Abstract
This study explores British social workers’ abilities to recognize incidents of interpersonal violence, how much domestic violence training social workers typically receive, and how awareness of organizational policies and practice experiences impact workers’ attitudes about domestic violence. Based on our findings we suggest that traditional higher education teaching methods of lecture and seminar combined with a service-learning component to course work should be explored. Additionally, local authorities and other health and social care agencies need to take more responsibility for ensuring their employees understand agency policy regarding domestic violence and how to apply it.
Keywords
Domestic abuse or domestic violence, 1 now much in the public gaze (Mullender and Hague, 2005), is recognized internationally with growing concern (Campbell, 2001; Fernandez, 1997; Kanno and Newhill, 2009; Romkens, 1997). It involves the emotional, physical, sexual and/or economic abuse of one or more members of a family by another within the domestic sphere (Bates and Brown, 1998; Eisenstat and Bancroft, 1999; Grace, 1995; Hearn, 1998; Home Office, 2000; Richardson and Feder, 1996). This includes ‘. . . any incident of threatening behaviour, violence or abuse between adults who are or have been in a relationship together, or between family members, regardless of gender or sexuality’ (Crown Prosecution Service, 2009). Domestic violence occurs across the social spectrum and it is likely that physical, psychological and sexual abuse is experienced in more than one way by most victims. Individuals affected by long-standing domestic violence often experience emotional health issues, such as low self-esteem, feelings of guilt or shame, depression, and even post-traumatic stress (Humphreys and Thiara, 2003; Romito et al., 2005).
Most domestic violence, however, is perpetrated by men towards women (Grace, 1995; Hague and Malos, 2005; Kanno and Newhill, 2009). In fact, male partner violence was the most common type of intimate violence experienced by women in England and Wales during the 2008–2009 time period (Roe et al., 2009). Given the statistics, it is not surprising then to find that mothers rather than fathers are more likely to be victims of domestic abuse (Cowan and Hodgson, 2007) and hence, by way of propinquity, their children are impacted as well. Children who live with domestic violence know it is happening, and are likely to be affected by the fear, distress and disruption that accompany domestic violence, even if they are not directly the target of the domestic violence (Buckley et al., 2007; Hester et al., 2000; Mullender, 2000).
Social workers and the prevalence of domestic violence cases in the field
Social workers come into contact with women and children living with domestic violence and abuse quite regularly in the various health and social care settings in which they work (Baker et al., 2010). Although Mullender (2000) contends that one-third of children on child protection registers live with domestic violence, intervention by child protection service workers in domestic violence cases has been the subject of very few studies (Bourassa et al., 2008). Research on the overlap and strategies to move forward, however, has been growing over the past decade (Friend et al., 2008; Mullender, 2000; Postmus and Merritt, 2010; Shlonsky and Friend, 2007). Child Protective Services (CPS) is but one service agency employing social workers and whilst they have been targets of public scrutiny over how they have responded to domestic violence cases, CPS is hardly the only agency that employs social workers who come in contact with women and children experiencing domestic violence. Social workers in hospitals, mental health agencies, and substance abuse treatment centres are just as likely to encounter women who have experienced domestic violence (Danis and Lockhart, 2003; Forgey and Colarossi, 2003). In fact, Blythe et al. (2010) demonstrate the need for cross-training of professionals working in the areas of domestic violence, child protective services, mental health and substance use.
Responses to domestic violence policy
Additionally, there have been numerous changes to policy and laws regarding domestic violence cases in the UK, which further introduced a range of reports (Home Office, 1999, 2000) as well as specific guidance and planning for certain professional groups (Crown Prosecution Service, 2009; Department of Health, 2000; Her Majesty’s Crown Prosecution Service Inspectorate and Her Majesty’s Inspectorate of Constabularies, 2004; Home Office, 2002). There is very little evidence, however, that the changes in domestic violence guidance and legal options have affected services offered to children and families who are victims of domestic violence (Rivett and Kelly, 2006). Specifically, the UK National Health Service (NHS) has adopted a highly visible ‘zero tolerance’ framework, which includes mandatory organizational and police reporting of violent acts. As an example, screening for violence during antenatal care is required as part of this policy. The Government’s Proposal on Domestic Violence addresses prevention, protection and support strategies (Home Office: Safety and Justice). While it may be promising, the mixed reviews (Feder et al., 2005) and limited research suggest it is premature to draw conclusions on the policy’s effects on actual practice. Saunders (2004) also underscores the limited application of some of the recent legal changes to actual practice.
