Advocacy for victims of intimate partner violence

Evidence Rating  
Evidence rating: Insufficient Evidence

Strategies with this rating have limited research documenting effects. These strategies need further research, often with stronger designs, to confirm effects.

Disparity Rating  
Disparity rating: Inconclusive impact on disparities

Strategies with this rating do not have enough evidence to assess potential impact on disparities.

Health Factors  
Decision Makers

Advocates work to partner with victims/survivors of intimate partner violence (IPV) to represent their rights and interests; link them to community services and protection, such as emergency shelter and psychological assistance, legal, housing, and financial advice; and help establishing safety plans. Advocates help victims understand the abusive situation and achieve their own goals, rather than prescribing pre-determined solutions. Advocacy support can be short-term, crisis-focused or include more intensive, longer-term services, depending on victims’ needs and programs’ designs1, 2.

Note: In this strategy the term “victim/survivor” refers to individuals who have experienced abuse (e.g., physical, sexual, psychological, financial, emotional, verbal abuse) and/or stalking by an intimate partner. County Health Rankings & Roadmaps recognizes that both terms have different implications in the context of criminal justice, legal processes, advocacy, and service provision.

What could this strategy improve?

Expected Benefits

Our evidence rating is based on the likelihood of achieving these outcomes:

  • Reduced intimate partner violence

  • Improved quality of life

  • Reduced post-traumatic stress

  • Improved mental health

What does the research say about effectiveness?

There is insufficient evidence to determine whether advocate support improves outcomes for victims/survivors of intimate partner violence (IPV)1, 3. Available evidence suggests that, in some cases, community-based advocacy may reduce female victims’ post-traumatic stress, depression, and fear4, 5, 6. The effect of advocacy interventions on future revictimization or intimate partner violence recidivism is unclear4, 5.

Available evidence suggests intensive community-based advocacy can reduce future physical abuse and improve quality of life for victims/survivors1. Advocacy interventions in an emergency department setting may increase female victims’ perceived safety and reduce their post-traumatic stress7. Community-based, multiagency-coordinated advocacy may improve service connection and engagement for survivors4. Advocacy support can be beneficial when advocacy intervention plans recognize survivors’ vulnerabilities and needs, and when an advocate builds a good therapeutic, non-judgmental relationship with a survivor3. A UK-based study suggests that advocacy paired with psychological and emotional support appears to improve victims’ mental health more than advocacy alone8. Additional evidence is needed to confirm effects and better understand which advocacy methods are most effective3.

Advocates report that systemic victim-blaming culture and societal lack of understanding of domestic violence are challenges to delivering services9. Advocates also report that some laws and policies establish time-consuming and complex procedures that create barriers to connecting survivors to safe and stable housing10. To provide effective advocacy, advocates need to be trauma-informed, open to others’ cultural backgrounds and identities, prioritize survivors’ needs, and engage them in safety planning2, 11. Providing adequate guidance and supervision to advocates is also recommended for better practice12. Some female survivors engage in advocacy work and support other survivors based upon their lived experience with abuse; such advocacy engagement can help survivors’ recovery and resilience13, 14.

How could this strategy advance health equity? This strategy is rated inconclusive impact on disparities.

It is unclear what impact advocacy for victims of intimate partner violence has on disparities in revictimization and violence-related outcomes for victims/survivors.

In the U.S., about 47% of women and 44% of men experience sexual violence, physical violence, and/or stalking by an intimate partner during their lifetime19. Non-Hispanic, multi-racial women (63%), American Indian or Alaska Native women (57%), and Black women (53%) are more likely to experience intimate partner violence including sexual violence, physical violence, and/or stalking in their lifetime19. Youth from sexual and gender minority groups and individuals with a disability are at greater risk of experiencing intimate partner violence than heterosexual youth and individuals without a disability, respectively20, 21, 22. Available research indicates that male survivors may be less likely to receive advocacy services compared to female survivors23, 24. Additionally, women survivors from marginalized racial and ethnic groups have less access to advocacy services due to structural barriers such as complex policies and lack of funding3.

What is the relevant historical background?

