Literature reviews

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An advocacy intervention program for women with abusive partners: six-month follow-up. Authors: Chris M. Sullivan, Rebecca Campbell, Holly Angelique, Kimberly K. Eby and Davidson, II, William S. Date: Feb. 1994 From: American Journal of Community Psychology(Vol. 22, Issue 1) Publisher: John Wiley & Sons, Inc. Document Type: Article Length: 7,916 words

Abstract:  Presented the 6-month follow-up findings of an experimental intervention designed to provide postshelter advocacy services to women with abusive partners. The intervention involved randomly assigning half the research participants to receive the free services of an advocate, 4 to 6 hours per week for the first 10 weeks postshelter. One hundred forty-one battered women were interviewed about their experiences immediately upon their exit from a domestic violence shelter: 95% of the sample were interviewed 10 weeks thereafter (postintervention), and 93% were successfully tracked and interviewed 6 months later. At the 6-month follow-up, participants in both groups reported increased social support, increased quality of life, less depression, less emotional attachment to their assailants, and an increased sense of personal power. Although women in both groups reported some decrease in physical abuse over time, there were no statistically significant differences between those with and those without advocates, and abuse continued to be a problem for many women. Those who were still involved with their assailants continued to experience higher levels of abuse and had been more economically dependent upon the men prior to entering the shelter. Women who had worked with advocates continued to report being more satisfied with their overall quality of life than did the women in the control group.

Full Text:  Little is known about the process women undergo as they attempt to escape abusive men with whom they are or have been involved. Attention has focused on the prevalence of woman battering (i.e., Straus & Gelles, 1986) and the factors associated with why some women stay in relationships with abusive men (i.e., Browne, 1987; Greaves, Heapy, & Wylie, 1988; Schutte, Malouff, & Doyle, 1988; Walker, 1983). No study to date, however, has experimentally examined the effects of providing women access to the help needed in ending their victimization. Nor has a study intensively tracked women over time to investigate the processes involved in leaving abusive partners. This article presents the 6-month follow-up findings of a research study designed to accomplish both these tasks.

Prior research has substantiated that many battered women lack the community resources deemed critical to successfully escaping abusive men. These resources include, but are not limited to, affordable housing, employment, police protection, health care, legal assistance, child care, and social support (Aguirre, 1985; Gondolf, 1988; Hilbert & Hilbert, 1984; Hofeller, 1982; Horton, Simonidis, & Simonidis, 1987; Mitchell & Hodson, 1983; Sidel, 1986; Strube & Barbour, 1983). Many women are trapped in relationships with their assailants because they lack the financial means to escape and cannot count on the criminal justice system to protect them.

HELP-SEEKING EFFORTS

To date, research using either purposive (e.g., shelter populations, participants recruited through community advertisements) or random sampling techniques has found most women with abusive partners have turned repeatedly to outsiders for help in ending their partners' abuse. Gondolf's (1988) comprehensive study of over 6,000 women from 50 different shelters revealed that women had sought help from the community an average of six times prior to their arrival at the shelter. Horton, Simonidis, and Simonidis' (1987) sample of women obtaining restraining orders had all been in contact with at least one community agency or resource, and the average number of services contacted was 3.48. Wauchope's (1988) nationally representative sample of 3,665 women found that 68% of those battered had sought help at least once and that the predicted probability of seeking help after suffering severe abuse was .77.

Types of Help Sought

Researchers who have examined the types of help sought by battered women have generally categorized this help into "formal" or "informal" assistance. Informal help includes friends, relatives, and women's groups, while formal assistance includes social service agencies, doctors/hospitals, the police and criminal justice system, religious organizations, and shelters.

Most of the research on help-seeking indicates that about half of any given sample of battered women have turned to their family or friends for assistance (Binney, Harkell, & Nixon, 1981; Bowker, 1983; Dobash, Dobash, & Cavanagh, 1985; Frieze, Knoble, Zomnir, &

Washburn, 1980; Gondolf, 1988; Schulman, 1979). As for formal help-seeking, Maynard (1985) randomly sampled social casework files and found that one third contained direct references to woman battering, indicating battered women are utilizing social service agencies. A random sample of emergency room patients found that 24% of the women identified themselves as victims of woman batterers (Goldberg & Tomlanovich, 1984). The percentage of women who contacted the police has been more variable, ranging in studies from 9 to 67% (Bowker, 1983; Gayford, 1975; Gondolf, 1988; Pagelow, 1981; Roy, 1977; Schulman, 1979).

