findings are presented under three themes: the first shows a consensus among different IPV service providers and disabled women on the importance of collaboration when supporting victims of IPV with disabilities; the second depicts the common ways in which collaboration occurs when supporting women with disabilities; and the third illuminates the critical elements that boost effective collaboration.ConclusionSupporting IPV victims with disabilities requires active collaboration at both an internal and external level. Strengthening collaboration among different actors requires trust, specified roles, and the allocation of adequate resources.

Identifying barriers and interagency solutions to meeting the needs of families experiencing intimate partner violence (IPV): Home visiting and IPV agency perspectives

BackgroundAddressing intimate partner violence (IPV) among expectant families and caregivers with young children requires that multi-professional systems work collaboratively towards a common goal. IPV services and maternal and infant home visiting programs are two important perspectives to consider in designing interagency strategies. The purpose of this study was to identify shared priorities among home visiting and IPV professionals on IPV-related challenges and interagency solutions to support families with young children. MethodsHome visiting and IPV service providers (n=22) separately completed a structured brainstorming activity during four virtual focus groups using nominal group technique (NGT) to generate, rank, and reach consensus on prioritized barriers and solutions for the service population. The multi-professional study team (including home visiting and IPV partners) grouped and organized the top three prioritized barriers and solutions identified across groups using a pile sort activity. As a reliance measure, NGT discussion transcripts were coded to the final pile sort categories to ensure our presentation of the data was contextualized and supported by original participant responses. ResultsTwenty-four items were sorted into seven piles (three barriers and four solutions). The need to address families’ concrete needs was consistently prioritized across groups and matched with solutions that provide families with immediate financial support. Participants prioritized barriers resulting from client involvement in multiple, complex systems and named interagency process solutions (e.g., cross-systems training, enhanced referral processes) as the corresponding solution. The impact of individual and collective trauma was discussed as a barrier and matched with community-facing development (e.g., healthy relationship education). Policy, advocacy, and funding-oriented solutions were discussed as cross-cutting across all barriers. ConclusionEffective cross-system efforts are warranted to meet the interrelated needs of families impacted by IPV. The study highlights a shared view on prioritized challenges and actionable solutions to inform interagency collaboration among IPV agencies and early childhood home visiting programs. Our findings shed light on the importance of an organized public health approach to target IPV prevention and response.

“There Are Not Enough Lawyers, and There Are Not Enough Financial Resources”: Canadian and American Intimate Partner Violence Service Providers’ Perspectives for Better Supporting Immigrant Women Survivors

Immigrant women are at a high risk of intimate partner violence (IPV) and experience many challenges to help-seeking. Currently, little is known about IPV service providers’ perspectives for better supporting immigrant women within their agencies. Drawing on an intersectional framework, constructivist grounded theory (CGT) with a modified written vignette technique was employed. Online surveys were used to gather service providers’ perspectives on the vignette, which described an immigrant woman experiencing IPV. Responses from over 50 IPV service providers in the U.S. and Canada indicated the need for enhanced training to aid immigrant survivors. Further, several respondents recommended changes to the immigration/legal systems, as well as more resources for community outreach and language, legal, and housing support.

Challenges and Adaptations Experienced by Intimate Partner Violence Service Providers During COVID-19 Pandemic

Purpose: COVID-19 is an unprecedented pandemic that has caused an increase in the intimate partner violence (IPV) victims rate, and social service-providing agencies shifted to emergency online and distance service-providing systems. In our study, we aimed to explore the experiences of IPV service providers during this pandemic.Method: We used a cross-sectional qualitative method containing some quantitative questions. Data were collected by conducting 15 in-depth interviews and a survey with the service providers (22–65 years old) from six IPV service-providing agencies that are located in the Dallas-Forth Worth metroplex in North Central Texas. We used a phenomenological hermeneutical method to capture the service providers’ experiences.Results: Four key themes highlight the essence of the experiences of the IPV service providers while providing the services during COVID-19. The four major themes are (a) experiences with telehealth, (b) barriers to social and legal services, (c) altered relationships, and (d) mental health impacts. In addition, a few subthemes are explored under the first three major themes. The service providers we interviewed provided details and vital information regarding challenges, adaptations, and resilience they experienced to assist the most disadvantaged group of the population.Conclusion: This study will contribute to making attention to improving facilities, accessibility, and resources for both service providers and their clients. Findings highlight the need for agency owners and policymakers to consider more multimodal and creative solutions for such a vulnerable population and their service providers.