Social work and domestic violence training
While a dearth of knowledge exists with regard to training social workers to be better able to intervene in cases of domestic violence, some early studies found that social workers themselves reported not having the skill to deal with domestic violence cases (Borkowski et al., 1983; Danis, 2003; Mama, 1989). Other studies demonstrated the need for specific training in this area as often the social workers were aware that domestic violence was occurring, but were reluctant to name it as such or address the issue straight-on (Bennett and Fineran, 2003; Black et al., 2010; Danis, 2004; Humphreys, 1999). Furthermore, during the 1990s social workers reported apparent ignorance of the realities of domestic abuse and the persistence of prejudice and stereotypes such as the ‘sanctity’ of the family and its right to ‘privacy’ (McMurray and Moore, 1994). Lack of knowledge, training and/or education about domestic violence intervention is not a UK phenomenon. Studies in Australia and the United States (Danis, 2003) have concluded that social workers often feel unprepared to deal with the complexities of domestic violence once they get into the field.
Not all is bleak however. Early work by Mullender (1996) shows that positive changes have been made. In the US, research demonstrates that social work’s poor record with respect to intervening in domestic violence cases is beginning to improve (Bennett and Fineran, 2003; Danis, 2003; Danis and Lockhart, 2003). Within the UK, new, more specific guidelines for health and social care practitioners who work with domestic violence cases and cross-training and inter-agency liaising have been introduced (e.g. Domestic Violence, Crime and Victims Act, 2004; and the National Report, 2005, both published by the Home Office).
The government’s efforts to combat domestic violence make this research extremely timely, as it allowed us to explore what social workers believe leads to domestic violence. Information about such perceptions is critical because the success or failure of government’s domestic violence strategies are mediated by social workers’ perceptions of the causes of domestic violence. Gathering such information from persons likely to come in contact with women and/or children who are experiencing domestic violence may be useful to those who are developing law, guidelines and best practice. Thus, this research helps to more accurately understand social workers’ responses and/or lack of responses in the field, so we can learn where our efforts should be concentrated with regard to domestic violence law, policy and services.
Design
This study, comprising a cross-sectional survey and follow-up of semi-structured interviews, provides a ‘snap-shot’ of social workers’ understanding of and responses to domestic violence and abuse in a British city located in the English Midlands. It is part of a larger study funded to explore both health and social care workers’ knowledge and experience of working with victims of domestic violence in that city, thus the sample of social workers used for this article is a subset of all respondents who participated in the study. It is important to point out here that the tool to collect data for the study was used throughout and the overall aims of the larger study were the same as those listed here. For the purpose of this article, however, the aims were modified to represent only those who indicated that they were social workers. Thus, non-social work professionals working within health and social care (i.e. nurses, midwives, doctors) were excluded from this analysis as we felt that the dearth of research regarding social workers’ knowledge of domestic violence was significant. Hence, the three aims of this study were: 1) to examine British social workers’ abilities to recognize incidents of interpersonal violence; 2) to examine how much domestic violence training social workers typically receive; and 3) to explore how awareness of organizational policies and practice experiences impact workers’ attitudes about domestic violence.
Design of the survey questionnaire
A mailed self-administered questionnaire containing 22 items (see Appendix 1) was developed through a three-phase pilot study and a review of the content and results from similar surveys previously carried out in this area (see, for example, Klein et al., 1997). A working draft of the questionnaire was pilot tested on colleagues and a small group of social workers and then the project advisory group, 1 who also discussed the instrument question by question, until a final version was agreed upon. A key concern of the research team was to maximize the response rate by ensuring clarity and brevity. The pilot test process served to enhance the reliability and validity of the responses to the questionnaire.
Procedure
Informed consent for the interview and the tape recording was obtained from the Local Research Ethics Committee and all respondents consented to having their interviews used for presentation and publication for research purposes. Each interview took approximately one hour. No names or personal details of participants are included in this article. Further, if the participant might be identified by information provided during the interview, the researcher reserved the right to change identifying details to preserve the respondent’s anonymity. The researcher also ensured that information about appropriate channels of support was available should the interviewee need them. The researcher took all reasonable steps to safeguard the security of any records including locking audio-tapes in a filing cabinet which could only be accessed by the research team and then destroying the tapes once the research was completed.
All questionnaires were anonymized by using a unique identification number and the names and addresses of potential respondents were held in a separate database from the questionnaire data on password-protected computers. The survey results on SPSS also were stored on password-protected computers although the ID numbers used were no longer traceable to the respondents themselves. The potential ‘weak’ spot was the request at the end of the questionnaire for contact details of people willing to be interviewed. These were logged immediately and deleted from the returned questionnaires (which were locked in a cabinet only accessible to the research secretary as stated above).
