Risk Factors Associated with IPV Among Latina American Women

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CHAPTER 4

Findings

This content-analysis based qualitative research aimed to examine risk factors associated with IPV among Latina American women as well as the psychological and physical effects. The analysis above displayed common themes that exhibited a repetition in the current results. The studied themes were (1) socio-demographic, (2) cultural beliefs, attitudes and religion, and (3) substance abuse. These themes encompassed subthemes that precisely described the topic in discussion, highlighting peculiarities and pervasiveness among each category of research. Education, income, unemployment, marital status, age and housing stability were subthemes of the Socio-demographic theme. Cultural beliefs, attitudes, and religion included Marianismo, male dominance, patriarchy, religion, familyism, machismo, and witness to abuse. Substance involved alcohol, opioid, marijuana, and cocaine.

Seventeen of the thirty three articles analyzed socio-demographic factors (Abramsky et al., 2011; Anderson, 1997; Avila et al., 2009; Beadnell et al., 2000; Benson et al., 2004; Bonomi et al., 2009; Cerulli et al., 2012; Hazen et al., 2007; Cho et al., 2014; Flicker et al., 2011; Gonzalez et al., 2011; Lown & Vega, 2001; Mc Closkey, 1996; Murdaugh et al., 2004; Resko, 2002; Murdaugh et al., 2004; Resko, 2002; Richardson et al., 2002; Rollins et al., 2012). Significant subthemes that emerged to be positively and profoundly correlated with IPV were education and low income. Ten of the seventeen articles studied education, and all of them revealed that women with lower education were more likely to become victims of DV (Abramsky et al., 2011; Anderson, 1997; Avila et al., 2009; Beadnell et al., Bonomi et al., 2009; Cerulli et al., 2012; Cho et al., 2014; Flicker et al., 2004; Mc Closkey, 1996; Resko, 2002).  Education makes women less vulnerable because as they gain knowledge and information, they feel empowered and capable of expanding their choices (Arends-Kuenning & Amin, 2001).

Ten of the thirty three articles examined low income as a subtheme (Anderson, 1996; Avila et al., 2009; Beadnell et al., 2000; Bonomi et al., 2009; Cho et al., 2014; Gonzalez et al., 2009; Lown & Vega, 2001; Mc Closkey, 1996; Murdaugh et al., 2004; Resko, 2002). All found that low income was a significant risk factor for IPV except for three. Two articles found that low income had the opposite effect (Gonzalez et al., 2009; Lown & Vega, 2001), and one showed that being married or not made no difference (Murdaugh et al., 2004). Thus, socio-demographic factors were one of the most analyzed variables.

A second common theme that emerged when examining IPV among Latinas was cultural beliefs, attitudes, and religion. Five articles reviewed the role of machismo among Hispanic as a subtheme and found it to be highly correlated with IPV (Abramsky et al., 2011; Ahrens et al., 2010; Moretti et al., 2006; Ozaki & Otis, 2016; Raffaelli & Ontai, 2004). Traditional beliefs give men the right to control women and make them more vulnerable to physical, emotional and sexual abuse by men. This view is derived from the unequal power relationships between men and women. In the Hispanic community, Machismo plays a significant role in shaping the Latin culture and accepting behaviors that consist of violence against Latina women. Another occurring subtheme was the role of witnessing abuse as a child and how it affected IPV. Three articles examined this variable, and all found it to be positively correlated with IPV (Abramsky et al., 2011; Moretti et al., 2006; Richardson et al., 2002).

A third characteristic theme that submerged in this literature review was substance abuse, alcohol consumption. Excessive use of alcohol was a variable that all articles in this theme examined and was found to be highly correlated with IPV (Abramsky et al., 2011; Avila et. al., 2009; Beadnell et al., 2000; Hazen & Soriano, 2007; Kim-Godwin et al., 2009; Murdaugh et al., 2012; Nowotny & Graves, 2013; Quigley et al., 2002; Resko, 2002). Excessive alcohol use alters the judgment of a person, affecting their physical and mental function. Excessive alcohol use decreases a person’s self-control, making him/her incapable of discussing a topic of conflict within a relationship in a non-violent manner (WHO, 2006).

