Perceptions of Women Receiving Services from
Domestic Violence Advocacy and Counseling Programs
Chapter 1: Introduction to the Study
The purpose of this study was to explore the perceptions of victims of domestic
violence (DV) about advocacy and counseling programs that provide women safe refuge,
prevention education, mental health treatment and other services. I also explored the risk
factors for being re-abused as a DV victim. Little is known about the extent to which
women victims of domestic violence receive the help they need from these services. The
perceptions of women who pass through these services can help to inform larger
quantitative studies and future research. Greater awareness of how women view advocacy
and counseling programs and their perceptions of risk factors for re-abuse may provide
DV victims helpful information for program improvement.
Chapter 1 will provide the study background, problem statement, study purpose,
nature of the study, assumptions, scope and delimitations, limitations, and significance.
The focus of research questions is on victims’ perceptions of advocacy and counseling as
program services. I used the health belief model ([HBM]; to theorize victims’ perceptions
of the services received and risk factors of being re-abused. In the chapter, I also describe
my use of a phenomenological design. In the definitions section, I define and interpret
key terms used throughout the study. Chapter 1 will conclude with significance, social
change implications, and a chapter summary.
Background
The populations impacted by intimate partner violence (IPV) include people of
every race, gender, culture, nationality, class, sexual orientation, and children. The
Centers for Disease Control and Prevention ([CDC]; 2015) described IPV as “physical,
sexual, or psychological harm by a current or former partner or spouse” (para.1). In
addition, the Domestic Violence Crisis Service ([DVCS]; 2015) described DV as an
“abusive and/or violent behavior used to control another family member or members”
(para. 1). As with IPV, “domestic violence can be physical, sexual, emotional, economic,
or psychological actions or threats of actions that influence another person” (USDJ, 2013,
para.1). According to the CDC (2011), there are four types of behavior associated with
IPV: physical violence, sexual violence, threats, and emotional abuse. However, Per the
CDC (2011), “IPV victims are also more likely to suffer economic and social abuse.”
Kaukinen and Outlaw (2009) concluded that perpetrators use nonphysical abuse more
than physical abuse.
IPV is a major public health problem. Per the CDC (2011), “4.8 million women
experience physical assaults each year,” while the National Intimate Partner and Sexual
Violence Survey (NISVS) (2011) estimates that 12 million women a year, which is
equivalent to a national average of 24 individuals per minute, are victims of IPV. Per the
CDC (2011), “In 2007, the number of deaths in the U.S. related to IPV was 2,340 which
accounted for 14% of all homicides” (para. 2). Kaukinen (2004) has reported that
physical abuse occurs in 4% of all relationships, but it is greater for women who are
minority, physically handicapped, or have an alcoholic partner.
Many studies have explored the effects of non-physical and physical abuse on the
abused. A victim of DV may not display visual scars of being abused; however,
nonphysical abuse can be as damaging as physical abuse. Outlaw (2009) reviewed
research on the effects of nonphysical abuse (emotional, social, and economic) in the
general population and among those who are currently experiencing physical abuse.
Effects include destruction of one’s self-esteem, self-criticism, criticism of others,
jealousy, or dependence upon the abuser (see, also, Peace, 2009). Shelter and counseling
services provide victims of abuse with resources to counter the effects of physical and
nonphysical abuse (Outlaw, 2009).
Evaluations of counseling and shelter services determined there is a need for these
services. In a study of DVvictims, Dichter and Rhodes (2011) reported that 38.6% used
counseling services and 57.9% were interested in counseling services; 62.5% saw them as
a current need, and 56.6% believed that they had helped them feel safer. However, the
requests for victims receiving advocacy and counseling services are not being met due to
limited resources. From an examination of the National Census of Domestic Violence
Services, Lyengar and Sabik (2009) reported that within a 24-hour-survey, there were
5,000 requests for services that could not be met due to lack of resources. Many of the
services include emergency shelter, transitional housing, counseling, and advocacy
(Dichter and Rhodes, 2011). Lyengar and Sabik (2009) concluded that individuals living
in rural and poorer areas have higher rates of unmet request.
This study is needed because little is known about advocacy and counseling
services provided or the victims being served. Domestic violence shelters assist victims
by providing safe shelter and personalized services to meet individual needs. Counseling
services provide the abused with interventions that consist of mental support, healing, and
education. In their study, Haj-Yahia and Cohen (2009) reported on the lived experience
of battered women residing in shelters. The perceptions of the DV victim life experiences
while staying at the shelter were viewed as being an encouraging and supportive
environment. It is important for this study to understand more about advocacy and
counseling services and how these programs can assist victims of DV and can help
revictimization.
Domestic violence shelters provide two types of services (advocacy and
counseling services) to provide victims of abuse with resources to build independence.
The main purpose of shelter and counseling centers is to provide the abused with
education and safety as a measure of healing (Pennington-Zoellner, 2009). In addition,
Grossman, Lundy, George and Crabtree-Nelson (2010) reported that shelters are more
likely to offer counseling and advocacy that meet the needs of the abused and which
continue to help women after they leave.
When counseling services are not offered within the shelter, DV victims are
recommended to other centers to help meet their needs. According to Kujipers, van der
Knapp, and Winkel (2012), “Victims of IPV are known to be at high risk of being
revictimization” (p. 33). Therefore, an effective intervention of counseling and advocacy
can help reduce victims of domestic violence from further revictimization. Victims who
seek and receive advocacy and counseling services have increased knowledge, improved
decision making, safety, self-efficacy, and empowerment to rebuild their lives (Ramsey,
2010). According to Fugate, Landis, Riordan, Naureckas and Engel (2005), many women
are not fully aware of the available resources, or access to these resources may be
prevented from their abusive partner, or they may not believe their abuse is severe
enough to seek help.
Problem Statement
DV is a serious public health concern. According to United States Department of
Justice ([USDJ], 2013), DV is “a pattern of abusive behavior in any relationship that is
used by one partner to gain or maintain power and control over another intimate partner”
(para. 1). DV is a crime that continues to increase and is underreported (Plichta, 2007).
Intimate partner violence against women (IPVAW) poses a serious health risk to victims (Plichta,
2007). Risks associated with IPVAW include poor mental health and an increased use of drugs
and alcohol (Plichta, 2007). However, the victims of IPVAW are least likely to use health care,
even though an increase in health problems are associated to IPVAW (Plichta, 2007).
There are many community-based DV programs that offer shelter, counseling,
domestic violence hotlines, and advocacy services (Lyengar & Sabik, 2009). For
example, advocacy programs provide victims with legal, medical, and social services.
Counseling programs provide overall support for the victims and their families (Lyengar
& Sabik, 2009). Previous research have addressed the need for why advocacy and
counseling programs services are necessary for victims of domestic violence. Both
advocacy and counseling services are designed to provide support to help the abused with
safety, education resources, and mental counseling for emotional and physical abuse in
addition to other services (Lyengar&Sabik, 2009). According to Lyengar and Sabik
(2009), community-based DV programs play an important role in the community.
In conducting this qualitative study, I sought to contribute to knowledge on shelter
intervention and prevention measures based on DV victims’ perceptions. Very little
attention has been given to victims’ perceptions of these services, including the extent to
which these services are actually providing the assistance that victims need, and the ways
in which the services could be better. In fact, there is a limited amount of literature
available specifically on shelter-based services.
Purpose of Study
The purpose of this study was to explore the perceptions of women who have
received services from DV advocacy and counseling programs. Support services are
empowerment tools that provide victims with resources and options to deal with their
current situation (Goodman & Smyth, 2011). In their study, Allen and Wozniak (2011)
stated, “During a lifetime, over half of all women will experience some form of physical
abuse within a domestic violence relationship” (p. 38). Even though there are many
advocacy and counseling programs, little is known about women’s perceptions of these
services. It is hoped that the results of this study will contribute to the development of
more effective advocacy and counseling programs that provide victims with the resources
they need.
Research Questions
RQ1: What was DV victims’ awareness of advocacy and counseling service prior to their
abuse?
RQ2: What are DV victims’ experiences of advocacy and counseling services that they
have received?
RQ3: What are DV victims’ perceptions of how advocacy and counseling services could
be improved to better serve their needs?
RQ4: What are the perceptions of DV victims of the role that advocacy and counseling
services play in preventing further abuse among domestic violence victims?
Theoretical Framework
I drew upon HBM, which was developed by Hochbaum, Rosenstock, and Kegels
(1958). Conceptual and theoretical frameworks are used in studies to reflect the
researchers’ assumptions and worldview about the phenomenon under study (Rocco and
Thatcher, 2011). According to Rocco and Thatcher (2011), “[a] theoretical framework is
built on a supportable premise or the extension of such premise through a logical path of
reported research and clear and clear reasoning” (p. 119). The theoretical framework
provides the foundation to analyze the perceptions and lived experiences of DV victims
who used advocacy and counseling services.
My purpose in using HBM was to explore DV victims’ perceptions of risk factors
associated with being re-abused and their perceptions of the services (counseling and
support programs) received. According to Thomas (2000), “HBM is based on value
expectancy theory that posits behavior is a function of the subjective value of an outcome
and the subjective expectation that a specific action will achieve that outcome” (p.19).
The premise of HBM is that victims will seek advocacy and counseling program services and
change their behavior based on the HBM theoretical constructs. The theoretical constructs of the
HBM are perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and
cues to action (Thomas, 2000). Perceived susceptibility refers to the extent to which people
consider themselves to be susceptible a health problem, and in this case it would refer to the
extent to which a victim of domestic violence believed they would be or had been victimized.
Perceived severity is how serious the victim believes the problem is. Perceived benefits determine
whether advocacy and counseling programs helped reduce the risk of re-abuse. Perceived barriers
are the negative factors that could arise after seeking help through advocacy and support services.
Some of the perceived barriers that may arise after seeking help may include fear of abuser,
threats, harassment, inadequate housing and financial resources. The last component (cues to
action) refers to what happened to cause the victim to seek help and want change. Self-efficacy is
another component of HBM because it allows victims of abuse to take action that influence
behavior change (Thomas, 2000). My interview questions of perceptions of DV advocacy and
counseling program users will be based on the HBM. Also, the interview questions will determine
how effective these programs are in increasing self-efficacy and empowerment.
Nature of Study
Phenomenology was appropriate for my study to explore in-depth and lived
experiences of domestic violence victims. A phenomenological design is important for
this study because it gives a more in-depth understanding of human behavior and focuses
on understanding the reasons for behavioral patterns. Also, phenomenology is an
appropriate study approach to explore the in-depth experiences of domestic violence
victims and will help encourage the abused through their own words to share their
knowledge, awareness, and perceptions of the services they received.
Semi-structured, opened-ended interviews were used to collect data on DV
victims’ perceptions and lived experiences related to the services they received. While
both men and women are victims of mental and physical abuse. This study will focus on
IPV against women. This study will also use a purposeful sampling of 9 to 10 women
who have used DV shelter services (advocacy and counseling programs). The use of
purposeful sampling is necessary to select participants based on their experience of the
phenomenon under investigation. Per Creswell (2007), a sample size of 10 is
recommended for data saturation. Data collection will consist of semi-structured,
openended, in-depth interviews with DV victims who have received advocacy and
counseling programs.
Definitions
The following key terms are used throughout this study:
Abuse: defined as: 1. a corrupt practice or custom. 2. an improper or excessive use or
treatment. 3. a deceitful act. 4. a language that condemns or vilifies usually unjustly,
intemperately, and angrily (Merriam –Webster’s online dictionary, n.d.). Abused:
defined as: 1. to wrongly or improperly; misuse: abuse alcohol; abuse a privilege. 2. to
hurt or injure by maltreatment; ill-use. 3. to force sexual activity on; rape or molest. 4.
to assail with contemptuous, course, or insulting words; revile. (The Free Dictionary,
n.d.).
Advocacy: “The act or process of supporting a cause or proposal: the act of process of
advocating something” (Merriam –Webster’s online dictionary, n.d.).
Counseling: Counselors may assist the abused by providing career counseling and
treatment options for DV victims who need employment or information and treatment
options for mental and substance abuse (Berry, 2000). Counselors are responsible for
educating the abused on DV and how they may be at potential risk for continued and
more severe violence (Hays et al., 2007).
Domestic violence: defined as:
“a pattern of abusive behavior in any relationship that is used by one partner to
gain or maintain power and control over another intimate partner. Domestic
violence can be physical, sexual, emotional, economic, or psychological actions
or threats of actions that influence another person. This includes any behaviors
that intimidate, manipulate, humiliate, isolate, frighten, terrorize, coerce, threaten,
blame, hurt, injure, or wound someone” (USDJ, 2013, para. 1).
Depression: “A mental disorder is often characterized by a lack of interest and pleasure in
daily activities, significant weight loss or gain, insomnia or excessive sleeping, lack of
energy, inability to concentrate, feelings of worthlessness or excessive guilt and recurrent
thoughts of death or suicide” (American Psychological Association, 2016). Economic
Abuse: Creating or attempting to make an individual dependent on the controller for
money or other financial assets, and denying the abused the ability to work or attend
social events (USDJ, 2013).
