Social Science Assignment I - See attachment for specific assignment details!!

California State University, San Bernardino California State University, San Bernardino

CSUSB ScholarWorks CSUSB ScholarWorks

Electronic Theses, Projects, and Dissertations Office of Graduate Studies

5-2021

WHICH INTERVENTIONS DO SOCIAL WORKERS BELIEVE ARE WHICH INTERVENTIONS DO SOCIAL WORKERS BELIEVE ARE

MOST EFFECTIVE WHEN WORKING WITH CHILD ABUSE MOST EFFECTIVE WHEN WORKING WITH CHILD ABUSE

VICTIMS? VICTIMS?

Ellen Davis

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WHICH INTERVENTIONS DO SOCIAL WORKERS BELIEVE ARE MOST

EFFECTIVE WHEN WORKING WITH CHILD ABUSE VICTIMS?

A Project

Presented to the

Faculty of

California State University,

San Bernardino

In Partial Fulfillment

of the Requirements for the Degree

Master of Social Work

by

Ellen L. Davis

May 2021

WHICH INTERVENTIONS DO SOCIAL WORKERS BELIEVE ARE MOST

EFFECTIVE WHEN WORKING WITH CHILD ABUSE VICTIMS?

A Project

Presented to the

Faculty of

California State University,

San Bernardino

by

Ellen L. Davis

May 2021

Approved by:

Dr. Armando Barragan, Faculty Supervisor, Social Work

Dr. Armando Barragan, M.S.W. Research Coordinator

© 2021 Ellen L. Davis

iii

ABSTRACT

Child abuse is often a very traumatic experience that can create long-

lasting psychological and emotional effects for some individuals. Social workers

often provide treatment services, such as therapy and/or case management

services, with the goal of assisting child abuse victims in coping with and

overcoming the negative impact of the trauma they’ve experienced. This study

evaluates the types of interventions social workers utilize when working with child

abuse victims, how the interventions address the resulting trauma of child abuse,

which interventions social workers believe are most effective when working with

this population, and why those interventions are believed to be most effective.

Data was collected for this study using qualitative means via use of interviews

conducted via Zoom. The interviews were audio recorded and then transcribed

for data analysis. The findings of the study highlight the use of art therapy,

journaling, active listening, and talk therapy as the most preferred and effective

interventions to utilize when working with child abuse victims. These

interventions were noted to be most effective as they are grounded on the

principles of safety, trust, client choice, empowerment, and they promote

resiliency and use of positive coping mechanisms.

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TABLE OF CONTENTS

ABSTRACT .......................................................................................................... iii

CHAPTER ONE: ASSESSMENT ......................................................................... 1

Introduction ................................................................................................ 1

Research Focus ......................................................................................... 1

Paradigm and Rationale for Chosen Paradigm .......................................... 2

Literature Review ....................................................................................... 2

Child Abuse ..................................................................................... 3

Trauma and its’ Effects ......................................................... 3

Trauma-Informed Care with Child Abuse Victims ................. 6

Theoretical Orientation............................................................................... 7

Potential Contribution of the Study to Micro and/or Macro Social Work Practice ...................................................................................................... 8

Summary ................................................................................................... 8

CHAPTER TWO: ENGAGEMENT ........................................................................ 9

Introduction ................................................................................................ 9

Study Site .................................................................................................. 9

Engagement Strategies for Gatekeepers at Research Site ..................... 10

Self-Preparation ....................................................................................... 11

Diversity Issues ........................................................................................ 12

Ethical Issues ........................................................................................... 13

Political Issues ......................................................................................... 13

The Role of Technology ........................................................................... 14

Summary ................................................................................................. 14

v

CHAPTER THREE: IMPLEMENTATION ........................................................... 16

Introduction .............................................................................................. 16

Study Participants .................................................................................... 16

Selection of Participants .......................................................................... 17

Data Gathering ........................................................................................ 18

Phases of Data Collection ........................................................................ 19

Data Recording ........................................................................................ 20

Data Analysis ........................................................................................... 20

Summary ................................................................................................. 21

CHAPTER FOUR: EVALUATION ....................................................................... 23

Introduction .............................................................................................. 23

Data Analysis ........................................................................................... 23

Participant Demographics ............................................................. 23

Open Coding ...................................................................... 24

Axial Coding ....................................................................... 26

Data Interpretation ................................................................................... 27