When identifying interventions within the micro, mezzo, and macro levels, all mentioned subthemes will be carefully inspected and used in the following case study, to describe and understand the actions of the individual and chose the right prevention strategies.

Prototype Case

Sarai is a 20- year-old Latina American woman, born in Mexico and now living in East Los Angeles where the Latino American population is concentrated. Sarai migrated to the United States with her mother and father when she was 3-years old. At the age of 5, Sarai’s father returned to Mexico and remarried. Sarai’s mother worked two jobs to raise her only child. Sarai did not develop a healthy relationship with her mother while growing up. She had very few friends and suffered from low self-esteem. At 15, she met her current boyfriend Roberto who was 17 at the time. Roberto did not go to school.  Instead, he worked full time at a meat factory and lived on his own in a one-bedroom apartment in East LA. His father who was abusive to his mother passed away when he was 14 years-old, and his mother was deported to Mexico soon after her husband’s death. Sarai moved in with her boyfriend shortly after they were dating. During the first year, Roberto was sweet, charming, and took good care of her. A year after, Roberto started to display some verbal aggression when Sarai would put on make- up or dress up for school. He started accusing her that she was seeing other men and forbade her to go to school. Roberto became physically violent towards Sarai when she tried to stand up for herself. He would push her toward the wall or slap her if the house was not clean, or the food was not tasty. Sarai was no longer allowed to go to Bible study and church on Sundays, communicate with her friends, and she had lost all contact with her mother. Sometimes he goes months without hurting her, and she tries to forget about it and keep herself busy at home. Sometimes he doesn’t even let her go to the store, and if he does and she takes longer than what he expected, he would hit her and accuse her of being with another man. He usually buys all the produce for the week and pays the bills. He does not give her any money to at least make her feel like a real person. Sarai had been to the hospital many times. Once for a broken nose, the other times for miscarriages. He hit her and kicked her when she got pregnant so that she would miscarry. Things worsened when Roberto started drinking. He became more violent and would often threaten to kill her with a knife if she would ever leave him. With no money, no education, no work experience and no support system, Sarai was fully dependent on Roberto and could not leave him. One time the neighbors heard screaming and yelling because Roberto was hitting Sarai and throwing things at her, so they called the police. When the officers were at the door, he asked of everything was alright. Sarai’s face was covered with blood. She finally had the guts to tell the officers that her husband was beating her up. One of the officers handed Sarai a bag to put important paper and belonging in it and escorted her to the police car, while the other officer handcuffed Roberto.

The presenting problems consist of Sarai being a victim of domestic abuse. Physically, Sarai suffers from injuries such as broken bones, knife wounds, back pain and headaches. She lost her hearing in the right ear due to severe beating on the head. She experiences frequent bladder infections and has developed irritable bowel syndrome. Psychologically, Sarai’s suffers from low self-esteem, sleep disturbances, depression, and has suicidal ideation. Her life-threatening experience and fear resulted in her developing PTSD. She has developed nightmares, flashbacks, and displays psychological distress due to the traumatic events she experienced.  During her last hospitalization, nurses identified signs of physical and psychological abuse and Sarai was screened for IPV. Authorities arrested Roberto and Sarai was referred to a social worker to provide her with resources and interventions that help her deal with her trauma.

Interventions

Battered women stay in abusive relationship for many reasons. Most fear the abuser from finding them and killing them. Other reasons include financial dependency, low or no self-esteem, and lack of social support. Interventions intended for abused women are needed to address many barriers that stop battered women from seeking help and involve socio-demographic and social measures that are intertwined stressors of IPV. The research displays the awareness of providing Latina women with evidence-based available intervention strategies ranging from micro, mezzo, and macro levels, as well as useful prevention measures that address the significant problem of IPV.