Emotional Abuse: is defined as “any kind of abuse that is emotional rather than physical
in nature. It can include anything from verbal abuse and constant criticism to more subtle
tactics, such as intimidation, manipulation, and refusal to ever be pleased” (Counseling
Center at University of Illinois, 2007, para 1).
Health Disparities: “differences between one population group in comparison to a more
advantaged group” that mostly “address issues of social justice and equity” (APA,2014,
para. 1).
Intimate Partner Violence (IPV): Same working definition as Domestic Violence.
According to the CDC, “Intimate Partner Violence (IPV) is a serious, preventable
public health problem that affects millions of Americans. The term “intimate
partner violence” describes physical, sexual, or psychological harm by a current
or former partner or spouse. This type of violence can occur among heterosexual
or same-sex couples and does not require sexual intimacy (CDC, 2014, para. 1).
Physical Abuse: Physical abuse “includes slapping, pushing or shoving to severe acts
such as being beaten, burned or choked” (NISVS, 2010, p. 37).
Revictimization: defined as: “To re-harm or re-commit a crime against (someone)”
(Merriam –Webster’s online dictionary, n.d.).
Survivor: defined as: “to remain alive: to continue to live” (Merriam –Webster’s online
dictionary, n.d.).
Victim: defined as: “a person who has been attacked, injured, robbed, or killed by
someone else” (Merriam –Webster’s online dictionary, n.d.).
Assumptions
In this study, it is assumed:
1. the participants will respond truthfully to the interview questions based on their
lived experiences and understanding of the questions being asked and
2. that participants’ current health beliefs predict later health behaviors, as posited
by the HBM.
These assumptions were necessary in the context of this study in order to ensure
the trustworthiness of the data collection and analysis. According to Creswell (2007) in
order to ensure substantive validation the researcher must clarify presumption from the
beginning of the study.
Scope and Delimitations
The scope and delimitations are limited to victims’ perceptions of their life
experiences of advocacy and counseling programs as services at domestic violence
shelters. The participants in the research study were survivors of domestic violence who
agreed to participate in the interview process. The study used participants that received
advocacy and counseling services within a community-based domestic violence shelter.
The objective of this study is to focus on the description of victims’ perception of
advocacy and counseling services at domestic violence shelters. Qualitative research is
not generalizable but transferable in which information can be applied to other context
and situations. This research was able to achieve a substantial description of the findings
that can potentially be applicable to future research or theory. Transferability in
qualitative methods seeks to discover an adequate description of a precise phenomenon
(Creswell, 2007). Some of the themes that emerge from this study could be useful in
future studies (qualitative and quantitative) of similar populations. According to Lincoln
and Guba (1985) external validity can be obtained through describing a phenomenon in
sufficient detail.
Limitations
A limitation of qualitative research is the inability of exploratory data to be
applied to the larger population. Within this study purposeful sampling selected
participants based on their use of advocacy and counseling services. Selection bias can
impact the trustworthiness the study data if the participants do not meet the selection
criteria. While, victims are able to receive services outside the shelters the main focus of
the study is to interview participants who received services within the shelter. The
limitation of purposeful sampling is that the research will not be generalizable to all
domestic violence shelters that have advocacy and counseling programs as services. This
limitation is acceptable in that the result will inform future research and larger studies.
Respondent bias is another limitation could be created study if participants are not honest
during the interview. Also, in this study self-selection bias can occur when the
participants are given the opportunity to decide if they want to participate in the research
study. Respondent bias can be minimized by making sure the research questions are
precise and clear. Self-selection bias can be reduced by making sure the participants are
representatives of the population beings studied. Also, reasonable measures to address
limitations within this study will be obtained through research credibility. The credibility
in data quality was established and validated through triangulation. According to Patton
(2002) the verification and validation of triangulation may involve checking for data
consistency within the sources and findings using different data collections.
Significance
This study can make a significant contribution to the literature related to domestic
violence advocacy and counseling programs, because it will describe ways that these
programs actually do help survivors of domestic violence, and ways that programs could
improve to serve unmet needs. Also, a thick descriptive qualitative data analysis can help
to inform readers who work at shelters or other organizations that offer advocacy and
counseling programs about the needs of victims. The goal of domestic violence shelters is
to provide services and programs to all women and men whether they have been abused
or not.
This study presented exploratory data to contribute to the knowledgebase related
to the role advocacy and counseling services provide to the abused, and what role users of
these services play in eliminating domestic violence. The social change implication of
this study is significant because it may increase awareness of how victims view advocacy
and counseling programs, and could help to inform larger studies. Data collection using
in-depth interviews captured the lived experiences and perceptions of the abused through
emerging themes identified in analyses. Data analysis helped to determine if advocacy
and counseling programs, as services, are actually helping the abused. The goal of
domestic violence shelters is to provide services and programs to all individuals and
survivors.
Summary
Chapter 1 discussed the background, problem statement, and study purpose
related to advocacy and counseling services. There have been numerous research studies
that explored many areas of domestic violence. However, little is known about the
victims’ lived experiences and perceptions related to advocacy and counseling programs
as services. The research questions formed by using the HBM framework will serve as
the foundation for understanding victims’ perceptions to advocacy and counseling
programs as services. The significance of this study is to obtain exploratory data on
advocacy and counseling services and determine if these programs are actually helping
survivors of domestic violence. Chapter 2, the literature review, will explore advocacy
and counseling programs as services to victims of domestic violence.
Chapter 2: Literature Review
Introduction
DV is a serious public health concern globally. Many women suffer physical,
emotional, and economic abuse. Psychological abuse, which has physical, emotional, and
economic aspects, can prevent the abused from seeking advocacy and counseling support
services (CITE). Hampton, La Taillade, Dacy and Marghi (2008) found that
socioeconomic disparities along with class and race result in fewer black women from
seeking advocacy and support services and reporting DV. The stigma associated with
abuse and the increase chances of facing further abuse prevent many victims of DV from
seeking advocacy and counseling support services (Hays et al., 2007). Peace (2009)
reported that DV can occur among all economic backgrounds but prevails in low
economic classes. Outlaw (2009) and Peace (2009) provided information on emotional,
economic, and physical abuse and the factors that lead to women being victimized.
Pennington-Zoellner (2009) reported that counseling services provide a level of
intervention to give the abused safety, healing, and education. Ramsey (2010) and Pyles
(2008) provided information on the importance of advocacy and their role in empowering
women of domestic violence to overcome the emotional and physical abuse. One of
the most important resources for women to overcome emotional and physical abuse is
domestic violence shelters. According to Pyles (2008), advocacy is important because it
focuses on offering personalized services tailored to meet the abused’s needs as well as
helping to provide safe shelter and access to community resources. According to Johnson
and Zlotnick (2009), domestic violence shelters are places where victims of DV can
receive support, counseling services, advocacy, and referrals to additional services based
on their needs. The role of advocacy a service within the shelter is extremely important to
the mental and physical health status of domestic violence victims (CITE). However,
shelter services often go unused (Grossman & Lundy, 2011).
Advocacy services focus on personalized services tailored to the abused needs,
and provides safe shelter and access to community resources (Pyles, 2008). Counseling
services use counselors to assist the abused by providing career counseling and treatment
options for DV victims who need employment or information and treatment options for
mental and substance abuse (Berry, 2000). Also, counselors are responsible for educating
the abused on DV and how they may be at potential risk for continued and more severe
violence (Hays et al., 2007).
The purpose of this qualitative phenomenological study is to explore counseling
and advocacy programs as services to victims of domestic violence. It is important to
explore counseling and advocacy programs because little is known about the extent to
which female victims of DV receive the help they need from these services. Domestic
violence is a widespread problem affecting all aspects of society. In order to stop
domestic violence, there must be resources readily available to assist victims and
knowledge as to whether these resources are actually helping the victim. This study will
explore the different ways counseling and advocacy programs assist victims of domestic
violence. The exploratory data obtained to understand how counseling and advocacy
programs will assist the abused and will attempt to summarize the gap in the literature
that helped facilitate this study.
Chapter 2 will start with a brief history and summary of domestic violence and
how the concept has been defined. Also, the literature review will discuss the major
critical aspects of domestic violence such as, physical abuse, emotional abuse, economic
abuse, advocacy, and counseling program services.
Literature Search Strategy
A literature search was conducted using Academic Search Complete, ProQuest
Central, EBSCOhost, PsycARTICLES, MEDLINE, Google Scholar, and SocINDEX.
The search terms used to locate the articles were the following: domestic violence,
intimate partner violence, advocacy, abuse, counseling, economic abuse, mental abuse,
physical abuse, non-physical abuse, spousal abuse, service, social disparities, support
services, health belief model, knowledge, perceptions, experience, and shelter. The
websites of CDCand Prevention and Ohio Domestic Violence Network were used to
obtain additional information. Also, electronic and print sources were reviewed for this
research. The results of the peer reviewed full text articles and publications were limited
to the last 5 years. However, there were a few studies used for informational purposes in
the literature review that were more than 5 years old. There was limited research using
qualitative approach, specifically a phenomenological design on this topic that addressed
victims of abuse who used advocacy and counseling services at domestic violence
shelters. However, the findings within the peer reviewed articles and publications were a
representative review of an exhaustive review of the literature, constructs of interest,
methodology and key concepts that are relevant to this study.
I included7 articles that had been published within the past 5 years related to the
concept of interest consisting of nonphysical and physical abuse, socioeconomic
disparities, and advocacy and counseling programs. An exhaustive literary review of
shelter-based advocacy and support programs were performed to gain knowledge of how
these types of services help the abused. However, I found a limited amount of literature
available specifically on shelter-based services. In my literature review, I was able to find
several studies conducted by public and private organizations that offer a range of
resources to victims of DV and their families. There was a limited amount of published
studies published within the last 5 years related to the research questions. There were
also14 articles that were used for informational purposes only.
Structure of Review
In this chapter, the following topics will be covered: conceptual framework for
the Health Belief Model, history of domestic violence, impact of domestic violence on
race, gender and support services, non-physical aspects of domestic violence, physical
aspects of domestic violence, social support services (counseling and advocacy), and
domestic violence shelters. In addition, a synthesis of findings will be provided after each
section.
History of Domestic Violence
One of the earliest incidences of violence against women can be dated back to 750
B.C. during the reign of Romulus in Rome (Lemon, 1996). Under The Laws of
Chastisement the husband was given rights to discipline his wife (Lemon, 1996). From
the earliest incidence in 750 B.C., until the late 19th century and 20th century the
violence perpetrated against women was often kept hidden from the society. However, it
was the advocacy of the feminist movement in the late 19th century and 20th century that
brought violence against women to the forefront of society. Chrisler and Fergusen (2006)
stated that violence perpetrated against girls and women is “an abuse of power in the
course of the domination, intimidation, and victimization of one person by another, often,
but not always, in the context of a relationship” (p. 235).
The strong emergence of the feminist movement in the 1900’s helped established
domestic violence shelters to provide victims with services and in the process raise public
awareness of IPV (Barner & Carney, 2011). However, as the number of shelters grew the
funding did not keep pace (Barner & Carney, 2011). According to Barner and Carney
(2011), “A reprieve came with the passage of the Victims of Crime Act (1984), which
initiated a broad-based federal funding process while an amendment of the law in 1988
established compensation funds for IPV victims” (p. 237). In 1988, the Violence against
Women Act (VAWA) was established to improve the needs and problems of the abused
by improving the criminal justice system and community-based social service response
(NCADV, 2005). The impact of domestic violence has drastically changed individuals
and family lives in the twenty-first century. Today domestic violence is recognized as a
serious health problem that crosses all racial, gender, cultural, and socioeconomic
backgrounds.
Non-Physical Domestic Violence
Non-physical abuse may consist of emotional, psychological, economic and social
abuse (Outlaw, 2009). Victims of physical abuse by their partners are more likely to
experience the inflictions of non-physical abuses that consist of emotional, economic,
social, and psychological abuse (Outlaw, 2009). Past study indicated that women
identified they had experienced non-physical abuse, but did not recognize non-physical
abuse as a form of violence (Outlaw, 2009; Miller, 1995).
In a current study using Tjaden and Thoennes (1998) survey data, researcher
Outlaw (2009) examined the rate of non-physical abuse (emotional, social, and
economic) in the general population, and among those who are currently experiencing
physical abuse. The analysis consisted of a subsample (n= 11,291) of individuals with
partners. The results strongly indicated that experiencing non-physical abuse put one at
higher risk of further abuse than would be the case for people who have not been abused
(Outlaw, 2009). However, these are not true prevalence data (which are quantitative and
based on large populations), but rather estimates based on small studies that may not have
been well controlled.
Economic Abuse
Economic abuse is defined as “making or attempting to make an individual
financially dependent by maintaining total control over financial resources, withholdings
one’s access to money, or forbidding one’s attendance at school or employment” (USDJ,
2013, para. 5). While recognized as a component of domestic violence, economic abuse is
rarely recognized as abuse, leaving the abused limited to social support services (Shobe
& Dienemann, 2008). These findings are supported by the research of Shobe and
Dienemann (2008), who indicated domestic violence, is three times more likely to happen in
relationships that experience wealthier household levels than relationships with poorer household
levels. Pennington-Zoellner (2009) argues that a lack of economic security restricts women from
leaving their abusive partner. However, more recent research suggests that within economic abuse
DV victims are more likely to suffer severe violence because their partner may be unemployed or
work in a low paying job (Peace, 2009). The role of counseling services is important to help the
abused gain knowledge and awareness through community support.