Implication of Findings for Micro and Macro Practice .............................. 28

CHAPTER FIVE Termination and Follow Up ...................................................... 29

Introduction .............................................................................................. 29

Termination of Study ................................................................................ 29

Communication of Findings to Study Site and Study Participants ........... 30

Ongoing Relationship with Study Participants ......................................... 30

Dissemination Plan .................................................................................. 30

Summary ................................................................................................. 30

vi

APPENDIX A: DATA COLLECTION INSTRUMENT………………………………32

APPENDIX B: INFORMED CONSENT .............................................................. 34

APPENDIX C: PARTICIPANT RECRUITMENT FLYER ..................................... 36

APPENDIX D: INSTITUTIONAL REVIEW BOARD ............................................ 38

REFERENCES ................................................................................................... 41

1

CHAPTER ONE

ASSESSMENT

Introduction

Chapter one provides an overview of the focus of this research study. The

post-positivist perspective and its’ incorporation into the research study is then

discussed. Next a literature review is provided to help one understand trauma,

its’ effects, and the importance of social workers utilizing trauma-informed care

within their practice when working with child abuse victims. The theoretical

orientation that frames the focus of the research study is then discussed. This

chapter concludes with a discussion on the study’s implications for micro and

macro social work practice.

Research Focus

Child abuse is often a very traumatic experience that can create long-

lasting psychological and emotional effects for some individuals. Social workers

often provide treatment services, such as therapy and/or case management

services, with the goal of assisting child abuse victims in coping with and

overcoming the negative psychological and emotional impact of the trauma they

have experienced. This research study is an exploratory qualitative study that

evaluates the types of interventions social workers utilize when working with child

abuse victims, how the interventions address the resulting trauma of child abuse,

2

which interventions social workers believe are most effective when working with

this population, and why those interventions are believed to be most effective.

Paradigm and Rationale for Chosen Paradigm

A post-positivist paradigm was applied throughout the research study. The

post-positivist paradigm employs an inductive approach to research, which

allowed the researcher to initiate the research process by focusing on one area

and then exploring patterns and additional aspects that began to emerge within

the data obtained. The post-positivist paradigm asserts that research is best

conducted in naturalistic settings, allowing researchers to obtain qualitative data

that best portrays how things occur in relation to the focus of one’s research

focus (Morris, 2013). Incorporation of this paradigm within the research study

helped the researcher identify key patterns related to focus of the study such as

common interventions utilized amongst social workers, how the interventions are

used, why specific interventions are selected to use over others, and clients’

responses and/or reactions to chosen interventions.

Literature Review

A literature review was conducted to help formulate a comprehensive and

thorough understanding of child abuse, trauma and its’ effects, and the

importance of social workers utilizing trauma-informed care within their practice

when working with vulnerable populations such as child abuse victims. The

3

following is a discussion of key information the researcher found when

conducting the literature review.

Child Abuse

Child abuse occurs when a caregiver’s actions and/or inactions result in a

child being seriously harmed or placed at substantial risk for imminent harm or

death (Child Welfare Information Gateway, 2020). The four common types of

child abuse are physical abuse, sexual abuse, neglect, and emotional abuse.

Freer, Sprang, Katz, Belle, and Sprang (2017) report 13.8% of children

are abused each year and that 25.6% of children experience at least one type of

abuse throughout their childhood. At least one in seven children have

experienced abuse in the past year, 84.5% of victims experienced one type of

abuse, and 15.5% are victims of two or more types of abuse (The Child Welfare

Information Gateway, 2020).

Trauma and its’ Effects. Trauma occurs when an individual is exposed to

an intense and unexpected experience that creates strong psychological and

physiological feelings of helplessness and fear (American Psychiatric

Association, 2013). Trauma experiences can vary, but they commonly involve

experiencing a sudden event outside of one’s control (Levenson, 2017). Natural

disasters, community violence, intimate partner violence, and child abuse are

some examples of traumatic events.

Individuals exposed to a traumatic event often suffer from emotional and

psychological distress after the event. Gipple, Lee, & Puig (2006) note anxiety,

4

confusion, agitation, flashbacks of the event, fatigue, dissociation, fear, a

heightened sense of arousal, and blunt affect as some of the emotional and

psychological distress symptoms individuals exposed to trauma may experience.