In her article Violence Against Women, Heise (1998) integrates an ecological system that describes the framework of violence. It is an approach to abuse that conceptualizes violence as a multidimensional paradox inherited in a micro, mezzo and macro systems. In order for social workers to deliver effective services, it is crucial to assess their decisions based on the micro, mezzo, and macro levels. In addition, social workers must identify barriers in all levels that can hinder their decisions and constraints their services. However, one must keep in mind that the three levels overlap at times and influence each other.

Micro-Level Interventions

The micro-system refers to the examination of the individual relationship of the women. It includes the concept of male dominance in the family, use of alcohol, witnessing marital violence as a child or being abused oneself as a child. Micro-interventions focus on strategies that meet the individual’s needs and improve his well-being. The role of the social worker is to provide a tailored care plan based on the individual’s needs. In cases that involve domestic violence, and rapes, social workers use the crisis intervention model to positively influence the coping capacities of the victims.

There is a range of social services interventions designed to prevent IPV and treat victims of DV, including advocacy services, shelters, counseling services, and financial empowerment (Berk et al., 1986; Gondolf & Fisher, 1988; King & Chalk, 1998). There are also some legal interventions that include protective orders to assure the victim’s safety, arrest of the batterer and treatment for the offenders (Dutton, 1986; Hamberger & Hastings, 1988; King & Chalk, 1998; Klein & Orloff 1996). Finally, health care interventions are detrimental in cases of IPB and include proper screening for DV in healthcare settings and clinics, and physical and psychological treatments for the abused (Bergman & Brismar,1991; Johnson & Zlotnick, 2009; Kubany, Owens, Iannes-Spencer, McCaig, Tremayne, &William, 2004; Nathanson, Shorey, Tirone, & Rhatigan, 2012; Parsons et al., 1995).

Social Services Interventions

Social service interventions employ empowerment as a strategy to help battered women recognize their strengths, become independent, build self-determination, and develop social skills. Social services include advocacy, services, providing shelters and transitional housing, peer support and counseling, Therapeutic services are provided to help with individual counseling and support groups, and financial support. Services also include help with education and assistance with employment.

Advocacy Services: Advocacy programs include supportive housing or shelters, education programs that help the victims obtain academic certifications and degrees, job opportunities, and knowledge about IPV and the cycle of violence. The role of the social worker consists of informing the client of her legal, medical, and financial options. The social worker is to show great empathy and provide emotional support.

Shelters: Shelters play an essential role in helping women seek appropriate support services (Gondolf and Fisher, 1988). Women who go to shelters tend to be less exposed to their batterers, reducing incidents of violence. Normally, shelters are designed to accommodate battered women with lower socio-economic groups. Women who are more financially stable seek temporary shelters or temporarily live with a friend or a relative (King & Chalk, 1998, page 111). It may be that women who use shelter services are experiencing the most severe violence at home and therefore do not represent other women who are victimized (Berk et al., 1986). Aside from traditional shelters, transitional housing programs provide not only shelter but also continued advocacy and counseling services to residents. This program “allow women to gradually make the transition from a violent home to emergency shelters, to developing the skills and resources necessary to eventually, live independently” (King & Chalk, 1998, page 112).

Peer Support Groups and Counseling:Peer support group is a beneficial service and is offered by different organization and agencies. A support group can be held in shelters, church or other community organization. The groups focus on identifying the victims’ emotions and their reactions to abuse. It further helps the victim develop coping skills and strategies to deal with their fear and self-blame. Support group help the victims become aware that they are not the only one who suffered from abuse by a partner. It provides a nurturing and safe environment for the victims to share their stories and experiences and facilitate their skill- building and self-protective behaviors. Furthermore, group therapy and counseling is a long-term service that is designed to decrease social isolation and increase self-esteem (King & Chalk, 1998, page 113).

Legal Interventions

In the late 1970s the collaborative interest of feminists and victim advocates lead to a sequence of modification to effectively increase the justice response to DV. DV legislation mandated changes in protective orders, enabling less arrest for misdemeanor assaults, and recognizing a history of abuse as part of a legal defense for abused women who kill their abusive husbands. Legal interventions include protective orders, arrest of the batterer, and court-mandated treatment for offenders.

