Responding to intimate partner violence victimisation: Effective options for help-seeking

Foreword | Approximately one in four women in most Western nations are at risk of becoming a victim of intimate partner violence (IPV). Interventions for IPV victims have shown to be significant in preventing negative outcomes. Using data from the International Violence Against Women Survey, this paper examines predictors of help-seeking by IPV victims and considers whether such responses are influenced by the severity of abuse experienced. Many IPV victims seek assistance informally from family and friends in the first instance and that experience may affect subsequent attempts to seek help from more formal sources. This study found that victims of IPV are more likely to explore formal avenues of support when married to the abusive partner, have children who have witnessed incidents of abuse, have used drugs or alcohol to cope with abuse and where the abusive partner has previously received counselling for his behaviour. It was found that in cases where the victim had experienced more severe types of abuse, and/or if they felt their life had been threatened during the most recent incident, there was a significantly increased likelihood of formal help-seeking. Collectively, these findings can inform the enhancement of current responses made by formal sources of support to better accommodate the needs of IPV victims and their children.

Adam Tomison

Director

Intimate partner violence (IPV) is a major social and public health problem, affecting many women worldwide (Klein et al. 1997; WHO 2005). Past research reveals that about one in four women are at risk of IPV in most Western nations (Mirrlees-Black 1999; Mouzos & Makkai 2004; Tjaden & Thoennes 2000; WHO 2005) and a range of factors associated with the prevalence and consequences of IPV have been identified (Clark & Foy 2000; Johnson 2004; LaViolette & Barnett 2000). Despite the accumulating knowledge, there is still a need to further understand the factors associated with victims' responses to IPV (Coker et al. 2000; Signal & Taylor 2008).

Past research illustrates the significance of interventions for IPV victims in enabling them to end the violence, prevent fatal outcomes and recover from the physical and emotional impact of victimisation (Hall Smith, Moracco & Butts 1998; Hoyle & Sanders 2000; Mouzos 1999; Stanko 1997). There are good reasons to believe that the severity and extent of IPV are related to women's help-seeking responses (Ellsberg et al. 2001; Gondolf & Fisher 1988; Leone, Johnson & Cohan 2007; Sabina & Tindale 2008). While some researchers describe a negative (and isolating) relationship between the nature, extent and duration of abuse and victims' general help-seeking behaviour (Walker 1991, 1979) others have identified a positive association, describing it as a survival instinct that encourages victims to reach out for support (Gondolf & Fisher 1988; Ruiz-Perez, Mata-Pariente & Plazaola-Castano 2006; Sabina & Tindale 2008). The current paper examines formal and informal forms of help-seeking among victims of intimate partner violence and considers whether such responses are influenced by abuse severity.

The role of informal and formal support

Informal sources of support play a major role in the help-seeking process of women experiencing IPV, as they are the most prominent sources chosen for support. People within the victim's social network, including family, friends, neighbours or colleagues play a crucial role in the overall help-seeking process of IPV victims (Davis 2002; Davis & Srinivasan 1995; Leone, Johnson & Cohan 2007; Sabina & Tindale 2008). Seeking informal help is often the first step in the help-seeking process and the outcome can shape victims' subsequent help-seeking decisions. Positive reactions of family and friends have been said to encourage more formal or professional help-seeking decisions, including the utilisation of law enforcement, counsellors, crisis accommodation and financial support (Davis & Srinivasan 1995; Goodkind et al. 2003; Moe 2007).

The majority of formal sources are approached in addition to, rather than instead of, informal ones (Kaukinen 2004; Leone, Johnson & Cohan 2007; Liang et al. 2005). Formal help-seeking is particularly important when attempting to stop the violence permanently as informal sources can be depleted quickly (Liang et al. 2005). While family and friends are often able to help by listening and providing tangible short-term support (eg a place to stay, financial assistance etc), the supporters ability to help and their understanding of the complex nature of the situation can be limited (Lempert 1997; Liang et al. 2005). To achieve a more lasting relief from violent experiences, many victims of IPV enter into a transitional process whereby they identify their situation as problematic, contemplate their options and seek informal feedback and advice (Brown 1997; Liang et al. 2005). This process often leads to a decision for action, involving safety-seeking, professional help-seeking or leave-taking. In this context, formal sources of support become crucial as a means for ending the violence, with or without ending the relationship (Brown 1997; Cluss et al. 2006; Davis 2002; Lempert 1997).