For those who are resilient and are able to identify effective coping strategies,

these symptoms may be mild and have a subtle impact. Others may experience

more severe and prominent symptoms that are difficult to cope with. Mirabito

(2017) notes three factors that predict the intensity of trauma reactions: one’s

level of available social support, the meaning of the trauma event to the

individual, and the amount of past trauma one has been exposed to.

There are three types of trauma: acute, complex, and chronic. Acute

trauma is when an individual experiences a single trauma incident in their life,

such as experiencing a natural disaster or being a victim of a crime. Complex

trauma is when an individual is exposed to multiple traumatic events. Individuals

who have experienced chronic trauma have experienced repeated and prolonged

abuse. Child abuse can fall into any of these three categories, as individuals may

experience abuse once, on multiple occasions, and/or continuously over long

periods of time.

The impact and intensity of the effects of trauma can vary depending on

various circumstances such as: the developmental status and age of the child

when the abuse occurred, the type of abuse experienced, the duration,

frequency, and severity of the abuse, as well as the relationship between the

victim and the perpetrator. Those who experience trauma have a higher risk of

5

developing various behavioral health and physical issues, such as depression,

diabetes, and obesity (Forkey, Morgan, Sagor, & Schwartz, 2016). Children who

experience abuse, may experience various developmental delays, such as:

social-emotional, speech, cognitive, and physical development delays (Culp,

Richardson, & Heide, 1987). The behavioral, emotional, and physiological effects

of trauma on children who have been abuse can extend into adulthood (Lee,

2017).

The Center for Disease Control and Prevention (CDC) and Kaiser

Permanente conducted the Adverse Childhood Experience study (ACEs study)

which evaluated the long-term impact on individuals who experienced childhood

adversities. The study found that individuals who experience one or more

adverse experience as a child are at greater risk of experiencing long-term

health, social, and emotional issues later in life compared to those who don’t

experience childhood adversities (Ford, Klevens, Merrick, Metzler, & Ports,

2017). Of the ten types of adverse childhood traumas that the CDC categorizes

as adverse childhood experiences within the study, child abuse makes up five of

the categories: emotional abuse, physical abuse, sexual abuse, physical neglect,

and emotional neglect (Ford et al., 2017).

6

Trauma-Informed Care with Child Abuse Victims. Social workers

frequently work with child abuse victims as they provide crisis intervention,

advocacy, and support services in various settings such as medical facilities,

child welfare agencies, community crisis centers, foster care agencies, mental

health departments, and counseling agencies. It is vital for social workers who

provide treatment services to child abuse victims to have a working knowledge of

trauma, its’ effects, and to incorporate trauma-informed care within their practice

in order to efficiently aid clients in overcoming the effects of trauma.

Providing trauma-informed care involves understanding that clients’

presenting issues are often directly correlated to their prior trauma experiences.

Levenson (2017) asserts that when social workers apply their working knowledge

of the effects of trauma and interact with clients in a compassionate and

empathetic manner, social workers in turn encourage clients’ self-determination

and their ability to develop positive coping strategies. Utilizing empathetic and

strengths-based interventions with child abuse victims, promotes trust within the

client-worker relationship and cultivates a strong safety and support network for

clients to work towards overcoming the effects of their trauma, feel empowered,

and to create the positive changes they desire (Wolf, Green, Nochajski, Mendel,

& Kusmaul, 2013).

The prevalence of trauma within the child welfare system emphasizes the

importance of social workers integrating trauma-informed care within their

practice. Ake et al. (2011) conducted a study that examined the complex trauma

7

histories and emotional and behavioral problems of youth involved in the foster

care system. Their findings note that conducting thorough assessments and fully

understanding foster youth’s trauma experiences can help social workers better

identify and address the various needs of foster youth.

The information found during the literature review highlights the necessity

for social workers to understand the effects of trauma in order to provide

appropriate treatment services to child abuse victims. The data obtained in this

research study can be utilized as an educational tool for social workers to

understand which interventions have been found by other social workers to be

effective when working with child abuse victims and may encourage social

workers to utilize new interventions and/or tailor current interventions they

already use within their own practice to better aid their clients in being resilient

and addressing and overcoming their trauma.

Theoretical Orientation

The theoretical orientation behind this study is trauma theory. Trauma

theory describes the correlation between traumatic experiences and the

emotional distress one experiences after experiencing a traumatic event. This

theory asserts that one must clearly understand the correlation between the two

in order to effectively address trauma symptoms. As such, having a clear

understanding of what trauma is will allow one better understand the impact and

effects trauma has on individuals.

