Running head: A SOLUTION TO COSTLY SERVICES FOR THE ABUSED 1

A Solution to Costly Services for the Abused

Julia Ruiz

Arizona State University

A SOLUTION TO COSTLY SERVICES FOR THE ABUSED 2

Abstract

Abusive relationships are not a new phenomena and will likely never cease to exist. The costs of

the aftercare expenses and financial aid takes a large toll. Most women who are abused have to

live in shelters and have little to no money and often big medical bills. These services are still

needed, but in order to lower the cost of the expenses, a preventative approach should be taken.

A solution to this would be a trained counselor or advisor who is trained in the abusive

relationship topic and is trained on mediation to go into homes of families that are at risk. If a

friend or family member is concerned for a woman in her home, they can call this

government-provided service to go and help her using this program. The counselor would go into

the home of the family once a week and have the couple do an online training program on topics

ranging from abusive relationships, to healthy relationships and do activities and a short quiz at

the end to make sure there was an understanding of the concept. After the short module, the

family will have the opportunity to do a therapy session where they can discuss issues that bother

them while having a mediator present. The counselor can then give personalized advice and can

help the family work through problems before they become too serious.

Key Words​: Abuse, relationships, counselor, training, therapy, prevention

A SOLUTION TO COSTLY SERVICES FOR THE ABUSED 3

Advocating To Take Preventative Measures

Abusive relationships are thriving today and unfortunately are not a thing of the past. ​One

in three murders against women are by their intimate partners as suggested by the Freedom K9

Project. ​An abusive relationship as defined by The National Domestic Violence Hotline is ​ “A

pattern of behaviors used by one partner to maintain power and control over another partner in an

intimate relationship.” In order to escape these relationships, women turn to programs that will

give them the tools they need in order to escape them. ​Funding for programs to help abused

women are essential. These programs are who women turn to when they have no one else to turn

to. They help house women and give them supplies that they need to survive. They feed them,

counsel them, and help them start new lives. The problem with these programs is that they are

expensive and costly. Some people advocate to eliminate them all together to cut spending.

However, they are detrimental to women trying to turn over new leaves in their lives. In order to

keep these programs, changes need to happen. While programs for abused women can be costly,

these costs can be relieved by prevention programs and online training courses.

Abusive Relationships

Abusive relationships are hard on the person in the relationship, as well as their friends

and family around them who have to watch their loved one go through something terrible.

Sometimes family and friends do not know what to do, while others try and talk to the victim

themselves. These approaches are usually not successful and do not work. Women face many

barriers when trying to escape an abusive relationship. They may think it is their fault, they
A SOLUTION TO COSTLY SERVICES FOR THE ABUSED 4

might not have anywhere else to go, or may even have large pets that they know would not be

allowed at shelters. Finances is also a common issue that women face when leaving an abusive

relationship because many times, the abuser will make the woman quit her job, or hand over all

her paychecks to him so that she is financially dependent on him (National Domestic Hotline

2019). At times, a woman will hold a blind faith that the abuser will stop abusing her and will go

back to how he was in the beginning of the relationship.

Many programs today are targeted to helping women after abuse and possibly physical

and psychological damage has occurred. These programs rack up expenses in hospital bills,

housing, possible financial aid, and more. Regardless, these programs need to stay in place for

the women who do go through such traumas. There are many intervention programs, but they are

very costly to whomever funds the program and has many moving parts within it. In recent years,

there has been tackles on this issue by economists and the programs themselves and have found

that by offering online training on abusive relationships and providing preventative programs in

an attempt to prevent abuse from ever happening has helped cut down the cost of money that

goes into the intervention programs.

Research over the past 30 years have been studying costs for all types of domestic

violence related cases, as well as emotional and psychological effects on women. A study done

by Varcoe in 2011 found that the estimated annual cost of dealing with the aftermath of abuse is

about $6.9 billion. This accounts for housing, medical costs, counseling, and other services a

woman would need to recover and get back on her feet. Women after abuse suffer deep-rooted

psychological damage such as Post Traumatic Stress Disorder.

