New Areas for Peer Support Groups: Intimate Partner Violence

 Intimate partner violence (IPV) is a global public health concern that increasingly involves healthcare providers in identifying and intervening with victims of IPV (Trabold, McMahon, Alsobrooks, Whitney, & Mittal, 2020). The World Health Organization (2005) defines IPV as any behavior within an intimate relationship that causes physical, psychological, or sexual harm to those in the relationship.  These can include acts of physical aggression, sexual coercion, psychological abuse, stalking, and/or controlling behaviors.   While both men and women are victims of IPV, data on female victims is more readily available (Scott-Storey, et al., 2023).

Global estimates of IPV indicate that about 30% of women experience some form of physical or sexual violence (Black et al., 2011; Breiding, Chen, & Black, 2014). Among women who have experienced IPV, 24–30% report physical violence, approximately 10% are raped, 11% experience stalking, and 48% experience psychological aggression (Breiding et al., 2014).

Victims of IPV suffer from poor mental health including depression, anxiety (Carlson, McNutt, & Choi, 2003), posttraumatic stress disorder (Wuest et al., 2009), eating disorders, substance abuse disorders (Danielson, Moffitt, Caspi, & Silva, 1998), sleep disturbances (Breiding et al., 2014), and suicide attempts (Devries et al., 2011). Victims of IPV have high utilization of health-care services and have substantially higher health-care costs (Fishman, Bonomi, Anderson, Reid, & Rivara, 2010). 

Peer Support interventions for victims of IPV have been growing in number and variety of format (Sullivan, 2012; Drouin et al. 2023; Tutty, Ogden, Wyllie, & Silverstone, 2017).  The current limited research evidence supports the conclusion that these interventions result in positive mental health outcomes, increased sense of empowerment and reduced reports of IPV.

Peer support interventions for users of violence in IPV settings have been around for 30+ years, including Batterers Anonymous (BA) (Hamm & Kite, 1991), Grace Therapy (GT) (Gold, Sutton, & Ronel, 2017). and Men Against Violence (MAV) (Vendrig-de Ron, & van Dam, 2024), all of which use elements of a 12-step format to help people who use violence to reduce or eliminate that behavior.   The limited outcome data available suggests that these formats provide positive benefits for participants in terms both of improved mental health and reduced likelihood of use of violence.

Stigma has been identified as an active and substantial barrier to helpseeking both for victims of IPV and users of violence (Taccini, & Mannarini, 2023).  Peer support groups are seen as venues to address both general stigma and self-stigma, and so may have a positive impact on help-seeking. 

Possible steps for building peer support groups for IPV:

1.      Find an experienced clinical partner.  IPV is a complex phenomena, and the potential for violence adds a significant risk.  Clinicians who work in this area have advanced training in how to intervene in effective and safe ways.  You will definitely want to partner with a well-trained clinician and probably a specialized treatment program.

 2.      Seek additional specialized training for yourself.  You may have personal experience, but you will want to complete a broader training on this topic, on peer support interventions, and on working with hi-risk clients.

 3.      Review the formats for existing interventions.  Vendrig and van Dam (2024) provide specific information about existing group interventions.  You may not want to use those interventions, but finding out what others have done is always a good place to start.

 4.      Work with your clinician partner to develop a potential pilot trial in which you try your intervention with a small group of motivated potential participants.  “Trials” are how we roll out new interventions to see if they work.  Everyone understands that we are trying something new and that we’ll likely have to revise our effort after that first trial.   Consider including another partner who can do a formal program evaluation of your trial so that you have solid information about the outcome.  With your partners, talk with other program managers about your trial and gather their input and support before you start providing care.

 5.      Review your experience with the trial with your partners.  Openly and honestly review how the trial went and whether there is evidence to support trying the intervention again or a revised version of the intervention.

 6.      Tell others about what you are doing.  There is a great deal of interest in peer support interventions for IPV.  Talk with others who may be interested.  You may find partners for future efforts.

Peer support interventions for IPV is a rapidly evolving area that will require a great deal of careful planning and execution. The potential benefit of these interventions is exciting.  The risk that something negative could occur in your work with this population simply underlines the need for you to partner with experienced clinicians and to proceed carefully as you investigate this important area.