Protective Orders: The victim of DV can request a civil order of protection or what is known as a restraining order issued by the court. It states that the “offender may not assault her, enter her home, approach her, or have any communication with her for a specified period” (King & Chalk 1998, page 173). The victim can obtain a temporary or a permanent protective order which is often used for one to three years (Klein and Orloff, 1996). The benefit of the protective order it that it focuses on the victim’s protection and addresses safety and economic well-being.

Arrest of the Batterer: If the plaintiff files charges and there is enough evidence to prosecute the perpetrator, arresting the offender becomes a necessary step for a treatment intervention to protect the victim. In fact, the intervention was evaluated in a study by Sherman and Berk in 1984 on the Minneapolis Police Department, and result showed that those arrested committed less violence in comparison to those who were not. Therefore, police officers should not hesitate to arrest perpetrators in DV cases for fear that it can increase violence.

Court-Mandated treatment for DV Offenders: Mandating batterers to a treatment program is an intervention that is proven to reduce violence. Studies have shown that batterers who have completed treatment were less likely to repeat DV than those who did not receive treatment or dropped out (Dutton, 1986; Hamberger & Hastings, 1988).  The goal of the treatment programs is to address anger management issues and the relationship of power and control to the use of violence. The length of the treatment and programs varies depending in the length and severity of the abuse.

Health Care Interventions

As observed in the articles, the results of DV may be one of women’s most significant health problems. Therefore, providing clinical care to victims of IPV is an essential intervention to help them recover mentally and physically (Parsons et al., 1995). According to Bergman and Brismar (1991), victims of IPV need a range of short-term and long-term medical care throughout their lives including therapeutic interventions and counseling. Before applying a treatment plan, screening, assessing and identification are necessary steps to provide accurate health services. Health care interventions include screening for DV, identifying the victims, and assessing the extent of abuse, as well as providing mental health treatments.

DV Screening, Assessing, Identification, and Medical Care Responses:  Screening IPV in clinics and hospitals settings may be useful mean to reduce the effect of violence and to maximize the victim’s safety. It is a tool that helps to identify the individuals as victims and provide them with resources. Once the individual is identified as a victim of abuse, evidence-informed assessment is needed to evaluate the severity and frequency of abuse becomes necessary to take appropriate actions and provide a safety plan.

Mental Health Treatments for DV victims: Mental health consequences of IPV are significant and urge women to seek services as frequently as do physical problems. Research in this literature review revealed that battered women are found to suffer from major depression, low self-esteem, and PTSD. Traditional treatments such as psychotherapy and medications become necessary to treat victims of IPV. According to Nathanson, Shorey, Tirone, and Rhatigan’s study (2012), cognitive behavioral treatments (CBT) for individuals experiencing PTSD and depression are found to be the most effective interventions. Cognitive-trauma therapy has also been found to be effective when treating PTSD and depression (Kubany, Owens, Iannes-Spencer, McCaig, Tremayne, and William, 2004). This approach includes different strategies to help with stress management, skill building, managing unwanted contacts with partners, self-advocacy, etc. For women who reside in a DV shelter and have ongoing safety concerns, the “Helping to Overcome PTSD through Empowerment (HOPE) was explicitly designed for them by Johnson and Zlotnick (2009). According to the authors, women in shelters commonly report greater severity of abuse and experience higher risk of PTSD. HOPE addresses the cognitive, behavioral, and interpersonal dysfunction associated with PTSD in women who have experienced DV (Johnson and Zlotnick, 2009).