The perspectives of intimate partner violence service providers regarding men as clients: between ‘gender’ and ‘gender-inclusive’

ABSTRACT Practitioners who work in IPV services have over the years addressed core questions regarding causes and accountability for IPV. Accordingly, service providers’ perspectives on IPV and treatment of men reveal that different organisations hold different ideologies, policies, and practices. The present study focused on the perspectives of directors of IPV services in Israel about IPV and men’s treatment, and the way they are reflected in practice and policy. 29 directors of centres for violence prevention and treatment in Israel participated in in-depth, semi-structured focus group interviews. The analysis offered three main themes: (1) A process of changing from a ‘gender’ to a ‘gender-inclusive’ perspective. (2) A question of whether service providers should confront men about their role as aggressors at the beginning of treatment. (3) Who is the main client? The study reveals a tension that exists between a ‘gender’ and ‘gender-inclusive’ approach and stresses the need to raise professionals’ awareness about assumptions and stereotypes regarding gender roles, and the way they reflected in policy and practice. In addition, the study emphasises the need to extend training to a variety of stakeholders, allowing them to see IPV as a complex problem, thus, improving policy, treatment, and working models of IPV.

Changes in Mental Health, Emotional Distress, and Substance Use Affecting Women Experiencing Violence and Their Service Providers during COVID-19 in a U.S. Southern State.

Research conducted during the COVID-19 pandemic has revealed many unintended consequences of mandated safety precautions, including increased perpetration of intimate partner violence (IPV), increases in substance use, and worsening mental health conditions. We conducted a repeated, cross-sectional survey of survivors of IPV, a longitudinal survey of service providers working in an IPV shelter, and interviews with both. We conducted surveys at the beginning of the pandemic and nearly half a year later to assess mental health and, for clients, substance use. Results showed that two small samples of survivors living in the shelter in 2020 and 2021 experienced both mental health decline and increased use of substances. Qualitative data from in-depth interviews suggest that COVID-19-related restrictions mirrored survivors' experiences of power and control in violent relationships. Further, IPV service providers-essential workers during COVID-19-experienced stress associated with reports of burnout and mental fatigue. This study suggests that community-based organizations can help mitigate the impacts of COVID-19 on survivors of IPV but should avoid adding additional work for staff as service providers experienced mental and emotional stress.

Navigating Biases and Distrust of Systems: American and Canadian Intimate Partner Violence Service Providers’ Experiences with Trans and Immigrant Women Clients

ABSTRACT To date, very little is known about intimate partner violence (IPV) service providers’ experiences serving trans and immigrant women (IPV) survivors and their barriers in reporting and/or accessing formal services. Employing constructivist grounded theory, two vignettes were constructed – one featuring a trans woman and the other an immigrant woman, both seeking IPV services. American and Canadian IPV service providers responded to open-ended survey questions about both scenarios, resulting in several emergent themes including, but not limited to: service provider biases, shelter conflicts, and distrust of systems. Policy implications and future research are also addressed.

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.

'If the Partner Finds Out, then there's Trouble': Provider Perspectives on Safety Planning and Partner Interference When Offering HIV Pre-exposure Prophylaxis (PrEP) to Women Experiencing Intimate Partner Violence (IPV).

Pre-exposure prophylaxis is an effective women-controlled HIV prevention strategy but women experiencing intimate partner violencefear partners' interference and subsequent violence could limit its utility. This study explores provider perceptions of safety planning strategies to prevent escalating violence, mitigate partner interference, and promote daily oral PrEP adherence. We conducted interviews (N = 36) with healthcare providers (n = 18) and IPV service providers (n = 18) in Baltimore and New Haven. Using the Contextualized Assessment for Strategic Safety Planning model we organized data into two categories: the appraisal process and strategic safety planning. Themes revealed during the appraisal process, providers conduct routine IPV screening, facilitate HIV risk perception, and offer PrEP. Strategic safety planning utilizes concealment tactics, informal sources of support, role playing and cover stories. Future interventions to enhance PrEP services among women exposed to IPV should implement safety planning strategies, integrate PrEP care with IPV services, and employ novel PrEP modalities to maximize effectiveness.