COMMUNITY RESPONSE TO WOMEN ESCAPING ABUSIVE PARTNERS

Research findings indicate battered women perceive the help they receive from their communities to be ineffective in ending their assailants' abuse (Binney et al., 1981; Dobash et al., 1985; Gelles, 1979; Gondolf, 1988). Dobash et al.'s (1985) study of battered women's help-seeking behavior found requests to social service agencies for concrete help were not likely to be met, reporting that, "Although some social workers did attempt to confront the men and/or actively pursue assistance for the woman, they acted primarily upon individual initiative and not because of priorities or policies set by the agency".

Dutton (1987) reviewed the criminal justice literature to examine the extent and effectiveness of arrest as a deterrent to woman battering. His review suggests incarceration does deter recurrence of abuse but that arrest is still very unlikely to occur (1 in 100 cases). Other studies also support that arrest is effective in reducing recurrence of abuse, although some studies report contradictory findings (Bell, 1985; Berk & Newton, 1985; Fagan, Friedman, Wexler, & Lewis, 1984; Hirschel, Hutchison, & Dean, 1992; Sherman & Berk, 1984). In a similar vein, Horton et al. (1987) conducted a 6-month follow-up of women who were successful in obtaining restraining orders and found that 86% of them were satisfied with their effectiveness.

Although arrest and legal interventions are sometimes effective in deterring further abuse, many women continue to have difficulty receiving this type of help. It is still unlikely for a police officer to arrest a man who has assaulted his wife or girlfriend (Bell, 1985; Dutton, 1987; Ferraro, 1989), and those who are arrested are not likely to be prosecuted (Ford, 1983; Hirschel et al., 1992). Many women continue to report dissatisfaction with the treatment they receive from the criminal justice system. For instance, 96% of the women in Hofeller's (1982) study sought legal services, but 40% were moderately or completely dissatisfied with the help they received. Sullivan, Basta, Tan, and Davidson (1992) reported that 50% of the women in their sample who had called the police were dissatisfied with the police response. In cases where assailants were arrested, women were more likely to report satisfaction with the police response, whereas when assailants were not arrested, women were somewhat or very dissatisfied with the police response.

Response from Family and Friends

In addition to finding little, if any, help from community sources, battered women often find limited support from their family and friends (Dobash & Dobash, 1979; Kuhl, 1982; Martin, 1976). Mitchell and Hodson (1983) found that lack of informal social support was related to more severe depressive symptoms in battered women. However, women who have reported receiving help from relatives or friends have rated it as very important to being able to leave their assailants (Bowker, 1983; Donato & Bowker, 1984). There is increasing evidence in the social support literature that supportive social networks contribute to positive psychological well- being. Supportive friends can provide needed emotional and material support during traumatic times, which can reduce the risk of becoming ill due to overstress (Gottlieb, 1981; House, 1981; Mitchell & Hodson, 1983; Mitchell & Trickett, 1980).

It is not surprising, given the limited support of friends, as well as the lack of resources and support women currently receive from their communities, that so many women remain trapped in abusive relationships. Therefore, it is important to concentrate on providing women access to those community resources vital to maintaining long-term, positive life change.