Method

The current analysis is based on data drawn from the International Violence Against Women Survey (IVAWS), conducted by the Australian Institute of Criminology (AIC) in 2002–03. The IVAWS was a national survey, based on a random community sample of over 6,600 women living in Australia at the time of data collection. Women between the ages of 18 and 69 years were interviewed by telephone, using a structured survey (for more detail regarding the original methodology and the key aims of the study, see Mouzos & Makkai 2004). Data regarding women's responses to IPV were collected in relation to the most recent incident. While this information only provides a snapshot of victims' help-seeking behaviour at one point in time, it offers a starting point to better understand factors associated with different help-seeking decisions.

A subsample of informal and/or formal help-seekers (n=1,692) was identified from survey respondents who reported having experienced abuse by a male intimate partner at some point in time (n=2,276). As highlighted previously, past research suggests that informal help-seeking often occurs independent of any other type of help-seeking, while formal help-seeking usually co-occurs with, or follows, informal help-seeking (Coker et al. 2000; Leone, Johnson & Cohan 2007). The current data confirm these past observations, with the majority of victims (n=984) having talked to informal sources without reporting the most recent incident to any formal source of support and another 578 women having approached both informal and formal sources for support. Victims who only reported the most recent incident to formal support sources, on the other hand, accounted for the minority of help-seekers (n=130) in the IVAWS data. This group has been excluded from the current analysis, as the small number would have limited the validity of multivariate analysis results used in this study. Furthermore, the current data does not allow for an examination of whether these victims had access to informal sources of support and whether these sources may have been exhausted during previous help-seeking approaches not captured by the IVAWS. The final subsample examined for this paper therefore includes 1,562 victims who have been divided into two discrete groups of help-seekers, namely victims who only talked to informal sources of support and victims who chose a combination of informal and formal help-seeking approaches in relation to the most recent incident.

Informal sources approached by survey respondents are defined as immediate and other family members, friends and co-workers. Formal sources include law enforcement and a range of specialised walk-in and residential victim services.

While the two discrete groups of help-seekers examined for this paper have in common that they accessed one or more of the informal sources, the second group is expected to differ due to their additional utilisation of one or more formal sources of support. The second group is therefore referred to as 'formal help-seekers' hereafter, as this is what distinguishes them from the solely 'informal help-seekers' in the first group.

Sample description

Table 1 provides an overview of victims' demographics by type of help-seeking. Both groups are similar regarding the proportions of women from non-English-speaking backgrounds, those who had children living with them and those who reported educational levels of Year 12 and below, or some tertiary education, respectively. Minor differences can be observed for the reported levels of education for victims' partners. More formal help-seekers reported partners with educational levels of Year 12 or below than informal help-seekers. In addition, there are differences regarding marital status as well as socioeconomic and employment status. As can be seen from Table 2, victims who sought formal, in addition to informal, support more commonly reported being married to their abusive partner. A greater percentage of formal help-seekers also reported being unemployed and sharing a lower combined net household income.

Factors associated with informal and formal help-seeking decisions

Further between-group comparisons were conducted to identify the relevance of the following factors: victim-related factors, partner-related factors and violence-related factors. Victim-related factors include victims' age, family make-up, socioeconomic status, education and drug/alcohol use to cope with the most recent incident. Partner-related factors include his level of education, previous counselling for his violent behaviour and whether he has been under the influence of drugs or alcohol during the most recent incident. The last subgroup of variables includes factors and consequences associated with the violence experienced during the most recent incident, including types of experienced abuse, injuries suffered and the perceived level of seriousness.

