Sarah Waller’s Help-Seeking Model: Understanding African American Women Intimate Partner Violence Survivors’ Help-seeking Process

Abstract

African American women overwhelmingly experience the poorest outcomes resulting from intimate partner violence (IPV) victimization. Despite theoretical advancements, there remain a paucity of theories that explicate this marginalized population’s comprehensive help-seeking process that includes the domestic violence service provision system and the Black church. We conducted 30 in-depth, semi-structured interviews with women who self-identified as African American. We utilized sensitizing concepts from the Transtheoretical Model of Change and Intersectionality theories, along with Agency framework and employed constructivist grounded theory methodology. Sarah’s Help-Seeking Model emerged from the data and includes nine phases: (1) Awareness, (2) Acknowledgment, (3) Assessment, (4) Enough, (5) Enlist, (6) Escalate, (7) Reject, (8) Resolve, and (9) Restoration. This is the first theory that identifies how this vulnerable and underserved population’s mental health and social support-seeking process is partially mediated by lack of mistrust of law enforcement, disappointment in linkage to care and services, fear of death, and willingness to survive.

Should We Trust You? Strategies to Improve Access to Mental Healthcare to BIPOC Communities During the COVID-19 Pandemic

“…Despite increased stressors, BIPOC continued to experience structural barriers that precluded their mental health help-seeking efforts. Notably, there is a dearth of access to culturally salient interventions, a paucity of quality of mental healthcare, increases costs for service, and challenges related to health insurance (Burkett, 2017 ; Hankerson et al, 2015 ; Hudson et al, 2018 ; Nicolaidis et al, 2010 ; Redmond et al, 2017 ; Waller et al, 2022a ; Woodward et al, 2008 ).…”

Intimate Partner Violence and Help-seeking Behavior Among College Students Attending A Historically Black College and University

“…Investigating how to assist these students is crucial to prevent adverse health effects and revictimization of IPV (Voth Schrag et al, 2021). Although comparable data of college students are not available in the previous studies, low utilization of formal help-seeking (e.g., health and mental health services) is not only common among Black/African American women IPV survivors (Lacey et al, 2020); these women also face structural barriers in the service systems seeking based on their race, gender, and/or class (e.g., not being believed by the provider, not receiving immediate service; Waller et al, 2022, 2023). These structural barriers also explain a critical gender-based difference in this study, which is that no male participant reported ever seeking help from health professionals.…”

“…On the other hand, Black/African American women consider many factors in their help-seeking process following IPV victimization. For example, one factor was elevation of IPV (when “the nature, severity, and frequency of the abuse worsened throughout the duration of the relationship,” Waller et al, 2023, p. 7180) so that they finally sought help from police or other formal services (Bent-Goodley et al, 2023; Waller et al, 2023). In other cases, most survivors stopped navigating formal services after experiencing barriers to support from these help-seeking systems (e.g., not being believed by the provider and not receiving immediate service) (Bent-Goodley et al, 2023; Waller et al, 2023).…”

“…For example, one factor was elevation of IPV (when “the nature, severity, and frequency of the abuse worsened throughout the duration of the relationship,” Waller et al, 2023, p. 7180) so that they finally sought help from police or other formal services (Bent-Goodley et al, 2023; Waller et al, 2023). In other cases, most survivors stopped navigating formal services after experiencing barriers to support from these help-seeking systems (e.g., not being believed by the provider and not receiving immediate service) (Bent-Goodley et al, 2023; Waller et al, 2023). Research findings have yet to provide clear evidence as to different types and severity levels of IPV among college women and men survivors attending HBCUs and why they underutilize help-seeking, especially regarding formal help-seeking.…”

Beyond the Initial Assault: Characterizing Revictimization in Intimate Partner Violence and Its Implications for Women’s Health

“…This includes examining their unique perception of risk, as well as the development of protective behaviors and strategies utilized to escape the cycle of violence. Such analysis can provide valuable insights to enhance their capacities and improve institutional and professional approaches to prevention, protection, and intervention ( Mannell et al, 2014 ; Waller et al, 2023 ).…”