THE ROLE OF ADVOCATES IN ASSISTING WOMEN WITH ABUSIVE PARTNERS

Since the recognition of woman battering is a relatively recent phenomenon, few conceptual models of intervention have been offered. For our understanding of this phenomena and our methods of change to be improved, we must begin to outline systematic models of change that can then be examined for their short- and long-term efficacy. Dissatisfaction with traditional approaches to woman battering, including psychological "treatment" of the victim and nonarrest of the batterer, has led to suggestions for alternative programs. One recurring model that has been proposed is advocacy intervention with women attempting to escape abusive partners (Berghorn & Siracusa, 1982; Bowker, 1983; Donato & Bowker, 1984; Hofeller, 1982; McDonald, 1989; Stark & Flitcraft, 1988). An advocate, according to Sarason (1976), is a person or group who works with and on behalf of targeted individuals, assisting them in accessing needed resources. Paraprofessional advocates have been an integral part of most shelter staffs since their inception, as they provide a source of inexpensive or free labor. As Donato and Bowker (1984) concluded from their study, "people who are often indigenous paraprofessionals rather than fully accredited professional therapists are remarkably capable of delivering services to battered women."

THE CURRENT RESEARCH

The current study is the 6-month follow-up of a 2-year longitudinal study, and was designed to serve two purposes. First, incorporating an experimental design allowed for the examination of providing advocacy services to women exiting a battered women's shelter. Although all of the study participants had fled to an emergency shelter to escape an abusive partner, not all were choosing to leave their assailants permanently. The study was based on the preliminary findings of a pilot study (Sullivan, 1991; Sullivan & Davidson, 1991) and was predicated on an ecological intervention approach. The ecological approach to social problems is based on the environmental resources conception of human behavior, which stresses the right of all individuals to possess certain community resources (see Davidson & Rappaport, 1978). It was hypothesized that women who worked with trained advocates would be more effective in obtaining needed community resources and would report increased levels of social support. These changes were expected to persist over time, resulting in increased overall quality of life and decreased abuse.

The second component of the study is to track research participants across the intervention time period as well as every 6 months thereafter for 2 years. This is the first research to systematically follow women across the 2 years following a shelter stay. Only

through longitudinal investigation can the difficult and erratic process of dealing with an abusive partner be examined.

METHOD

Research Participants

Research participants were recruited from a domestic violence shelter located in a medium-sized Midwestern city. All women who stayed at least one night at the shelter and who intended to stay in the general vicinity were told about the project, regardless of whether they intended to return to their assailants. Residents were told that, should they agree to participate, they would be interviewed six times after their shelter exit--immediately upon exit, 10 weeks thereafter (postintervention), and at 6, 12, 18, and 24 months postintervention. Women were also told that half of the participants would receive the free services of trained advocates for 4 to 6 hours per week during the first 10 weeks after leaving the shelter. All women were paid for participating in interviews ($10, $40, $60, $80, $90, and $100, respectively).

Most eligible participants (93%) expressed interest in participating in the study. Of the 146 initial study participants, 4 women ended their participation within the first 2 weeks, and 1 woman was murdered 1 week into her intervention. Results are based on the remaining 141 participants, 71 of whom were randomly assigned to work with advocates. Two of the women were dropped as outliers from the multivariate analysis of variance, but are included in demographic and abuse history information. Both women exhibited signs of mental illness which interfered with their ability to answer certain questions. One experienced active hallucinations and believed her assailant tormented her through her brain waves, and the other was mentally confused to the point of being unable to provide consistent information.

Where possible, project interviews were conducted in person in the community, most often in women's homes. Women who had moved out of the general area were interviewed over the telephone. Interviewers were project staff or trained undergraduates who received extensive training.

Demographics

Of the study participants, 45% were white, 43% black, 8% Latina, and 1% Asian American. Ages ranged from 17 to 61 years of age, with the mean at 28.5 years (Mdn = 28). All but 22% of the women had at least one child living with them.

Of these participants, 82% were unemployed and 81% were receiving some type of governmental assistance; their mean income the year prior to entering the shelter had been $11,800, and 60% lived below the federal poverty line (Bureau of Census, 1990). Sixty- four percent of the women had completed high school or had obtained a graduate equivalence degree; 31% had at least some college experience.