Emotional Abuse
There are many emotional abuse problems associated with victims of domestic
violence. According to Outlaw (2009), “Emotional abuse involves comments, actions,
insults/put-downs, name-calling, public embarrassment, or even accusations intended to
undermine the victims self-respect and sense of worth” (p. 264). Outlaw (2009) found
that many women who experience domestic violence are likely to suffer from emotional
abuse. The effects of emotional abuse can include the victim being isolated from family,
and her self-esteem being destroyed (Peace, 2009). However, the lifelong effects women
face from physical abuse can be just as devastating. Outlaw (2009) reported that when the
abuser used both emotional and social abuse they were more likely to inflict physical
abuse.
Findings reported that respondents (n= 134) from 21 focus groups believed that
nonphysical abuse can be more detrimental and enduring as physical abuse (Seff et al.,
2008).
In their study, researchers Seff, Beaulaurier and Newman (2008) used maximum
variation sampling measures to recruit participants into 21 focus groups that investigated
nonphysical violence in older and middle age women. The participants reported that
nonphysical abuse had negative effects on “self-esteem and self-image”, and recovery
from non-physical violence can be slow or non-existent (Seff et al., 2008, p. 362). The
strength of this study is that the findings are consistent with other studies. The weakness
of this study was the study participants did not represent older women in the geographic
area, which contributed to bias in the sample measures and analysis.
Emotional abuse can damage the victims’ sense of self. In a recent mixed methods
study using the grounded theory approach, Lynch (2013) explored how 100 women
believed partner violence impacted their perception of self. According to Lynch (2013)
“82% of the women indicated their partner yelled or screamed at them, 70% reported
their partner swore at them, 57% reported their partner was critical of their appearance,
and 58% believed they were being monitored” (Lynch, 2013, p. 226). The strength of
Lynch’s (2013) research study is that it could be used as an implication tool for battered
women. The weakness of this study was that participants were selected based on an
advertisement asking if they been hurt or had a conflict with their partner with the past
year (Lynch, 2013). Also, the population of women selected was not chosen from a
domestic violence shelter.
In view of these statistics, and to support the key concepts of the literature review,
it can be concluded that emotional abuse can impact victims’ sense of self. According to
Lynch (2013), “Self-in-relation theory, specifically developed to explain women’s sense
of self, posits that individuals define their self through their relationships with others (p.
221). The review of current research literature indicated emotional and economic can
prevent the abused from seeking advocacy and counseling support services. The victims’
perceptions of advocacy and counseling services used to treat emotional and economic
abuse will help fill the gap in literature if these services are actually helping the victims.
Physical Aspect of Domestic Violence
Physical Abuse
Physical abuse “includes slapping, pushing or shoving to severe acts such as
being beaten, burned or choked” (National Intimate Partner and Sexual Violence Survey
(NISVS), 2010, p. 37). The World Health Organization (WHO; 2012) described two
different types of physical abuse as moderate or severe. The WHO (2012) reported
women who experienced moderate or severe physical abuse had experienced emotional
physical abuse. Outlaw (2009) argues that physical abuse is correlated to non-physical
abuse. The WHO (2012) also reported moderate physical abuse was interpreted as using
open hands to inflict physical harm such as, slapping, pushing, and shoving. Also, severe
physical abuse is interpreted as the use of direct threat that involve punching, kicking,
and use of weapon (WHO, 2012). In a 12-month study, NISVS (2010) reported that
approximately 32.9% of women in the United States have suffered physical abuse from
their intimate partner. Recent research has determined that women who experience
physical violence from their partner are more likely to seek treatment from an emergency
room (Peace, 2009).
There is some evidence that individuals who experience physical abuse have also
experienced non-physical violence. In a current descriptive study, researchers Simmons,
Lehmann, and Collier-Tenison (2008) compared women in domestic violence offender’s
program with women in domestic violence shelter on their partner controlling behavior.
Both groups reported high levels of physical, emotional, and controlling behaviors;
however, the women in domestic violence shelter reported their partner had considerably
more abusive and controlling behavior. The strength within this study was the implication
for future research on domestic violence victims service needs. The weakness within this
study was that the level of violence could have been overestimated because women in the
offender program may have “willingly responded in a violent manner to their experiences
of domestic violence” (Simmons et al., 2008, p. 391). Also, the women responses could
have been used to make them look favorable, and the women selected may not be
representative to the entire population (selection bias) which would potentially affect the
study findings (Simmons et al., 2008). In view of these statistics and to support the key
concepts of the literature review it can be concluded that individuals who experience
physical abuse have also experienced non-physical violence. In addition, the two aspects
of psychological abuse (emotional and economic) can hinder the abused from seeking
advocacy and counseling support services.
The emotional, economic, and physical abuse DV victims’ experienced will help
contribute to the knowledge base of shelter intervention and prevention measures using
the victims’ perceptions. The perceptions of DV victims’ will help fill the gap in
literature if shelter advocacy and counseling programs are actually providing the abused
with the necessary assistance.
Public Policy Related to Domestic Violence
According to Schneider (2008) the seriousness of domestic violence has
facilitated changes in the law. As a result, on August 12, 2012, an executive order was
issued by the President of the United States to globally improve gender equality and
empowerment by advancing womens’ and girls’ rights (The White House, 2012).
Therefore, under the executive order, it is required “U.S. government agencies and other
stakeholders increase coordination of gender-based violence prevention and response
efforts” (The White House, 2012, para. 3). Also, the executive order will increase U.S
government programs that administer gender-based violence (The White House, 2012). It
has been recently studied that women who experience domestic violence often share
experiences on the nature of abuse and how the abuse seemed to develop over time (Ard
& Makadon, 2011).
Domestic Violence Shelters
Awareness of Shelter
Domestic violence shelters are an extremely important resource to battered
women. According to the National Coalition against Domestic Violence (NCADV)
(2008), domestic violence shelters provide 300,000 women and children a safe place to
stay each year. In addition to offering a safe place to stay, they offer a wide range of
programs for the abused such as, advocacy, mental health, support, and referrals to social
service services and legal resources, reflecting the fact that the most important time to
offer intervention and changes in an abused life is after a woman enters a domestic
violence shelter (Johnson & Zlotnick, 2009).
Domestic violence shelters are particularly beneficial to women who were in a
very violent relationship (Panchanadeswaran & McCloskey, 2007). However, the abused
is often directed to shelter through many channels of referrals such as law enforcement,
domestic violence advocate, domestic violence hotline, family, friends and etc. Equally
important, when domestic violence victims finally escape their abuser their main concern
is a place of safety. According to the National Network to End Domestic Violence
(NNDEV) (2011), the primary need of shelter is particularly important because of the
dangerous situation a domestic violence victim face. Domestic violence shelters establish
rules for victims to follow for their protection and others who reside within the haven.
Haj-Yahia and Cohen (2009) stated in most shelters smoking, alcohol, psychoactive
substances, and telling the location of shelter is prohibited. Emergency shelter is one type
of service the abused choose to access through domestic violence shelters.
Access to Shelters
For many victims who are escaping their abuser domestic violence shelters can
mean the difference between life and death (Baker, Billhardt, Warren, Rollins and Glass,
2010). Domestic violence shelters are beneficial to the abused because it provides women
a place of safety in a confidential location away from their abuser (Baker et al., 2010).
However, the needs of victims often are unmet due to the limited amount of space
available within domestic violence shelters.
In a recent study based on National Census of Domestic Violence Services,
researchers Lyengar and Sabik (2009) examined the “National Census of Domestic
Violence Service, an innovative safety focus survey, to count services provided by more
than 2000 programs” (p. w1052). The study determined by a 24-hour-hour survey more
than 5,000 requests for services could not be met due to lack of resources. Many of the
services included emergency shelter, transitional housing, counseling, and advocacy. The
survey also determined that individuals living in rural and poorer areas have higher rates
of unmet need. Also, services are limited to individuals who reside in an area that is
predominately populated by black or Native Americans. The impact of domestic violence
in minority communities can increase inequalities. In comparison, Hampton, La Taillade,
Dacy and Marghi (2008) believed the factors of socioeconomic disparities along with
class and race can hinder many black women from seeking advocacy and support
services, and reporting domestic violence. A high rate of domestic violence and
socioeconomic disparities occurs within the Native American Community. Even more
revealing than the fact that socioeconomic disparities, class, and race can hinder women
from reporting violence is the demand of services that are unmet each day because of
resource restraints.
The strength of the study was it is consistent and supports the key concept on how
socioeconomic disparities are major factors that can hinder women from reporting
violence. A limitation of the study is due to resource restraints, the chances that an abused
woman actually receives advocacy and support services are almost nonexistent depending
on the area in which they reside. In view of these statistics and to support the key
concepts of the literature review it can be concluded socioeconomic disparities are a
major component that limit the abused from reporting abuse. However, if the request for
services is unavailable due to lack of resources to DV victims’ the abused will not receive
the necessary assistance of advocacy and counseling programs to rebuild their lives. In a
national survey the NNEDV (2011) reported that on September 5, 2011in the United
States:
•There were 67,399 victims served.
•Approximately 36,332 domestic violence victims found refuge in emergency
shelters or transitional housing provided by local domestic violence programs.
•More than 10,000 victims’ requests were unmet for services, including emergency
shelter, housing, transportation, childcare, and legal representation (para. 1).
Motels are another form of emergency shelter offered to the abused, primarily
when local shelters are full occupied. Many community domestic violence shelters have
arrangements with local motels to provide emergency shelter to victims and their family
for a specified period (Baker et al., 2010). While motels can provide a haven for the
abused, many of the services provided at domestic violence shelters become limited
(Baker et al., 2010). According to Clevenger & Roe-Sepowitz (2009) victims with
children are more likely to seek shelter than victims without children. Often when the
abused seek shelter they are more fearful about the safety of their children (Clevenger &
Roe-Sepowitz, 2009). However, Grossman et al., (2010) argued that shelters are more
likely to offer counseling and advocacy that meet the needs of the abused, and continue to
help women after they leave. Grossman, Lundy, George, & Crabtree-Nelson (2010)
acknowledge that domestic violence victims have a greater opportunity of receiving
counseling services while in shelters, but report that not all shelters offer 24-hour
emergency service to the abused, so that many of the abused must find a place to sleep
(Grossman and Lundy, 2011).
Clevenger & Roe-Sepowitz (2009) conducted a quantitative study to examine
which variables, if any, would influence the abused to use shelter services or not to use
shelter services. There were (n= 265) females and (n= 18) males recruited as sample
participants. The study findings determined that individuals with children were more
likely to utilize shelter services (Clevenger & Roe-Sepowtitz, 2009). Also, individuals
who suffered physical abuse were more likely to utilize shelter services (Clevenger &
Roe-Sepowitz, 2009). The strength of this study was the implication for practice to
understand why the abused chose not to seek shelter. Also, the implication to additional
training and education could help increase the worker’s response to calls received from
victims (Clevenger & Roe-Sepowitz, 2009). The weakness in the study was the crisis
center had 3 males working during the study period and could have influenced the
victims’ decision when seeking shelter services (Clevenger & Roe-Sepowitz, 2009).
In addition, this study focused on domestic violence shelter as a service to the
abused. As stated earlier, in a cross-sectional study, researchers Dichter and Rhodes
(2011) administered a self-report questionnaire to (n= 173) adult women. Within this
study, there were 24.8% who used DV shelter; 29.9% who were interested in this service;
28.7% see it as a current needed service; and 38% who thought it help them feel safer.
The strength of this study was the self-administered survey determined an interest and
current need of the abused receiving shelter service. The weakness is the participants
were recruited from the emergency department and community based services using
nonrepresentative samples.
Similar findings were also reported by Panchanadeswaran and McCloskey (2007)
who based their quantitative study on “secondary analysis of a 10 year longitudinal data
set that studied intergenerational transmission of aggression” (pg. 52). Within their study,
a subsample of 100 women was chosen from the initial 192. There were several factors
that led to initial women being chosen for this study. For example, there were 43 women
who were lost to follow-up; 39 became separated before the study began; 7 could not
provide the date they left the shelter, and 3 had responses that were not consistent. On the
strength side of the domestic violence shelters, result from the longitudinal study of 100
women using history analysis (Panchanadeswaran and McCloskey, 2007). Also, the study
discovered was that 81.8% of women who utilized shelters had also ended their abusive
relationship. The initial participants were recruited through posters and domestic violence
shelters. Also, the data collected was not used for research purpose; therefore, in-depth
questions were not administered or response categories in were narrow.