Addressing the Shadow Pandemic: COVID-19 Related Impacts, Barriers, Needs, and Priorities to Health Care and Support for Women Survivors of Intimate Partner Violence and Brain Injury

Intimate partner violence (IPV) affects 1 in 3 women and has intensified during the COVID-19 pandemic. Although most injuries are to the head, face, and neck, leaving survivors vulnerable to sustaining traumatic brain injury (TBI), the intersection of IPV and TBI remains largely unrecognized. This article reports on COVID-19–related effects, barriers, needs, and priorities to health care and support services for women survivors of IPV-TBI. Using a participatory research model, we engaged 30 stakeholders in virtual meetings drawn from an IPV-TBI Knowledge to Practice Network in two virtual meetings. Stakeholders included women survivors, service providers, researchers, and decision makers across the IPV, TBI, and healthcare sectors. Data were gathered through small group breakout sessions facilitated by the research team using semistructured discussion guides. Sessions were recorded, transcribed verbatim, and analyzed using thematic analysis techniques. Stakeholders were given the opportunity to contribute to the analysis and knowledge transfer through member checking activities. Ethics approval was obtained through the University of Toronto. Stakeholders shared that COVID-19 has increased rates and severity of IPV and barriers to services and help-seeking. These effects have been exacerbated by infrastructure difficulties in rural and remote areas, including limited access to services. They noted the need to carefully consider implications of virtual care such as safety, privacy, and usability. Requests from survivors for peer support have increased significantly, indicating a need for more formalized and better-supported peer roles. Stakeholders further noted that an overwhelming lack of awareness of the intersection of IPV-TBI continues. Increasing education and awareness among health care and IPV service providers, survivors, and the public remains a priority. The COVID-19 pandemic has intensified IPV-TBI, increased challenges for women survivors, and accentuated the continued lack of IPV-TBI awareness. Key recommendations for health care and rehabilitation to address this priority are discussed.

Supporting Employment and Mental Health for Women Survivors of Intimate Partner Violence & Traumatic Brain Injury: A Community-Based Participatory Research Study

<h3>Research Objectives</h3> Explore employment and mental health related barriers and facilitators, service needs, and priorities for women survivors of intimate partner violence (IPV) with traumatic brain injury (TBI) and develop stakeholder informed knowledge translation (KT) materials and implement them through the Abused & Brain Injured Toolkit. <h3>Design</h3> Two sequential projects: one exploring knowledge and service gaps, and the second to develop KT materials to address those gaps. Data were collected via focus groups and semi-structured interviews. Reporting shall follow the consolidated criteria for reporting qualitative research. <h3>Setting</h3> Community-based, participatory research model with data collection taking place online via phone or videoconference interviews, online surveys, and email. <h3>Participants</h3> A convenience sample of key stakeholders including frontline workers, executive directors/program managers in the IPV sector, women survivors of IPV, health care professionals, and employers. 24 stakeholders participated in interviews or focus groups to inform development of the KT materials and were invited to provide feedback mid-design. <h3>Interventions</h3> N/A. <h3>Main Outcome Measures</h3> We engaged in member checking to seek feedback on the prototype KT materials. <h3>Results</h3> Based on identified gaps and stakeholder input, two KT modules, one for employment and one for mental health, were developed for our existing online educational toolkit (Abused and Brain Injured Toolkit, abitoolkit.ca). Survivors' employment needs fell into two main categories, maintaining employment and obtaining employment. Mental health related challenges centred on difficulties parsing impacts of brain injury from mental health. <h3>Conclusions</h3> TBI knowledge among IPV service providers is increasing. As it does, additional education and resources will be needed to support survivors in various aspects of their lives. The development of KT modules directly addresses this, broadening available educational material in this area. <h3>Author(s) Disclosures</h3> The authors have no disclosures to report.

Assessing Provider-, Clinic-, and Structural-Level Barriers and Recommendations to Pre-Exposure Prophylaxis (PrEP) Uptake: A Qualitative Investigation Among Women Experiencing Intimate Partner Violence, Intimate Partner Violence Service Providers, and Healthcare Providers.