As shown in Table 2, formal help-seekers more commonly reported being married to their abusive partners and having children who had witnessed one or more violent incidents in the past. These women furthermore reported a lower combined net household income than women who sought informal support only. In addition, formal help-seekers had more commonly used drugs or alcohol to cope with the most recent incident. The two groups showed no significant differences regarding victims' levels of education.

The examination of partner-related variables revealed that a larger proportion of abusive partners of formal help-seekers had lower levels of education when compared with partners of informal help-seekers. Abusive partners of formal help-seekers had also more commonly received counselling for past violent behaviour than partners of informal help-seekers.

Comparisons regarding violence-related factors revealed a range of significant between group differences. While women in both groups had similar experiences of sexual victimisation during the most recent incident, women in the formal help-seeking group generally perceived the most recent incident as more serious than informal help-seekers. Formal help-seekers also more commonly reported having suffered injuries in general and injuries that required medical attention in particular. In addition to the perceived seriousness of the most recent incident, formal help-seekers also more commonly reported violence that ranged in the more severe end of the employed Conflict Tactic Scale (CTS), including attempted suffocation, having being burned or scalded and/or having been threatened with a weapon during the most recent incident.

The findings presented in Table 2 reveal that victims who sought formal, in addition to informal, support more commonly reported longer relationship duration and greater levels of severity regarding experienced types of abuse and suffered injuries. Victims who talked to informal sources only, on the other hand, reported significantly lower levels of perceived seriousness of the most recent incident. Women who classified the most recent incident as very serious or even a crime and those who felt their life was in danger during that particular incident were more commonly represented in the formal help-seeking group. These findings are consistent with observations made by prior research (Ellsberg et al. 2001; Ruiz-Perez, Mata-Pariente & Plazaola-Castano 2006; Sabina & Tindale 2008) and lend strong support to Gondolf's Survivor Hypothesis, which predicts increasing levels of help-seeking with increasing magnitude, frequency and duration of abuse (Gondolf, Fisher & McFerron 1990).

To examine the relationship of victim, partner and violence-related factors further, a logistic regression model was estimated. The results are shown in Table 3.

Table 3 reveals that formal help-seekers can be distinguished from those who sought informal help only on a number of the thematically-informed factors. The results show that all three victim-related variables were able to predict a change in victims' likelihood of seeking formal, in addition to informal, support. Victims who were married to their abusive partner, and had children who witnessed any of the violent incidents, were more than twice as likely to seek formal support. Additionally, victims who had used drugs or alcohol to cope with the most recent incident were significantly more likely to approach formal sources of support than victims who did not report substance use as means of coping with the abuse.

Of the two partner-related variables included in the model, only prior counselling remained statistically significant. Table 3 shows that victims whose partners had received counselling for their abusive behaviour in the past were over three times more likely to seek formal, as well as informal, help. This factor predicted the greatest change in victims' likelihood of talking to formal sources of support out of all factors included in the comprehensive model.

Results relating to the violence-related factors highlight two significant predictors of formal help-seeking. Victims who reported more severe types of abuse, such as attempted suffocation or the use of weapons, and those who perceived the most recent incident as life-threatening, were significantly more likely to seek formal, in addition to informal, support.

Discussion of findings

The findings presented in this paper indicate that victims are more likely to explore formal avenues of support when married to their abusive partners. While this does not necessarily mean that unmarried victims of IPV respond by passively enduring the violence, it nevertheless indicates that experiencing violence within a marital relationship increases victims' likelihood of actively seeking formal support to stop the violence. Although speculative, unmarried women, on the other hand, may be more likely to terminate the relationship instead of seeking support to deal with the violent experiences due to the lack of legal commitment in dating relationships.