A SOLUTION TO COSTLY SERVICES FOR THE ABUSED 5

The cost of dealing with the consequences of abuse were estimated to be $13,162 per

woman per year. This includes assessing health services, hospital visits, health testings,

addictions, counseling, and a small amount of services unrelated to health such as financial aid,

social assistance, employment insurance, etc. ​Rather than intervene after abuse has occured, after

the woman is scarred and injured, after losing herself, their aim is to prevent it all from

happening in the first place.​ It has been suggested by Wells that by doing more preventative

programs, money will be saved in the long run. Investing more in prevention and intervention

programs can return as many $20 for each dollar invested (Wells, Boodt, Emery 2012). This is a

big step in cutting down costs and saving money. The Varcoe study also suggests that by taking

preventative measures, it saves about $11,370 in spending on downstream interventions.

Possible Solution

A solution to help bring down the cost of services for abused women would be a

combination of counseling at home and an online training program to educate people on abuse

and violence. These counseling visits would help families work through issues they have as well

as give the counselor a chance to see in the house of the woman at risk to make sure everything

is okay. During the span of these visits, the counselor would also help the families do an online

training course on violence, abuse and healthy relationships.

Implementation

If a woman is being abused or at risk of being abused, a theoretical family member would

contact this solution program to come and monitor the household as well as counsel and advise

the family through any issues. Once a week, an assigned counselor who specializes in abusive

relationships will come over to the family’s residency. Once there, the counselor will give a brief
A SOLUTION TO COSTLY SERVICES FOR THE ABUSED 6

lesson on topics ranging from violence to what a healthy relationship looks like. After this brief

lesson, the family will complete a module online with activities and a short quiz to make sure the

content was understood. After the module is complete, the family will have the chance to talk

through any issues they are currently having with the counselor mediating. This program would

go on for as little as 6 months, to 2 years, depending on what the counselor feels is best.

With technology being on the rise and getting more popular to use as forms of education,

there have been attempts to prevent abuse from happening by doing online training programs in

similar fashions. Hilton suggests that this training program is more accessible to people by being

online and the person going through the program can go at their own pace. Evidence also

suggests that it can be more effective than face-to-face training (Hilton 2014). However, there is

only limited research on these online training programs as it is fairly new. In the same study,

there are new online programs that evaluates risk and takes into account the criminal’s history,

the most recent domestic assault, as well as the victim’s circumstances. The program has a scale

of 0-13 which is divided into 7 categories on and predicts the risk of the criminal reoffending.

After doing analyses, it has been found that this program is better than other risk assessment

instruments and a fraction of the cost.

The MOSAIC program is another program that does not cost much money and is similar

to the possible solution. It is a program where trained and supervised local mothers visit houses

over a 12 month period while befriending the pregnant woman at risk in order to evaluate risk.

Similar programs have been implemented in the United States such as the Nurse Family

Partnership (NFP). This program helps to transform lives of vulnerable mothers-to-be. Each

mother is partnered with a nurse who continues to visit through her child’s second birthday.
A SOLUTION TO COSTLY SERVICES FOR THE ABUSED 7

Evidence suggests that not only was domestic violence reduced, but health and pregnancy

complications were reduced as well as increased earnings and better maternal child mental

health. Nurse Family Partnership produced a cost benefit ratio of 5:7:1 meaning that for every

dollar spent, $6 in education, child maltreatment, domestic violence and employment outcome

for women and children were gained by both the government and community.

These programs are both good, bit combining the general concepts of the two of them

would help make a big difference. It is important to have the one on one counseling, but the

training also plays a vital role in the prevention of abuse. Having personalized help is pivotal

because no two situations are the same and what might work for one family, will not always

work with another one. This way, there is protection for both parties and will likely bring down

the cost. In the MOSAIC project, there was no meetings with the mother-to-be and her partner if

applicable; it was only the mother. This was not an issue, however, the program would likely be

far more successful if the nurse met with the father or partner as well. In the training program

and risk analysis, there was not a professional present when doing the training, so questions

likely went unanswered. While the risk analysis may not be needed in the possible solution, it

could be something to keep in mind if prior abuse has occurred within the relationship.