8

Potential Contribution of the Study to Micro and/or Macro Social Work Practice

The data obtained from this study can potentially contribute to the field of

social work at both the macro and micro levels. On the micro level, the data

produced from this study can increase social workers’ use of empathy and

engagement with their clients and encourage social workers to employ trauma-

informed care within their practice when working with individuals whom have

experienced trauma. On the macro levels, this study can help contribute to the

understanding of the need for social service agencies to employ trauma-informed

services and policies.

Summary

This chapter provided an overview of the focus of this research study. An

explanation of the post-positivist perspective and its’ incorporation within the

research study was discussed. A literature review was provided, followed by an

explanation of the theoretical orientation that frames the focus of the study. The

chapter concluded with a brief discussion regarding the ways in which the

research study can contribute to micro and macro social work practice.

9

CHAPTER TWO

ENGAGEMENT

Introduction

Chapter two explores how engagement was performed throughout the

research study. Details regarding the research site and the researcher’s

interactions with site’s gatekeepers are discussed. A discussion regarding how

the researcher prepared for the study is then provided. Ethical, diversity, and

political issues of the study are then addressed. The chapter concludes detailing

how technology was utilized throughout the study.

Study Site

The research was focused on individuals located in a county in Southern

California. The study site was a non-profit organization that provides crisis

intervention services, counseling services, referrals and linkage to community

resources, and support and advocacy services and/or groups, to individuals who

have experienced child abuse. The primary goal of the study site is to aid clients

in addressing and overcoming the trauma associated with the abuse they have

experienced. The agency employs paid staff and also has volunteers whom work

directly with agency clientele. The agency provides services to clients on-site

within their various office locations, and also off site at locations within the local

community such as prisons, hospitals, and school settings. The agency services

10

a diverse clientele population that includes adults and children, various gender

identities, and various races and ethnicities.

Engagement Strategies for Gatekeepers at Research Site

The gatekeeper for the study site was the agency’s director. The director

is responsible for ensuring all program services are ran effectively and in

compliance with the agency’s goal and mission. The director oversees all staff

members within the agency, secures program funding, collects and organizes

data pertaining to agency statistics, and gives final approval of selection and

hiring of staff at the agency.

The researcher initiated engagement with the gatekeeper by placing a

telephone call to the agency and obtaining the gatekeeper’s contact information

(email address). An email was then sent to the gatekeeper in which the

researcher introduced them self and discussed the researcher’s desire to

conduct an exploratory qualitative research study at the agency site, with the

agency’s staff members acting as study participants. The researcher provided an

overview of the study, its’ purpose and focus, and detailed the role of study

participants partaking in interviews with the researcher. The researcher received

an email response from the gatekeeper noting the gatekeeper’s excitement and

interest in allowing the researcher to utilize the agency as the study site. During

this email exchange, an in-person meeting was scheduled with the gatekeeper to

discuss the study in further detail.

11

During the in-person meeting, the researcher and gatekeeper thoroughly

discussed all aspects of the study which included: how the researcher planned to

recruit and select study participants, how the research interviews would be

conducted, the interview questions, the researcher’s plan to provide informed

consent to study participants, how confidentiality would be maintained throughout

the study, and what assistance would be needed from the gatekeeper in linking

the researcher to the agency staff.

The researcher further explained to the gatekeeper how the study would

benefit the agency as the study’s findings would note which interventions their

employees used with agency clients, how successful the interventions were in

addressing clients’ trauma and aligned with the agency’s mission and goals,

provide insight into additional interventions staff members could incorporate

within their practice in the future, and stimulate discussion and brainstorming on

how certain practices and interventions could be expanded throughout the

agency to further aid and support the agency clientele. The gatekeeper gave

approval and provided written consent for the researcher to use the agency as

the research study site and to recruit study participants from the agency’s staff

members.

Self-Preparation

A literature review was conducted and provided the researcher with a

detailed understanding of the key elements pertaining to the research topic. The

literature review highlighted the importance of the researcher understanding child

12

abuse as a traumatic event, trauma symptoms, the impact of trauma, and the

importance of social workers employing trauma-informed care within their

practice when working with child abuse victims. The literature review further

provided an understanding that utilizing trauma-centered and empathetic

interventions can effectively aid child abuse victims in overcoming their trauma.