The United Nation’s 1993 Declaration on the Elimination of Violence Against Women states, “violence against women is a manifestation of historically unequal power relations between men and women, which have led to domination over and discrimination against women by men and to the prevention of the full advancement of women”25. Systemic gender inequality constructs different authority and responsibilities assigned to men and women in intimate relationships. In such a binary framework of gender, men use violence to maintain masculine aggression, control female partners, make female partners feminine and weak, and punish female partners who they perceive as failing to meet their needs26. Gendered, patriarchal religious beliefs, such as Christianity, also justified male dominance over women and taught women to be submissive to men and stay in abusive relationships27. Patriarchal ideology contributed to building systems of society and government in which men hold the power and women are excluded from it28. Such patriarchal systems, including police, legal systems, and community organizations, fail to respond appropriately and effectively to intimate partner violence and to protect victims.

Until the legal reforms of the late 1970s, female victims could not get a restraining order against a violent husband without filing for divorce at the same time and the enforcement of protective orders was weak29. In the 1970s and 1980s, heightened attention on the domestic violence response led to the creation of new organizations and resources, including the Abused Women’s Aid in Crisis in New York, the first emergency rape crisis line in Washington, D.C., and shelters across the country for women victims and children30. The Violence Against Women Act of 1994 acknowledged domestic violence and sexual violence as crimes and provided the first federal comprehensive legal protection and support to end violence against women30.

Equity Considerations
  • How can advocacy work center survivors’ voices and choices at an organizational level? How can advocates and their organizations counter victim blaming and create survivor-driven advocacy?
  • What training and guidance are available for advocates to work with for survivors from underserved, marginalized groups? Do the trainings help advocates become trauma-informed and culturally competent so they can build stronger, positive relationships with survivors?
  • Which state and local policies are barriers to promptly connecting survivors to relevant services? How can communities help advocate for change to problematic policies?
Implementation Examples

There are various efforts across the country to advocate for and support victims/survivors of intimate partner violence, for example, the National Coalition Against Domestic Violence15 and National Resource Center on Domestic Violence16. VAWnet provides resources for policy and systems advocacy and training materials for advocates to respond to domestic violence in diverse groups, including lesbian, gay, bisexual, transgender, and queer (LGBTQ) communities, immigrant communities, and Native American and Alaskan communities17.

The 2023 U.S. National Plan to End Gender-Based Violence recognizes the important roles that advocates, law enforcement, justice systems, health care providers, and community organizations have in a coordinated community response. The plan is commited to expanding survivors’ access to services, for both economic security and housing. For example, it includes funding increases for the Transitional Housing Assistance Grants for Victims of Domestic Violence, Dating Violence, Sexual Assault and Stalking Program and revises the Federal Housing Administration’s Single Family Housing Policy Handbook for survivors of domestic violence18.

Implementation Resources

Resources with a focus on equity.

NCDVTM-ACRTI - National Center on Domestic Violence, Trauma, & Mental Health (NCDVTM). Accessible, culturally responsive, trauma-informed advocacy (ACRTI).

CSAJ-Equity mapping - Mejia K, Schmid I, Wee S. Mapping equity in domestic violence advocacy at the state-level. Washington, D.C.: Center for Survivor Agency & Justice (CSAJ); 2021.

SHP-Resources - Safe Housing Partnerships (SHP). Understanding the intersections: Equity & accessibility.

CDC-IPV Resources - Niolon PH, Kearns M, Dills J, et al. Intimate partner violence prevention resource for action: A compilation of the best available evidence. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (CDC); 2017.

Footnotes

* Journal subscription may be required for access.

1 Campbell-Rivas 2016 - Rivas C, Ramsay J, Sadowski L, et al. Advocacy interventions to reduce or eliminate violence and promote the physical and psychosocial wellbeing of women who experience intimate partner abuse: A systematic review. Campbell Systematic Reviews. 2016:2.

2 Sullivan 2019a - Sullivan CM, Goodman LA. Advocacy with survivors of intimate partner violence: What it is, what it isn’t, and why it’s critically important. Violence Against Women. 2019;25(16):2007-2023.

3 Cochrane-Rivas 2019 - Rivas C, Vigurs C, Cameron J, Yeo L. A realist review of which advocacy interventions work for which abused women under what circumstances. Cochrane Database of Systematic Reviews. 2019;(6):CD013135.

4 Johnson 2022a - Johnson L, Stylianou AM. Coordinated community responses to domestic violence: A systematic review of the literature. Trauma, Violence, and Abuse. 2022;23(2):506-522.