Mezzo-Level Interventions

The mezzo-system comprises small communities rather than individual. Mezzo social workers focus on making changes to neighborhood, schools, and local organizations like law enforcement, health care providers, and religious establishments that environ the victim. Social workers also increase community awareness by facilitating educational programs about DV within the community. It is essential to examine the interactions among family violence, neighborhood environments, and the social culture when assessing for IPV. Factors such as poverty, unemployment and discrimination act as a map guide to initiating appropriate mezzo interventions that can be beneficial for the whole community. Mezzo interventions in IPV are intended to reduce and prevent DV by focusing on small community services. The goal of mezzo-level interventions is to change attitudes held by the public towards IPV, as well as their behaviors, and network by educating communities, provide training and knowledge to healthcare professionals, and family therapists. A mezzo-level social worker’s primary goal is to coordinate community-wide services for victims of domestic violence. Five community-based interventions are discussed in this section: schools, workplace, faith and religious organizations, public health care and individual and family therapy (Anderson, Renner, & Danis, 2012; De La Rue, Gillum, Sullivan, & Bybee, 2006; Halpern, Spriggs, Martin, & Kupper, 2011; King, P. & Chalk, 1998; Polanin, Espelage, & Pigot, 2014; Swanberg, 2004; Swanberg & Macke, 2006; Tolman & Rosen, 2001; Zachary, 2000).

Community-Based Interventions

Community-based interventions include advocacy centers, coordinated community responses to IPV, family support resource centers, treatment centers for substance abuse, programs for treating victims of IPV and batterers, settlement houses, and shelters. Creating a community response to IPV requires educating communities and neighborhoods about IPV, its impact, and how to prevent it is a good starting point to raise awareness among as many people as possible. This process can be accomplished by partnering up with the communities’ DV shelters for women, women’s organizations, or police officers who can work with the community, local schools, local businesses, religious organizations and others to implement workshops, meetings, talks, and group sessions that address this issue. All these systems must share the goal of improving the quality of services provided to victims of DV.

Schools: Studies have revealed that IPV peaks during adolescence and young adulthood. Research conducted by Halpern et al., (2011) showed that eighty percent of the studied sample who experienced IPV were adolescents, and most occurred during teen dating. Data from the National Intimate Partner and Sexual Violence Survey (2013) (NISVS) reported that IPV often starts in adolescence. According De La Rue et al., (2014), increasing knowledge of how to build a healthy relationship in dating couples results in less tolerance of violence in a relationship. Informative and prevention programs at schools are community-level approaches that are necessary to foster positive youth development, promote healthy relationships and reduce IPV. Social workers can facilitate the implementation of social-emotional learning programs for youth that focus on teaching the students skills like respect, empathy, and healthy communication. Other approaches include healthy relationship programs for teen couples, anti-violence programs preventing teen dating violence and adolescent aggression, change the culture of violence, gender equality educational programs, and gender norms. Some potential outcomes include reducing IPV among teens, preventing IPV among young adults, reducing high-risk sexual behaviors, changing attitudes that accept violence in relationships and increasing the use of healthy relationship skills (www.youth.gov).

Workforce: Many workplaces don’t consider how gender inequality affect workplace practices, policies, and cultures (Swanberg & Macke, 2006). According to Swanberg (2004), the gender norms and inequality had unconsciously prevented organizations from developing policies and practices that are responsive to female employees that experience IPV at home.  Swanberg and Macke (2006) reported that woman employee who is in an abusive relationship don’t perform well at their workplace. Consequences include frequent absences, poor productivity, more tardiness, or loss of job which can decrease a woman’s financial self-sufficiency that is needed to overcome her abusive relationship (Tolman& Rosen, 2001; Zachary, 2000). Social workers can facilitate the training for managers and supervisors about DV, including awareness raising, recognizing employers who are experiencing DV, creating policies and practices that encourage the victims to seek help, identifying and responding to the problem, providing support and referring to the appropriate help.  Also, such approaches change cultural norms that are associated with gender inequality and diversity, identify patterns of gender discrimination and assault in the workplace.

Faith-Based Organizations: Collaboration between social programs and faith-based communities is essential to respond to the needs of victims of IPV effectively. Studies have revealed that for many battered women, religious involvement decreased their depression and promoted a higher quality of life (Gillum, Sullivan, & Bybee, 2006). Anderson, Renner, and Danis’s (2012) research found that forty percent of abused women received religious counseling. All recipients found spiritual counseling to be among the most effective services received. Social workers can work with religious leaders to help the victims recover. Cross-training and education with clergy and religious leaders are useful for raising awareness of IPV. Religious leaders can reprimand abusive behavior and at the same time refer help-seeking perpetrators to appropriate resources. Churches and other religious establishments can establish educational and therapeutic programs within their locations to promote healthy relationships and provide support for the victims.