The presence of children was also identified as a predictor of formal help-seeking. Children's observation of violent incidents significantly increased victims' likelihood of seeking formal support. This is an important observation because it indicates the salience of victim's protective attitudes towards their children. While women may not always seek the (formal) support they need for their own physical and emotional wellbeing, the findings indicate that their likelihood to do so increases when their children's wellbeing is at risk. This observation is consistent with findings from past research, which suggest that the presence of children encourages victims to reach out for formal support (Akers & Kaukinen 2009; Gondolf, Fisher & McFerron 1990). However, it is inconsistent with findings from other studies, which reveal that victims may remain silent when children are involved due to their fear of losing the children to their ex-partner or child-safety interventions as a result of having 'exposed' them to a violent home environment (Fugate et al. 2005; Logan & Walker 2004). These inconsistencies between past and current research findings suggest that the role of children in victims' decision-making processes is complex. Future research needs to employ a more nuanced analysis with longitudinal data to examine whether victims consider a number of potential outcomes for themselves and their children at different points in time.

Another relevant victim-related variable that contributed to the distinction of the two help-seeking groups relates to victims' coping mechanisms. Women who reported having used drugs or alcohol to cope with the most recent incident showed an increased likelihood of seeking formal help. This observation may partly be a result of victims' abusive experiences. While there is a lack of findings on the correlation between substance use and victims' help-seeking behaviours, past research has identified increasing severity of abuse as a strong correlate of substance abuse (Clark & Foy 2000; Coker et al. 2000). Since the data revealed a significant association between abuse severity and victims' choices of support, the observed changes in victims' likelihood of talking to formal in addition to informal sources if using drugs or alcohol to cope with the most recent incident may therefore have been affected by victims' initial abusive experiences rather than their coping responses.

Results from the logistic regression model also provide insight to the influence of one of the partner-related variables, namely prior treatment interventions for the partner's abusive behaviour. While several studies have examined the usefulness of batterer intervention programs, little is known about the role of these interventions in relation to victims' subsequent help-seeking decisions (Gondolf 2005; Heckert & Gondolf 2000; Labriola, Rempel & Davis 2008). Findings presented in this paper indicate an increased likelihood of seeking formal support if the abusive partner had previously received counselling for his violent behaviour. This observation may be a result of having sought and received help in the past. While the past support may not have achieved the desired result of ending the abusive incidents, it nevertheless left victims with the awareness of available support and the knowledge of where to find it. In addition, these victims may feel that options of batterer interventions have been exhausted and other formal alternatives need to be explored, including police interventions and specialised victim services. Similar associations between past and future formal help-seeking approaches have been revealed by research on victims help-seeking and leave-taking decisions (Davis 2002).

In addition to victim- and partner-related variables, the model examined violence-related variables. As mentioned earlier in this paper, some research findings suggest that increasing levels of violence lead to increasing levels of isolation and decreasing levels of help-seeking (Walker 1991; 1979). More recent research, however, supports a positive relationship between abuse severity and help-seeking (Gondolf & Fisher 1988; Ruiz-Perez, Mata-Pariente & Plazaola-Castona 2006; Sabina & Tindale 2008). Findings from the current analysis showed a significantly increased likelihood of formal help-seeking if victims had experienced more severe types of abuse and if they felt their life had been in danger during the most recent incident. These findings therefore lend strong support to the latter group of research findings and Gondolf's Survivor Hypothesis (Gondolf & Fisher 1988).

Policy implications and conclusion

The current findings highlight the role of children, partners' prior counselling experiences and the severity of abuse as key predictors of victims' decisions to seek formal, in addition to informal, support. These findings illuminate opportunities for intervention. For example, victims' increased likelihood of seeking formal support when children are involved indicates their protective attitude towards their children. It is therefore important to accommodate the needs of victims with children to further encourage their utilisation of formal services.

Formal sources of support should ensure:

• provision of onsite child care for victims seeking advice and information from walk-in services;
• provision of onsite or alternate child care for victims who initiate legal proceedings (eg for the duration of court hearings);
• access to counselling for children affected by IPV-related trauma;
• availability of child-friendly crisis accommodation for victims who seek refuge;
• suitable crisis accommodation for victims with male children over the age of 12 years; and
• information and transparency of child custody-related issues when seeking formal support to counteract the fear of losing custody, which is often instilled by the abusive partner (Fugate et al. 2005; Logan & Walker 2004).