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

6 DePrince 2012 - DePrince AP, Labus J, Belknap J, Buckingham S, Gover A. The impact of community-based outreach on psychological distress and victim safety in women exposed to intimate partner abuse. Journal of Consulting and Clinical Psychology. 2012;80(2):211-221.

7 Basheer 2022 - Basheer MB, Bell R, Boyle AA. Systematic review of the effectiveness of advocacy interventions for adult victims of domestic violence within an emergency department setting. Cureus. 2022;14(6).

8 Evans 2018 - Evans M, Malpass A, Agnew-Davies R, Feder G. Women’s experiences of a randomised controlled trial of a specialist psychological advocacy intervention following domestic violence: A nested qualitative study. PLOS ONE. 2018;13(11):e0193077.

9 Choi 2021b - Choi GY, An S, Cho H, Koh E. Understanding the complexity of domestic violence service delivery through the lived experiences of domestic violence advocates. International Social Work. 2021;66(3):855-867.

10 Sullivan 2019b - Sullivan CM, López-Zerón G, Bomsta H, Menard A. 'There's just all these moving parts:' Helping domestic violence survivors obtain housing. Clinical Social Work Journal. 2019;47:198-206.

11 Costello 2020 - Costello J, Durfee A. Survivor-defined advocacy in the civil protection order process. Feminist Criminology. 2020;15(3):299-318.

12 Logan 2018 - Logan TK, Walker R. Advocate safety planning training, feedback, and personal challenges. Journal of Family Violence. 2018;33:213-225.

13 Crann 2019 - Crann SE, Barata PC. “We can be oppressed but that does not mean we cannot fight oppression”: Narratives of resilience and advocacy from survivors of intimate partner violence. Journal of Interpersonal Violence. 2019;36(17-18):8004-8026.

14 Wood 2017 - Wood L. “I look across from me and I see me”: Survivors as advocates in intimate partner violence agencies. Violence Against Women. 2017;23(3):309-329.

15 NCADV - National Coalition Against Domestic Violence (NCADV). The voice of victims and survivors.

16 NRCDV - National Resource Center on Domestic Violence (NRCDV). Strengthen and transform efforts to end domestic violence.

17 VAWnet-Advocacy - VAWnet. Policy & systems advocacy content.

18 US National GBV plan - The White House. U.S. National plan to end gender-based violence: Strategies for action. May 2023.

19 CDC-Leemis 2022 - Leemis RW, Friar N, Khatiwada S, et al. The national intimate partner and sexual violence survey: 2016/2017 report on intimate partner violence. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (CDC); 2022.

20 CDC-IPV Fast facts - Centers for Disease Control and Prevention (CDC). Fast facts: Preventing intimate partner violence (IPV).

21 CDC-LGB TDV - Centers for Disease Control and Prevention (CDC). Infographic about LGB teen dating violence data.

22 CDC-IPV Disabilities - Centers for Disease Control and Prevention (CDC). Sexual violence and intimate partner violence among people with disabilities.

23 Brignone 2022 - Brignone L, Gomez AM. Access to domestic violence advocacy by race, ethnicity and gender: The impact of a digital warm handoff from the emergency department. PLoS ONE. 2022;17(3):e0264814.

24 Machado 2017 - Machado A, Santos A, Graham-Kevan N, Matos M. Exploring help seeking experiences of male victims of female perpetrators of IPV. Journal of Family Violence. 2017;32:513-523.

25 UN Women-Norms and standards - UN Women. Global norms and standards: Ending violence against women.

26 Anderson 2001a - Anderson KL, Umberson D. Gendering violence: Masculinity and power in men's accounts of domestic violence. Gender and Society. 2001;15(3):358-380.

27 VAWnet-Fortune 2006 - Fortune M, Enger CG. Violence against women and the role of religion. Harrisburg, PA: VAWnet; 2006.

28 Shore 2019 - Shore J. The role of patriarchy in domestic violence. Focus for Health. 2019.

29 Fagan 1996 - Fagan J. The criminalization of domestic violence: Promises and limits. National Institute of Justice Research Report. Washington, D.C.: U.S. Department of Justice, National Institute of Justice; 1996.

30 FAC-IPV reform - Freedom and Citizenship (FAC). History of intimate partner violence reform.

Date last updated