The mean length of stay at the shelter had been 17 days (range = 1 to 45, SD = 12.3). Before arriving at the shelter, a third of the women had been married to and living with their assailants; an additional 45% had been living with their assailants but were not married. Six percent of the women were involved with their assailants but not living together, and 15% were no longer involved with their partner at the time of the last assault (either separated, divorced, or no longer dating). The women were demographically similar to the samples of other studies (Berk, Newton, & Berk, 1986; Finn, 1985; Gondolf, 1988; Greaves et al., 1988; Hilbert & Hilbert, 1984; Mitchell & Hodson, 1983; Okun, 1986; Pagelow, 1981; Schutte et al., 1988; Stacey & Shupe, 1983), indicating they are representative of women who utilize domestic violence shelters.(3) Parametric and chi-square statistics were performed on demographic variables to ensure the women in the control condition were not significantly different from women in the experimental condition. No statistically dependable differences emerged.

Retention Rate

Tracking women over the first 6 months postintervention was highly successful, resulting in a 93% retention rate.(4) Of the 10 women who were not interviewed at 6 months, 3 informed the project they were no longer interested in being interviewed, and the project has reason to believe, but cannot positively confirm, that 2 of the women were killed. Five women could not be located, despite intensive tracking efforts. The demographics of these 10 cases were comparable to the rest of the sample in terms of age, race, relationship status, number of children, and condition assignment.

Advocate Training

Advocates were female undergraduates from a large Midwestern university, who earned college credits for their participation. Training lasted for 10 weeks, and consisted of information regarding the prevalence and severity of woman battering, as well as the difficulties women face after leaving a shelter. In addition to receiving empathy training, advocates were trained to generate and mobilize an assortment of community resources.

Experimental Intervention

The 71 women randomly assigned to the experimental condition received the free services of trained advocates for 10 weeks after their shelter exit. Although each intervention was necessarily unique, based on the needs and circumstances of the project participant, all advocates were instructed to focus on helping to access community resources while providing needed social support. Results from the postinterviews revealed that advocates spent an average of 6.9 hours per week with or on behalf of their clients in person (mode = 6 hours) and an additional 2.5 hours per week on the phone.

Measures

The study employed preexisting measures as well as those created specifically for the research project. Depression was assessed by the CES-D (Radloff, 1977), a self-report checklist of psychological distress within the general population (coefficient [Alpha] = .88). Long-term fear and anxiety was measured by the first 40 items of Kilpatrick's (1988) Rape Aftermath Symptom Test (RAST). This scale's internal consistency was .94, with item-total correlations ranging from .33 to .68.

Locus of control was measured by Levenson's (1972) Internal-Powerful Others-Chance (IPC) scale, which has been used in prior research with battered women. The Internal subscale of this scale was dropped from analyses due to low internal reliability. The Powerful Others subscale was combined with the Chance subscale (due to high intercorrelations) to create an External subscale, with alpha = .83 and item-total correlations ranging from .24 to .56.

To measure relationship with assailant, each participant was asked, at each of the assessment periods, what her current relationship was with her assailant. Emotional attachment was measured by a 13-item scale developed for this study. Women responded true or false to such items as "I try to see only the best in him" and "When I try to imagine never seeing him again, I feel empty." Item-total correlations ranged from .35 to .65, with an alpha of .84.

Self-efficacy items were created specifically for this study. Three hypothetical situations were developed to examine what each woman would specifically do to obtain inexpensive furniture, a new job, and a new home. Women were asked to explain what exactly they would do (or instruct a friend to do) in these situations, how effective they thought these strategies would be in meeting their goals, and how confident they were in their abilities to engage in the mentioned behaviors. Women responded on a 7-point scale from very uncertain to very certain. Internal consistency of this 6-item scale was .78, with item-total correlations ranging from .46 to .61.

Social support was assessed by a measure developed by Bogat, Chin, Sabbath, and Schwartz (1983), which has a coefficient alpha of .87. This instrument measured the perceived quantity and quality of women's overall social support, as well as specific domains of support: companionship, advice and information, practical assistance, and emotional support. Overall psychological well-being was measured by a modification of Andrews and Withey's (1976) Quality of Life measure. Twenty-five items which pertained to the experiences of battered women were selected to predict overall quality of life (coefficient [Alpha] = .90, item-total correlations ranging from .30 to .65). On a scale ranging from extremely pleased (1) to terrible (7), women rated items such as "In general, how do you feel about your life overall?" and "How do you feel about your emotional and psychological well-being?"

