This paper examines the work of domestic violence programs within a “social and emotional well-being” framework. It first elucidates how domestic violence negatively impacts survivors’ and their children’s well-being, and which factors have been shown to restore this well-being over time. It then describes the Theory of Change that is at the foundation of domestic violence programs’ work, and details how domestic violence programs creatively engage with survivors and their children to influence the factors known to promote their well-being. It concludes with a review of the empirical evidence examining the extent to which domestic violence programs have been effective in achieving their desired outcomes.
The Problem: Intimate Partner Violence and Its Consequences
Intimate partner violence (IPV) is a serious and pervasive social problem with devastating physical, psychological, and economic consequences for victims. The most recent national survey, commissioned by the U. S. Centers for Disease Control and Prevention, reported that over one-third of women in the United States have been physically assaulted, sexually assaulted, and/or stalked by an intimate partner (Black et al., 2011). One in four men also reported experiencing some form of domestic violence, although stark gender differences were found in the types of abuse experienced as well as the impact of abuse on victims. For example, only 35% of the men reporting domestic violence said that it had negatively impacted their lives, and only 5% said the violence had made them afraid. Women were far more likely than men to have been slammed against something, strangled or suffocated, beaten, or stalked by a current or former partner. Nearly four times more women experienced injury-causing domestic violence, and nearly five times more women needed medical care (Black et al., 2011). Although some couples engage in mutual or low-level violence that does not alter the power dynamics within their relationship, the larger social problem of “battering” includes a pattern of behavior, generally committed by men against women, that perpetrators uses to gain an advantage of power and control over their victims (Bancroft, 2003; Johnson, 1995; Stark, 2007). Such behavior includes physical violence and the threat of continued violence, but also includes psychological torment designed to instill fear or confusion in the victim, and to make her question her abilities. The pattern of abuse also often includes sexual and economic abuse, coerced or forced illegal activity, coerced or forced substance use, social isolation, and threats against loved ones (Adams, Sullivan, Bybee, & Greeson, 2008; Bancroft, 2003; Black et al., 2011; Pence & Paymar, 1993).
Intimate partner violence results in far more than physical injuries, although injuries can be severe or life-threatening (Black et al., 2011), and a third of female murder victims have been killed by intimate partners (Campbell et al., 2007). Other physical health consequences that have been found to relate to IPV include chronic pain, frequent headaches, and difficulty sleeping (Black et al., 2011; Coker et al., 2002; Sutherland, Sullivan, & Bybee, 2001). In addition to physical health consequences, IPV has been found to relate to Post Traumatic Stress Disorder (PTSD), depression, and suicide ideation (Carlson, McNutt, Choi, & Rose, 2002; Coker et al., 2002; Pico-Alfonso et al., 2006; Zlotnick, Johnson, & Kohn, 2006). Further, many women turn to alcohol or other drugs to cope with their victimization (Cunradi, Caetano, & Schafer, 2002; Fowler & Faulkner, 2011; Kilpatrick et al., 1997; Martino, Collins, & Ellickson, 2005).
Battering often includes economic abuse as well, including preventing women1 from working or going to school, sabotaging their employment or housing, or ruining their credit (A. Adams et al., 2008; Alexander, 2011). These tactics make leaving and staying out of the relationship extremely difficult.
(Note: While all those being victimized by a partner deserve effective advocacy, protection, and support, the overwhelming majority of adult domestic violence survivors seen by local programs are women. Intimate partner violence is a gendered social problem, with women being disproportionately targeted and harmed by male partners. For that reason, adult survivors are referred to as “women” and “she/her” throughout this document. This is not meant to minimize the experience of women abused by women, or men or transgendered victims abused by male or female partners. Nor is it meant to ignore the experiences of men or trangendered survivors served by domestic violence programs.)
Millions of children witness their mothers being abused each year (Graham-Bermann, Howell, Lilly, & DeVoe, 2011; McDonald et al., 2007), and many of these children are directly abused by the perpetrator as well (Appel & Holden, 1998; Edleson, 1999). A growing body of literature indicates that children who witness abuse against their mothers, even when they themselves are not the targets of violence, are at risk for maladjustment when compared to children who have not been exposed to such violence (see Kitzman, Gaylord, Holt, & Kenny, 2003, for a review). Children’s emotional and behavioral reactions to witnessing battering can be severe and pervasive, and include somatic complaints, behavioral problems, withdrawal and depression (Grych et al., 2000; Kitzman et al., 2003). Not all children, of course, respond in the same way to witnessing abuse against their mothers, and some children are more adversely affected than others (Graham-Bermann, Gruber, Girz, & Howell, 2009).
Given that millions of women are victimized by partners and ex-partners each year, and that even more children are exposed by abusers to this violence, communities throughout the United States have created a broad range of supports for these families, including shelter programs, advocacy, transitional housing, support groups, supervised visitation centers, outreach, and counseling services. Domestic violence (DV) programs have never limited themselves to focusing solely on the abuse a woman and her children might have experienced before seeking assistance. They do clearly care about survivors’ immediate and long-term safety, but also realize that physical safety is not sufficient to ensuring women’s and children’s long-term health and well-being. To restore or create that well-being, DV programs are built on a philosophy of “empowerment,” or helping adult and child survivors achieve personal, interpersonal, and social power (Sullivan, 2006). This is why services are individually tailored to survivors’ needs, and span the range from crisis intervention to intensive advocacy. It is also why a key component of DV work is systems change and social change: people’s well-being is directly impacted by the level of supports and opportunities available in their environments.
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