We acknowledged the possibility that some respondents may have experienced domestic abuse at some point in their lives and that receiving a questionnaire of this nature might cause distress. Therefore, phone numbers of help-lines were provided on the questionnaire.
Access to the Social Services departments was arranged via the Director of Social Services in the targeted city, who provided the staff list mailing information. The survey questionnaires were then posted to the individual social workers with a pre-paid reply envelope. Volunteers who participated in the survey and were prepared to be interviewed were asked to provide their work telephone number. Potential respondents were subsequently contacted and interviews arranged. The interviews were tape-recorded and transcribed verbatim. The interviews were structured in that all participants were asked the same questions in more or less the same sequence, but they also were in-depth and allowed the respondent to respond with whatever information they were willing to share.
Sampling
The postal survey was sent to all practising social workers registered with the Social Services department on the mailing list in the target city (N = 450). Respondents to the survey were given the option of taking part in an interview as part of the next stage of the study.
Data analysis
Data from the survey were analysed using SPSS version 17 by means of descriptive and inferential statistics to test for significance and possible generalizability. All of the tapes were transcribed verbatim and the text was examined to identify broad categories and themes. Both cross-case and within-case analysis approaches were used to analyse the data. With cross-case analysis the researcher groups answers from the different respondents according to the common questions that were asked and as such can analyse different perspectives on a particular issue (Patton, 2002).
The transcripts were reviewed by the research team and common themes were identified by each researcher separately. Next we held a group meeting where we compared notes to confirm themes that each of us had identified and from this process we developed a final code system. This process helped us ensure trustworthiness of the data with regard to identified themes. Once the final coding scheme was developed, the researchers then went back and recoded each individual interview. The team meeting also allowed us to discuss relevant quotes that were identified by each of us and differences of opinion. In addition to tape recording the interviews, the researchers also took notes at the time of the interviews, which were reviewed with the respondent at the end of each interview to make sure that we were accurately capturing the information being provided.
Results
Questionnaires were returned by 181 social workers thereby yielding a response rate of 40.3 percent. Of these, 30 were male and 149 were female with two respondents not reporting their gender. Of the 181 respondents, only 19 agreed to be interviewed and all of the volunteers were female. The mean age for the survey group was 43.65 years (SD = 9.197). No other demographic information was collected. Respondents represented a variety of social service agencies working with different client groups, such as family services, hospital social work, and geriatrics to name a few.
With regard to the first aim, understanding and recognizing domestic violence and abuse, there was broad agreement with no significant differences between female and male respondents. All six behaviours listed on the survey (punching, threats of violence, slapping, sex without consent, controlling social life and verbal aggression) were seen as constituting domestic violence by study participants: I think it involves one partner in a relationship trying to control the other partner by whatever means they can use . . . emotional blackmail, just controlling. (Interview 4,
2
hospital social worker on a postnatal ward) Physical [violence] would be the first obvious [sign] that I would say. Other things would be emotional abuse where someone’s confidence and self-esteem is being undermined constantly and people having power over other people . . . That control issue. (Interview 1, social worker working with older people in residential and respite care)
We also asked social workers about the frequency with which they worked with known or suspected cases of domestic violence and abuse. Well over one-half (62%) of the social workers indicated that they currently or had previously worked with women who experienced domestic violence. When asked to indicate how frequently they met with women who they suspected had been affected by domestic violence over one-half of the survey respondents (57.5%) suspected cases of domestic violence among their client group as frequently as every three months, with 40 percent of the respondents suspecting such cases less frequently than every three months. This finding appears to be rather skewed in light of the fact that so many of the respondents indicated that they worked with women suffering from domestic violence. In both cases, the statistics are significant indicating that the probability of such a distribution is outside expectations for the normal population.
In the interviews, the respondents also reported relatively few suspected or known cases of domestic abuse. For example: In my working career as a social worker, and I have been a social worker now since 1988, I’ve come across it very, very infrequently. Certainly there’s been occasions but it’s been infrequent. (Interview 7, child placement services)
Interestingly, there is a significant difference between the distribution of men’s and women’s beliefs about the frequency of domestic violence in the community, with a higher proportion of male social workers (46.4%) than female social workers (28.8%) believing that one in four women experience domestic violence from a male partner.
Identifying attitudes and explanations of domestic violence was the second aim of the project. We found there were some gender differences in the attribution of causes of man to woman domestic violence. Just over one-half of the female social workers (53.6%) believed domestic violence was drug/alcohol-related while a little over one-third of male social workers (39.1%) did so. Male respondents (78.2%) are slightly more likely than female respondents (61.6%) to consider seeing domestic violence at home while growing up as causing men to subsequently commit acts of domestic violence. A slightly higher proportion of female (20.5%) than male (17.3%) respondents consider the explanation that society accepts domestic violence as a reason for male violence while 89.2 percent of female respondents and 78.2 percent of male respondents believe that men are violent in order to be in control.