Effectiveness of Shelters
Shelters serve as an establishment of social change because it has the ability to
change behavior, attitude, and beliefs of the abused (Haj-Yahia & Cohen, 2009). In their
study, Haj, Yahia & Cohen (2009) used a phenomenological approach to examine the
victims’ perception of their stay at the shelter. The in-depth semi-structured interview
was administered using a purposive sample of (n=18) women. The four themes generated
from the analysis were, the abused shelter perception; the abused perception on life
experiences and herself; perception of other women in the shelter; and perception of staff
members (Haj et al., 2009). The women viewed the shelter perception as being an
“environment bond by rules, obligations, and regulations” (p. 98). The perception of the
abused and her life experiences while staying at the shelter were viewed as being an
encouraging and supportive environment (Haj et al., 2009). The abused perception of the
other women staying in the shelter was viewed as being negative experiences (Haj et al.,
2009). Most of the women viewed their experiences with other women in the shelter as
being tensed, unpleasant, deceitful, and etc. (Haj et al., 2009). However, the results of the
analysis from the victims’ perception determined most of the women were satisfied with
their staff members (Haj et al., 2009). The limitation within this study was the abused
perception of the services received was not included in the study. The strength of this
study was the researchers did offer a comprehensive perception of the abused residing in
a violence shelters. Also, the implications of this study can be used to improve the
relationship between the abused and staff members.
In the review of current research literature and studies, it can be determined that
domestic violence shelters are extremely important to the abused to not only receive
emergency shelter, but to receive the necessary resources to make them feel safe. Current
research literature and studies indicates that shelters are more likely the first place the
abused will seek. In support of the research questions and gap in literature DV shelters
may offer the abused with an array of resources for them and their children. For example,
shelters provide protection, food, clothing, transitional housing, transportation, mental
support and etc. DV victims’ perceptions on advocacy and counseling services provided
at the shelters will help understand the gap in the literature if these services are actually
providing the necessary assistance.
Advocacy
Domestic violence advocates are part of the public health practice because they
operate as a joint force with collaborative partnerships (available resources from state and
federal government, etc.) and the community. The involvement of advocacy, as a support
service in shelters is important because it serves as a social support network within the
community to give individuals a sense of emotional and physical comfort that they
belong to a community of people who care about them and value how they feel.
According to Ramsay, Carter, Davidson, Dunnel, Eldridge, Feder and Hegarty et al.,
(2009) advocates serve as a connection that empowers and link the abused to community
services. Domestic violence advocates play an important role in helping women
overcome the emotional and physical scars inflicted on them by their abuser. Advocacy is
important to victims of DV because it improves self-efficacy through empowerment, and
helps the abused determine how to better their situation through support services
(Ramsey, 2010). According to Pyles (2008) advocacy is important because it focus on
personalized services tailored to the abused needs, and provides safe shelter and access to
community resources. A partnership of DV shelters and community participation can
allow individuals to feel a degree of connectedness to other individuals; which can help
the community’s health by improving self-efficacy and by helping individuals cope with
many physical and mental needs.
While there are many cultural barriers that deter women from reporting domestic
abuse, a primary reason why abuse goes unreported is the stigma associated with being
abused and the increase chances of facing further abuse (Hays et al., 2007). In order to
understand this issue, in a research study Hays et al., (2007) discovered there are roughly
90% of women who fail to report their abuse. However, Pyles (2008) reported 67%
women who received a protection order experienced a decrease in harassment and contact
from the abuser. In addition, Pyles (2008) reported that a fear of the legal process was the
reason why the victim experienced a decrease in harassment and contact from the abuser.
Therefore, the role of advocacy is extremely important to the mental and physical health
status of domestic violence victims; however, the utilization of these services often goes
unused (Grossman & Lundy, 2011).
In a recent study, Grossman and Lundy (2011) data were collected using
secondary analysis comparing women who utilized shelter resources and those who did
not obtain shelter. A random sample of women (n= 2500) those who obtain shelter and
(n= 2500) those who did not obtain shelter was used in the quantitative analysis. The
study findings indicated that women who received shelter obtain more of the shelter
resources than women who choose not to seek shelter (Grossman & Lundy, 2011). Also,
those who obtain shelter services were more likely to receive legal advocacy to help with
criminal charges and protection orders than those who choose not seek shelter (Grossman
& Lundy, 2011). The strength of this study was acknowledgement that shelter services
offer an array of helpful needed resources to those who seek help. The weakness of this
study was the outcome of the services the abused received.
According to Allen, Larsen, Trotter and Sullivan (2012) women who worked with
advocates had an “improvement in mental health outcomes, reported less violence, and
greater quality of life” (p. 4). In their study, researchers Allen et al., (2012) examined the
delivery process of the Community Advocacy Project (CAP) intervention on survivors of
domestic violence. A Qualitative analysis using semi-structured interviews of 51
survivors’ interviews responses determined that 3 main service delivery elements of CAP
helped them receive successful supportive service. The 3 services delivery elements are
community-based advocates being non-judgmental, engaging emotional support, and
advocates being accepting and validating to survivors (Allen et al., 2012). The strength of
the study indicated CAP was able to determine that survivor centered advocacy, and their
goal to provide services and programs to all women and men whether they have been
abused or not. The weakness of this study was the participants were asked about their
experiences with the program which could have led to overly positive responses. In a
view of this study, it can be reported that advocacy is a needed service that support the
abused by helping them feel validated without being judgmental, but at the same time is
able to support the abused with emotional support and etc.
The review of current research literature and studies help support the research
questions and gap in literature that counseling is a critical support service that assists the
abused through many different phases (mental treatment, education resources, promoting
safety, etc) to help them reclaim their lives. The perceptions of the victims will help
determine and fill the gap in literature if counseling service is actually assisting victims
with critical support service.
Counseling
The two different types of support services available to domestic violence victims
are short-term and long-term counseling. However, the needs of the victims will
determine what type of intervention is appropriate. Ramsey (2009) reported that
shortterm advocacy can consist of one single meeting that can last approximately 12
hours.
However, the study’s findings further revealed that long-term advocacy (numerous
meetings that will last more than 12 hours) is usually required when the abused have
necessities that require a longer level of intervention (Ramsey, 2009). While, counseling
centers provide necessary resources for the abused to reclaim their lives. The main
purpose of counseling centers is safety and healing (Pennington-Zoellner, 2009). In their
research study, Pennington-Zoellner (2009) reported that counseling centers provide the
abused with “education and counseling” while DV shelters provide the abused a haven
(p. 540). According to Hays, Green, Orr and Flowers (2007) advocacy counseling for DV
survivors’ responsibility is to “provide interventions that promote client empowerment,
create sociopolitical changes, and support client and community welfare” (p. 185). The
study’s finding further revealed that counselors may help the abused feel as though they
belong to the community by altering their perception (Hays, Green, Orr and Flowers,
2007). In addition, Hays et al., (2007) believed that counselors are responsible for
educating the abused on DV and how they may be at potential risk for continued and
more severe violence. The most critical part of counseling is the initial visit when
counselors can help promote the safety of the abused by helping them identify escape
routes, safe places to go, making an escape kit (money, keys, phone numbers etc.) just in
case the abused choose not to return to counseling (Hays et al., 2007). Additionally,
Ramsey (2009) established that the resources available at DV shelters offer many health
benefits to victims of domestic violence.
Current research studies indicate that counseling services are not able to support
the treatment of the abused women. In the following study, the use of counseling services
for treatment of the abused was examined. In a cross-sectional study, researchers Dichter
and Rhodes (2011) administered a self-report questionnaire to (n= 173) women. The data
collected indicated that 38.6% used counseling services; 57.9% were interested in
counseling services; 62.5% see it as a current need, and 56.6% believe it help them feel
safer. The strength of this study indicated an interest and a need for counseling services
among victims of abuse. The weakness within this study is the participants were from
non-representative samples recruited from an emergency department and community
based services.
In a phenomenological study, researchers McLeod, Hays and Chang (2010)
investigated the different types of community and personal resources victims of abuse
used after leaving their partner. The sample size consisted of 5 women between the ages
of 24 to 38 years recruited from counseling centers and community agencies that help the
abused. The abused responded to four themes within the personal resources: “needing
social support, desiring personal validation, engaging in self-care (spirituality,
researching IPV etc.) and reaching out to others” (McLeod et al., 2010, p.305). Also, the
participants responded to four themes within the community resources: “receiving
adequate assessment, feeling validated during community response, being offered
protection, and having support and options” (McLeod et al., 2010, p.305). The strength of
this study is the implication for future practice because it is the first study to investigate
the different types of personal resources the abused believe is helpful, and how
counselors can help the abused who are in the process of leaving their partner find
community resources (McLeod et al., 2010). The weakness within this study was the data
analysis determined the abused had both negative and positive outcomes with personal
and community resources.
Based on the study findings it can be stated that counseling is a needed service to
help the abused feel safe and to promote self-empowerment. The review of current
research literature and studies help support the research questions and gap in literature
that counseling is a critical support service that assists the abused through many different
phases (mental treatment, education resources, promoting safety, etc) to help them
reclaim their lives.
Perception
As stated earlier, the purpose of this study is to explore lived experiences,
perceptions, and the role of advocacy and counseling services among women who are
domestic violence victims. HBM will be used to explore the perceptions of domestic
violence victims to risk factors associated with being re-abused and their perceptions of
the services (counseling and support programs) received. The research questions formed
by using the HBM conceptual framework will serve as the foundation of understanding
victims’ perceptions of advocacy and counseling programs as services. The Health Belief
Model will be used to theorize the perceptions of domestic violence victims to risk factors
associated with being re-abused and their perceptions of the services received.
Theoretical Framework
Health Belief Model
The theoretical framework for this study will be Health Belief Model (HBM)
developed by Hochbaum, Rosenstock and Kegels (1958). The theoretical framework will
provide the foundation to analyze the perceptions and lived experiences of domestic
violence victims’ who used advocacy and counseling services. The HBM has been used
by researchers to examine health decisions, behaviors, health beliefs and health threats.
As stated in Chapter 1, both conceptual and theoretical frameworks are used to reflect the
researchers’ assumptions and worldview of a known phenomenon under study (Rocco
and Thatcher, 2011). According to Rocco and Thatcher (2011), “A theoretical framework
is built on a supportable premise or the extension of such premise through a logical path
of reported research and clear and clear reasoning (p. 119). The conceptual framework
will provide the foundation to analyze the perceptions and lived experiences of domestic
violence victims’ who used advocacy and counseling services. Domestic violence is a
serious health problem that can affect the victim’s mental and physical well-being. The
purpose of HBM within the study is to explore the perceptions of domestic violence
victims to risk factors associated with being re-abused and their perceptions of the
services (counseling and support programs) received. The rationale for using the HBM is
to understand that a victim of domestic violence will take the necessary action if they feel
further abuse can be avoided. In study, Janz and Becker (1984) believed that a specific
health action will reduce or prevent the risk of a threat.
Also stated in Chapter 1, the HBM will be used within the study to theorize the
perceptions of domestic violence victims to risk factors associated with being re-abused
and their perceptions of the services (counseling and support programs) received. Also,
these programs will increase domestic violence victims’ self-efficacy because it serves as
an empowerment tool that help women deal with their current situation. The hypothesis
and assumptions of HBM are that victims will seek advocacy and counseling program
services and change their behavior. However, the abused must first believe, understand
the benefits, understand the barriers, and determine what causes them to seek help. The
components of the HBM are perceived susceptibility, severity, benefits, barriers, and cues
to action (Thomas, 2000). All five components of the HBM are the building blocks for
the theoretical proposition. The research questions will follow the five components of the
HBM such as, understanding knowledge, awareness, perception, attitudes and lived
experiences of domestic violence victims. However, the abused must first, 1) believe
they have been victimized, 2) understand the severity of the problem, 3) understand the
benefits of advocacy and counseling programs, 4) understand the barriers of seeking help
from advocacy and counseling programs, and 5) The cues of action that caused victim
seek help. The research questions will build upon the role of advocacy and counseling
services to educate domestic violence victims through prevention on how to avoid
harmful actions and behaviors. The assumption of the health belief model within this
study is that the abused will take the necessary actions to seek help.
In a current research study, Waite and Killian (2008) used the HBM to explore
when African American women made the decision to seek treatment for their depression.
In their study, a purposeful sampling of 14 African American women was recruited from
a nurse managed health care center (Waite and Killian, 2008). The researchers explained
the problem by using a pre-existing survey instrument (Patient Health Questionare-9), a
self-reported questionnaire for depression that is validated as the only instrument used as
a screening, severity, and outcome measure (Waite & Killian, 2008; Lowe, Unutzer,
Callahan, Perkins & Kroenke, 2004). The weakness within the study was the study
focused on one racial group. The limitation of focusing on one particular race limits the
study from exploring and comparing perceived health beliefs from a more diversified
population (Waite & Killian, 2008). The strength of the study was that credibility,
dependability, confirmability, and transferability was used to establish the trustworthiness
of collected data (Waite & Killian, 2008; Lincoln & Guba, 1985).
