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Running head: INDEPENDENCE IN VICTIMS OF DOMESTIC VIOLENCE

How Interventional Programming in Domestic Violence Shelters Can Develop Independence in

Victims of Domestic Violence

Ali Arcaro, Heather Robinson, Juliet Fetteroll, Brooklyn Oliver, and Muriel Movida

Public Health Research - E. Jobli

University of North Florida

Introduction and Literature Review

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Running head: INDEPENDENCE IN VICTIMS OF DOMESTIC VIOLENCE
Introduction

Domestic violence is an extremely prominent and often overlooked issue in the United States;

an estimated 22% of women will be victims of domestic violence in their lifetime (Bennett,

Black, Weisz, 2010). Domestic violence is an umbrella term that includes multiple different

categories, including but not limited to: physical abuse, sexual abuse, emotional abuse, economic

abuse, psychological abuse, threats, stalking, and cyberstalking (U.S. Department of Justice, n.d).

Domestic abuse no longer only blames the female in the relationship, but also encompasses

spouses, dating partners, sexual partners, family members, children, and cohabitants (Find Law

n.d,). Among the many difficulties that a victim faces once they have left a shelter, one of the

most significant is the struggle of finding a place to live. Throughout the United States, there is

known to be approximately 1,500 emergency domestic violence shelters that are open 24 hours a

day. Their services attempt to provide temporary salvation to the harsh effects of domestic

violence, however these services are not long-term (Tracy, 2016).

The Hubbard House is a women’s domestic violence shelter in Jacksonville that provides

safety and structure to those getting out of abusive relationships or those attempting to leave an

abusive partner. Over the course of 42 years, The Hubbard House has answered over 92,000

domestic violence hotline phone calls and has sheltered over 36,800 victims of domestic violence

(Hubbard House, n.d.). Although the Hubbard House provides mental health counseling as one

of their included services, there is no service that prepares survivors for being independent once

they leave the Hubbard House. Co-dependence is often a large problem for women trying to

reestablish their lives after the abuse. Counseling could provide women with the ability to

maintain independence and find success in their own lives once outside of an abusive

relationship.
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Running head: INDEPENDENCE IN VICTIMS OF DOMESTIC VIOLENCE
The proposed study will implement a program that provides financial information, lessons on

independence, and basic lifestyle skills that will make it possible for women to succeed on their

own once outside of the Hubbard House or other domestic violence shelters. The proposed

intervention program could help victims maintain a healthy lifestyle once completely detached

from their domestic violence relationship.

Literature Review

Statistics on Domestic Violence

Domestic violence has become an epidemic in the United States - nearly 3 in 10 women (29%)

and 1 in 10 men (10%) in the US have experienced rape, physical violence, and/or stalking by a

partner and report a related impact on their mental health (The National Domestic Violence

Hotline, 2018). There are different types of domestic violence, which include, “control, physical,

sexual, emotional, isolation, verbal abuse, male privilege and economic abuse,” (Arizona

Coalition to End Sexual & Domestic Violence, n.d.). Domestic violence and intimate partner

violence (IPV) usually result in physical injury, assault, and mental health repercussions

(Karakurt, Patel, Whiting, Koyutürk 2016). To determine differences, researchers observed

lifestyle patterns of two groups of women, one of which were victims of domestic violence (or

IPV) and one that was a comparison non-victim group. The results found that women who were

victims of domestic violence were much more likely to be affected by the following: “acute

injury; chronic substance abuse; mental health disorders; gynecological issues; pregnancy related

problems; allergy; procedures; congenital/hereditary; nutrition; neoplasm; personal history;

family history; neuropathy; diabetes; gastrointestinal; cardiovascular; nervous system;

respiratory; musculoskeletal; eyes, ears, nose & throat, excretory; endocrine; immune system;
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Running head: INDEPENDENCE IN VICTIMS OF DOMESTIC VIOLENCE
skin related problem,” (Karakurt, et. al., 2016).The issue of domestic violence is extremely

detrimental to its victims, as it negatively impacts them for the rest of their lives. To prevent the

onset of repercussions from domestic violence, it is extremely important to educate people on the

warning signs of an unhealthy relationship and to mentally rehabilitate if there is an incidence of

IPV or domestic violence.