With the knowledge obtained from the literature review, the researcher

created a list of pre-determined questions to ask study participants in the

research interviews.

It was important for the researcher to remain cognizant and aware of

personal biases and values to ensure that they did not influence the researcher’s

data gathering process. As such, the researcher kept two journals throughout the

research study to aid the researcher in managing any biases. The researcher

utilized the journals to reflect on the research process, document the

researcher’s thoughts and feelings regarding the research process, and to

document the actual data obtained from study participants during the study.

Diversity Issues

A key diversity issue pertaining to this study was the minimal inclusion of

males in the research process. In general, there is a higher ratio of females

employed in the social work field compared to males; this was also the case

within the study site. To address this issue, the researcher constructed eligibility

requirements that included participants of all gender identities and the researcher

ensured recruitment efforts remained inclusive to all gender identities.

13

Ethical Issues

A proposal of the study was presented to the Institutional Review Board

(IRB) to obtain approval to conduct the study and for review in order to avoid any

possible ethical issues. To avoid ethical issues, informed consent was provided

to study participants to ensure they had a full understanding of the scope of the

research study, the type of information that would be obtained from them, the

steps that would be taken to ensure their confidentiality, and how their responses

would be used within the study. Due to the inability to conduct interviews in

person with study participants due to COVID-19 pandemic restrictions, each

participant verbally stated their consent to participate in the study, acknowledged

that they received proper informed consent regarding the parameters of study,

and stated their willingness to act as a study participant.

Another ethical issue that was taken into consideration was confidentiality.

In order to ensure the confidentiality of the study participants, the researcher did

not collect personal identifying information from study participants. Furthermore,

after each interview was completed with the study participants, the audio

recordings of the interviews were transcribed into Microsoft Word documents

using Trint transcription software, and then the audio recordings were deleted.

Political Issues

A key political issue pertaining to this study was society’s current focus on

human and social service workers’ incompliance with legal and ethical standards,

which has led to various lawsuits against child welfare agencies and social

14

workers. There may have been fear that the study could indicate that the agency

that acted as the study site wasn’t doing enough to assist clients or wasn’t doing

things in an appropriate ethical and legal manner. The researcher addressed this

issue during the engagement process with gatekeeper, as the researcher

explained the goal, intent, and potential for the study’s findings to highlight the

positive things the agency is doing when working with clients and to enlighten the

agency on practices they may want to expand on and improve in order to

increase client and agency outcomes.

The Role of Technology

Technology was used in the engagement process through telephone calls

and emails with the study site’s gatekeeper. Email exchanges also occurred

between the researcher and study participants to identify and select study

participants and to schedule the research interviews with the study participants.

The video conferencing application “Zoom” was also utilized to conduct the

research interviews with study participants, as COVID-19 restrictions prohibited

the researcher’s ability to conduct in-person interviews. The interviews were

recorded with a digital audio recording device.

Summary

This chapter explored how the researcher initiated engagement with the

gatekeeper of the study site and obtained approval to use the gatekeeper’s

agency as the study site for this research study. Details regarding the study site

15

and how the researcher prepared for the study were also discussed, followed by

potential issues the researcher needed to remain aware of and address

throughout the research process. The chapter concluded detailing how

technology was utilized in the study.

16

CHAPTER THREE

IMPLEMENTATION

Introduction

Chapter three discusses how the research study was conducted. First,

study participants are identified and an explanation of how study participants

were selected is noted. Next, the methods for data gathering, the phases in

which data was gathered, and how data was recorded are discussed. Then an

explanation was provided as to how the research data was analyzed. The

chapter concludes with a description of how termination and follow-up took place

and how the study’s research findings were distributed and communicated.

Study Participants

As the study sought to determine which interventions social workers

believe are most effective when working with child abuse victims, social workers

experienced in working with individuals who have experienced child abuse were

selected as study participants. The sample size for the study was six.

Participants were employees employed at the study site, as the study site

provides services to victims of child abuse. The study participants were

comprised of mixed genders and ages, and possessed at minimum a Bachelor’s

degree to ensure the participants had a thorough understanding of the key topics

pertaining to the research study (child abuse and trauma).

17

Selection of Participants

This study used homogeneous sampling to select study participants. This

sampling strategy is a purposive sampling technique that aims to acquire a

sample that has the same and/or similar characteristics (Morris, 2013). This

sampling strategy was utilized in order to allow data to be collected from a

sample of social workers that share the characteristics of having experience

working with child abuse victims and having a working knowledge of trauma.