Increased awareness and knowledge about the role of children in victims' help-seeking decisions among law enforcement and social service practitioners is crucial for expanding capacity and facilitating the help-seeking decisions of abused mothers with dependent children.

The findings observed for partners' prior counselling experiences also offer valuable knowledge for intervention. Victims whose partners have sought and received help in the past are more likely to seek formal support for future violent experiences. This is likely to be the result of their increased knowledge on how and where to find suitable support and/or a transition from one formal help-seeking approach to another due to the exhaustion of the initial approach. It is therefore important to increase the transparency and awareness of available and accessible services and to offer follow-up support for couples who received initial forms of batterer interventions.

Finally, the observed association between abuse severity and victims' help-seeking behaviours illuminates the opportunity for further reducing harm. Victims who experienced more severe and often life-threatening types of abuse are significantly more likely to approach formal sources including, but not limited to, medical professionals. Responses by formal service providers therefore need to include:

• a thorough risk assessment of the incident circumstances to prevent further harm and fatal outcomes;
• detailed information on victims' rights, availability of legal advice, counselling and alternate accommodation;
• the removal of the abusive partner from the premises by the police where risk assessment indicates a high risk of subsequent and retaliatory abuse to ensure victim safety; and
• inter-agency cooperation to facilitate help-seeking from a range of available formal services.

This paper identifies predictors of formal help-seeking for IPV victims and illuminates opportunities for improving formal intervention measures. A combination of intervention measures can facilitate increased formal help-seeking and begin to offer strategies for harm reduction for victims affected by IPV. Future research is needed to further explore the help-seeking decisions of minority and high-risk populations. Data limitations of the current telephone household survey sample do not allow the generalisation of findings to Indigenous women, different migrant women or hard-to-reach populations, such as homeless women.