Risk and Protective Factors

There are many risk factors that lead to the victimization of a target in a domestic violence

situation. Understanding said risk factors largely contributes to preventing domestic violence

before it happens. Low self-esteem and emotional dependence can make an individual more

susceptible to become an abuser. In a cohort study done in 2002, lower income was studied as a

possible cause of violence: “family poverty in childhood and adolescence, low academic

achievement and aggressive delinquency at the age of 15 years all strongly predicted physical

abuse of partners by men at the age of 21 years,” (WHO, 2002). Low IQ is associated with

domestic violence as well - poor academic achievement at an early level of childhood education

may be indicative of male aggression in a relationship by the age of 21. Poor behavioral control

and other personality traits (i.e. being antisocial) are more likely to be expressed with aggression

and displays of psychopathology, which is typically higher among the abusers. If a child is

exposed to aggressive behavior between its parents, the child’s cognitive development may be

affected. “Men who had been beaten as children or had witnessed their mothers being beaten

demonstrated higher rates of abuse against their partners,” (WHO, 2002). Lastly, the desire for

power and control in a relationship is may cause a potential abuser to assert their dominance over

their partner in the form of physical harm. While there are risk factors with IPV, there are also
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Running head: INDEPENDENCE IN VICTIMS OF DOMESTIC VIOLENCE
protective factors; good social support groups with high quality friendships and proper resources

and services within a community greatly increase the probability of a victim getting out of an

abusive relationship.

Mental Health Repercussions

Domestic violence victims suffer most when they must compromise their mental health to

remain in an abusive relationship. “Ninety percent of domestic abuse victims exhibited PTSD

symptoms within weeks of having been attacked, and it has been shown that they are more likely

to develop PTSD. Depression is also prevalent among victims of intimate partner violence,”

(Fujiura, Resnick, 1997). These trauma-related symptoms are a direct result of violent assault:

PTSD, depression, increased frequency of panic attacks, physical health issues such as

hypertension, increased risk of heart attack, substance abuse, and higher rates of sexually

transmitted diseases. Self-harming behaviors (risky sexual behavior and alcoholism) are

sometimes used as coping mechanisms to reduce any anxiety or depression after a traumatic

event (Fujiura et al. 1997). More often than not, victims of domestic violence struggle with

emotional stability after the abuse. This can be made even more difficult when they leave the

safe comfort of the Hubbard House. “Higher levels of non-acceptance of positive emotions,

difficulties engaging in goal‐directed behaviors when experiencing positive emotions, and

difficulties controlling impulsive behaviors when experiencing positive emotions were related to

a higher level of PTSD,” (Weiss, Dixon-Gordon, Peasent, Sullivan, 2018).Lack of ability to

properly cope with negative emotions is a large contributing factor to the need for independence

therapy in the Hubbard House.

Domestic Violence Shelters and Interventions

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Running head: INDEPENDENCE IN VICTIMS OF DOMESTIC VIOLENCE
Although victims of domestic violence are burdened by mental and emotional trauma, the

interventional services provided by domestic violence shelters can help alleviate their stress.

When women live in an abusive environment, they are highly likely to blame themselves for the

violent actions that happen to them, resulting in a decrease of self-worth and loss of sense of

control. Domestic violence shelters try to help victims regain their self-confidence and control

through the framework of the shelter’s services. “Shelters can encourage place-identity and

place-attachment by creating a home-like atmosphere with non-institutional furnishings and

encouraging personalization through bulletin boards, display areas, and secure storage for

personal possessions,” (Rutledge, 2015) and allowing residents control of the temperature and

lighting of their room gives victim a sense of regaining control (Grieder and Chanmugam, 2013).