The researcher created a recruitment flyer that detailed the study, its’

focus, the researcher’s desire to seek volunteer participants, the role of

participants in the study, listed the criteria participants needed to meet in order to

be selected as a participant (have at minimum a Bachelor’s degree and provide

direct treatment services to the study sites’ clients), and noted how those

interested in participating in the study could contact the researcher.

The gatekeeper distributed the researcher’s recruitment flyer to the study

site’s staff members prior to some of the study site’s staff meetings.

With the consent of the gatekeeper of the study site, the researcher

attended two of the study site’s staff meetings, met with the study site’s staff

members, discussed the research study (its’ objectives, purpose, how data would

be obtained and analyzed, and the benefits the study would have for the study

site and how the data could improve staff’s practices with the study site’s

clientele), explained the researcher’s goal of recruiting staff members from the

study site to act as study participants, explained the criteria to be considered and

18

selected as a study participant, and thoroughly explained what the study

participants’ role would be in the study (participating in an interview with the

researcher and answering a series of questions pertaining to the services they

provide and the interventions they utilize with their clients). The researcher

explained how those interested in participating in the study could contact the

researcher via email to inform the researcher of their interest, that they meet the

study’s criteria, and to schedule a date and time to complete the research

interview.

The researcher further explained that confidentiality would be maintained

throughout the study by not obtaining and/or including any personal identifying

information obtained from study participants throughout the research process.

Data Gathering

Semi-structured interviews were utilized as the data collection method

during this research study in order to obtain qualitative data. The interviews were

conducted via the video conferencing application “Zoom” in compliance with

COVID-19 protocols. Utilizing semi-structured interviews allowed the researcher

to ask study participants a series of predetermined questions that were created

prior to the interviews, as well as additional and/or follow up questions to seek

clarity of and explore participants’ responses. The researcher remained open and

flexible throughout the interview process and allowed participant responses to

guide the research and highlight additional aspects related to the research topic

19

that the researcher may not have originally considered or been previously aware

of.

The interview questions consisted of open-ended questions that

encouraged participants to openly communicate and express their thoughts

within their responses. Several descriptive questions were asked, such as: What

is your understanding of trauma and its’ effects? How have you seen trauma

effect child abuse victims? When working with child abuse victims, what

interventions do you use and why? Structural questions were also asked. For

example: “What are the interventions intended to target, address, or treat?”

Contrast questions were also utilized during the interviews, such as: Are there

certain interventions you believe are more effective to utilize when working with

child abuse victims? If so, why? A complete list of the predetermined questions

that were asked in the interviews is attached and referenced herein (see

Appendix A).

Phases of Data Collection

When conducting the interviews with study participants, the researcher

structured the interviews into three phases that began with asking questions that

built engagement and rapport with participants. The researcher chose to start the

interviews with general questions to help participants become comfortable with

the researcher and the interview process. As the researcher transitioned into the

second phase, the developing portion of the interviews, the researcher

transitioned into asking essential questions focused on the research topic. The

20

final stage of the interviews was the termination stage in which generic and

minimal follow up questions were asked to help lower the intensity of the

interviews and conclude the interviews. At the end of the interviews, participants

were provided the opportunity to add information to any of their responses.

Data Recording

With the verbal consent of the study participants obtained prior to each

interview, an audio digital recorder was utilized to record interviews. The audio

recordings of the interviews were transcribed and reviewed after each interview.

Transcribing the interviews allowed the researcher to accurately note and refer

back to participants’ responses as needed when analyzing the data.

Two separate journals were also utilized to record data. The researcher

used one journal to take detailed notes regarding all aspects of the research

process such as: the researcher’s preparation and planning for the study,

interactions with the gatekeeper, study participants, and all of the data collected

during the study. This journal documented the research study from start to finish.

The second journal held more of a reflective purpose for the researcher, as it

included the researcher’s reflections pertaining to the research process and

decisions made throughout the study.

Data Analysis

A qualitative analysis of the data obtained during the study was

conducted. The units of analysis were social work practitioners who have

21

experience working with victims of child abuse and utilized interventions, as the

purpose of the study was to evaluate which interventions are believed to be most

effective in addressing trauma when working with child abuse victims.