Experience of physical abuse was measured by a modified version of Straus's (1979) Conflict-Tactics Scale Violence subscale, found in this study to have an internal consistency of .90. Two items were dropped from this scale ("burned" and "drove recklessly so that you felt endangered") due to lack of variance. The Index of Psychological Abuse was specifically developed for this study, and is a 33-item measure of ridicule, harassment, and criticism experienced. On a scale ranging from never (1) to often (4), women were asked items pertaining to the last 6 months, such as how often their assailants "ridiculed or criticized you in public" and "criticized your intelligence." Internal consistency of this scale was .97, with item-total correlations ranging from .51 to .90.

Women's access to resources was measured by numerous items created specifically for this study. For each of the 11 resource areas (housing, education, transportation, employment, legal issues, health care, making friends, finances, material goods, child care, and other issues for children) women were asked how satisfied they were with the level of that resource in their lives from very dissatisfied (1) to very satisfied (4). Participants were also asked how much of a problem, if any, obtaining each resource had been over the last 6 months ranging from not a problem at all (1) to very much a problem (4) and whether they had had any desire to work on obtaining that resource from none (1) to a great deal (4). Some items varied depending on the source (i.e., "Are you employed?" and "Where are you living right now?"), and were designed to measure women's possession of each resource.

Initial Pre-Post Findings

The initial pre-post results of this research study supported the hypotheses that women would be in need of numerous resources upon their shelter exit and that advocates can be effective change agents in helping battered women access needed resources (Sullivan, Tan, et al., 1992). Women randomly assigned to the experimental condition (who worked with trained advocates for 10 weeks) were more likely to have worked on obtaining the resources they desired and reported greater success in acquiring those resources. A repeated measures multivariate analysis of variance also revealed that women in the experimental condition were more pleased with their level of social support and reported a higher quality of life compared to women in the control condition. At the 10- week period there were no statistically reliable group differences on whether women had experienced further abuse. Abuse significantly dropped in frequency and severity for participants regardless of condition.

RESULTS

Descriptive Information at Six Months

Involvement with Assailants

Upon initial shelter exit (preintervention), 65% of the project participants indicated they were not involved with or were ending their relationships with their assailants. At the 10-week interview (postintervention), 88% of these women were still uninvolved with the men who had originally abused them. This percentage did not change at the 6-month follow-up time period (88%). Of the women who initially returned to their assailants, 90% were still involved with them 10 weeks later, but only 68% were still involved at the 6-month follow-up. Overall, two thirds of the entire sample of women were not involved with their assailants at 6-month follow-up. There were no differences between the experimental and control women on whether they were involved with their assailants.

Experience of Abuse

When participants were interviewed 6 months postintervention, 43% reported having experienced further physical abuse from their assailants. There were no statistically reliable differences between experimental groups. Table I provides more extensive information

about the types of violence and injuries experienced by the study participants over the 6 months preshelter as well as 10 weeks postshelter and 6 months postintervention.

Women who were involved with their assailants reported the highest levels of physical abuse, with 76% having been physically harmed over the last 6 months and 95% having been psychologically abused. Of those women not involved with their assailants, 28% continued to be physically abused by their initial assailants.(5)

Of the women who had experienced physical abuse in the 6 months postintervention, 23% received medical treatment for their injuries and 32% felt they needed medical attention but did not receive it. Sixty-three percent had called the police at least once. Of those who called the police (range = 1-15 times) 43% were somewhat or very dissatisfied with the police response. Twenty-one percent of the abusive men (n = 12) were arrested for their violence, resulting in two convictions.