As there were no men who volunteered to be interviewed, it is not possible here to look at the gender differences in any greater detail. However, the interviewees we questioned were clear about the impact of the early childhood environment on boys. One respondent asserted that there is a gender difference between how young girls and boys manage anger which remains true in adulthood.
It’s very, very difficult, because they [boys] are the ones that are going to act out their anger, you know they are going to be, well I’m generalizing, much more likely to be aggressive, destructive, violent, like difficult to work with. Girls are much more likely to internalize their anger, they are more likely to be withdrawn and quiet and practise self harm, seeking approval, more compliant, so already and we are seeing this earlier and earlier and earlier, even as sort of young as three, three or four we are seeing this. (Interview 7)
Another respondent confirms the view that men who see or who experience violence at home while growing up are prone to acting in a violent manner in adulthood: I think largely because they were, treated wrongly, when they were growing up . . . because they’ve seen it carried out to them, is it normal, it’s common in their background. (Interview 4) Interviewer: . . . There isn’t really a final excuse for it is there, but there’s probably lots of reasons why it happens. . . . lots of different reasons. Yes, I think it’s a hard, hard cycle to break out of. (Interview 4)
As a group, all the social workers participating in the survey support the view that women are entitled to help, and that more public money should be spent on services for women and children who have experienced domestic violence. They also agree that whether or not a woman returns to her partner should not affect her entitlement to services. However, the interviews suggested that there may be contradictory views about the role of some women in the abusive/violent relationship. For example: I think women find it difficult ’cos they get used to that relationship . . . when they leave that relationship there’s something missing and they don’t know how to replace . . . they feel like they can’t cope without that person ’cos that person has had control and power over them for however long and to suddenly find yourself as an independent being must be very frightening . . . a lot of women can’t cope with that and would rather return to the safety of what they know . . . they don’t have the confidence to cope with new situations or the support. Yeah, I do personally find it very strange when they do go back to abusive partners but I understand why. I would find it very frustrating if it was one of my friends and I wouldn’t understand, I would try to understand but I wouldn’t really. (Interview 1) I think it is a very difficult question to answer because I think you know the kind of public perception is that if a woman is in a situation like that why doesn’t she just walk, and it isn’t that easy. It can be so many things you know. I think people want relationships to succeed and to actually say this is what’s happening to me is a sign of failure in the relationship but it’s also a scary thing because once you acknowledge it, it means that you have to do something about it, and that is the hardest bit. (Interview 7)
In order to address the third aim of the study, participants were asked about the level of training in domestic violence practice that they had received to this point. Respondents indicated a general lack of adequate training in issues regarding domestic violence. Nearly half of the sample reported having had no training while one-third had post-qualifying training. Of the respondents who had post-qualifying training, two-thirds did not believe that their training had been adequate.
During the interviews we also inquired as to whether there were possibilities for training on mandatory/statutory duties and found that once again there was a lack of training specific to domestic violence. Some of the respondents’ remarks, however, overlapped skill and knowledge training with the need to understand their organizations’ policies on domestic violence as demonstrated below: I think certainly policies, I haven’t been familiar with it but I am now and I would like some training about that because there’s so many interpretations of what you’re reading. I would like a bit more awareness around legal things and when women are disclosing things to know to say to them, it’s not a matter for the police and to be quite clear about where those boundaries are. I think that’s important ’cos I don’t know anything about that. Also what to do with information, how to handle it, how to work with people so they’re safe. I think it would be interesting to have women who have been victims of domestic abuse to do that. To find out about their experiences and reflections on what they found useful. That would be the most beneficial really. (Interview 1)
Responses to cases of domestic violence in the context of organizational policy and practice revealed that more than half of the study participants indicated that they were aware of their respective organization’s policies, definitions and guidelines on domestic violence, however, only one-third reported having used them. For at least one respondent, completing the survey led her to seek out additional information on domestic violence policy.
Interviewer: Are you aware of any policy? I am now but I wasn’t when I filled the questionnaire in. Since then I thought there must be one and I found one. (Interview 1) Interviewer: In connection with that, do you feel quite supported within your organization in terms of trying to give help? Yes, we can discuss it in supervision and my colleagues here are very supportive. In the small team we have here, if I was getting personally upset by the issue and frustrated, I can come down here and have a chat and share the experience, if something distresses me that much, my colleagues would help me along.