A bottom-up approach was utilized to analyze the qualitative data

obtained. This was completed in three stages: open coding, axial coding, and

selective coding. During the open coding stage, the transcriptions of the

interviews were reviewed and broken down into smaller sections that allowed the

researcher to analyze the data more easily and in more detail. In doing so, the

researcher separated pertinent information found within the data into prevalent

categories and concepts related to the research focus. In the axial coding stage,

the researcher identified relationships and themes and that existed between the

previously identified categories and concepts that emerged in the open coding

stage. The researcher explored and tested these relationships as data continued

to be collected in subsequent interviews with study participants. In the selective

coding stage, the researcher identified a main theme that was present within the

study’s data and formulated a theory that focused on why social workers believe

certain interventions are most effective when working with child abuse victims.

The researcher then developed an overall statement regarding how the theory

identified during the selective coding stage applies to human interaction.

Summary

This chapter discussed how the research study was conducted. An

explanation of how study participants were identified and selected was noted.

22

The chapter then concluded by discussing the data methods that were used, as

well as how data was gathered, recorded, and analyzed.

23

CHAPTER FOUR

EVALUATION

Introduction

Chapter four begins with a description of the study participants’

demographics. The categories and concepts discovered during the open coding

stage of the data analysis are noted. The themes developed during the axial

coding stage are then provided. The data interpretations are discussed next. The

chapter concludes discussing the impact of study’s findings on social work

practice.

Data Analysis

Participant Demographics

The study included six participants that ranged in age from 23 to 53 years

old; the average participant age was 32. All participants with the exception of one

were female. 50% of the participants self-identified as Latino, 33% self-identified

as African American, and 17% self-identified as Native American. The

participants’ time frame of working in the social services field ranges from 3 years

to 10 years. The participants time frame of working at the study site ranged from

half a year to five years. Participants reported working with child abuse victims at

the study site that range in age from 10 to 81 years old.

24

Open Coding. The following concepts were identified during the first stage

of analysis: assessment tools, engagement, and common interventions.

Common interventions noted to be used by participants with their clients

were art therapy, journaling, talk therapy, and active listening. All study

participants reported using art therapy with their clients as a way to help their

clients communicate and express their thoughts and feelings. Participant 1

reported the following:

One of the best ways that I've seen in terms of dealing with children and

getting them to express their feelings is through art. So usually during the

first couple of sessions with clients, I'll do an art project that helps them

metaphorically express their feelings via the art. So I'll tell them, draw for

me what your world looks like, or what today looks and feels like for you. I

had one child who drew lightning bolts and raindrops on one side of the

paper and then on the other side they drew the beach. We then compared

the sides, and she explained that the side with raindrops is often how she

feels (sad and frightened) and the side with the beach is how she wishes

she felt more often (calm). I've noticed that's it’s easier for my clients to

communicate their feelings when it's done in that aspect; through art

(Personal Communication, November 2020).

Participant 3 reported the following:

I often have my clients draw a pair of eyes. One eye represents how they

see themselves now and where they currently are in life. The other eye

25

represents how and where they would like to see themselves. Sometimes

there’s a lot of split things going on…it'll be dark and gloomy on one side

and then more hopeful on the other side. From there we talk about things

they feel they can do to reach the happy and hopeful side or where they

would like to be (Personal Communication, January 2021).

Five of the participants identified journaling as a main intervention they

utilize with their clients. Participant 1 described how they use journaling at times

with their teenage clients:

Dump journaling is another thing that I've recently started doing with the

teenagers and they really like it, especially right now with the situation

we're in with COVID. A lot of them are getting very stressed with just

being at home…There's a lot of distractions and often prioritizing stuff

causes anxiety for them. So the journaling is a way for them to kind of

doodle their feelings and get all their thoughts out, and it also helps them

organize their thoughts. So it can be used like an organizational type of

coping technique. It helps them eliminate those anxieties and feelings of

being overwhelmed (Personal Communication, November 2020).

All participants described the need to find the right way to engage with

each of their clients in order to establish and build rapport with them. Participant

6 described how the process of establishing and building rapport with their clients

often takes time:

26

During my first few sessions with them I really try to work to build rapport

and common ground with them so that they become comfortable working

with me and opening up to me. This can take a while some times, and

other times I get some clients who are completely okay with just talking

about things and jumping right into the reason of why they’re there to see

me. I really take it at their pace and let them choose what it is they want to

talk about (Personal Communication, January 2021).