Economic Independence

A number of connections were found between women's economic situations and their involvement with their assailants. Of the women who had received little or no financial assistance from their abusers before entering the shelter, 78% were no longer involved with them 6 months later. TABULAR DATA OMITTED Women who did depend on their assailants for at least half of their income before entering the shelter were less likely to have left their assailants 6 months later, with only 22% no longer involved, [ .sup.2](1, N = 141) = 8.43, p [is less than] .01. Thus, if the assailants made little financial contribution in the first place, the women were less likely to suffer economic harm in leaving them. If, however, women were economically dependent on the men, it appeared more difficult to leave. These findings are based on the income of the women and their economic dependence on the assailant prior to entering the shelter. Examining the income and economic independence of women 6 months later lends further support to this argument. Most of the women no longer involved with their assailants at the 6-month follow-up were financially independent and brought in all their income (79%). Only 57% of the women still involved with their assailants brought in all of their income at follow-up, [ .sup.2](3, N = 131) = 8.81, p [is less than] 1.05. Most of the women who had left their assailants, therefore, were economically independent. Although independent, the standard of living for these women was dismal. Women who brought in more than half their own income were more likely to be living below the federal poverty lines (81 vs. 65%), [ .sup.2](1, N = 129) = 4.16, p [is less than] .05, and were more likely to be receiving governmental assistance (79 vs. 64%), [ .sup.2](1, N = 131) = 3.74, p = .05, than the women still with their abusers. Economic independence, be it from employment or governmental assistance, be it above or below the poverty line, appears important in women's decisions and abilities to leave assailants.

Possession of and Need for Resources

At the 6-month follow-up, women were doing slightly better overall compared to the 6 months before entering the shelter. While 18% had been employed within the 6 months before going to the shelter, 31% were employed at the 6-month follow-up. The percentage of women attending school rose from 13 to 23%, and slightly more women had regular access to a car (32% before entering the shelter, 47% at the 6-month follow-up). However, many women still reported lacking and/or needing a variety of community resources.

The 10 main types of resources women were asked about included financial issues (i.e., money other than through employment), employment, child care, housing, education, transportation, social support, material goods, health care, and legal assistance. Money continued to be a problem for 87% of the sample, and 82% of the unemployed women were interested in obtaining a job. Of the mothers with dependent children 67% had need for child care, and 48% had attempted to obtain child care in the last 6 months. Of these women, 76% had difficulty doing so.

Since leaving the shelter, 59% of the sample had moved at least once within the last 6 months, and 38% were dissatisfied with their housing situations. Of the women not in school, 86% expressed some desire to continue their educations. Many women expressed the need for a dependable car (63%), and a third of the women expressed dissatisfaction with their level of social support. Almost half of the sample (49%) rated the quality and quantity of their material goods (furniture, clothing, etc.) as fair or poor.

Health care continued to be an issue for many women, but most were successful in obtaining medical assistance when they needed it. Only 37% rated their health as "good," and 63% indicated they had had some need for health care in the prior 6 months. Of these women, 98% were able to obtain the needed medical assistance. Almost half the sample (48%) had worked on legal issues over the last 6 months. Of the women who sought the services of lawyers (42%), 78% were successful in their efforts. There were no significant differences on any of these variables for relationship status or whether women had or had not worked with advocates.

Experimental Effects Over Time

To examine experimental effects over time, a doubly multivariate repeated measures analysis of variance was conducted, with three time periods (pre, post, 6-month follow-up), one independent variable (experimental vs. control condition), and nine outcome variables: physical abuse, psychological abuse, depression, fear and anxiety, locus of control, self-efficacy, emotional attachment to assailant, social support, and overall quality of life. A Time x Condition interaction effect was significant F(18, 108) = 1.87, p [is less than] .05; therefore, significant univariate tests within the MANOVA were examined.

Between-Group Effects

Univariate analyses within the MANOVA indicated a significant group difference on one dependent variable at the 6-month follow-up period. A Time x Group interaction effect was found on social support F(1, 125) = 13.74, p [is less than] .01, but, as can be seen in Figure 1, both groups regressed toward the mean on this variable. The significant difference was accounted for by the large disparity between the groups at post, combined with the experimental group's decrease and the control group's increase between post and 6- months.