REFERENCES

Black, M. C., Basile, K. C., Breiding, M. J., Smith, S. G., Walters, M. L., Merrick, M. T., & Stevens, M. (2011). National intimate partner and sexual violence survey. Atlanta, GA: Centers for Disease Control and Prevention, 75.

Breiding, M. J., Chen, J., & Black, M. (2014). Intimate partner violence in the United States—2010. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention.

Capaldi, D. M., Knoble, N. B., Shortt, J. W., & Kim, H. K. (2012). A systematic review of risk factors for intimate partner violence. Partner abuse, 3(2), 231.

Carlson, B. E., McNutt, L. A., & Choi, D. Y. (2003). Childhood and adult abuse among women in primary health care: Effects on mental health. Journal of Interpersonal Violence, 18, 924–941.

Danielson, K. K., Moffitt, T. E., Caspi, A., & Silva, P. A. (1998). Comorbidity between abuse of an adult and DSM-III-R mental disorders: Evidence from an epidemiological study. American Journal of Psychiatry, 155, 131–133.

Devries, K., Watts, C., Yoshihama, M., Kiss, L., Schraiber, L. B., Deyessa, N., ... Jansen, H. (2011). Violence against women is strongly associated with suicide attempts: Evidence from the WHO multi-country study on women’s health and domestic violence against women. Social Science & Medicine, 73, 79–86.

Drouin, M., Flanagan, M., Carroll, J., Kerrigan, C., Henry, H., & Toscos, T. (2023, August). Piloting a peer support program for patients who screen positive for intimate partner violence, suicidal ideation, and depression. In Healthcare (Vol. 11, No. 17, p. 2422). MDPI.

Fishman, P. A., Bonomi, A. E., Anderson, M. L., Reid, R. J., & Rivara, F. P. (2010). Changes in health care costs over time following the cessation of intimate partner violence. Journal of General Internal Medicine, 25, 920–925.

Gold, D., Sutton, A., & Ronel, N. (2017). Non-violent empowerment: Self-help group for male batterers on recovery. Journal of Interpersonal Violence, 32, 3174-3200. https://doi.org/10.1177/0886260515596980

Hamm, M. S., & Kite, J. C. (1991). The role of offender rehabilitation in family violence policy: The Batterers Anonymous Experiment. Criminal Justice Review, 16, 227-248. https://doi.org/10.1177/073401689101600206

Scott-Storey, K., O’Donnell, S., Ford-Gilboe, M., Varcoe, C., Wathen, N., Malcolm, J., & Vincent, C. (2023). What about the men? a critical review of men’s experiences of intimate partner violence. Trauma, Violence, & Abuse, 24(2), 858-872.

Sullivan, C. M. (2012). Support groups for women with abusive partners: A review of the empirical evidence. Harrisburg, PA: National Resource Center on Domestic Violence.

Taccini, F., & Mannarini, S. (2023). An attempt to conceptualize the phenomenon of stigma toward intimate partner violence survivors: a systematic review. Behavioral Sciences, 13(3), 194.

Trabold, N., McMahon, J., Alsobrooks, S., Whitney, S., & Mittal, M. (2020). A systematic review of intimate partner violence interventions: State of the field and implications for practitioners. Trauma, Violence, & Abuse, 21(2), 311-325.

Tutty, L. M., Ogden, C., Wyllie, K., & Silverstone, A. (2017). “If they can get through it, so can I”: Women’s perspectives of peer-led support groups for Intimate Partner Violence 1. In Innovations in Interventions to Address Intimate Partner Violence (pp. 33-49). Routledge.

Vendrig-de Ron, A., & van Dam, A. (2024). Recovery in peer support groups for batterers—A qualitative study. Psychology, 15(3), 414-432.

Wuest, J., Ford-Gilboe, M, Merritt-Gray, M., Varcoe, C., Lent, B., Wilk, P., & Campbell, J. (2009). Abuse-related injury and symptoms of posttraumatic stress disorder as mechanisms of chronic pain in survivors of intimate partner violence. Pain Medicine, 10, 739–747.

KEY WORDS: Peer Support Specialist, Intimate Partner Violence, Domestic Violence, Recovery, Peer Support Training, Peer Support Certification, Peer Support Jobs