In another study, Sullivan, White, Young, Chang, Roos and Scott (2008) used the
HBM to examine how predictors of intention could reduce individuals who are at risk of
stroke. There were 76 individuals between the ages of 56 to 90 years old with 74.8 being
the average age (Sullivan et al., 2008). The study used two instruments the
Cerebrovascular Accident Attitude and Beliefs Scale-Revised (CABS-R) to measure
stroke health belief; and the Stroke Knowledge Test (SKT) was used to measure stroke
knowledge. The strength of the study was the HBM determined that stroke beliefs are a
major aspect of health prevention and treatment (Sullivan et al., 2008). The concept of the
first study was to explore how the health beliefs of the participants with depression could
improve treatment between patients and practitioners. The dependent variable in the
second study was to reduce stroke risk. Both studies are important to understanding how
behavioral change can impact health outcome.
Summary and Conclusion
The objective of domestic violence programs is to educate society on domestic
violence; however, the goal of domestic violence shelters is to provide services and
programs to all women and men whether they have been abused or not. Advocacy and
counseling programs are the best level of intervention to educate and eliminate domestic
violence in the community (Johnson & Zlotnick, 2009). Domestic violence is a serious
public health concern in which many women suffer physical, emotional, and economic
abuse. Counseling services provide a level of intervention to give the abused with safety,
healing, and education (Pennington-Zoellner, 2009). Advocacy services are personalized
and tailored to each victim’s needs and provide safe shelter and access to community
resources (Pyles, 2008). One of the most important roles of domestic violence advocates
is to help the abused overcome their emotional and physical scars. DV shelters are the
most important resource for women in need of safety. When escaping from an abusive
relationship, a DV shelter can provide a place of safety. DV shelters are places where the
abused can receive support, counseling services, advocacy, and referrals to additional
services based on their needs (Johnson & Zlotnick, 2009). However, many DV shelters
are not able to accommodate every victim due to lack of beds and limited 24-hour DV
shelters. Research has been done on many areas related to domestic violence; however,
little is known about the extent to which women victims of domestic violence get the help
they need from these services.
This study will explore the specific roles of advocacy and counseling programs, as
support services in DV shelters, because little is known about the victims’ perceptions of
the services received, or communities being served (Lyengar and Sabik, 2009). Chapter 3
will be an overview of the qualitative study design; rationale; role of researcher;
phenomenological approach (methodology); instrumentation; data analysis plan;
trustworthiness; and ethical procedures.
Chapter 3: Research Method
Introduction
As stated in Chapter 1, the purpose of this study was to explored women’s
perceptions of DV advocacy and counseling programs, which are designed to provide
women and men with safe refuge, prevention education, mental health treatment, and
other services (Lyengar & Sabik, 2009). The intent of the study explored the role of
advocacy and counseling programs as services for victims of domestic violence, and
factor for re-abuse. Little is known about the extent to which female victims of DV are
getting the help they need. Exploratory data may help inform larger quantitative studies.
Chapter 3 will discuss the major aspects of my research design, including research
design and rationale, methodology, instrumentation, recruitment procedures, data
collection, data analysis, issues of trustworthiness, and ethical procedures. The chapter
ends with a summary.
Research Design and Rationale
The research questions that will be answered in this study are
RQ1: What was domestic violence (DV) victims’ awareness of advocacy and counseling
service prior to their abuse?
RQ2: What are domestic violence victims’ experiences of advocacy and counseling
services that they have received?
RQ3: What are domestic violence victims’ perceptions of how advocacy and counseling
services could be improved to better serve their needs?
RQ4: What are the perceptions of DV victims on the role that advocacy and counseling
services play in preventing further abuse among domestic violence victims?
The research tradition of qualitative studies is the use of ethnography, narrative,
grounded theory, case studies, and phenomenology. All the research tradition of
qualitative studies was considered and reviewed for this study. However, the
phenomenology qualitative approach was an appropriate choice to answer the research
questions.
Phenomenology is an appropriate approach to explore in-depth and lived
experiences of domestic violence victims. Also, phenomenology is an appropriate study
to explore the in-depth experiences of domestic violence victims and will help encourage
the abused through their own words to share their knowledge, awareness, and perceptions
of the services they received. The phenomenological approach selected for this study was
Moustakas (1994) transcendental approach.
Transcendental phenomenology focuses on the description of the participants’
experiences by bracketing the researcher experiences (Moustakas, 1994). According to
Creswell (2006), “the data analysis procedures, illustrated by Moustakas (1994), consist
of identifying a phenomenon to study, bracketing out one’s experiences, and collecting
data from several persons who have experienced the phenomenon” (Creswell, p. 60).
Moustakas asserted that focusing on Husserl’s concept of epoche´ will help the
“researcher set aside their experiences and take a new perspective toward the
phenomenon under investigation” (Creswell, 2006, p. 59). The data analysis in
transcendental phenomenology is reduced into significant statements and then combined
into themes (Creswell, 2006). In addition, the themes developed a textural description of
the experiences of the participants and a structural description (context of the
experiences) will convey the essence of the participants (Creswell, 2006). Also, a
transcendental phenomenological approach helped to support the literature review and
research questions that explored the role of advocacy and counseling programs as
services for victims of domestic violence.
Phenomenology was at first a philosophical movement (Moustakas, 1994).
Phenomenology from Husserl belief should focus on the perception of the individual
experience from their point of view (Moustakas, 1994). The phrase Epoche´ means
“allowing things, events, and people to enter anew into consciousness, and to look and
see them again, as if for the first time” (Moustakas, 1994, p. 85). In order to apply epoche
´ to the research study, the researchers must set aside their biases for the relevance of
establishing valid and credible data analysis (Moustakas, 1994).
Phenomenology is important to research because it provides a more in-depth
understanding of human behavior. Phenomenological researchers seek more insights
about the reasons for behavioral patterns. Transcendental phenomenology is an
appropriate study to explore the in-depth experiences of victims of domestic violence.
According to Creswell (2007), phenomenology is used to understand the lived
experiences as described by the participants. Phenomenology study give ultimate
attention to focusing on how individuals experience and interpret the world around them.
The phenomenological approach is considered subjective because it relies on
understanding participants’ views and perceptions (Crosby, DiClemente and Salazar,
2006). Also, the phenomenological approach is able study several individuals that share a
common experience (Creswell, 2007).
The sample for this study consisted of women who have been victims of DV and
who use the services at a community-based shelter, as detailed below. The establishment
of saturated data occurred when data analysis was no longer coding new patterns or
perspectives. Women who have used domestic violence shelters was sought for this study
to understand their perception of the services received. Phenomenology analysis requires
a series of steps that include: 1) epoch: allows the researcher to explain or eliminate bias,
2)
phenomenological reduction: used by researchers to bracket presuppositions and
acknowledge data in pure form, 3) transcribing: the researcher searches for themes and
recurring patterns, and 4) coding: the researcher looks for patterns and perspectives of the
participants’ life experience (Patton, 1990).
Role of the Researcher
The role of the researcher within this study was to facilitate an understanding of
the perceptions of women receiving services from domestic violence advocacy and
counseling programs. The researcher acted as an instrument within the study to gather the
participants, ask questions and facilitate the interview process. Also, the researcher was
responsible for collecting, analyzing, and interpreting the perceptions from the
participants who experienced the phenomenon. The researcher made sure his or her
questions are free from bias. The researcher was also responsible for upholding ethical
research standards. According to Isreal and Hay (2006), researchers who care about the
moral principles of research also uphold truthfulness of research.
Researcher-Participants Relationship
The researcher established an engagement of trust, credibility and rapport with the
participants. As an instrument, the researcher was responsible for assuring confidentiality
of the participants (see Confidentiality Agreement, Appendix D), screening the
participants for the study (see Screening Instrument, Appendix A), and securing the
informed consent form from participants (see Verbal Consent Form, Appendix C). In
order to accurately report the study participants’ experiences, the researcher should avoid
inflicting personal biases into the study data and analysis (Creswell, 2009). The study
participants may be more willing to answer the research questions if the researcher is
honest and respectable (Isreal and Hay, 2006). The possibility of this research study
conflicting with the interest of the researcher work environment is impractical due to
unrelated duties. An incentive of a $20 WalMart gift card was given to each participant to
compensate for their participation.
Methodology
Participants Selection Logic
As stated earlier, a purposeful sampling of approximately 10 women who have
used shelter services in Ohio was used. Data saturation was attained when all possible
themes had emerged the data suggested had been exhausted. Therefore, when
determining the sample size the goal should be to “not only to study a few sites or
individuals but also to collect extensive detail about each site or individuals studied”
(Patton, 2002, p. 157). The use of purposeful sampling was necessary in order to select
participants based on their experience of the phenomenon under investigation. The study
selected abused women who have used domestic violence shelter services such as,
advocacy, emergency shelter, and individual and family counseling. The study
participants was sought through personal contact with domestic violence shelter. I sought
shelters that would help in the recruitment of potential participants and serve as a
potential research site. I presented the executive director with a letter of invitation and
research flyer that explained the research study. Upon acceptance of the executive
director agreeing to this research study, I sought a formal letter of cooperation to assure
IRB guidelines are kept. The executive director task were to identify the potential
participants who identify with the characteristics of the phenomenological group.
The sample consisted of females who are a) 18 years or older, b) have sought help
at a community-based domestic violence shelter, and c) have utilized shelter services. As
stated earlier, this study selected domestic violence shelters for the services they provide
to abused women and their family such as, advocacy, emergency shelter, and individual
and family counseling. In addition, a variety of domestic violence shelters located
throughout the Ohio region was sought that offered different cultural specific programs
tailored to the minority community. Also, a research flyer explaining the study purpose
was posted on my facebook for my friends to share with others who may know someone
who meets the criteria of the study. Potential participants using facebook contacted me
via the phone number where I talked to them more about the study and determined their
eligibility. All potential participants were required to sign a consent form (Appendix C)
prior to being interviewed. An incentive of a $20 WalMart gift card was given to each
participant to compensate for participating in this study, not as a form of coercion to gain
potential participants. However, there will not be an incentive given to domestic violence
shelter workers.
Instrumentation
In qualitative research there are three types of interviews used to gather
information: semi-structured, unstructured, and structured (Creswell, 2009). The primary
instrument is the Interview Protocol (Appendix B). Also, an audio digital recorder was
used in the interview and during transcribing. The saturation of interviews allows the
researcher to have a level of control over the questions being asked (Creswell, 2009).
Saturation occur when interviews fail to yield new themes, data or information (Byers
and France, 2010). When the participants started to replicate what other interviewees
were discussing in prior interviews then saturation had been achieved. (Byers and France,
2010). Also, the sufficiency of using an audio digital recorder to transcribe data will
allow the participant to share their perception and allow the researcher to not assume
(Creswell, 2009).
Researcher Developed Instruments
As stated previously, the participant screening questionnaire (Appendix A) was
used to select participants based on their experience of the phenomenon under
investigation. The research questions and interview guiding questions (Appendix B)
explored the victims’ perceptions of advocacy and counseling as program services. The
sufficiency of the research questions and interview guiding questions allowed the
researcher to accurately report the participants’ perception to the phenomenon under
investigation. A pilot study was not used to determine the validity of the instrument.
Procedure for Recruitment, Participation, and Data Collection
The procedure for recruitment required numerous emails sent to the staff at
domestic violence shelters that offer advocacy and counseling support programs to
victims of domestic violence. In addition, I contacted the shelter or shelters for a personal
visit to understand how the organization functions. Also, word of mouth to individuals
who may know someone that meets the criteria of being a potential participant. If the
required number of participants is not met then flyers outlining the study will be placed
on community message boards or an ad will be placed in the local newspapers. All
emails, flyers, and newspaper ads will provide a brief synopsis of the research study and
criteria for participation. I will provide potential participants with my contact information
if they want to participate in the study. The interviews of selected participants will be
conducted at local domestic violence shelters or a private meeting room at the local
public library. The eligibility of potential participants will be determined through the
screening questionnaire (Appendix A).
For each research question, the procedure for collected data consisted of
semistructured in-depth interviews with women who have utilized domestic violence
shelter advocacy and counseling support programs. The researcher was solely responsible
for data collection. In order to retain data privacy, the data collected will be stored in a
locked filing cabinet up to a maximum of 10 years. The frequency of data collection
continued until saturated and all participants have been interviewed. The duration of data
collection took approximately 50 minutes per participant. Data collection took multiple
weeks to complete. The data was recorded using an audio digital recorder. Also, taking
notes was used as a backup if the digital recorder fails. If the recruitment resulted in too
few participants for the study, then semi-structured email interviews would allow more
participants to be reached geographically. The participant exited the study through
debriefing. Debriefing was used to educate the participants on the research study and
clarify to ensure they understand any deceptive practices used in the study. A follow-up
interview was necessary for the data analysis to emerge a consistent theme that would
suggest new questions to be asked (Creswell, 2009). The study participants were
informed prior to data collection of the possibility of a follow-up interview. Participation
in a follow-up interview will be left solely at the discretion of the interviewee.
Data Analysis
Data analysis will require the following series of steps to be used for each
research questions, the phenomenology analysis requires a series of steps that include: 1)
phenomenological reduction: used by researchers to bracket presuppositions and
acknowledge data in pure form, 2) transcribing the data into NVivo; 3) use of NVivo to
code the data and search for themes and recurring patterns (Patton, 2002). As stated
earlier, according to Creswell (2007), phenomenology is used to understand the lived
experiences as described by the participants. Phenomenology study gives ultimate
attention to focusing on how individuals experience and interpret the world around them.