References

All URLs correct at 13 January 2010

• Akers C & Kaukinen C 2009. The police reporting behaviour of intimate partner violence victims. Journal of Family Violence 24(3): 159–171
• Brown J 1997. Working towards freedom from violence—the processes of change in battered women. Violence Against Women 3(1): 5–26
• Campbell JC & Soeken KL 1999. Women's responses to battering over time: An analysis of change. Journal of Interpersonal Violence 14(1): 21–40
• Clark AH & Foy DW 2000. Trauma exposure and alcohol use in battered women. Violence Against Women 6(1): 37–48
• Cluss P et al. 2006. The process of change for victims of intimate partner violence: Support for a psychosocial readiness model. Women's Health Issues 16(5): 262–274
• Coker AL, Derrick C, Lumpkin JL, Aldrich TE & Oldendick R 2000. Help-seeking for intimate partner violence and forced sex in South Carolina. American Journal of Preventive Medicine 19(4): 316–320
• Davis LV & Srinivasan M 1995. Listening to the voices of battered women: What helps them escape violence. Affilia 10(1): 49–69
• Davis R 2002. Leave-taking experiences in the lives of abused women. Clinical Nursing Research 11(3): 285–305
• Ellsberg MC, Winkvist A, Peña R & Stenlund A 2001. Women's strategic responses to violence in Nicaragua. Journal of Epidemiology & Community Health 55(8): 547–555
• Fugate M, Landis L, Riordan K, Naureckas S & Engel B 2005. Barriers to domestic violence help seeking: Implications for intervention. Violence Against Women 11(3): 290–310
• Gondolf EW 2005. Culturally-focused batterer counseling for African American men: Report. Washington DC: US Department of Justice
• Gondolf EW & Fisher ER 1988. Battered women as survivors: An alternative to treating learned helplessness. Lexington MA: Lexington Books
• Gondolf EW, Fisher ER & McFerron JR 1990. The helpseeking behavior of battered women: An analysis of 6,000 shelter interviews, in Viano E (ed), The victimology handbook: Research findings, treatment, and public policy. New York: Garland
• Goodkind JR, Gillum TL, Bybee DI & Sullivan CM 2003. The impact of family and friends: Reactions on the well-being of women with abusive partners. Violence Against Women 9(3): 347–373
• Hall Smith P, Moracco KE & Butts JD 1998. Partner homicide in context: A population-based perspective. Homicide Studies 2(4): 400–421
• Heckert DA & Gondolf EW 2000. Predictors of underreporting of male violence by batterer program participants and their partners. Journal of Family Violence 15(4): 423–443
• Hoyle C & Sanders A 2000. Police response to domestic violence: From victim choice to victim empowerment? British Journal of Criminology 40(1): 14–36
• Johnson H 2004. Key findings from the drug use careers of female offenders study. Trends & Issues in Crime and Criminal Justice no. 289. Canberra: Australian Institute of Criminology.
• Kaukinen C 2004. The help-seeking strategies of female violent-crime victims: The direct and conditional effects of race and the victims-offender relationship. Journal of Interpersonal Violence 19(9): 967–990
• Klein E, Campbell JC, Soler E & Ghez M 1997. Ending domestic violence: Changing public perceptions/halting the epidemic. Thousand Oaks CA: Sage Publications
• Labriola M, Rempel M & Davis RC 2008. Do batterer programs reduce recidivism? Results from a randomized trial in the Bronx. Justice Quarterly 25(2): 252–282
• LaViolette AD & Barnett OW 2000. It could happen to anyone: Why battered women stay. 2nd ed. Thousand Oaks CA: Sage Publications
• Lempert LB 1997. The other side of help: Negative effects in the help-seeking processes of abused women. Qualitative Sociology 20(2): 283–309
• Leone JM, Johnson MP & Cohan CL 2007. Victims help-seeking: Differences between intimate terrorism and situational couple violence. Family Relations 56(5): 427–439
• Liang B, Goodman L, Tummala-Narra P & Weintraub S 2005. A theoretical framework for understanding help-seeking processes among survivors of intimate partner violence. American Journal of Community Psychology 36(1/2): 71–84
• Logan TK & Walker R 2004. Separation as a risk factor for victims of intimate partner violence: Beyond lethality and injury: A response to Campbell. Journal of Interpersonal Violence 19(12): 1478–1486
• Mirrlees-Black C 1999. Domestic violence: Findings from a new British Crime Survey self-completion questionnaire. London: Great Britain Home Office
• Moe AM 2007. Silenced voices and structure survival: Battered women's help seeking. Violence Against Women 13(7): 676–699
• Mouzos J 1999. Femicide: The killing of women in Australia 1989–1998. Research and public policy series no. 18. Canberra: Australian Institute of Criminology.
• Mouzos J & Makkai T 2004. Women's experiences of male violence: Findings from the Australian component of the International Violence Against Women Survey (IVAWS). Research and public policy series no. 56. Canberra: Australian Institute of Criminology.
• Ruiz-Perez I, Mata-Pariente N & Plazaola-Castano J 2006. Women's response to intimate partner violence. Journal of Interpersonal Violence 21(9): 1156–1168
• Sabina C & Tindale RS 2008. Abuse characteristics and coping resources as predictors of problem-focused coping strategies among battered women. Violence Against Women 14(4): 437–456
• Signal T & Taylor N 2008. Propensity to report intimate partner violence in Australia: Community demographics. Behaviour and Social Issues 17: 8–19
• Stanko EA 1997. Should I stay or should I go? Some thoughts on the variants of intimate partner violence. Violence Against Women 3(6): 629–635
• Tjaden P & Thoennes N 2000. Full report of the prevalence, incidence, and consequences of violence against women: Findings from the National Violence Against Women Survey. United States: Department of Justice
• Walker LE 1991. Post-traumatic stress disorder in women: Diagnosis and treatment of battered women syndrome. Psychotherapy 28(1): 21–29
• Walker LE 1979. The battered woman. New York: Harper & Row
• World Health Organization (WHO) 2005. WHO multi-country study on women's health and domestic violence against women: Initial results on prevalence, health outcomes and women's responses: Summary report.

About the authors

Silke Meyer is a Research Fellow at the University of Queensland, Centre of Excellence in Policing with the Institute of Social Science Research