Creating a safe environment where women feel accepted is an important aspect of wellness in

domestic violence shelters. Using social support in the form of group therapy facilitates

adaptation and improves associated health outcomes by validation within their cohort

(Constantino, Crane, Kim, 2005). Women who are victims of IPV who have received any form

of social support show significantly less healthcare issues than women who have not received

any social support. The women who received a social support method of intervention had lower

levels of psychological distress compared to the groups who did not receive the same treatment.

The social support model provided a safe environment for the women who were dwelling in

these shelters. Another intervention, the Sanctuary Model, is, “based on theories of trauma and

attachment and looks at the physical, cognitive, emotional, social, and behavioral responses to

danger as well as people’s need for a safe, nurturing, and predictable social environment,” (Blitz,

Madsen, McCorkle, Panzer, 2003). The Sanctuary Model focuses on healthy attachments and
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Running head: INDEPENDENCE IN VICTIMS OF DOMESTIC VIOLENCE
psychoeducation that is rooted in recovery from various types of trauma. One of the aspects of

the Sanctuary Model involves an emphasis on the staff’s ability to teach skills and behaviors

involved in psychoeducation. These practices were implemented under the assumption that the

environment would reflect security and healing for the victims. The victims utilizing this model

were expected to further their personal development and participate in decision making seminars.

The purpose of this program was to make sure that all voices were heard and respected. The staff

did this by listening to each of recovering victims’ experiences and encouraged them to seek

healing within themselves.

Children involved in IPV experience suffering from witnessing abuse between their

parents. By implementing programs for children, such as art or individual services to address

behavioral issues, the mothers are helped as well. Strengthening the relationship between

caregiver and child is an important step in healing. “Supportive counseling and some parenting

relief empower the mother, allowing her to function more effectively as a parent,” (Beran, Poole,

Thurston, 2008). The mothers were also taught strategies of successful parenting in order to

solidify their relationships with their children. The maternal interventions took an educational

approach; the mothers were taught how to parent effectively by enhancing their knowledge about

their child’s emotional needs. This intervention was simple, yet effective.

Conclusion

The Hubbard House is a women’s domestic violence shelter in Jacksonville that has sheltered

over 36,800 victims of domestic violence by providing safety and structure to those getting out

of abusive relationships or those attempting to leave an abusive partner (Hubbard House, n.d.).

While the Hubbard House is an amazing resource for women who struggle with domestic
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Running head: INDEPENDENCE IN VICTIMS OF DOMESTIC VIOLENCE
violence, there are no services that prepare the survivors for being independent when they leave.

“Ninety percent of domestic abuse victims exhibited PTSD symptoms within weeks of having

been attacked, and it has been shown that they are more likely to develop PTSD…” (Fujiura,

Resnick, 1997). PTSD causes survivors to struggle with positive emotions that regulate coping

and impulsive behavioral control.

The intervention being proposed to be implemented in the Hubbard House will focus on teaching

how to foster positive emotions and independence through three interventions: environmental

psychology, social support, and aforementioned The Sanctuary Model. These interventions will

work together to form a system that will close the gap of independence outside the Hubbard

House for better adjustment once they enter society. The proposed study will implement a

program that provides financial information, lessons on independence, and basic lifestyle skills

that will make it possible for women to succeed on their own once outside of the Hubbard House

or other domestic violence shelters. This intervention program could help victims maintain a

healthy lifestyle once completely detached from their domestic violence relationship. Our

research purpose is to implement new plans of action for domestic violence shelters to educate

women on how to be more financially, socially, and emotionally independent once they return to

society after being in a domestic violence shelter and relationship.