Public Health Care for Preventing IPV: Abused women suffer from a serious of physical and mental health problems, and in some cases even death. Many become addicted to drugs and alcohol. Battered women also contract sexually transmitted diseases or have unwanted pregnancies, and when pregnant, have a higher risk of miscarriage or of having a premature or low birth weight baby. In clinics, it is essential for doctors and nurses to ask the right questions to uncover what is really happening. It is also important to listen with compassion so the survivors will be more likely to share their stories. Health professionals can be hesitant to ask questions about DV for different reasons. To name few, lack of training and knowledge about cultural norms, personal histories of abuse, and fear of offending the victim (King, P. & Chalk, 1998, page 225). Training and institutional reform efforts are means to address these reasons. Healthcare professionals must challenge cultural attitudes that say it’s ok for a husband to hit his wife. They need to reassure women that it’s not their fault and work with them to help them stay safe and connect them with other services that can provide them safety such as shelters, psychological support, legal services and financial opportunities. More women can find their way to a life without violence when changes are implemented across health care and other systems. Changes include private rooms for consultations, training that enables doctors and nurses to identify victims of abuse and respond better to their need, and raising awareness of the harmful consequences of violence for women, and how to prevent it. Making these changes helps foster a culture where violence is unacceptable and where women dare to speak out. Health care providers should raise awareness, learn more about the issue of IPV, listen with care and empathy, link women to other services and speak out to end and respond to violence.

Family Therapy: In family therapy, the focus of family therapy is to eliminate all kind of abuse for all members of the family. Examples of approaches include building skills on how to recognize anger and de-escalate it, take responsibility for one’s behavior, and teach better communication skills. A social worker can promote couple and family therapy sessions in schools, churches, and other community organizations. However, research has shown that having separate interviews with both clients is advisable for successful couple therapy. Seeking individual treatment is critical because it helps the therapist gain a better understanding of each person’s contributions to the abusive behavior (Carolla, n. d.). For example, DV offenders might have been victims of abuse or witnessed DV as children. Therefore, interventions that approach violence as a learned behavior becomes necessary to address the beliefs that contribute to the batterer’s violence. Social workers can create new programs or build on existing programs that are cost-effective. Such programs encourage DV offenders to think about changing their perceptions of violence and their attitudes towards women.  Programs of a sort also teach the batterers anger management skills, and social and communication skills.  In case of substance abuse, the community-based intervention will be to have the perpetrator attend AA meetings as an additional treatment.

Macro-Level Interventions

The macro level system consists of economic and political agencies that influence the awareness and responses towards IPV (Heise, 1998). Interventions on this level, focus on policy legislation and system reform. Macro social workers tend to understand the social problem, and advocate for policy change and the development of state and national programs that effect a certain population. In DV, social workers identify areas that need a system reform, facilitate policy formation with key political leaders, focus on improving legal procedures including law enforcement, public safety, and social service providers to stop abuse against women.

There is a list of organizations working to eliminate violence. To name few: American Bar Association on domestic and sexual violence, Battered women’s justice project (BWJP), Institute of DV in the African American Community, National Center on domestic and sexual violence (NCDSV), National Latino Alliance for the elimination of DV (ALIANZA), and many more (Newcomer, 2013). The common goal of these organizations is to increase justice for the survivors of DV; advocate for effective policing, prosecuting, sentencing and monitoring of perpetrators of DV; addressing the needs of minority women of DV, and advocate for significant societal changes (Newcomer, 2013). A major organization’s goal, Futures Without Violence (FWV), is to enhance the education, health, and security for women worldwide. FWV played a significant role in developing the Violence Against Women Act (VAWA) in 1994 (Newcomer, 2013).

