Battered Women's Profiles Associated with Service Help-Seeking Efforts: Illuminating Opportunities for Intervention.

Although they may not be aware of it, social workers see battered and endangered women in their practices every day. Battered women frequently seek support from their social networks and human services providers for a range of life problems without calling attention to the violence in their lives (Henning & Klesges, 2002). Comparatively few battered women seek services from providers who specialize in domestic violence. Social workers span a broad spectrum of human services agencies and are well positioned to facilitate abused women’s entry into service systems equipped to address the violence in their lives (Nurius & Asplund, 1994). If most women in violent relationships are not seeking domestic violence services, where are they going for help? What are their needs? What can we learn from violence exposure, biopsychosocial, and demographic factors to better anticipate their needs across diverse services? We addressed these questions through an investigation of services help-seeking efforts in a sample of battered women following an incident of intimate partner violence. Our goal is to provide practitioners with detailed information about the needs, resources, and characteristics of battered women as they seek help, predominantly from service providers other than violence specialists. Research generally indicates that women cope with partner violence through informal means as long as possible (Coker, Derrick, Lumpkin, Aldrich, & Oldendick, 2000). As a result, battered women who seek formal services from agencies and providers may have long-standing needs and severe problems (Hutchison & Hirschel, 1998). Partner violence has a radiating impact, with “first order” effects on a woman’s physical and mental health and secondary effects on her ability to function in her social world (for example, school, work, or parenting), spanning out to affect others such as family, friends, and coworkers (Riger, Raja, & Camacho, 2002). Service needs illustrated through earlier research include help for biopsychosocial problems related to mental and physical health and injury (Golding, 1999; Plichta & Falik, 2001), substance use (El-Bassel, Gilbert, Schilling, & Wada, 2000), and employment and financial difficulties (Lloyd, 1997). Although safety is a universal concern, battered women vary in the needs, characteristics, and resources that shape their experience of violence and help seeking (Mitchell & Hodson, 1986). On one hand, they may need formal services to manage the difficulties in their lives to escape or end the abuse. On the other hand, disclosing the abuse or trying to protect themselves and their children may increase their danger in terms of escalated or more insidious abuse, interference with work or schooling, damaged social relations, impairment of the woman’s parenting, or danger to children’s well-being (Wolf, Ly, Hobart, & Kernic, 2003). Inroads have been made in assessing battered women’s needs and resources that galvanize help-seeking efforts. In summarizing their own and others’ research, Hutchison and Hirschel (1998) found considerable variation in help seeking, with only a small proportion of women not seeking help eventually from sources outside their social network during the course of an abusive relationship. This and related work have provided initial findings linking demographic characteristics to services help seeking. However, research generally has not addressed biopsychosocial problems that might co-occur with partner violence. We addressed this gap through an examination of partner violence exposure, biopsychosocial, and demographic factors in relation to battered women’s help-seeking efforts across a range of human services directly following an incident of intimate partner violence. We hypothesized that the combination of partner violence, biopsychosocial, and demographic factors would better profile battered women’s needs and resources related to human services contacts than would any one of these sets of factors alone. Consistent with prior research, we investigated three subtypes of partner violence—psychological, physical, and sexual abuse—to discern the differential relationships these three types of violence have on service help-seeking efforts (Sackett & Saunders, 2001). In addition to behavioral acts of partner violence, we examined women’s appraisals of the threat of their abusive partners (Smith, Earp, & DeVellis, 1995). We included biopsychosocial characteristics that have been found to be related to partner violence, including depression (Tjaden & Thoennes, 2000), physical illness and injuries (Petersen, Gazmarariam, & Andersen, 2001), and substance abuse (Levine & Greene, 2000). Social interactions and relationships are other biopsycho-social factors that have been found to be related to battered women’s help seeking (Barnett, Martinez, & Keyson, 1996). We examined positive and negative social relationships to determine if these qualitatively different kinds of social ties would have different implications for help seeking across different types of services (Lincoln, 2000). Finally, we investigated demographics to represent social structural factors, including employment, income, education, race/ethnicity, and age (Henning & Klesges, 2002). Our goal was to help determine how battered women’s needs, characteristics, and resources are associated with help seeking across a spectrum of formal human services: domestic violence, legal, health care, public assistance, counseling, substance abuse, and religious or spiritual. We examined both successful and attempted but not successful help-seeking efforts, which allowed us to include participants’ help-seeking behaviors even if these efforts did not result in service delivery. For example, a woman may seek services from a domestic violence shelter but be turned away because the agency is full to capacity. First, we compared participants who reported attempts to or successful receipt of services help seeking with participants who reported no services help seeking. Subsequently, we analyzed patterns of needs and resources among participants who attempted to or obtained help across social, health, and legal services.