Benefits and Challenges

A benefit to this solution is that there is a trained counselor going into the home and

seeing how home conditions are and is able to give personalized help. No two families are the

same and even the ones with the same or similar issues will not always benefit from the same

solutions. With having a counselor there, they are able to see for themselves the dynamic of the

couple and family and can dictate whether or not the woman or family is at risk. In the case that
A SOLUTION TO COSTLY SERVICES FOR THE ABUSED 8

they are, or if they see something suspicious, they are able to report the issue themselves to the

police and have someone investigate.

One challenge that may arise with the counselor is the possible rescheduling of

appointment times as well as the lack of participation. If one person does not feel like they

should be taking the course and feel they know everything, it can be hard to get them to

participate. In this case, the program require participation by the government in order for things

to run smoothly, but it would be hard to make participation required without making it a law of

some sort. While there may be some benefit of a counselor going into the home and inspecting

the home without being suspicious to the residents, it can also put the counselor in harm’s way.

If the man is truly violent or has no care to improve his character, he could get mad that he is

under inspection and possibly harm or kill the counselor if he feels threatened.

By giving lessons on violence but also healthy relationships, it gives the woman

assurance and clarity of what a healthy relationship looks like and hope. By educating the family

on these issues, they become more knowledgeable on the subject and know the risks as well as

the consequences of abuse. With the built-in therapy session, any and all issues are able to be

brought to the table before it becomes something too big. If one partner has an issue with the

other, they can feel comfortable enough to voice their frustration in a nice way and are mediated

by another person. They will be able to learn “I” statements instead of accusing and attacking the

other, putting them in defense mode. Before issues become too big and underlie all other issues

they may have with each other, the mediation is helpful to the relationship and are able to receive

back personal advice for their issues as well as relationship.

A SOLUTION TO COSTLY SERVICES FOR THE ABUSED 9

A challenge of the lesson and therapy sessions is lack of participation. Perhaps the man

could be abusive and does not want his ways to be exposed so he tells the woman what to say

and do while the counselor is there and threaten to harm her if she does not obey him. There also

is the issue of someone becoming defensive regardless of the use of “I” statements and shutting

down instead of willingly working through the issues. The online training is useful, but there is

no way to know for sure that the knowledge learned would be applied and used. The knowledge

while useful, will do no good unless the couple or family wants to use it and improve

themselves.

Conclusion

While taking preventative measures would help bring down costs of handling the abused,

there will always be women suffering abuse. Investing a good chunk of money for preventative

services will decrease the overall spending on the abused in general. Abusive relationships will

most likely never come to a halt, but it can help be prevented through the counseling and training

program. Rather than pay for housing, financial aid and medical expenses for women who went

through unforgettable traumas, the numbers could be dramatically decreased. With the help of a

trained counselor and a training program geared to educate people on abuse and relationships,

the number would decrease even further. This solution would help cut down all costs of medical

expenses and other types of financial aid and keep families together. With the counselor present

during the online training, they are able to answer any questions the families may have and can

supervise and make sure the training is completed. Having a therapy session at the end of the

meeting will help solve problems before they become too large to handle and solve.
A SOLUTION TO COSTLY SERVICES FOR THE ABUSED 10

Bibliography

Anderson, K. M., Renner, L. M., & Bloom, T. L. (2017). Exploring Protective Strategies among

Rural Women in an Abusive Relationship. ​Issues in Mental Health Nursing​, ​38​(8), 610–618.

https://doi-org.ezproxy1.lib.asu.edu/10.1080/01612840.2017.1322159

Baholo, M., Christofides, N., Wright, A., Sikweyiya, Y., & Shai, N. J. (2015). Women’s

experiences leaving abusive relationships: a shelter-based qualitative study. ​Culture, Health

& Sexuality​, ​17​(5), 638–649.

https://doi-org.ezproxy1.lib.asu.edu/10.1080/13691058.2014.979881

Cervantes, M., & Sherman, J. (2019). Falling for the Ones That Were Abusive: Cycles of

Violence in Low-Income Women's Intimate Relationships. ​Journal of Interpersonal

Violence,​ 886260519829771.

