How Does a Strong Advocate-Survivor Alliance Help Survivors of Domestic Violence?
“Domestic Violence Survivors’ Empowerment and Mental Health: Exploring the Role of the Alliance With Advocates” (abstract). Lisa A. Goodman, Jennifer E. Fauci, Cris M. Sullivan, Craig D. DiGiovanni, and Joshua M. Wilson. American Journal of Orthopsychiatry, Vol. 86, No. 3 (2016).
What it’s about: Researchers Goodman, Fauci, Sullivan, DiGiovanni, and Wilson wanted to know what specific aspects of the relationship between survivors of domestic violence and their advocates might contribute to survivor well-being. To find out, they surveyed 370 help-seeking female survivors from eight different programs across the Northeast and Midwest for symptoms of depression and post-traumatic stress disorder (PTSD). They also explored how empowered the survivors felt to keep themselves and their families safe without creating new problems. The survey also took into account such factors as race/ethnicity, financial strain, and length of stay in the program.
Why read it: Goodman et al. note domestic violence has powerful negative effects on survivor mental health and well-being. However, they write, few studies have examined how domestic violence programs might work to improve survivors’ mental health. This newer study explores the direct relationship between the advocate-survivor alliance with symptoms of depression and PTSD, and the indirect relationship between these symptoms and safety-related empowerment. The findings could help inform a theory of change for programs seeking to create one, Goodman et al. suggest.
Biggest takeaways from the research: The researchers observed the following results:
The role of safety-related empowerment. Goodman et al. suggest that the quality of the relational bond and the alignment of goals between survivors and advocates helped survivors gain a sense of empowerment in the arena of safety. Prior research shows that safety-related empowerment is related to reduced symptoms of PTSD and depression among domestic violence survivors. Therefore, Goodman et al. suggest that the alliance between survivors and advocates served as a foundation for participants to work toward improved well-being.
The role of race/ethnicity, financial strain, and length of involvement in program. Survivors who identified as Black/African American or Multiracial/Other experienced significantly lower levels of alliance than White or Latina participants. Financial strain also appeared to set back possible alliances. Finally, the longer a participant spent in a program the higher her sense of empowerment and the lower her PTSD and depressive symptoms.
The relationship between advocacy alliance and mental health symptoms. Contrary to the researchers’ expectations, the alliance with advocates did not appear to affect depressive symptoms. However, the alliance appeared to increase rather than decrease PTSD symptoms, though the difference was small. Goodman et al. suggest that those reporting a stronger alliance may have found more relief from the social isolation PTSD and depression can produce. Alternatively, they write that establishing a strong alliance alone, without also providing therapeutic support, might be insufficient to reduce symptoms of depression and PTSD.
The authors note that while the sample population was drawn from an ethnically diverse variety of programs in the Northeastern and Midwestern United States, these results might not be representative of populations in other geographic areas. They also emphasize that this study assessed associations between factors, but could not confirm causality. However, they do suggest that their work provides preliminary support for cultivating strong alliances between survivors and their advocates in order to help improve their mental health and regain a sense of power and control over their safety.
Review the Center for Epidemiological Studies Depression Scale (CES-D), which the researchers used to measure survivors’ severity of depressive symptoms.
Learn how to use the Measure of Victims’ Empowerment Related to Safety (MOVERS) (PDF, 805KB), which this study used to assess survivors’ empowerment in the domain of safety.