Intimate partner violence (IPV) relates to HIV susceptibility and acquisition. Existing research examined barriers to pre-exposure prophylaxis (PrEP) uptake among women but few studies assess uptake and delivery among IPV service providers, along with provider-, clinic-, and structural-level barriers. We conducted 34 semi-structured interviews with PrEP-eligible cisgender heterosexual women experiencing IPV, Reproductive Health providers, PrEP providers, and IPV service providers in Northeast US. Systems theory was used to examine barriers from individuals who either work closely with or are part of the population. The framework method was used to draw descriptive and explanatory conclusions. Findings suggest limited knowledge for Reproductive Health and IPV Service Providers. Providers often did not feel equipped to discussed PrEP in visits or focused efforts solely on safety. Expanding PrEP awareness is necessary and marketing should include women. Future research should investigate how providers can work collaboratively across sectors to ensure women receive comprehensive trauma-informed care.

The Position of the Child in the Life Experiences of Immigrant Survivors of Intimate Partner Violence: A Study of Service Providers’ Perspectives in Spain

Intimate partner violence (IPV) is a global public health concern that has serious effects on the well-being of women and their children. Being a mother and an immigrant are critical factors that prevent women from seeking to end an abusive relationship. Evidence suggests that immigrant women see their children's well-being and future as paramount while managing an abusive relationship. However, less is known about how women negotiate their children's needs and interests when deciding whether to stay with or leave an abusive partner. Drawing on interviews with IPV service providers in Spain, this study aims to explore providers' understandings of the position of the child in mothers' reflections regarding whether to end an abusive relationship and of the implications of such positioning for mothers' decision-making. The findings indicate that children hold two main positions in this process. In one, children are positioned as a trigger for mothers to stay with abusers. This occurs when women are economically dependent on their partner, when they think that their children need a father figure, or when the abuser plays a role in women's migratory status within Spain. Second, children are positioned as a trigger for mothers to leave abusers when mothers see children as victims of violence or children in need of a mother figure. Framed by positioning theory, we discuss how we can understand the consequences of such positioning for immigrant women who are survivors of IPV and for service provision in this context. The implications of the findings for research, policy making, and professional decision-making are discussed.

Developing a Model to Address Mental Health, Substance Use, and Intimate Partner Violence Among Home Visiting Clients.

Perinatal women enrolled in home visiting (HV) programs exhibit high rates of depression, substance use, and intimate partner violence (IPV). While HV programs have increasingly screened for these psychosocial risks, initiation and uptake of community-based services to address these risks remain challenging. This project used a community-engaged research approach to engage key HV stakeholders in developing the screening, referral, and individualized prevention and treatment (SCRIPT) model. We highlight how a group of key HV stakeholders-the SCRIPT Advisory Panel-collaborated with academic researchers to develop the SCRIPT model by reviewing literature on HV programs' response to psychosocial risk factors and qualitative data obtained from mental health, substance use, and IPV service providers to whom HV programs referred clients. SCRIPT focuses on (a) screening for psychosocial risks, (b) developing partnerships with outside agencies to address these risk factors, and (c) establishing concrete and systematic processes for client referral and monitoring with outside agencies. SCRIPT provides a structured model for HV programs to systematically identify clients for key psychosocial risks and structure their referral and monitoring process when working with social service agencies. Future work should examine the impact of SCRIPT on mental health, substance use, and IPV service access and use by a vulnerable population.

Traumatic brain injury and intimate partner violence: Addressing knowledge and service gaps among indigenous populations in Canada

AbstractBackgroundTraumatic brain injury (TBI) is a serious consequence of intimate partner violence (IPV) that is often overlooked. In the case of Indigenous women in Canada the challenges are broad, multidimensional, and left almost entirely unexplored. Given the elevated rates of violence and injury experienced by women exposed to IPV and the increased levels of physical assault among Indigenous women in Canada, it is important to understand the unique experiences and service needs of these women. This study sought to identify barriers and facilitating factors for TBI-sensitive service provision for Indigenous women experiencing IPV.Method:As part of a larger national stakeholder consultation process to develop a TBI educational toolkit for IPV service providers, input from Indigenous stakeholders was specifically sought to allow for insights into unique challenges and strengths related to this population. Interviews and focus groups were conducted with IPV direct-service providers, support professionals, and advocates working with Canadian First Nations and Inuit women.Findings:Findings suggest that multiple intersections of marginalization, shame and stigma, and colonization, coupled with significant barriers to service provision in remote communities are such that solutions generated for urban-based settler populations are ineffective.Conclusions:Recommendations include a widespread educational campaign to raise awareness of the seriousness of TBI among Indigenous women exposed to IPV. Education is particularly important among healthcare and direct service providers, survivors and their families and communities, legal professionals and child protection agencies, and Indigenous and settler government bodies. Future research should focus on expanding our understanding of this complex issue and developing culturally sensitive, community-based supports.