The phenomenological approach is considered to be subjective because it relies on
understanding participants’ views and perceptions (Crosby, DiClemente and Salazar,
2006). Also, the phenomenological approach can study several individuals that share a
common experience (Creswell, 2007).
For each research question, NVivo allowed the coding of the interview data based
on emergent themes or ideas. The principle of using NVivo is the researcher must first
look for “recurring regularities in the data” (Patton, 2002, p. 465). The recurring
regularities will determine what patterns to place into categories (Patton, 2002). Each
theme were organized by research questions. As pointed out by Creswell (2009),
qualitative data analysis also requires the researcher to constantly ask questions, write
notes, and reflect on data. Any discrepant data cases will be revised, recorded and
discussed in the limitations section of the study. According to Harding and Bryman
(2009), “deviant cases (discrepant cases) can show that analytic generalizations that are
being advanced have broken down and need revising” (p. 618).
Issues of Trustworthiness
Patton (2002) reported that trustworthiness of data collection is only obtained
through the person who collects and analyze the data. In order to develop trustworthiness,
the researcher should have their findings reviewed by analysts, and use several theories to
analyze the data (Patton, 2002). The trustworthiness in qualitative research was
established through the research credibility, dependability, confirmability, and
transferability.
Credibility
The credibility in data quality was established and validated through triangulation.
There are four main types of triangulation, source, methods, researcher, theories (Patton,
2002). According to Patton (2002), the verification and validation of triangulation may
involve checking for data consistency within the sources and findings using different data
collections. Patton (2002) believed searching for the best fit requires a thorough
assessment of the data analysis and seeking themes that fit the research questions.
Inductively finding the best fit would require organizing the data to determine if
alternatives themes or patterns are discovered (Patton, 2002).
Dependability and Confirmability
Dependability in qualitative research is an audit trail that provides a detailed
reference of how data are collected and analyzed (Bloomberg and Volpe, 2012). An audit
trail is obtained by using an intra-coder to code to help code interviews (Bloomberg and
Volpe, 2012). An intra-coder helped establish the reliability of the collected data by
analyzing the transcript data. The reliability in an interview can be obtained through
detailed field notes, and having additional coders who will analyze the transcript data
(Creswell, 2007).
Confirmability is an unbiased measure that is established when the study can
demonstrate trustworthiness, fittingness and adaptability (Lincoln and Guba, 1985).
Confirmability refers to “the extent to which the characteristics of the data, as posited by
the researcher, can be confirmed by others who read or reviews the research results”
(Bradley, 1993, p. 437). Confirmability was established through audits of the data
findings and interpretations.
Transferability
Qualitative research is not generalizable but transferable in which information can
be applied to other context and situations. Some of the themes that emerge from this
study could be useful in future studies (qualitative and quantitative) of similar
populations.
Ethical Procedures
There are many ethical considerations that must be established throughout this
study. As a student and researcher, I upheld the integrity of Walden University in my
research writing, citing, data collection, analysis and interpretation. According to
Walden’s Institutional Review Board (IRB) researchers may not advertise or begin
recruiting participants (i.e., obtaining consent form signatures) prior to IRB approval
(IRB Application, para. 5). Walden’s IRB stated, “The purpose of the application is to
collect enough information to document that the study’s benefit outweighs the costs and
that the procedures follow federal regulations and universities policies” (IRB
Applications, para. 7). Therefore, before the IRB application can be approved the ethical
principles of the participants must be upheld (IRB Application, para. 7). The beneficence,
justice and respect for the person shall be upheld in the recruitment and data collection of
study participants. Researchers have to be careful to not “put the study participants at risk
and respect population vulnerable populations (Creswell, 2009, p. 91), and benefits and
burdens should be distributed fairly (IRB, para. 14). There were signed consent forms in
order to avoid any ethical concerns in regards to the recruitment process.
Potential study participants were sought through domestic violence shelters. Also,
potential study participants were informed about the study and their purpose within the
study. However, before research begins a signed consent form was in place. Pseudonyms
were used to identify the study participants’ without compromising true identity. Lastly,
the researcher should not engage in fraudulent practices “to meet the researcher’s or
audience needs” (Creswell, 2009, p. 92). Therefore, the study participants must have
experienced the phenomenon in question. All study participants have the right to refuse to
participate or withdraw early from the study. All withdrawals will be recorded in the
study limitations.
The ethical code of researchers is to protect the privacy of all study participants
involved in the study (Creswell, 2009). All data collected from study participants will
remain anonymous and confidential. To secure data collection and confidentiality, the
data will be stored on a separate hard drive and placed in a locked filing cabinet. The
analyzed data will need to be retained for a specific period of 5 years. According to
Sieber (1998), the recommended period to keep data analysis can range between 5 years
to a maximum of 10 years.
Incentive
As stated earlier, an incentive of a $20 WalMart gift card was given to each
participant to compensate for participating in this study, not as a form of coercion to gain
potential participants.
Summary
Qualitative research is appropriate for this study and research questions because it
gives a more in-depth understanding of human behavior and focus on understanding
perceptions, and the reasons for behavior. Also, qualitative research can be used to
explore and seek understanding about an individual or group. The phenomenology
approach is also appropriate for the research questions to discover how domestic violence
advocates help women of domestic violence and whether social support programs are
helping to empower victims. Additionally, the design may generate new theories related
to advocacy and counseling services. Chapter 4 will be an overview of the study results,
including the demographics; data collected; data analysis; trustworthiness; and results.
Chapter 5 will present the study’s findings, discussion of the social change implication,
conclusions, and recommendations.
Chapter 4: Results
Introduction
The purpose of this phenomenological study was to explore the perceptions of
victims of DV about advocacy and counseling programs that provided women safe
refuge, prevention education, mental health treatment, and other services. I also wanted to
examine risk factors for re-abuse. Chapter 4, will summarize the research questions and
methods of data collection, and present study findings, including participant
demographics and themes that emerged from data analysis. The research questions for
this study is, as follows:
RQ1: What was domestic violence (DV) victims’ awareness of advocacy and counseling
service prior to their abuse?
RQ2: What are domestic violence victims’ experiences of advocacy and counseling
services that they have received?
RQ3: What are domestic violence victims’ perceptions of how advocacy and counseling
services could be improved to better serve their needs?
RQ4: What are the perceptions of DV victims on the role that advocacy and counseling
services play in preventing further abuse among domestic violence victims?
Themes emerging from the research data are presented and discussed in further detail for
each of the research questions.
Participant Recruitment
After obtaining Walden IRB approval (number 08-05-15-0200208), I initiated data
collection via social media on Facebook. I friended two DV online support groups in
Ohio. I attached a flyer to a Facebook post that was for women who had previously
stayed at a DV shelter and had used advocacy and counseling services. Data collection
continued until saturated, and all participants have been interviewed. Data collection took
multiple weeks to complete. Data was recorded using a digital audio recorder. Also,
taking notes were used as a backup if the digital recorder failed. The participants exited
the study through debriefing. A debriefing was used to educate the participants on the
research study and clarify to ensure they understand any deceptive practices utilized in
the study. The study participants were informed before data collection for the possibility
of a follow-up interview. Participation in a follow-up interview was left solely to the
discretion of the participant.
Setting
The prescreening questionnaire (see Appendix A) was conducted via telephone.
The interviews were conducted in person private meeting rooms at local libraries in the
following Ohio locations: Sidney, Findlay, and Toledo. All participants were recruited
and interviewed through Facebook. All eight eligible participants lived in Ohio and had
used the state’s DV shelter advocacy and counseling services. There were 3 participants
from Allen County, two participants from Shelby County, one from Hancock County, and
two participants from Wood County. I collected data via semi-structured in-depth
interviews. All the women interviewed were no longer with their abuser; therefore, they
were without fear of participating in this study.
As the researcher, I was solely responsible for all data collection. The collection
of data took approximately 50 minutes per participant. Data collection took place over a
3-week period in September and October of 2015. Follow-up interviews were necessary
with four participants to examine their perceptions in more detail and to elaborate on
what were already stated within their interview. The follow-up interviews took place over
a 2-week period in April 2016. All follow-up interviews were conducted via telephone.
After receiving approval from IRB, I provided each of the initial and follow-up
interviewees with a $20 e-gift card for their participation.
Demographics
The screening questionnaire for the study required participants to be (a) female;
(b) 18 years or older; and (c) to have sought help at a domestic violence shelter and
utilized shelter services (see Appendix A). If the potential participants did not meet the
criteria of the screening questionnaire, they were excluded from the study. There were 9
participants screened, but only 8 met study requirements. All participants who met the
requirements were interviewed as Participant A, B, C, and so on to conceal their identity.
Data Collection
Data collection began on September 26th, and was conducted in September and
October 2015. Each participant’s interview responses were recorded using a digital audio
recorder. A handwritten log was also used to backup interview responses, and was used
to organize the data received from each participant. Probing with open-ended questions
was used to promote and broaden the dialogue with participants. Additional probing was
also used to explore the themes and contexts that emerged within interview questions
responses. The phenomenological approach was used to collect data from the open-ended
interview questions that were aimed at understanding the phenomenon of the participants’
experiences. After each interview, the participants’ responses to the research questions
and interview protocol (see Appendix B) data recordings were transcribed and all
interviews were stored in a Microsoft document. All data collected from study
participants were stored on a separate hard drive and placed in a locked filing cabinet.
The analyzed data will be retained for a required period of 5 years.
Data Analysis
NVivo 10.0 qualitative data analysis software was used to organize and code the
data. I also, hand coded and organized the data. Phenomenological analysis requires a
series of steps that include: 1) data reduction to bracket presuppositions and acknowledge
data in its pure form, 2) data transcription and coding into NVivo; 3) use of NVivo 10.0
to code the data and search for themes and recurring patterns (Patton, 2002). For each
research question, NVivo 10.0 allowed the coding of interview data based on emerging
themes or ideas. The principle of using NVivo is the researcher must first look for
“recurring regularities in the data” (Patton, 2002, p. 465). The recurring regularities
determined what patterns to place into categories (Patton, 2002). Each theme was
organized by all four research study questions (see Figure 1).
Figure 1 . Word cloud showing frequency of words in all research questions.
The word frequency weighted by percentage was used to aid in the development
of the five frequent themes (see Table 2). The cloud terms demonstrate the prevalent
themes that emerged from the interview responses. The following words were developed
by coding the frequency words relationship within the nodes folder in NVivo 10. The
frequent words identified by NVivo 10 based on percentage were: (a) great 7.42%, (b)
everything 6.25%, (c) improved 5.47%, (d) need 5.47%, and (e) nothing 5.47%. These
words were linked to participants’ responses regarding their perceptions of receiving
services from domestic violence advocacy and counseling programs. The common words
were the basis for the three emergent themes: Supportive shelter advocacy and counseling
services, increased awareness of advocacy and counseling services, understand signs of
domestic violence, and Protective services for DV victims who used advocacy and
counseling services (see Figure 5& 6).
Results by Research Questions
RQ1: What was domestic violence (DV) victims’ awareness of advocacy and
counseling service prior to their abuse?
Figure 1 shows the word frequency for responses to the questions on this topic.
The commonest words were ‘shelter’, ‘services’, and ‘counseling’. The participants’
responses to the research question indicate that many of the women who sought shelter
did not know about the different services available within the shelter.
Figure 1. Word Frequency for RQ #1
Some women reported not knowing anything about advocacy and counseling
services until they had to seek shelter, for example, “I didn’t know until an advocate
picked me up and took me to the shelter that there were different programs available to
help me and my children.” (P7) Or “I didn’t know anything about advocacy and
counseling services.” (P6)
Many of the participants sought shelter because they needed a safe place to stay,
e.g. “I went to the shelter seeking safety from my abusive husband” (P6), and “I went to
the shelter to escape my boyfriend. I was only looking for a safe place to stay for a few
days” (P7).
Most of these women discovered that shelter services extend far beyond shelter to
include advocacy and counseling, e.g. “When I got the courage to seek shelter, I realize
how little I knew about all the different services that were available to help me” (P2). “I
realize what I thought I knew about shelter services were not accurate at all” (P3)
Three potential themes arrive from these data:
1. Women often know little about advocacy or counseling services until they have to
seek shelter.
2. Many women seek shelter because they need a safe place to stay.
3. Many women are surprised to find that shelter services include advocacy and
counseling
RQ2: What are domestic violence victims’ experiences of advocacy and counseling
services
Figure 2 show the word frequency for responses to the questions on this topic.
The commonest words were ‘shelter’, ‘advocacy’, ‘services’, ‘counseling’, and
‘counseling.’ The participants’ responses to the research question indicate that shelter,
advocacy, and counseling were very helpful to their wellbeing.
Figure 2. Word Frequency for RQ #2
All the women were pleased with the services they received at the shelter, for
example, ‘I was very nervous going to the shelter because I did not know what to expect.