Discussion and implications
On the positive side, all of the social workers in this sample were concerned for the overall welfare of women and children who have experienced domestic abuse and believe help should be readily available and even increased. They also were clear as to what constitutes domestic violence and generally agreed on its causes. Such views as to what constitutes domestic violence could in part be correlated to government’s efforts to combat domestic violence, as more and more work is being done to educate professionals and lay persons about domestic violence in the UK. This conclusion, however, cannot be drawn specifically from this research. It is difficult to address the degree to which social workers in this study failed to recognize domestic violence cases in their own work in light of their apparent understanding of the frequency of such cases in the larger community. There appears to be a disjuncture between their understanding of what constitutes domestic violence and their perceptions of how often their clients actually experience domestic violence. In short, while they know domestic violence exists, they are less likely to believe it is happening to their clients. This may be due to lack of training regarding the prevalence of domestic violence and how to screen individuals for domestic violence.
Perhaps the UK’s relatively new comprehensive and coordinated efforts to build preventative measures for domestic violence may change these perceptions in the future. Prospective research should examine gender differences with regard to perceptions of why domestic violence occurs, as significant differences were found between male and female respondents with regard to their perceptions of why men commit domestic violence, with more women attributing it to drug and alcohol abuse and more men attributing it to seeing violence in the home as a child.
It is noteworthy that male respondents more accurately estimated domestic violence rates within the community, which once again may be directly related to respondents’ perceptions of why domestic violence occurs. Future research could examine if female British social workers truly tend to underestimate the frequency of interpersonal violence in the UK. Also taking a closer look at how such perceptions influence how social workers intervene in suspected as well as confirmed cases of domestic violence is much needed. Prospective studies could examine whether this trend exists in other countries as well.
Relevant education and training appears to be a crucial component to increasing social workers’ awareness of domestic violence and improving their ability to intervene in such situations. This finding is not necessarily unique to this study as the need for training has been documented in previous studies (Black et al., 2010; Humphreys, 1999). Tower (2003), however, found that academic training alone was not enough to enhance the barriers to effective screening for possible victims of domestic violence. Rather, both academic and experiential training is necessary and learning must move beyond the classroom (Blythe et al., 2010; Danis, 2004).
Based on this study and past research on the need for more cross-training with agencies that often come in contact with women who have experienced domestic abuse, we recommend that these training initiatives should include a larger effort to promote community-wide collaboration amongst all those working to educate social workers and other who work with service users of health and social care services (Blythe et al., 2010; Moles, 2008). Building the skills and knowledge base needed to be better able to identify victims and/or survivors of domestic violence cannot be solved by offering a one-time training or information session on the topic. Local authorities need to support ongoing academic training and vice versa. Community initiatives need to be developed to promote awareness of the prevalence of domestic abuse, but also to underscore the importance of identifying the different types of abuse and how to recognize when individuals are in an abusive relationship. Developing a service-learning component will emphasize the importance of civic engagement while preparing students to work with individuals at risk of domestic violence and providing a crucial preventative service. The benefits of service learning as a pedagogy have been widely accepted in US higher education (Astin and Sax, 1998; Dauenhauer et al., 2010; Eyler and Giles, 1999; Eyler et al., 2001; Westheimer and Kahne, 2002).
Additionally, university curricula need to incorporate evidence-based practice techniques for working with women and children who experience or are at risk of experiencing domestic violence. At the same time, local authorities need to provide settings that foster evidence-based practice, thereby further allowing students to practise their skills. Introducing students to the complexities of issues involved in working with women and children who may be in abusive relationships is a priority. Knowledge or classroom instruction is not enough however, and persons who have experienced domestic violence should be involved in guiding best practice to develop this social work training.
Regardless of positive strides being made in acknowledging domestic violence as a global health issue, there remains a serious gap in research exploring social care intervention in cases of domestic violence. Moreover, the findings from this study need to be viewed in light of the study’s methodological limitations. For one, our results are limited to the extent that they do not represent all practitioners but rather rely on a select view of social workers from one city in the UK. Although an effort was made to recruit a diverse and representative sample of respondents from across the field of health and social care, it was difficult to recruit large numbers of respondents for this study. Simply put, the training experiences and knowledge of domestic violence services of participants in this study are not generalizable to all practitioners in the UK. Future research should focus on ways to survey a larger sample of health and social workers in the UK in order to identify best practice training protocols employed throughout the UK and then strategies for ensuring treatment integrity and fidelity could be employed.
Footnotes
Appendix 1: Survey
Appendix 2: Interview schedule guide for health and social care professionals
Funding
This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