Quality of life was also examined due to the significant difference found between groups postintervention. The univariate ANOVA within the MANOVA was not significant, suggesting that no time by group effect persisted. However, a t test conducted at the 6- month time period did reveal the two groups continued to differ significantly, t(1, 127) = 2.008, p [is less than] .05. In other words, and as Figure 2 illustrates, the two groups showed a significant Time x Intervention effect at post, then stabilized between post and 6- month follow-up. The group that worked with advocates continued to report a higher overall quality of life at the 6-month follow-up interview.

Time Effects

Not surprisingly, women in both conditions showed significant improvement on all variables between Time 1 (shelter exit) and Time 3 (6-month follow-up). Two significant time differences were also found between Time 2 (postintervention) and Time 3. In the 6 months postintervention, women in both groups felt less emotionally attached to their assailants F(1, 125) = 5.86, p [is less than] .05, and reported increased feelings of personal control over their lives, F(1, 125) = 8.23, p [is less than] .01.

Overall, then, at the 6-month follow-up, women reported significantly lower levels of depression, fear and anxiety, and emotional attachment to their assailants. They also reported increased feelings of personal control and mastery, as well as an overall higher quality of life and increased satisfaction with their social support. Especially notable was women's level of depression over time: At the preinterview, over one third (36%) of the respondents could be classified as severely depressed according to CES-D classifications, while only 17% indicated no depression at all. Ten weeks later only 16% were severely depressed, while 42% indicated no depression at all, F(1, 131) = 45.65, p [is less than] .001. These levels remained unchanged at the 6-month follow-up.

DISCUSSION

By the time participants had received their 6-month follow-up interviews, two thirds were no longer involved with the men who had originally abused them. Many shelter workers and researchers have previously underestimated this statistic, assuming that about half of shelter residents return to their assailants. This study substantiated that women who were no longer involved with their assailants were less likely to have been economically dependent on the men prior to entering the shelter and were more likely to be bringing in their own income at the 6-month follow-up (whether through employment or governmental assistance in their own name). Clearly, a woman's level of economic dependence on the man who is abusing her is a strong factor in her decision and/or ability to leave him. It is critical for community service providers and those working in the criminal justice system to understand that many women are choosing poverty for themselves and their children should they leave their abusers. Women should not be forced to trade one form of physical danger for another.

Women who were still involved with their assailants were more likely to have been abused within the 6-month period (77%), but over one fourth of the women who had ended their relationships with their assailants continued to be physically abused by them as well. This statistic lends credence to the argument that leaving an abusive man does not always in and of itself lead to the cessation of his violence. Although almost half of the sample had experienced further abuse in the 6-month follow-up time frame, only 21% of the abusive men were arrested for their violence, resulting in only two convictions. These facts, combined with the high level of dissatisfaction with police response, suggest that many women continue to be inadequately protected by the criminal justice system.

At the postintervention time period, women who had worked with advocates reported greater effectiveness in obtaining desired resources, increased social support, and higher quality of life compared to women in the control condition. At the 6-month follow-up interview, women in the experimental condition continued to report being more pleased with their overall quality of life, but the difference in social support did not persist, as both groups regressed toward the mean. This suggests that the large disparity between the two groups on social support at Time 2 was due to the presence of the advocate during the prior 10 weeks.

There could be a number of reasons why women who had worked with advocates continued to feel better about their quality of life over the 6 months following the intervention. Perhaps simply having someone express a sincere interest in their lives immediately upon their shelter exit resulted in the continued satisfaction. It is also plausible that having had such intensive assistance resulted in women feeling more empowered about their lives. Even though we did not identify concrete differences in the number of resources held by the women in the two conditions, those who had received intensive advocacy services may have subsequently felt more supported by and empowered within their communities, resulting in a heightened overall satisfaction.

Women in both conditions indicated improvement between shelter exit and the 6-month follow-up on level of physical abuse, extent of psychological abuse, depression, fear and anxiety, locus of control, self-efficacy, emotional attachment to assailant, social support, and quality of life. Clearly, interviewing women while they are in shelters or immediately upon shelter exit provides only limited information about the effects of battering on women's overall well-being. Although interviewing people during periods of crisis can be important to our understanding of critical life events, we must be careful not to overgeneralize these findings to battered women's long-term psychological well-being.