Axial Coding. During the axial coding stage of analysis, the concepts and

categories identified in the open coding stage were further analyzed and the

researcher discovered that the concepts related to an overarching theme of using

interventions with child abuse victims that: promote empathy and empowerment,

enable one to confront their trauma, and help one find their power and voice to

create their own narratives. While analyzing the concepts discovered in the open

coding stage, the researcher found that the concepts provided a way for the

participants to show empathy to and empower their clients and provided an outlet

for participants to allow their clients to acknowledge the trauma they’ve

experienced and to develop the strength and ability to tell their trauma stories.

Participant 1 reported their goal of seeking to empower their clients:

More than anything it’s empowerment. I want them to feel like they're in

this place where it's safe and they feel good and they feel some sort of

relief. The other important thing is being able to validate their feelings.

Like, for instance, when we have talk therapy, a lot of clients seem to think

27

crying is a negative thing and something that just shows weakness. I want

them to understand that crying however can be a good thing and act as a

sense of release. So we have to kind of re-work their views so that they

don't just see expressing their emotions as a vulnerability, but rather as a

powerful tool that they could use…Validating their feelings is also

important for me, but also allowing them to validate themselves is key

(Personal Communication, November 2020).

Data Interpretation

This study found that use of assessment tools, proper engagement

strategies, and interventions such as journaling and art therapy were primary

methods for participants to identify their clients’ needs, understand the intensity

and impact the trauma of abuse has on their client, and to address their clients’

trauma.

The main overarching theme discovered in the study was the use of

interventions that promote empathy and empowerment, aiding clients in

confronting their trauma, exploring and listening to victim narratives, and helping

clients find their power and voice. The data supports the assertion that use of

interventions based on the principles of safety, trust, choice, and empowerment

are effective in addressing child abuse victims’ trauma and helps aid in their

journey towards resiliency.

28

Implication of Findings for Micro and Macro Practice

The findings from this study can potentially contribute to the field of social

work at both the macro and micro levels. On the micro level, the data produced

from this study can encourage and increase social workers’ use of empathy and

engagement with clients and further encourage social workers to employ trauma-

informed care within their practice when working with individuals whom have

experienced trauma. On the macro levels, this study highlights the importance

and need for local and state governments to not only fund community programs

that provide assistance to trauma victims, but also to provide ongoing appropriate

training regarding trauma-informed care to employees within such community

programs.

29

CHAPTER FIVE

TERMINATION AND FOLLOW UP

Introduction

This study evaluated interventions social workers believe are most

effective when working with child abuse victims. This final chapter begins with a

description of how the termination process of the study occurred. Next, how the

study findings were communicated to the participants and study site is discussed.

This is followed by a description of the researcher’s ongoing relationships with

study participants. The chapter concludes with discussing how the study findings

were disseminated.

Termination of Study

Each participant was thanked for their time and participation after each

respective interview. Termination of the study at the study side was conducted by

presenting the study’s findings to the study site. The final termination of the study

as whole occurred upon submitting the study’s findings for open access in the

University’s ScholarWorks depository and presenting the findings at the

University’s Research Symposium Event.

30

Communication of Findings to Study Site and Study Participants

The researcher met with the study site’s gatekeeper via Zoom once the

study concluded and discussed the findings of the study. The researcher then

once again attended one of the study site’s staff meetings virtually, and

communicated the study findings via a PowerPoint presentation to the study site

and study participants.

Ongoing Relationship with Study Participants

Termination with study participants began at the end of each respective

interview and then concluded when the researcher communicated the study

findings to all staff at the study site.

Dissemination Plan

The findings of the study were submitted for open access in the

University’s ScholarWorks depository and were presented at the University’s

Research Symposium Event.

Summary

This chapter began by describing how the termination process of the study

occurred. The way in which the study findings are communicated to the

participants and study site was then discussed. Next, a description of the

researcher’s ongoing relationships with study participants was provided. The

31

chapter concluded with a discussion of how the study findings were

disseminated.

32

APPENDIX A

DATA COLLECTION INSTRUMENT

33

34

APPENDIX B

INFORMED CONSENT

35

36

APPENDIX C

PARTICIPANT RECRUITMENT FLYER

37

38

APPENDIX D

INSTITUTIONAL REVIEW BOARD

39

40

41

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