But, the advocates and counselor at the shelter really made me feel safe” (P1), “I am
really happy with the services I received at the shelter. The advocates and counselors
were all great” (P2), “The counselor and staff within shelters were awesome” (P3), “The
advocates and counselor were very helpful” (P4), “Everyone was great! They helped me
understand my situation and not to blame myself” (P5), “I was very pleased with the
support I received at the shelter” (P6), “I am pleased with the services and help I received
at the shelter” (P7), “The advocates were always available when I needed to talk with
them (P8).
Three potential themes that arrived from these data:
1. The women were pleased with the advocates and counselors support they received at
the shelter.
2. The support services the women received at the shelter helped them feel safe.
3. The women understood that they weren’t responsible for their abuse.
RQ3: What are domestic violence victims’ perceptions of how advocacy and
counseling services could be improved to better serve their needs?
Figure 3 show the word frequency for responses to the questions on this topic. The
commonest words were ‘improvements’, ‘services’, ‘shelter’, ‘needed.’ The participants’
responses to the research questions indicate that the shelter do not need improvements to
advocacy and counseling services.
Figure 3. Word Frequency for RQ #3
Most of the women reported that no improvement was needed with advocacy and
counseling services they received at the shelter, for example, “everything was great, no
improvements needed. I just wished I had sought shelter earlier. I felt very safe and cared
for by the entire staff at the shelter.” (P1), “I don’t see where they would need to make
improvements to their services. I am very pleased with the services I received” (P2), “I
am pleased with the services received at the shelter and don’t believe any improvements
are necessary” (P3), “No improvements needed; I am very satisfied with the services I
received. All the services I received helped made me get stronger mentally” (P4), “They
were always there for me when I needed them. I don’t think they need to make any
improvements” (P5), “No improvements needed. I thought everything was great! The
staff at the shelter helped me rebuild my confidence and I am very thankful for them”
(P6) and “I have no complaints about the services and help I received at the shelter.
Therefore, I see no improvements being made to the services” (P7). There was one
participant who wanted more counseling within the week. e.g. “I wish they would offer
counseling service twice a week. I really felt as though I needed to talk to the counselor
more often. I would have days when my spirit was up and other days when I felt as
though I needed that extra visit” (P8).
Two potential themes that arrived from these data:
1.Women who received shelter services were pleased with the services they received.
2. All the women who utilized shelter services saw no need for improvements to
shelter services.
RQ4: What are the perceptions of DV victims on the role that advocacy and
counseling services play in preventing further abuse among domestic violence victims?
Figure 4 show the word frequency for responses to the questions on this topic. The
commonest words were ‘know’, ‘helped’, ‘signs’, and ‘look.’ The participants’ responses
to the research questions indicate that they know what signs to look and how advocacy
and counseling services can help them from being further abused.
Figure 4. Word Frequency for RQ #4, Part 1
There were four questions that were used to answer Research Question 4, the first
part of the interview questions would reveal research question 4, participants’ perceptions
on whether advocacy could prevent further abuse. All the women believed that advocacy
services could prevent further abuse, for example, “The shelter services helped me
recognize and see others through their words and actions” (P1), “They helped me to know
what to look for if I was to ever get in another relationship” (P2), “They helped me to
understand the signs and clues and what I should be looking for” (P3), “I know the red
flags to look for. The advocates were very helpful and they explained what actions to take
against my husband legally to keep me safe” (P5), “They helped me understand the signs
and I know not to excuse an outburst as he is just having a bad day” (P6), “The services I
received helped me see the red flags, so I don’t make the same mistakes all over. I know
what kind of behaviors to not ignore and accept as being okay” (P7), “I know what to
look for and how to protect myself if I was ever to get in another abusive relationship.”
(P8).
Two potential themes that arrived from these data:
1. All the participants believed that advocacy services could prevent further abuse.
2. All the participants believed that advocacy services helped them to understand what to
look If they were to get in another relationship.
Figure 4. Word Frequency for RQ #4, Part 2
Figure 4 show the word frequency for responses to the questions on this topic. The
commonest words were ‘counselor’, and ‘abuse.’ The participants’ responses to the
research questions indicate that counseling services can help them from being further
abused.
The second part of Research Question 4 “Why do you believe that counseling
services could help someone from being further abused?” All the women agreed that
counseling services could help someone who was abused from being further abused, for
example, “During my relationship my abuser, I dismissed a lot of things that should have
been taken seriously. The counselor helped me see the mistakes I made and learn from
them so I am never abused again. (P1), “The counselor was very helpful, she helped me
understand that the abuse was not my fault. (P2), “The counseling support I received at
the shelter really helped me and my children understand the abuse.” (P3), “I am glad that
there was someone to help me mentally understand the abuse I received. (P4), “Counselor
explained to me what red flags not to ignore.” (P5), “When I came to the shelter, I had no
idea what to expect when I was sent to counseling. Bu the counselor really helped me
understand that the abuse was not something I did, but a problem with my husband. (P6),
“The counselor explained to me what to look for to prevent further abuse.” (P7), “I
suffered emotional abuse from my partner and the counselor was able to help me
understand how to prevent further abuse.” (P8)
One potential theme that arrived from these data:
1. All the women agreed that counseling services could help someone who was
abused from being further abused.
HBM Questions
Within this study, I also addressed four HBM questions:
HBM 1: Benefits or receiving advocacy and counseling services through the shelter.
HBM 2: Barriers that might have prevented a victim from seeking advocacy and
counseling services.
HBM 3: Perceive risk of being a victim of domestic violence.
HBM 4: Severity of being a victim of domestic violence.
HBM Results in Relation to the Literature
As stated earlier, the purpose of HBM of the study is to explore domestic
violence victims’ perceptions of risk factors associated with being re-abused and their
perceptions of the services (counseling and support programs) received. Within the first
theme of HBM 1: An equal response of eight participants believed that advocacy and
counseling services helped them feel safe and understand that the abuse they received was
not their fault. Within the second theme of HBM 2: All the participants acknowledged
that their husband or boyfriend was the biggest barrier that would have prevented them
from seeking advocacy and counseling services. In the third theme HBM 3: All the
participants were able to recognize and perceived their risk as being a victim of domestic
violence. All the victims suffered from emotional and physical abuse from their abuser.
Lastly, in HBM 4: Seven participants experienced physical and emotional abuse and were
aware of the severity of being a victim of domestic violence. However, only one
participant experienced emotional abuse. However, the severity of emotional abuse she
endured was just as traumatic as physical abuse. In chapter 2 literature review, the HBM
was used within the study to theorize the perceptions of domestic violence victims to risk
factors associated with being re-abused and their perceptions of the services (counseling
and support programs) received. The hypothesis and assumptions of HBM are that
victims will seek advocacy and counseling program services and change their behavior.
However, the abused must first believe, understand the benefits, understand the barriers,
and determine what causes them to seek help. However, the abused must first, 1) believe
they have been victimized, 2) understand the severity of the problem, 3) understand the
benefits of advocacy and counseling programs, 4) understand the barriers of seeking help
from advocacy and counseling programs, and 5) The cues of action that caused victim
seek help. The assumption of the HBM within this study is that the abused will take the
necessary actions to seek help.
Evidence of Trustworthiness
Trustworthiness
Trustworthiness was established through internal validity, external validity, reliability,
and objectivity (Patton, 2002). The trustworthiness in qualitative research was established
through the research credibility, dependability, confirmability, and transferability. The
concept of trustworthiness with the participants was obtained with purposive which
helped to negate researcher bias. Triangulation was established through different
resources. For example, methodological triangulation were established using a screening
eligibility questionnaire to identify women who have sought help at domestic violence
shelter and utilized shelter services (see Appendix A). Also, triangulation was established
through the research questions which allowed the participant’s experiences to be
compared against other participants. Lastly, triangulation was established by the
researcher using two methods of data collection such as NVivo and handwritten interview
logs for the same phenomenon to confirm the validity of the data.
Credibility (Internal Validity)
The credibility in the study data was established through triangulation. There are
four main types of triangulation, source, methods, researcher, theories (Patton, 2002). As
stated in Chapter 3, the verification and validation of triangulation may involve checking
for data consistency within the sources and findings using different data collections
(Patton, 2002). The procedure I used for collecting data consisted of semi-structured
indepth interviews with women who have used domestic violence shelter advocacy and
counseling services. An audio digital recorder and a handwritten log were used to capture
the participants’ experiences. After each interview, I reviewed the participants’ responses
for clarity and additional information. I found it easier to establish a log of the
participants’ responses, so I could compare each participant against each other to
establish which interviewee would need a follow-up interview. As the researcher, I was
solely responsible for all data collection and analysis. For each research question, I used
NVivo 10 allowed to code the interview data based on emergent themes. I handled
discrepant cases by the interview I quickly reviewed their responses and asked for clarity
on any question that needed further information. A follow-up interview was not necessary
to clarify any discrepancies.
Transferability (External Validity)
This study achieved a substantial description of the findings that can potentially
apply to future research or theory. Transferability of qualitative methods seeks to
discover an adequate description of a precise phenomenon (Creswell, 2007). This
transcendental phenomenology study explored the in-depth experiences of the victims
and through their words they were able to share their knowledge, awareness, and
perceptions of the services they received. The limitation of transferability is that the study
results may not be useful in future qualitative or quantitative studies. Also, this study
could be limited based on the small sample associated with qualitative study verse
quantitative data which were expressed in higher numbers.
Confirmability
As stated in Chapter 3, confirmability is an unbiased measure that is established
when the study can demonstrate trustworthiness, fittingness, and adaptability (Lincoln
and Guba, 1985). As the researcher, I was solely responsible for recording the data
collection, interpreting the findings, and reporting the results. Confirmability was
established through audits of the data results and interpretations. The data analysis in
transcendental phenomenology is reduced into significant statements and then combined
into themes (Creswell, 2006). Also, the themes were able to develop a textural description
of the participants’ perceptions and a structural description (context of the experiences)
will convey the essence of the participants (Creswell, 2006).
Dependability (Validity)
Dependability were established by making sure the data analysis was consistent
with the research findings. As stated earlier, dependability in qualitative research is an
audit trail that provides a detailed reference of how data is collected and analyzed
(Bloomberg and Volpe, 2012). The reliability in an interview can be obtained from
detailed field notes, and having additional coders who will analyze the transcript data
(Creswell, 2007).
Summary
Chapter 4 presented the study outcomes, the four research questions and themes
that emerged from the participants’ interview responses. For each research question,
NVivo 10.0 allows the researcher to code the interview data based on emergent themes or
ideas. The principle of using NVivo 10 is the researcher must first look for “recurring
regularities in the data” (Patton, 2002, p. 465). The recurring regularities will determine
what patterns to place into categories (Patton, 2002). The themes generated an overall
perception of the participants’ responses to the interview questions. RQ1: Most of the
women reported not knowing anything about advocacy and counseling services until they
had to seek shelter; RQ2: All the women were pleased with the services they received at
the shelter; RQ3: Most of the women reported that no improvement was needed with
advocacy and counseling services they received at the shelter; RQ4: All the women
believed that advocacy services could prevent further abuse. Also, the study results of the
health belief model were presented in the chapter. Chapter 5 will present the study’s
findings, interpretations of findings results in relation to literature, and health belief
model results concerning literature. Also, chapter 5 will conclude with a discussion of the
social change implication, conclusion, and recommendation.
Chapter 5: Discussion, Conclusions, and Recommendations
Introduction
The purpose of this phenomenological study was to explore the perceptions of
victims of DV about advocacy and counseling programs that provide women with safe
refuge, prevention education, mental health, treatment, and other services. The study
explored the risk factors for being re-abused as a domestic violence victim.
Phenomenology was the most appropriate qualitative design, I believe, to explore the
indepth and lived experiences of domestic violence victims. The phenomenological
approach was important to this study because it gave a more in-depth understanding of
human behavior and focuses on understanding the reasons for behavioral patterns. Also,
phenomenology was an appropriate study approach to explore the in-depth experiences of
domestic violence victims and helped encourage the abused through their own words to
share their knowledge, awareness, and perceptions of the services they received.
All the participants were recruited and interviewed in September and October
2015. All participants lived in Ohio and had used the state’s domestic violence shelter
advocacy and counseling services. All the participants agreed to share their perceptions
and experiences with advocacy and counseling services they had received at a DV
shelter. Eight prominent themes emerged from data analysis (see Table 1). These were
(a) awareness of advocacy and counseling service prior to their abuse, (b) victims’
perceptions of advocacy and counseling services improvements, (c) victims’ perceptions
of advocacy and counseling services improvements, (d) DV victims on the role that
advocacy and counseling services play in preventing further abuse, (e) HBM - benefits of
receiving advocacy and counseling services through the shelter, (f) HBM - barriers that
might have prevented a victim from seeking advocacy and counseling services, (g) HBM
- perceived risk of being a victim of domestic violence, (h) HBM - perceived risk of
being a victim of domestic violence, and (i) HBM - severity of being a victim of DV.
Key Findings
The purpose of the research questions was to explore the perceptions of women
who have received services from domestic violence advocacy and counseling programs.