VAWA: VAWA was passed by Congress in as a “part of the Violent Crime Control and Law Enforcement Act of 1994” (Legalmomentum.org). It was the result of hard advocacy by women who lobbied to persuade Congress to issue policies that address this violence. Primary funding of VAWA was to provide Grants to create training programs that develop and strengthen law enforcement and prosecution strategies to fight violence against women. Overall, the act had succeeded in various areas such as improving the criminal justice response, ensure that victims have access to social services, and create positive change (Zweig & Burt, 2002). Statistics show that VAWA had reduced IPV efficiently in November 2012. From 1994 to 2010 the Bureau of Justice Statistics shows that the rate of IPV decreased by more than 60%. Although public policies such as VAWA has attained great success in reducing the rate of IPV, little progress has been observed in protecting Latina women due to institutional and legal barriers (Moe, 2007).

Many Latina women feel entrapped in an abusive relationship due to institutional and legal challenges that they face (Moe, 2007). Reina and Lohman’s (2015) study reports the multiple challenges faced by this vulnerable population. Some of the significant discussed barriers are immigration status, institutional discrimination, and economic inequality (Reina & Lohman, 2015).

Immigration Status: Undocumented Latina women fear being deported by the legal system if they report the abuse to law enforcement. The fear of deportation provides the perpetrator more power and control over his victim (Reina & Lohman, 2015). Menjivar and Salcido (2002) explain that the offender uses the victim’s legal status as a “form of blackmail to keep the violence from being disclosed” (page 908-909). The inability to report DV makes it impossible for these women to escape from victimization.

Institutional Discrimination: There is a negative attitude towards Latina victims and the perception that they are an “undeserving” population of public services (Purvin, 2007). Latina victims of abuse are often denied public service assistance, receive poor services and experience disrespect from government assistance provider (Reina & Lohman, 2015). Such behavior is proof of prejudice, discrimination, and lack of cultural competency regarding the needs of minority group members.

Economic Status: There is evidence that Latina women have limited financial resources and are financially dependent on their partner or husband (Purvin, 2007). Leaving an abusive relationship requires them to be economically independent and able to survive on their own. To make things more complicated, if the victim is undocumented and does not speak English, her job opportunities become limited, her dependency on her abusive partner increases, and she remains entrapped in an abusive relationship.

Although policies provide safety and financial security to victims of DV, studies revealed that they don’t necessarily protect Latina victims of IPV or women of color. Latina women face barriers that affect the quality of services they receive if they report the abuse. As far as the immigration status, social workers need to advocate for policy reform about the legal status of the victims. Social worker, public officials, and policymakers need to evaluate existing policies regarding undocumented immigrant who qualify for immigration benefits under VAWA. Undocumented Latina victims of IPV need to “be able to access all public service regardless of their legal status” (Reina & Lohman, 2015).  As far as institutional discrimination, an effective way to reduce the negative attitudes and the stigma is by addressing the issue at social services, schools, and local businesses. Developing training programs that focuses on job skills, cultural competence, values, and ethics are also effective means to reduce discrimination.

Program Evaluation: Some argue that a barrier is the incapability of the federal government to manage the grants given to the non-profit organizations effectively, and efficiently monitor if the organizations were fulfilling the desired outcomes (Van Slyke, 2002).  Evaluating programs is necessary to determine the worth of the program and how to improve it if needed. It also develops knowledge and ensures compliance within an organization. Social workers must evaluate programs and investigate the root-causes of the problems.

Case Study Interventions

In relations to the case study identified above, the following interventions for Sarai and her husband will be examined and analyzed into the three different intervention levels discussed earlier in this chapter. Micro, Mezzo and Macro levels interventions are used to help Sarai get out of the abusive relationship. As a social worker on the case, a bio-psycho-social assessment needs to be conducted to get all important information necessary to provide specific interventions.

Micro-Level Intervention

Sarai has no support system from family and friends. She hasn’t spoken to her mother since she moved in with Roberto, and lost contact with all her high school friends. Sarai was escorted to women’s shelter where she can feel safe and supported. She was lucky to find an available bed because frequently women’s shelters are full. The shelter is the beginning of intervention to assure the victim’s safety. Other interventions provide help to transform the victim into a survivor. They include educational programs, referral and resources, mental health counseling, independent life skills classes, computer training, job referrals, transitional programs, and direct legal services.