Battered and Brain Injured: Assessing Knowledge of Traumatic Brain Injury Among Intimate Partner Violence Service Providers.

Background: Traumatic brain injury (TBI) as a result of intimate partner violence (IPV) is a significant health concern; yet, little is known about the intersection between the two. Existing research is scarce, limiting the ability of health care providers to develop effective supports. This pilot project surveyed the IPV support community in Toronto, Canada to understand the degree of existing TBI-specific knowledge and relevant services available among these service providers and to seek to bridge the divide between research and practice by developing a national knowledge-to-practice network to support brain-injured women survivors of IPV.Materials and Methods: In phase 1, 68 agencies providing IPV support services were invited to complete an anonymous online survey. In phase 2, 22 stakeholders attended a workshop held to disseminate existing knowledge, develop a national knowledge-to-practice network, and determine next steps in research and practice.Results: The results highlighted a general lack of TBI awareness and understanding among IPV service providers. In addition, participants stated that frontline workers and women survivors of IPV alike do not recognize signs or symptoms of TBI. Recommendations addressing research gaps, professional and public education, and service development were identified and are discussed herein.Conclusions: The identified lack of TBI knowledge among IPV service providers highlights the immediate need to increase education among management and frontline workers. Further investigation identifying best practices for knowledge transfer are suggested. The development of a national strategy addressing education, research, and funding is critical for successful uptake and integration of TBI-sensitive services within the IPV sector.

Intimate Partner Violence and Concern for Animal Care and Safekeeping: Experiences of Service Providers in Canada.

The present study examined the experiences of animal welfare and intimate partner violence service providers living in urban, rural, and northern communities in Saskatchewan, Canada. Two online surveys were distributed among animal welfare and intimate partner violence service providers across the province. Quantitative and qualitative information was obtained to further understand how concern for animal care and safekeeping impacts the decision to leave an abusive relationship. The questions asked in the online surveys were designed, reviewed, and revised based on feedback from a community-based project advisory team. Descriptive statistics and detailed comments highlighted important findings and suggestions for improvement. Findings suggest that concern for animal care and safekeeping creates challenges for individuals leaving abusive partners, especially those living in rural and northern communities, and further demonstrate the importance of collaboration between animal welfare and intimate partner violence service providers. Further research is warranted to inform and improve the development and implementation of national support services and resources.

“It’s Tricky …”: Intimate Partner Violence Service Providers’ Perspectives of Assessments and Referrals by Child Welfare Workers

The present study explored the perceptions of workers who provide intimate partner violence (IPV) services regarding child welfare workers’ IPV assessment and referral processes. Data from four focus groups was interrogated to find common themes. A total of 27 individuals participated in the focus groups, working in the community, shelters, and prisons/jails. Participants primarily expressed concerns regarding child welfare workers’ practices. IPV providers perceived child welfare workers as incompetent in performing IPV assessments and making referrals. IPV workers also perceived that some child welfare workers engaged in dismissive, manipulative, or coercive behaviors when working with IPV victims. While the present findings are not generalizable, they speak to the tension frequently noted between victim services and child welfare. Child welfare agencies should consider ongoing, trauma-informed training for IPV assessment to help increase worker self-efficacy in performing these tasks. Local, interdisciplinary trainings including both IPV and child welfare providers may be particularly useful to promote better understanding of each provider’s role in cases with co-occurring IPV and child maltreatment concerns, which may help to reduce tensions between the intersecting service systems.

Trauma-Informed Decision-Making Among Providers and Victims of Intimate Partner Violence During HIV Testing: A Qualitative Study

We explored the process of implementing an HIV testing program at an intimate partner violence (IPV) service agency from the client and provider perspectives. A qualitative descriptive approach was used wherein semi-structured interviews were conducted with 19 key informants (i.e., women with a history of IPV, HIV service providers, IPV service providers). Interviews focused on facilitators and barriers to HIV testing implementation, the decision-making process during HIV testing, and support needs. All interviews were recorded and transcribed. The text of the interviews was analyzed using directed content analysis. Unique factors were found to influence HIV testing in victims of IPV including potential for re-traumatization, readiness for testing, competing priorities, and the influence of children. The results provided important information that can be used to improve the implementation of HIV testing, tailoring processes so they are more trauma-informed; and better support individuals with a history of IPV.