Support services are empowerment tools that provide victims with resources and options
to deal with their current situation (Goodman & Smyth, 2011). In their study, Allen and
Wozniak (2011) stated, “During their lifetimes, over half of all women will experience
some form of physical abuse within a domestic violence relationship” (p. 38). Despite the
fact that there are many advocacy and counseling programs, little is known about
women’s perceptions of these services. All participants said they had had good
experiences using shelter services. The participants stated that advocacy and counseling
services helped them understand that the abuse was not their fault and that the services
they received could help them from being further abused.
Table 1
Study and Emerging Themes
Study questions Emerging themes
RQ1: What was domestic violence (DV)
victims’ awareness of advocacy and
counseling service prior to their abuse?
HBM 1: Benefits or receiving advocacy and
counseling services through the shelter
1) Most of the women reported not
knowing anything about
advocacy and counseling
services until they had to seek
shelter
HBM 1: Shelter protection against
further abuse
RQ2: What are domestic violence victims’
experiences of advocacy and counseling
services that they have received?
HBM 2: Barriers that might have prevented a
victim from seeking advocacy and
counseling services.
2) All the women were pleased with
the services they received at the
shelter.
HBM 2: Partner prevented victim from
seeking advocacy and counseling
services
RQ3: What are domestic violence victims’
perceptions of how advocacy and counseling
services could be improved to better serve their
needs?
HBM 3: Perceive risk of being a victim of
domestic violence.
3) Most of the women reported that no
improvement was needed with advocacy
and counseling services
they received at the shelter
HBM 3: Lack of awareness on domestic
violence
RQ4: What are the perceptions of DV
victims on the role that advocacy and
counseling services play in preventing further
abuse among domestic violence victims?
HBM 4: Severity of being a victim of domestic
violence.
4) All the women believed that advocacy
services could prevent further abuse.
HBM 4: Overall wellness for those being
abused
Interpretations of the Findings
In this study, there were various responses to the themes that emerged from the victims’
responses to their perceptions of advocacy and counseling services used within the domestic
violence shelter. Five themes emerged in relation to the research questions (see Table 1).
Advocacy and counseling services were able to support the participants with increased awareness
of what negative signs to look for in a relationship. Staffers at these services were also able to
offer supportive and protective services to victims (see Table 1). Also, three themes emerged
from the HBM questions: partner prevented the victim from advocacy and counseling services,
lack of awareness of domestic violence advocacy, counseling services, and overall wellness for
those being abused (ee Table 1).
The themes that emerged from the research questions indicated that some of the
participants were aware of the counseling and advocacy services offered at the shelter, and some
had a lack of knowledge about counseling and advocacy services at the shelter. The themes
created from the HBM questions indicated that participants believed that advocacy and
counseling services helped them feel safe and understood that the abuse they received was not
their fault. The second research question theme indicated that all the participants acknowledged
that their husband or boyfriend was the biggest barrier that would have prevented them from
seeking advocacy and counseling services (see
Appendix F).
In the third theme, all participants said they were able to recognize and perceived their risk
as being a victim of domestic violence (see Appendix F). All the victims reported suffering from
emotional and physical abuse (see Appendix F). Lastly, seven participants had experienced
physical and emotional abuse and were aware of the severity of being a victim of domestic
violence (see Appendix F).
Many of the participants said the staff and counselors did a great job or were helpful with
other support services (see Table 1). Also, most of the participants agreed that no improvements
needed to be made to advocacy and counseling services (see Table 1). Being a victim of past
abuse many of the participants know what to look for to avoid further damage (see Table 1). The
themes that emerged from the HBM indicated that many of the participants believed that
advocacy and counseling services helped them feel safe and understand that the abuse they
received was not their fault (see Table 1). All the participants acknowledged that their husband or
boyfriend was the biggest barrier that would have prevented them from seeking advocacy and
counseling services (see Table 1). All the victims suffered from emotional and physical abuse
from their abuser. Lastly, only one participant experienced emotional abuse while the others
experienced physical and emotional abuse. However, all were aware of the severity of being a
victim of domestic violence (see Table 1).
Results in Relation to the Literature
RQ1: What was domestic violence (DV) victims’ awareness of advocacy and counseling
service prior to their abuse?
In the first question, participants were asked to identify their awareness of advocacy and
counseling service before their abuse. Half of the participants were not aware of the counseling
and advocacy services offered at a domestic violence shelter before their stay. Also, the remaining
half of the participants had knowledge of counseling and advocacy services within the shelter but
knew little about the services provided. In chapter 2; Grossman et al., (2010) believed that
shelters are more likely to offer counseling and advocacy that meet the needs of the abused and
continue to help women after they leave. The involvement of advocacy, as a support service in
shelters is important because it serves as a social support network within the community to give
individuals a sense of emotional and physical comfort that they belong to a community of people
who care about them and value how they feel.
RQ2: What are domestic violence victims’ experiences of advocacy and
counseling services that they have received?
The second question relates to the participants’ experiences of advocacy and counseling
services they received within the shelter. Half of the participants that thought the services they
received at the shelter were excellent. A half of the remaining participants thought the services
they received from counseling services helped. In chapter 2; domestic violence advocates play an
important role in helping women overcome the emotional and physical scars inflicted on them by
their abuser. Advocacy is important to victims of DV because it improves self-efficacy through
empowerment, and helps the abused determine how to better their situation through support
services (Ramsey, 2010). According to Pyles (2008) advocacy is important because it focuses on
personalized services tailored to the abuse needs, and provides safe shelter and access to
community resources. Also, Hays et al., (2007) believed that counselors are responsible for
educating the abused on DV and how they may be at potential risk for continued and more severe
violence. The most critical part of counseling is the initial visit when counselors can help promote
the safety of the abused by helping them identify escape routes, safe places to go, making an
escape kit (money, keys, phone numbers etc.) just in case the abused choose not to return to
counseling (Hays et al., 2007).
RQ3: What are domestic violence victims’ perceptions of how advocacy and counseling
services could be improved to better serve their needs?
The third question relates to the victims’ perceptions of how advocacy and counseling
services could be improved to serve better their needs. Seven participants’ agreed that the services
needed no improvements or had no unmet needs. However, one participant preferred to have
received counseling services twice a week. In chapter 2, the study findings indicated that women
who received shelter obtain more of the shelter resources than women who choose not to seek
shelter (Grossman & Lundy, 2011). Also, those who obtain shelter services were more likely to
receive legal advocacy to help with criminal charges and protection orders than those who choose
not seek shelter (Grossman & Lundy, 2011). In addition to chapter 2, current research studies
indicated that counseling services as a support service is an unmet service for the abused. In a
crosssectional study, researchers Dichter and Rhodes (2011) administered a self-report
questionnaire to (n= 173) women. The data collected indicated that 38.6% used counseling
services; 57.9% were interested in counseling services; 62.5% see it as a current need, and 56.6%
believe it help them feel safer. Based on the study findings it can be stated that counseling is a
needed service to help the abused feel safe and to promote self-empowerment.
RQ4: What are the perceptions of DV victims on the role that advocacy and counseling
services play in preventing further abuse among domestic violence victims?
Within the fourth question, the participants was asked the role that advocacy and
counseling services had in preventing further abuse. In chapter 2, domestic violence advocates
play a major role in helping women overcome the emotional and physical scars inflicted on them
by their abuser. Advocacy is important to victims of DV because it improves self-efficacy
through empowerment, and helps the abused determine how to better their situation through
support services (Ramsey, 2010). There was 1 participant that said the advocate helped them see
the whole picture. In chapter 2, according to Allen, Larsen, Trotter and Sullivan (2012) women
who worked with advocates had an
“improvement in mental health outcomes, reported less violence, and greater quality of life” (p.
4). The remaining 7 participants said that after receiving advocacy and counseling services, they
knew what to look for to prevent further abuse.
Implications
The social change implication of this study is that greater awareness of how women view
advocacy and counseling programs and their perceptions of the risk factors for reabuse could
provide helpful information for implementing new programs to help victims of domestic
violence. This study can make a significant contribution to the knowledgebase literature related to
domestic violence advocacy and counseling programs based on the perceptions of the participants
on how they viewed advocacy and counseling programs and these programs actually help
survivors of domestic violence, and ways in which these programs could be improved to serve
unmet needs. As stated earlier, the goal of domestic violence shelters is to provide services and
programs to all women and men whether they have been abused or not. This study was able to
present exploratory data from the participants’ perceptions based on the research questions as to
how the victims viewed advocacy and counseling services they received at the shelter. Also, the
participants’ responses could contribute to the knowledgebase related to the role advocacy and
counseling services provide to the abused, and what role readers play in eliminating domestic
violence. Finally, the social change implication on the perceptions of how domestic violence
victims viewed advocacy and counseling services they received at the shelter is significant
because it may increase awareness of how victims see advocacy and counseling programs and
could help to inform larger studies through knowledgebase literature. Data collection using in-
depth interviews captured the lived experiences and perceptions of the abused through emerging
themes identified in analyses. Data analysis helped to determine if advocacy and counseling
programs, as services, are helping the abused. The goal of domestic violence shelters is to provide
services and programs to all individuals and survivors.
Recommendation
The impact of this study suggests that it can have a positive social change among domestic
violence shelters, coalitions, advocates, and counselors. The recommendations include
establishing a google page for domestic violence shelters, which will contain the title and
description of the study and a link to the published dissertation. A simulation of the results on a
Google page outlining this study could help domestic violence shelters to understand better how
they could serve victims and meet their needs. Grossman, Lundy, George and Crabtree-Nelson
(2010) reported that shelters are more likely to offer counseling and advocacy that satisfy the
needs of the abused and continue to help women after they leave. While there was only one
participant who said; she would like to have an additional session with the counselor within her
stay at the shelter, this finding suggests that there may be more victims who would like additional
sessions. Nevertheless, the participant thought the services at the shelter met her needs, but she
believed that an additional counseling session would help her mentally.
A quantitative study would be a logical next step to generate additional data regarding
advocacy and counseling services received at domestic violence shelter and would be
generalizable. Additional, interview questions would give a more in-depth understanding of the
victims’ childhood. These particular research questions established within another study would
determine through a case study/s if there is a correlation between what domestic violence victims
have seen within their family growing up and the companion they select.
Limitations
As stated earlier, a limitation of qualitative research is the inability of exploratory data to
be applied to the larger population. The main limitation of this study is the small amount of data
due to the different counties and the limited number of participants recruited. Therefore, the
findings from this study cannot be generalized. As stated earlier, the limitation of purposeful
sampling is that the research will not be generalizable to all domestic violence shelters that have
advocacy and counseling programs as services. Extreme challenges were working with shelters to
obtain participants. For example, many shelters were contacted to participate in this study some
expressed interest. Some shelters agreed to take part in the study but when the time came to seek
participants the shelters never responded or could not help at that particular time. Selection bias
can impact the trustworthiness the study data if the participants do not meet the selection criteria.
While, victims can receive services outside the shelters the main focus of the study is to
interview participants who received services at the shelter. The limitation of purposeful sampling
is that the research will not be generalizable to all domestic violence shelters that have advocacy
and counseling programs as services. This limitation is acceptable in that the result will inform
future research and larger studies. Respondent bias is another limitation could be created study if
participants are not honest during the interview. Also, in this study self-selection bias can occur
when the participants are given the opportunity to decide if they want to participate in the
research study. Respondent bias can be minimized by making sure the research questions are
precise and clear. Selfselection bias can be reduced by making sure the participants are
representatives of the population beings studied. Also, reasonable measures to address limitations
within this study will be obtained through research credibility. The credibility in data quality was
established and validated through triangulation. According to Patton (2002), the verification and
validation of triangulation may involve checking for data consistency within the sources and
findings using different data collections. Within this study purposeful sampling selected
participants based on their use of advocacy and counseling services. Lastly, qualitative research is
not generalizable but transferable in which information can be applied to other context and
situations. Some of the themes that emerge from this study could stimulate larger primary data
collections efforts of similar populations.
Conclusion
Many studies have explored the devastating effects of non-physical and physical abuse on
the abused. However, this study explored the role of advocacy and counseling programs for
victims of domestic violence. This study’s findings can contribute to the literature because not
enough research on the perceptions of domestic violence victims has been studied related to
advocacy and counseling programs that provide women safe refuge, prevention education, mental
health treatment and other services.
As stated earlier, the objective of domestic violence programs is to educate society.
Advocacy and counseling programs are the best levels of intervention to educate and eliminate
domestic violence in the community (Johnson & Zlotnick, 2009). The research questions were
developed to explore the victims’ perceptions of advocacy and counseling as program services.
Data gathered revealed that women victims of domestic violence were getting needed help from
advocacy and counseling services they received at the shelter.
The social change implication of this study is that greater awareness of how women view
advocacy and counseling programs, and their perceptions of the risk factors for re-abuse could
provide helpful information for future research. The study’s findings reflect that a majority of the
women who utilize advocacy and counseling services are pleased with the services received.
Participants who sought and received advocacy and counseling services had increased knowledge,
improved decision making, safety, selfefficacy, and empowerment to rebuild their lives.