Sarai was struggling to come to term with what had happened in her relationship with her husband. As soon as she entered the shelter, the social worker assigned on her case made an urgent clinical appointment. Sarai was diagnosed with PTSD and major depression. She was immediately transferred to a hospital that supplied her with affordable medicine and helped her understand her condition. Sarai raised her concern about obtaining counseling services and how she might benefit from one of the therapists. Sarai was to receive group counseling and one-on-one therapy from an LCSW at the shelter. Individual counseling sessions are more specific to Sarai’s treatment needs and teach her to utilize coping strategies to manage feelings and emotions appropriately. The group counseling sessions help Sarai feel part of a safe community where she shares her experiences with other women and offers support to one another. Both individual and group therapy help Sarai reveal her strengths, identify healthy relationships, increase her self-esteem and confidence, as well as teach her coping skills to help her deal with her PTSD and depression.

Sarai did not want to go back to her husband even if he would comply with the court order of him attending AA meetings and Anger management program; she wished for a divorce. Therefore, the social worker linked her to an IDVA who is a specialist supporter worker legally trained to work with victims of DV. The IDVA was able to file a restraining order against her husband. Sarai was also supported to attend the Family Court proceedings. She shared her concerns and fears during group therapy and was provided with safety planning tools. Sarai’s wished to go back to school and get her high-school diploma, attend a non-profit organization that teaches independent life skills classes and attend a church where she can reconnect with God.

Mezzo-Level Intervention

Empowering Sarai by having access to community resources (school, church, job training programs, etc.) help her to participate more efficiently in activities that increase her self-efficacy and success, as well as the power to gain better control over her environment. The focus of mezzo-level interventions for Sarai will target surrounding herself with supportive peers at schools, increase her knowledge about IPV, improve self-confidence and develop social skills. Providing Sarai and other Latina students with proper education about IPV at school allows for women to meet in safe places, identify coping skills in dealing with violent acts, build healthy relationships with peers and others, develop a safety plan and change cultural norms. Building good relationships with other students can improve Sarai’s social support and reduce her depression. By interacting with others, Sarai will develop strong communication skills, build up her confidence, and gain a sense of self-efficacy.

For Sarai, developing spirituality and support group within the church give her strengths and comfort. It means looking for inner peace, increase emotional strength, and feel supported by others through prayers. Sarai believes that her religious beliefs and practices helped her survive her husband’s beatings. Being affiliated to a church and have a spiritual support group helps her deal with her mental distress, give her a sense of belonging, and the feeling of being connected to a divine power that will always protect her.

Macro-Level Intervention

Macro-level interventions require specific skills and experiences. The process of passing a bill and implementing new policies or amending existing one often need time, experiential learning practices and connections with communities. Eliminating acts of violence against women, change attitudes, expansion of VAWA and reauthorization of the Violence Against Women act all require organizational and community change, work of engagement, consensus building, and relationship development. Social actions and strategies to improve the problem of DV among Latina women are to write letters to the President as well as the representative of the United Nations, to the Women’s Health Organization (WHO) and the National Organization of Women (NOW), and to the governors and the cities they reside.

Battered women who escape an abusive relationship seek protection at women’s shelters. Unfortunately, women shelters are often underfunded or understaffed (www.simplemost.com), and the number of available beds is limited. Also, many shelters allow survivors to stay for as little as 30 days or no more than 90 days. The problem with this is that many women leave the shelter and have nowhere to go, and end up homeless on the streets. Statistics showed that 1 in 4 women consider DV to be the primary factor in their current homelessness (Dupere, 2016). Locating funding for shelters and transition housings requires macro-level intervention. Advocates need to submit funding proposals and grant applications to local and state government as well as private foundations. The funding should be utilized to increase staff, beds, and services including temporary housing, legal advice, job training and healthcare facilities. The funding should also allow women to stay longer until theygather the resources necessary to survive on their own.

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