Methodology

Participants

The sample population for this study will include any female who is a victim of domestic

violence who is staying at the Hubbard House. Women currently receiving cognitive behavioral

therapy within the shelter will be offered to participate in the intervention, but they will not be
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Running head: INDEPENDENCE IN VICTIMS OF DOMESTIC VIOLENCE
forced to participate. The age of women staying in domestic violence shelters ranges from 28-45,

so the population will be around that age group. The sampling method that will be used is quota

sampling. The sample population will be obtained by asking every woman already participating

in cognitive behavioral therapy if they are interested in receiving additional, free counseling. Our

quota for the sample is 100 women.

Instrumentation

The instrumentation used to collect data for our proposed experiment will be in the form

of a pre-test and post-test survey measuring self-efficacy and self-confidence of the victims at the

Hubbard House. The questions will include: How would you rate your self-esteem on a scale

from 1-10 (10 being extremely confident)? Would you describe yourself as self-sufficient and

independent? How would you rate your feeling of hopelessness on a scale from 1-10 (10 being

extremely hopeless)? Prior knowledge on basic life skills, (paying bills, cooking etc.). This

survey would be given to the control and experimental groups and the answers will be compared

to determine whether or not our study produced a significant outcome. The dependent variable is

the mental health of the victims and their ability to be autonomous after receiving the

independent variable, which is the Independence Intervention program.

Design and Procedure

The design that will be implemented will be a randomized control study. At the Hubbard

House currently, they implement a standardized cognitive behavioral therapy, which assists in

emotional recovery and healing from trauma. Both control and experimental groups will

continue to receive the once-a-week, one-hour, cognitive behavioral therapy provided by the

Hubbard House. The experimental group will receive an additional twice-a-week independence

invention program for two hours, which will include independence training on how to survive
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Running head: INDEPENDENCE IN VICTIMS OF DOMESTIC VIOLENCE
once outside of the Hubbard House, teaching them how to gain independence. In addition to this,

there will be a skill-building program teaching the women basic life skills, such as how to pay

bills, how to fix various household items, and how to find and keep a job. Our interventional

program is all about teaching the women to survive on their own outside of the Hubbard House

and outside of the domestic violence relationship that they were previously in. Both the control

and the experimental group will continue for one month and women will be split up randomly

into either group. Both groups will begin either the basic cognitive therapy or the independence

intervention program plus the cognitive therapy a day after the pretest survey is administered.

The posttest survey will be administered one week after completing the month of the cognitive

behavioral therapy or the intervention program with the cognitive behavioral therapy to see if

there is in an improvement between the pretest and posttest scores in how much more knowledge

the victims now have about how to be independent, how self-sufficient they are, and if their basic

life skills have improved.

Data Analysis
The data collected will be explained in a variety of ways. The survey questions will be

interpreted and shown by different techniques dependent upon whether they are nominal, ordinal,

interval, or ratio data. The survey question answers from the pre-test and post-test will be

compared, as well as the results from the control and experimental groups. For the survey

questions that have two variables (i.e. would you describe yourself as self-sufficient and

independent?), the data will be interpreted using T-tests. The questions that have more than two

variables (what was your prior knowledge on basic life skills, such as paying bills, holding a job,

etc.) will be collected and interpreted with an ANOVA test. The data collected about the

comparative difference between pretest and post test will be portrayed via histogram to show the

growth or decline between subjects and their self efficacy/confidence. These quantities will be
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Running head: INDEPENDENCE IN VICTIMS OF DOMESTIC VIOLENCE
expressed in percentages based on the mean of each set of questions. The difference between

self-efficacy/confidence between the control and experimental group will also be put in a

histogram to show the magnitude of difference. Based on the effectiveness of incorporating the

Independence Intervention Program, an increase in self-efficacy/self-confidence and attitude can

be expected. The satisfaction and helpfulness of the counseling can be determined by the results

of the post-test survey; if victims felt more independent and mentally stable after the

intervention, then their answers will be indicative of a successful therapy.

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Running head: INDEPENDENCE IN VICTIMS OF DOMESTIC VIOLENCE

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Running head: INDEPENDENCE IN VICTIMS OF DOMESTIC VIOLENCE
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