This study is informative in two ways. First, there now exists experimental evidence that, although providing advocacy services to women upon their shelter exit resulted in short-term positive results, this intervention by itself was insufficient to create long-term change in the lives of women with abusive partners. Women who worked with advocates maintained a higher overall quality of life through their first 6 months postintervention, but there were no group differences at the 6-month follow-up on women's possession of resources or level of revictimization. Perhaps if advocacy were available to women, as they needed it, on an ongoing basis, longer term change would occur. On the other hand, there were and are system-level problems facing women that our advocates simply could not rectify. For example, while advocates were available to spend hours with women searching for affordable housing, they could not change the fact that very little decent, affordable housing existed. Similarly with legal assistance, while advocates would help women obtain restraining orders, they were working within a system that often ignores those orders. Therefore, we argue that advocacy services are a helpful and inexpensive way to assist individual battered women, if the services are available on an ongoing, "as-needed" basis and if they are offered while systems-level change is simultaneously being addressed.

The second contribution this study makes to the field of domestic violence is its ability to examine the process involved for women after their exit from a shelter for women with abusive partners. Research studies that interview women only while they are residing at a shelter can be misleading regarding the mental health of battered women. Through repeated interviews we can examine changes in levels of depression, fear and anxiety, sense of personal control, violence, social support, emotional attachment to assailant, self- efficacy, and quality of life. Not surprisingly, this research found that women improved on all these dimensions between shelter exit and their 10-week interview. Further, between the 10-week interview and the 6-month follow-up, women reported less attachment to their assailants and an increase in their sense of personal control, while the other variables appeared to level off. This indicates that (a) women who utilize shelters are quite resilient despite numerous obstacles, and (b) some psychoemotional characteristics continue to change at least 6 months after their shelter stay.

Leaving an abusive man was associated with lower economic status within this sample, as more "uninvolved" women were living below the federal poverty line and were more likely to be receiving governmental assistance. We did not, however, detect a direct link between possession of other resources (such as housing, employment, transportation, child care) and experience of violence. Further analyses are underway to examine potential causal and correlational relationships over additional time periods, but one explanation for why no other differences were found could simply be that there was too little variability in the overall poverty level of this sample. Most of the women were so impoverished and had access to so few resources that our group differences were, in reality, often between women doing badly and women doing very badly. Of the women who were employed, most were in low-paying, low-status jobs. Women in school were often trying to complete their high school educations. Therefore, we were unable to compare economically successful women from economically impoverished women because the number of women doing well financially was so small.

Although we did not substantiate that access to nonfinancial resources (housing, employment, child care, etc.) influenced a woman's ability to escape intimate violence, we also did not confirm the alternative hypothesis that access to such resources did not influence this ability. So few of the women in our sample had access to a high level of resources that such comparisons were not possible. Perhaps over time, if more women are able to significantly improve their situations, additional analyses can examine the effects of community resources, community response, and social support on women's decisions to remain in or leave abusive relationships and on their success in remaining free of their partners' and expartners' violence.

In conclusion, advocacy services alone do not appear to dramatically affect a woman's ability to remain free of intimate violence. This is hardly surprising, given the complexities involved for women with abusive partners. One would not expect one remedy or one solution to make all the difference in a woman's success in escaping abuse. It has been argued, for example, that arrest alone, with no additional sanctions, is insufficient to decrease intimate male violence. Shelters, too, while offering a vital and necessary community service, do not always in and of themselves reduce the amount of intimate male violence a woman will experience. That does not mean, however, that each of these services is unimportant. Rather, all of these components must be a part of a larger, comprehensive package that coordinates community response to batterers and their victims. Only then can we expect to see a serious decrease in the level of male battering of women.

3 A table providing a breakdown of these demographic variables for all project participants by condition assignment can be found in Sullivan, Tan, Basta, Rumptz, and Davidson (1992).

4 The extensive procedures involved in tracking participants over time can be found in Rumptz, Sullivan, Davidson, & Basta, 1991.

5 Unfortunately we neglected to ask women who were no longer involved with their assailants whether they continued to be psychologically abused by them.

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