https://journals-sagepub-com.ezproxy1.lib.asu.edu/doi/full/10.1177/0886260519829771
A SOLUTION TO COSTLY SERVICES FOR THE ABUSED 11

Diemer, K., Humphreys, C., & Crinall, K. (2017). Safe at home? Housing decisions for women

leaving family violence. ​Australian Journal of Social Issues (John Wiley & Sons, Inc. ),​

52​(1), 32–47. ​https://doi-org.ezproxy1.lib.asu.edu/10.1002/ajs4.5

DeRiviere, L. (2015). Pay Now or Pay Later: An Economic Rationale for State-Funded Helping

Services to Assist Women Leaving an Abusive Relationship. ​Violence & Victims,​ ​30(​ 5),

770–797. ​https://doi-org.ezproxy1.lib.asu.edu/10.1891/0886-6708.VV-D-13-00124

Duffy, L. (2015). Achieving a Sustainable Livelihood After Leaving Intimate Partner Violence:

Challenges and Opportunities. ​Journal of Family Violence​, ​30​(4), 403–417.

https://doi-org.ezproxy1.lib.asu.edu/10.1007/s10896-015-9686-x

Farris, E. M., & Holman, M. R. (2015). Public Officials and a “Private” Matter: Attitudes and

Policies in the County Sheriff Office Regarding Violence against Women. ​Social Science

Quarterly,​ ​96(​ 4), 1117–1135.

http://web.a.ebscohost.com.ezproxy1.lib.asu.edu/ehost/detail/detail?vid=0&sid=2b088b2e-04

77-4390-b3d6-3478ef6069c1%40sdc-v-sessmgr02&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%

3d%3d#AN=1643013&db=eoh

Forenza, B., & Bermea, A. (2017). An Exploratory Analysis of Unhealthy and Abusive

Relationships for Adults with Serious Mental Illnesses Living in Supportive Housing.

Community Mental Health Journal,​ ​53(​ 6), 679–687.

https://doi-org.ezproxy1.lib.asu.edu/10.1007/s10597-017-0141-8

Freedom-k9-project | FACTS. (n.d.). Retrieved January 18, 2019, from

https://www.freedomk9project.com/facts?gclid=Cj0KCQiA7briBRD7ARIs​ABhX8aB4_I9oW

ERlZmGyIulyY7vEwxeKvq7XLr0XZIlc9fj-jBxQsveK4Y8aArSjEALw_wcB
A SOLUTION TO COSTLY SERVICES FOR THE ABUSED 12

HALLIGAN, C., KNOX, D., & BRINKLEY, J. (2013). Trapped: Technology as a Barrier to

Leaving an Abusive Relationship. ​College Student Journal​, ​47​(4), 644–648. Retrieved from

http://search.ebscohost.com.ezproxy1.lib.asu.edu/login.aspx?direct=true&db=aph&AN=9381

3993&site=ehost-live

Hilton, N., & Ham, E. (2015). Cost-Effectiveness of Electronic Training in Domestic Violence

Risk Assessment: ODARA 101. ​Journal of Interpersonal Violence,​ ​30​(6), 1065-1073.

https://journals-sagepub-com.ezproxy1.lib.asu.edu/doi/full/10.1177/0886260514539762

Home. (n.d.). Retrieved January, from ​https://www.thehotline.org​/

Iyengar, R., & Sabik, L. (2009). The dangerous shortage of domestic violence services. ​Health

Affairs (Project Hope),​ ​28(​ 6), W1052-65.

https://www-healthaffairs-org.ezproxy1.lib.asu.edu/doi/10.1377/hlthaff.28.6.w1052

Lana Wells, Casey Boodt, & Herb Emery. (2012). Preventing Domestic Violence in Alberta: A

Cost Savings Perspective. ​The School of Public Policy Publications,​ ​5​(17), 1-17.

https://doaj.org/article/51023de5c10343c8946a280ee0636b4f

Michaels, H., Neal Kimball, Cynthia, Pressley, Jana, & Pyykkonen, Benjamin. (2016). ​Why She

Doesn't Just Leave: The Interaction of Attachment and Perceived Barriers to Leaving an